Jan 29, 2015Chris Davis & Alfred Ramsby
Colerain High School, Cincinnati, Ohio
By Patrick Bohn
Patrick Bohn is an Assistant Editor at Training & Conditioning. He can be reached at: [email protected].
Teammates push each other in the weightroom all the time. But when Colerain High School junior football players Chris Davis and Alfred “L.A.” Ramsby both went down with serious knee injuries in the span of two weeks during the 2011 season, Jason Taylor, ATC, Head Athletic Trainer at Colerain, took that motivational concept one step further by having Davis and Ramsby rehab together to aid in their return to the field.
Davis’s injury occurred on Sept. 2 during Colerain’s second game of the season. In the third quarter, the starting running back took a handoff and began running to his left. Just as he hit his stride, Davis’s knee buckled and he went down. “It looked like he hyperextended his right knee,” Taylor says.
The injury had occurred on a non-contact play and at first glance, didn’t appear to be severe. But when Davis didn’t get up, Taylor grew concerned. “Chris isn’t the type of kid who stays on the ground after a play,” he says. “When I got to him, he was screaming. I put my hand on his knee and felt something I shouldn’t have been feeling–his tibial plateau had rotated around.”
The pain from the injury was excruciating. “I thought my career was over,” Davis says. “I’d never experienced anything like that before. When Jason came out on the field, he was talking to me, but I couldn’t concentrate on what he was saying because it hurt so much.”
The team physician was able to reduce Davis’s knee on the field, which lessened the pain, but Davis was upset as he was taken off the gridiron. Taylor tried his best to keep the running back focused on the positive. “Every athletic trainer gets a pit in their stomach when they see a season-ending injury,” he says. “But my goal was to keep Chris from worrying about it too much. I kept telling him that whatever the injury was, we were going to take care of it.”
In the hospital, Davis got grim news: he had dislocated his right kneecap, completely torn his ACL and LCL, and partially torn both his PCL and MCL. While it was a serious injury, there was no arterial or nerve damage–something Taylor stressed to Davis and his parents shortly after the diagnosis.
“I didn’t want to get too far ahead of myself, but I told Chris and his parents that the injury was fixable, and we could rehab it,” Taylor says. “I also told them that the lack of nerve and artery damage was a benefit not just when it came to Chris returning to play, but to his life after football as well. That helped reassure them it was going to be okay.”
Davis was scheduled for surgery on Sept. 23, when he would receive a cadaver allograph to repair his ACL and posterial lateral corner, and reinforce his LCL. Davis was looking at a lost season and a long rehab. In a twist of fate, however, he would soon have his teammate and closest friend there to help him through it.
Exactly one week before Davis’s surgery, during Colerain’s fourth game of the season, Ramsby, the team’s starting quarterback, rolled out looking to pass. When he attempted to make a jump cut, he felt his left knee give out and fell to the ground.
“Like with Chris, it didn’t look like anything serious when it first happened,” Taylor says. “In fact, when I met L.A. out on the field, the first thing he told me was, ‘My knee feels funny, but I think it’s okay.’ I did a Lachman test, and his knee felt very loose, so I told him we needed to take him into the athletic training room to get a better look at it.”
The team physician told Ramsby he had torn his ACL and surgery was scheduled for Oct. 18. While his injury wasn’t as extensive as his teammate’s, he too had immediate concerns about his playing career. “The first two days after the injury, I was pretty down,” he says. “I didn’t think I’d be able to play the way I had before. But Jason kept telling me it was going to be okay.”
“I told L.A. to watch some NFL games and see how many quarterbacks were using functional braces–that some of those quarterbacks wear them because they had a previous ACL injury,” Taylor says. “It was pretty easy to find examples of players coming back from an ACL tear.”
While Ramsby began preparing for his surgery, Davis was beginning his rehab. Although Davis’s injury was complex, Taylor had him follow a relatively standard knee injury rehab protocol. The first few weeks focused mainly on neuromuscular re-education of Davis’s right leg. He did quad sets, heel slides, and leg raises, and had Russian e-stim performed on his quad.
“I also focused on swelling and pain reduction in those first few weeks,” Taylor says. “I wasn’t as concerned with getting his knee straight at that point. I wanted to make sure the posterial lateral corner had adequate time to heal.”
Davis was non-weight bearing immediately following surgery, but after a few weeks, Taylor began to introduce a lot of weight shifting by having Davis catch a ball while standing on his right leg. He also had him balance on it while reaching down to pick objects up off the ground. Glute and hip strength was developed through exercises like clam shells and bridges, and Davis worked his core with planks and leg lifts.
