The ACL is one of the knee’s four primary ligaments, and for surfers it’s critical, providing the stability to cut and balance on roiling walls of water. Florence opted for surgery immediately. “I was thinking, Well, if I get surgery now, there’s a chance for me to surf Pipe [Masters] in December—in case I need that event to qualify for the Olympics.” He had five months to rehab his knee—half the normal time for recovery from ACL surgery.
In July, Florence flew to Newport Beach, California, to see orthopedic surgeon Warren Kramer, M.D., who, in a high-tech but common procedure, snipped a segment of Florence’s right hamstring and grafted it to his knee, creating a new ACL. After ten days of pain and sleepless nights, Florence’s recovery plan was simple: several months of rest, easy leg lifts, and basic mobility work to maintain range of motion as the ACL and hamstring gained strength.
It got tougher in October. Florence went to Santa Ana to work with Drew Morcos, D.P.T., P.T., who had spent five years as the director of rehabilitation in USC’s athletic-medicine department. Now he runs Motus Specialists Physical Therapy, a boutique rehab facility that’s worked with top athletes like Russell Wilson and Carmelo Anthony. Morcos combines old-school strength training and new-school movement drills to strengthen the muscles around injured areas, and he uses new tech to speed up healing. For two months, he pushed Florence through a twice-a-day regimen three times a week, packing in plenty of slow-tempo squats and a variety of lunges to add bulk to his atrophied hamstring and quad. “Slow-tempoed movements generate the most muscle recruitment,” says Morcos. “The stronger muscles get tired, and then you recruit other muscle fibres to work.”
Morcos often wrapped Florence’s upper thigh in a restriction cuff, a tourniquet that limits blood flow to a region, and pushed his muscles to their limits with light weights. “I was training really hard,” says Florence. “Pushing myself past the point where I was like, ‘Is this okay?’ It was crazy how much strength I gained in a short amount of time.” Morcos also stimulated blood flow and healing using a Kelvi wrap, which rapidly alternates between hot and cold, flooding blood in and draining it out of the knee.
To replicate the pop-up and balance of surfing, Florence did one-legged squats on a Bosu ball and balance drills on a surfboard atop a foam roller while catching tennis balls. “I’m throwing balls at John John and he’s still standing,” says Morcos. “I haven’t seen anyone else who’s so aware of coordination and balance.”
As the Pipe Masters contest approached, Morcos made regular weekly trips to Hawaii where Florence continued his two-a-days. Florence was amazed by his progress, but he hadn’t surfed inside a barrel in a backside position (ass facing the wave), since his injury. Yet if he would soon be doing just that. He started surfing in front of his house in smaller waves—assuming the position of riding in a barrel, even though he wasn’t in a barrel at all. “The closer and closer I got to Pipe—the wave, I was scared,” he says. “That crouched backside position feels really vulnerable on your back knee because it’s so tucked in. I was working through the things I felt nervous about, doing the things I needed to do to get up the confidence.” Florence didn’t surf Pipe at all before the event.
At Pipe, Kelly Slater, surfing’s 47-year-old GOAT, would need to beat Florence by two spots to earn an Olympic berth. Florence didn’t advance out of his first bracket, forcing him into an elimination round. But he wasn’t worried. That round blew away all the cobwebs and his knee felt strong. “It got me fired up,” he says.
His flow returning, Florence bobbed and weaved through a series of huge, perfect waves in the next heat, showcasing a reignited ability to finesse his board through giant barrels. “I totally forgot I was injured,” he says. He won that heat and eventually placed equal fifth, scoring enough total points to stay ahead of Slater. Now Florence is headed to the Olympics, whenever that will be. “Physically, I’m now the best I’ve been,” he says. “As for the Olympics delay, I look at it like, This just gives me that much more time to get even better."
Energise Your Legs
Build strength and fine-tune your balance with these drills from rehab guru Drew Morcos, D.P.T., P.T. Do the moves 3 times a week.
1. Dynamic Curtsy Lunge
Stand on a smooth floor with a dish towel under your right foot, left leg grounded. Bend your knees and push your butt back slightly. Slide your right leg backward and to the left, bending your left knee more as you do. Squeeze your left quad and glutes to stand back up. That’s 1 rep; do reps until you can no longer maintain form, then switch sides. Do 3 sets.
2. Single-Leg Romanian Deadlift
Stand on a Bosu ball or a stack of pillows, feet together, core tight. Lift your right leg. Bend your left knee slightly and slowly move your right leg behind you, shifting your torso forward as you do this. Pause when you start to feel your back round. Reverse the movements to stand upright again. That’s 1 rep; do reps until you can no longer maintain form, then switch sides. Do 3 sets.
3. Doorway-Assisted Single-Leg Squat
Stand in a doorway, grabbing the trim with both hands, your left big toe and knee touching the frame. (Cushion your knee with a towel.) Lift your right foot. While holding the frame and keeping your knee and toe against the door, bend your left knee, lowering yourself over 6 seconds until your thigh is parallel to the floor. Squeeze your quad to come up, taking another 6 seconds to stand. That’s 1 rep; do 6, then repeat on the other side. Do 2 sets.
This article originally appeared on Men's Health US.
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