Personalized care for ROTC squad leader gets him back to training

Alex Workman was in the final game of an intramural volleyball tournament when his career plans were nearly shattered.

Workman, a cellular/molecular biology major and squad leader for the U.S. Army Reserve Officer Training Corps (ROTC) program at Ball State University, was pleasantly surprised at how well his team was playing.

“The winning team received a trophy and one thousand dollars for their program,” Workman said. “As the tournament went on, it was really looking like the ROTC team could win the whole thing.”

It was the final game, and a player on the opposing team was gaining point after point on the ROTC team with his serve. Diving enthusiastically for the next ball, Workman landed and felt a sharp pain in his knee. He shook off the discomfort, dismissing it as a simple bruise, and continued to play. A few points later, the ROTC team won the tournament. After the weekend’s victory was celebrated and the classes resumed on Monday, Workman noticed that something was off.

As a student in the ROTC program, Workman’s daily routine includes a rigorous schedule of running, heavy lifting, coursework, mentoring and training for the Army combat fitness test. When his usual physical training started to cause discomfort, he was referred to Kevin Doulens, MD, IU Health Orthopedics and Sports Medicine, to take a closer look at his knee.

Dr. Doulens assessed the injury and determined that Workman had a meniscus tear and a strained ACL. After verifying the diagnoses with an MRI, Doulens told him that the tear was significant.

“One of the big questions with meniscus injuries is whether we're going to repair or remove the meniscus,” said Doulens. “For someone like him who is young, we really don't want removal to be an option. So, we explained to him that at his age, we will do everything we possibly could to repair this so that he had the meniscus, ideally, for the rest of his life. We discussed with him operative repair of the meniscus and explained to him how the process and the recovery period would work.”

Workman’s semester was nearly over, but he was worried about what the injury and surgery would mean for his program in the upcoming fall semester.

At the appointment, Workman explained that as an ROTC student, he had to return to his program and fully resume his exercise regime in August. Otherwise, he would risk not being in the program, losing his position as a squad leader, and falling behind in his coursework and graduation timeline. Dr. Doulens reassured him that once everything was healed, he would be able to return to his ROTC activities and move forward in his program.

“We discussed with him that we will be able to facilitate getting his surgery done as soon as possible,” Doulens said. “And we would get him into therapy immediately to try to lessen the amount of time for recuperating from his repair. We laid out a timeframe for him that worked out so that he would ideally finish his physical therapy just prior to returning to school.”

Doulens says the key to doing a meniscus repair is that the patient attains full range of motion with no pain. The meniscus is a shock absorber in the knee and when you do range of motion, the femoral condyle will put pressure on the meniscus. If it doesn't heal correctly, it will generate pain. A successful outcome in Workman’s case is a full range of motion with no pain, as well as getting his strength back.

Workman’s surgery went well, and he had an excellent recovery period. After a few months of physical therapy and consultations with Dr. Doulens in the summer, he was able to return to the program with his preoperative level of strength—and no exercise restrictions— in the fall.

“When I was back at school, I was ready to run,” said Workman. “I was ready to start lifting. I can already see that I'm back to normal. I was worried because when I first started out after the surgery, I was down because I couldn’t do anything. At first I was like, there's no way I'm going to be able to recover. I was all down and out of routine. But here I am after a month and I’m back at it again and ready to keep moving forward. It’s really awesome. I’m so grateful that they were able to listen to my concerns and be flexible around my schedule.”

For others who might experience a sports injury like Workman’s, Dr. Doulens has advice for when to seek treatment.

“If you're unable to walk on it at all, you should see somebody immediately,” he says. “If you can walk on it and it's uncomfortable, waiting a couple of days to see if pain and swelling decreases while using anti-inflammatories and ice is a reasonable course of action. But if within a week of the injury, even if you're able to walk on it, it is not feeling better, you should see somebody. With certain injuries, the sooner we get to them, the better it is.”