Physio Explains Why Patrick Mahomes’ ACL Injury Wasn’t Random
When a high-profile athlete like NFL star Patrick Mahomes suffers an ACL tear, it's often put down to the brutal, unpredictable nature of contact sports. But what if these injuries could sometimes be a consequence of hidden, pre-existing limitations elsewhere in the body? As a Physiotherapist, looking beyond the knee itself can reveal crucial factors that might influence injury risk and recovery.
In my recent video, I explore the idea that an ACL injury might not always be a simple knee failure, but potentially a result of subtle dysfunctions in the lower back, hips, or ankles. Using available footage of Patrick Mahomes, I discuss themes I frequently see in clinical practice.
Shifting Our Perspective on ACL Tears
It's common to view an ACL rupture as a moment of pure bad luck -being in the wrong place at the wrong time. While direct trauma happens, many injuries occur during non-contact movements like landing or cutting. This suggests the moment of injury might expose underlying mechanical flaws that were already present.
A Key Clinical Concept
The instant an ACL tears may be the moment that reveals the quality of pre-existing leg mechanics. The ligament might simply be the structure that couldn't tolerate forces generated by hidden restrictions or weaknesses further up or down the kinetic chain.
This perspective is vital for rehabilitation. The goal isn't just to rebuild the knee, but also to address any hidden dysfunctions that may have contributed to the vulnerability in the first place.
Common Hidden Factors to Consider
When assessing someone for ACL injury risk or during their rehab, I often look at a checklist of areas that could be influencing knee load.
The Potential Contributors
- Lower Back Function: Stiffness, poor core control, or slouched sitting postures can affect the nerve signals controlling leg muscles, potentially altering how the knee is stabilised.
- Hip Mobility & Strength: A lack of hip rotation or weak gluteal muscles can cause the knee to cave inwards (valgus), a position frequently linked to ACL strain.
- Ankle Mobility: This is often the most overlooked factor. Restrictions in ankle dorsiflexion (bringing your toes toward your shin) can force the knee to compensate and move differently during activity.
Why Ankle Mobility Deserves More Attention
In reviewing Patrick Mahomes' case, his past injury history stood out. Public records indicate several foot and ankle issues over recent years. Clinically, a common long-term effect of ankle sprains is a residual loss of ankle dorsiflexion range.
Many people finish rehab once pain and strength return, but never fully restore their end-range ankle mobility. Over time, this creates a functional "handbrake." During dynamic sport, if the ankle can't move freely, the body may find a path of least resistance, potentially putting excessive strain on the knee.
Furthermore, footwear choices may play a role. Consistently wearing shoes with an elevated heel can subtly reduce the time your ankle spends in a stretched, dorsiflexed position, which might contribute to stiffness over time.
Want to Dive Deeper into the Analysis?
This blog post summarises the key concepts, but the full video provides a more detailed visual analysis of movement patterns and the specific clues that point to these potential underlying causes.
WATCH THE VIDEO ABOVE to see the discussion in context and understand how these principles might apply to you or someone you know looking to prevent or recover from a knee injury.
Watch the Full Video on YouTubePractical Takeaways for Prevention & Recovery
Whether you're an athlete or someone wanting to stay active, this perspective encourages a more holistic approach.
- Think Beyond the Knee: If you've had an ACL injury or want to prevent one, consider asking your physio or trainer to assess your lower back, hip, and ankle function.
- Prioritise Full Ankle Rehab: After any ankle sprain, make restoring full range of motion a key goal, not just reducing pain and swelling.
- Consider Your Footwear: Incorporating time in minimal or flat shoes (gradually) can encourage natural ankle mobility and leg strength.
- Rehab is an Opportunity: ACL recovery is a long process. It can be a valuable time to not only heal the knee but to optimise the entire leg's mechanics for a stronger return.
While not every injury is preventable, understanding and addressing these hidden factors could potentially reduce risk and build more resilient athletes and individuals.
Need Personalised Guidance?
If you'd like help trying to uncover the underlying cause of your pain or dysfunction, consider booking an online Telehealth consultation with Grant here!