With a month of Davis’s rehab behind him, Taylor began planning for the next step. At the same time, he was welcoming Ramsby into the athletic training room and planning his rehabilitation. That’s when the idea of a rehab partnership was formed.
“The concept of working with two people on the same rehab isn’t that uncommon,” Taylor says. “People in a clinic come in with the same injuries all the time. However, I had never tried it at the high school level and I was a bit worried about how they would handle all the distractions other athletes presented because I could really only watch one of them at a time. But they were good friends, and I knew they would be motivated to get healthy for their senior years. We all know players benefit when they’re doing a workout with someone, so why wouldn’t that philosophy apply to rehab?”
Both players immediately bought into the idea. “Working with Chris was great,” Ramsby says. “Sometimes when I’m alone, I may slack off a bit, but with him there, I knew I wasn’t going to get bored doing the work. For me, the mental aspect of the rehab was challenging, but Chris was always there, keeping me accountable, telling me, ‘You’re going too slow, you’ve got to keep working and push yourself.'”
“L.A. is like my brother,” Davis says. “We’ve grown up together and played together for a long time. Every day I was excited to come in and do the work because I knew he would be right next to me. I couldn’t take a day off.”
Ramsby began his rehab in late October, doing much of the same exercises as his teammate, such as leg raises, wall squats with and without a physio ball, and step-ups. Although Davis’s injury was more severe, because his surgery had occurred nearly a month sooner, the two players were at similar stages in their rehab timelines by the time Ramsby was ready to work.
As fall turned into winter, it became apparent that having the players do their workouts together was providing major benefits. “For example, when they progressed to leg presses in December, I wanted to keep the weights light and focus on their form,” Taylor says. “And if I had to correct the form of either one of them during the exercise, the other one would get on them about it quickly as well. It served as a great motivator.”
Taylor admits it was tricky keeping Davis and Ramsby from lifting heavier weights at first, but he often let the results speak for themselves. “One of them might have said, ‘I can’t believe you’re only going to let me do 20 pounds on the leg press while my teammate is watching,'” he says. “But by the time they got to the end of the exercise, their leg would be shaking.”
In January, Taylor allowed the two players to do upper body and core work with the rest of their teammates four days a week before doing lower body and plyometric work with him. “The guys were interested in more than just getting back on the field,” he says. “They were going to be senior leaders on the team, and they needed to forge that dynamic and get the younger players looking up to them.”
In mid-January, Taylor wanted to see how the rehab was progressing, so he had the players do a single-leg hop test on their injured leg. Both scored over 80 percent, well above the normal level.
At this point, their workouts intensified. Ramsby and Davis began doing step-ups while holding weights ranging from 15 to 40 pounds before progressing to a 45-pound bar. By February, the players were doing squats until they hit the top of a box set at a specific height. The box gradually got lower as the players increased their range of motion to 90 degrees. Both players were progressing so quickly that each week Taylor added 25 to 50 pounds to their squat weight.
Taylor also introduced agility ladder and plyometric box work to the rehab programs at this time. The box work provided the players more opportunities to push each other. “I started them on a six-inch box and had them jump on it 20 times,” Taylor says. “That progressed to 12 inches, and then 24. Each time we did it, whichever one of them went second would try to do it just a little faster.
“I think it also helped them to have someone to watch,” he continues. “If they were doing the agility ladder, they could watch the technique the other one used and improve on their own. Sometimes, they would even criticize the other’s technique before I had a chance to bring it up.”
Taylor was in constant communication with the Colerain coaching staff regarding both players’ return-to-play status. While the initial goal was to have them back for August workouts, by late April, Ramsby and Davis were both cutting and running on the field. A checkup with their orthopedists around this time resulted in a clear to return to practice with the team in June.
Both Ramsby and Davis made successful returns to the gridiron this past fall and helped the Cardinals remain one of the best teams in the country. Ramsby says his leg feels stronger now than it did before the injury. “I am playing at 195 pounds as a senior after playing at 188 at the beginning of my junior year, but I feel like I am faster and more athletic now,” he says.
And Davis is back running with confidence following his devastating injury. “I wasn’t nervous getting back on the field because I knew Jason had done a great job helping me through my rehab,” he says. “I don’t have any pain in my knee and I’m thankful to him for that.”
Taylor says this rehab experience got him to appreciate the importance of thinking outside the box. “I don’t think I ever imagined there would be a benefit to approaching a rehab like you would a traditional workout,” he says. “But Chris and L.A. both attacked their rehabs and strove to be better than each other, and that really paid off.