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Former Redskins learn all ACL injuries are different

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If timetables were assured, then Tim Hightower would have been a productive NFL running back in 2012. If the six-to-nine month recovery period projected for his left knee ACL reconstruction went as promised, then we wouldn't necessarily know Alfred Morris to be a burgeoning star in the Washington Redskins' backfield. Hightower, though, understands the reality of rehabilitation from major knee surgery.

"In life," he said, "there is no guarantees."

He learned that by being forced to observe the 2012 football season. While his former team completed an historic turnaround that culminated with the NFC East division championship, he continued to rehabilitate a knee injury that leaves him unemployed 16 months after he injured it on an otherwise forgettable 4-yard carry.

As doctors expect Redskins quarterback Robert Griffin III to rehabilitate his surgically repaired right knee ligaments and meniscus in time for the 2013 season, Hightower is proof that timetables are nothing more than frameworks established by precedents.

"One thing I did learn and I'm learning: every ACL, every knee surgery is not the same," Hightower said. "Different guys' bodies respond different ways to different things."

That works both ways. If Hightower is the dark, then Minnesota Vikings running back Adrian Peterson is the shining light.

Peterson tore the ACL and medial collateral ligament and damaged the medial and lateral meniscus in his left knee against the Redskins on Christmas Eve 2011, about six yards from where Griffin's knee finally gave out at FedEx Field two Sundays ago.

Dr. James Andrews, the same surgeon who operated on Griffin last week, performed Peterson's and Hightower's knee surgeries. Peterson returned to play in all 16 games this season and came within nine yards of breaking Eric Dickerson's all-time single-season rushing record of 2,015 yards.

Redskins coach Mike Shanahan last week cited Peterson's remarkable return to form as a comfort when asked about any concern regarding Griffin's absence from Washington's offseason program.

However, experts caution that Peterson is more of an exception than an example athletes and fans should expect athletes to replicate.

"The Adrian Petersons of the world are unusual, who perform at that high of a level starting at eight months after surgery," said Rick Wright, professor in the department of orthopedic surgery at Washington University's School of Medicine and the head team physician for the NHL's St. Louis Blues. He is the principal investigator of a leading ACL revision study that's funded by the National Institutes of Health.

"The athletes will tell you that they really kind of feel back to normal and stop thinking about their knee so much at about 12 months," said Wright, who has not examined Griffin.

Wright noted that even Peterson performed at a higher level as the season progressed and time distanced him from his surgery date.

Peterson averaged 4.41 yards per carry during the Vikings' first six games. In their last 10 games, a span that began about 10 months after Peterson had surgery, he averaged 6.8 yards per carry.

Hightower embraced and applauded Peterson's comeback. Where resentment or jealousy might have taken hold, motivation and inspiration spawned.

"His accomplishments were amazing," Hightower said. "That's something people can strive to; people can strive to do better. The amazing thing that Adrian Peterson taught a lot of people is that regardless of the situation, there's always going to be a prognosis, but an exception to the rule. I can't define that, and Dr. Andrews can't define that for [Griffin]."

To Hightower's point about the differences in each surgery and recovery, it must be noted that Peterson, Hightower and Griffin each required different repairs.

Hightower tore his ACL and damaged the meniscus. The Redskins released him in August, and he required another surgery on his meniscus, a procedure from which he still is recovering. Peterson suffered the same injuries and also tore his MCL.

Griffin's injuries required a revision of the ACL reconstruction he had in 2009. Andrews had to repair his torn lateral collateral ligament and build him a new ACL using a patellar tendon graft from his left knee.

Last August, Andrews revised the ACL reconstruction of linebacker Jonathan Goff, Griffin and Hightower's former Redskins teammate, using the same method.

Goff continues to rehabilitate his knee at the Andrews Institute in Gulf Breeze, Fla., where Griffin is beginning his rehab.

"You have to pay a little bit more attention to that leg," Goff said about the patellar tendon graft removed from his left (healthy) knee. "They're just taking out a chunk from your knee, so it's not the best feeling in the world. But since the beginning, it has been strong and sturdy. It's just that there's a fair amount of pain management and soft-tissue work that you got to do to keep it moving."

Goff has accepted the fact he'll have to manage his knee for the rest of his career.

"I wouldn't say it's mentally taxing or frustrating at all," he said. "As a football player, the longer you play, the more you're going to have to do in the offseason to keep yourself healthy throughout the entire season. And even then, with the NFL being a 100 percent injury rate, nothing is guaranteed."

No guarantees. As Griffin embarks on his rehabilitation, that seems to be the only certainty.

"Just because there's no guarantees doesn't mean that you don't set expectations and you don't set goals," Hightower said. "That's something that, for him, yes, you have to be realistic. But your realism cannot affect your positive outlook.

"You have those feelings — it's human nature — where you get frustrated. You're sore, you're hurting. Things that were so routine to you before are such a challenge. But when you have those high expectations and high goals, when you place that demand on yourself and on your body, it helps you get through those times."

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