Photo by Harlie Raethel
An ACL rupture may seem like no big deal, but it can affect your sense of self in deep ways.
This Q&A features Dr. Keagen Hadley, a doctor of occupational therapy specializing in psychological treatments such as acceptance and commitment therapy (ACT).
As an athlete, Keagen tore both ACLs playing college and semi-professional football. This experience made him acutely aware of the struggles associated psychologically post-ACL injury and how to overcome them with positive results.
Let’s explore the emotional fallout of physical injuries with someone who knows the experience intimately…
BEVOYA: Can you tell me about yourself? Where do you live? What are your credentials? What kinds of people do you work with?
KEAGEN: am a Doctor of Occupational Therapy (OTD, OTR/L) specializing in psychiatric conditions. Specifically, I am devoted to helping individuals recover psychologically and physically from joint injuries. This is mainly because I, as an athlete, tore both of my ACLs, requiring 4 surgeries.
I’m currently residing in Bismarck, North Dakota, and I enjoy working out and pushing my body to the limit. Between my girlfriend, working out, and writing, that is all I do anymore, and I love it. My “day job” is as the associate director of medical writing at Supernus Pharmaceuticals. Essentially, I manage or write numerous deliverables for submission to regulatory agencies (like the FDA). While this may seem totally unrelated, I assure you it isn’t. Supernus focuses solely on neurologic and psychiatric conditions like treatment-resistant depression, OCD, etc.
BEVOYA: How do people tend to find you?
KEAGEN: People find me or what I am up to, generally, via word of mouth. I am supremely active on LinkedIn, which certainly helps. I have also started appearing on more and more podcasts with like-minded individuals to promote my upcoming book “Torn: Overcoming the Psychological Challenges Post-ACL Injury”. Lastly, my blog and website have recently been initiated and I post content multiple times a week relevant to mental health, joint health, workout technology, entrepreneurship, and personal development.
BEVOYA: Can you walk us through the typical experience you have with new patients/clients?
KEAGEN: When I work with new patients, I like to start by getting to know them and their goals. My clients are generally struggling with how to function optimally and navigate the landscape of injured life. Many feel they have lost their self-esteem and self-identity because of the injury.
My goal is to assist clients, using ACT, to cultivate the skills necessary to minimize the associated psychological effects on their physical rehabilitation and life. For example, a common issue my clients have is verbalizing severely fused thoughts negatively affecting how they view themselves due to the injury. Cognitive fusion is the thought process that “I am sad” or “I am broken”, rather than being able to understand “I am having feelings of sadness” or “I feel as though I am broken”. While this may seem like a small and trivial revelation, it is just one of many steps down the path to psychological flexibility.
BEVOYA: Do you only work with ACL injuries? If not, what other injuries do you commonly see?
KEAGEN: I do mainly work with ACL injuries due to the nature and length of the rehabilitation process. The reason these injuries are so debilitating to people is the large amount of time that it takes to heal. When you see a huge, seemingly “manly” NFL player weeping after an ACL injury, I can all but assure you it is due to the loss of what they love, which is football, and not due to pain. They, like many athletes, are acutely aware of the magnitude of the injury they likely have endured and know they “may” never be the same, therefore losing the ability to self-identify as a player of sport x, y, or z.
In the future, I plan to also work with the 30-70 age group as well to prevent the necessity of total knee surgeries. That is another passion that I have, and likely it will become another book.
BEVOYA: What are some of the patterns you see with people with ACL injuries and identity struggles?
KEAGEN: There are a few identity struggles that commonly emerge in people who have suffered ACL injuries. First, many individuals tend to feel a great sense of loss or grief after sustaining an ACL injury. This is often compounded by the fact that they are no longer able to participate in activities that were once central to their identity. For example, a former athlete may feel like they have lost a part of themselves after being forced to give up their sport, even if this is just for rehabilitation.
After suffering an ACL injury, many individuals have difficulty discovering a new sense of purpose. This can be especially hard on athletes who have dedicated their whole lives to their sport. They may feel as if they do not have a reason to train and stay in shape if they are unable to participate.
Finally, many people with ACL injuries also struggle with body image issues. The injury can cause deformity and swelling, which can lead to feelings of self-consciousness and dissatisfaction with one’s appearance. Not only that but if they were already prone to body dysmorphic thoughts then this would be compounded by the inability to work out as rigorously as before.
BEVOYA: What advice do you give people who struggle to accept physical limitations and pain (asking for a friend LOL)?
KEAGEN: I would say that it is my personal belief that anyone, regardless of where they are starting, can make huge gains with targeted and joint-specific training. At 25 I would spend weeks during the spring and fall in severe pain due to my 4 surgeries. Now, a few months from 30, I can probably do more physically than I could prior to the surgeries. I attribute all my success to incremental and scalable exercises that ANYONE can start. BUT in the meantime, I would say from a psychological perspective, it is important to give yourself grace and understand that your body has likely gone through a lot. Even with the right program, it will take months or years to get where you want. The real secret is learning to love where you are in the process.
The hardest part is finding the right process, and that is what I want to provide to my clients, both psychologically and physically.