Concerned.

As a keen social basketballer, I’ve been lucky to remain fit and healthy enough to stay on the court well into my forties. Doing that has not been easy – nowadays I tend to spend about as much time off the court preparing my body for basketball as I do actually playing.

This has been, in part, because seven years ago I received the frustrating news that I had fully ruptured my Anterior Cruciate Ligament (ACL) after a seemingly innocuous fall on the court. What happened since has been an interesting experience in rehabilitation – and not just the physical strengthening and conditioning work – I’ve also been intrigued at the reactions from people around me when I tell them the story of my injury.

This journey started with a chance encounter at work. Following the injury, I had been booked in for surgery and was hobbling around my workplace until the day arrived. Speaking to one of my colleagues at the time, he mentioned that his friend had a similar challenge, and had actually found someone who had helped him to rehabilitate the injury using non-surgical methods.

At the time, I’d never heard that this was even possible. To be clear – this wasn’t a case of the ligament healing by itself (which is also possible, by the way). Instead, you don’t do anything about the ACL at all. You leave it torn and simply attempt to strengthen and stabilise everything around it.

If I’m honest, non-surgical seemed a bit nonsensical, given that I’d been bombarded since childhood with news stories of professional athletes rushing to surgery after tearing their ACLs. It was clear: you tear your ACL, you go and get surgery.

The surgeon seemed to think so too. He was in his sixties and told me:

“If you ever want to play sport, dance or run again you’ll need to have surgery”.

Surgery seemed like the easy decision. But when I heard about someone rehabilitating an ACL injury without surgery, I was intrigued. It seems obvious to me now that the reason I was so curious about this potentially revolutionary method was because it reinforced one of my strongest personal values – that of self-reliance. That is, if I could rehabilitate the injury myself without needing to be “fixed” by a surgeon, I’d have much more control over the outcome and my recovery. And besides, who wouldn’t want to avoid surgery if they didn’t need to have it?

A short time later, I’d consulted with a physiotherapist who specialised in non-surgical rehabilitation of these particular injuries. He showed me some examples of professional sportsmen and women who had successfully returned to top-flight competition without needing an ACL. Some of these people were Olympians, which was very encouraging. After all, I didn’t need to reach Olympic-level performance – I only needed to achieve an amateur low-grade basketball level of performance.

I cancelled the surgery, and what followed was five months of rehabilitation including strengthening, balance and jumping exercises. I used to think I had relatively strong legs, but quickly discovered that they were not so powerful when put to the test with serious rehabilitation. To cut a long story short, after this time I successfully returned to basketball without a functioning ACL in my right knee, playing games without holding back twice per week. I even ditched the knee brace which I had been wearing for years previously, because my legs were stronger than they’d ever been.

The rehabilitation part of this journey is not the most interesting to me, however. It’s much more interesting to consider how our beliefs play a huge part in our responses when faced with such a story.

Surprise, curiosity and concern.

When I tell people this story, the responses are mixed. Some people are shocked, because they haven’t heard of anybody avoiding surgery before. Many of these people then become curious. How does it work? What’s the process? Do you need to have surgery eventually? They are keen to learn more to satisfy their curiosity, because their mind is open to the idea that such a thing is possible.

Other people are enthusiastic and supportive. They think it’s great that I could avoid surgery and still play sport. They don’t dig for much extra information – they seem to take what I say at face value. That is – if I say it’s true, then they choose to believe it and will support me for going down that path. For them, it doesn’t seem far-fetched or impossible, simply uncommon. It’s also possible that they’re thinking “that sounds far-fetched, but if you want to try it…”.

But it’s the final type of reaction that is most interesting to me: and that is when people show concern for my choice. I find that the concerned response usually comes from someone who is close enough to me to care about my wellbeing. If you ran into a stranger in the street who told you this story – and you didn’t believe it was possible – it would be easy to dismiss it as the rantings of a lunatic and let them go on their way. Most people really only demonstrate the commitment of caring to someone who they are relatively familiar with.

There are several scenarios where somebody would support my decision regarding rehabilitation. They might choose to support it because they believe in the concept. That is, they believe that non-surgical rehabilitation is a reasonable possibility. Or, they may believe in my judgement – if Ben chose this option, then it must be reasonable, otherwise he wouldn’t be going down that path.

The concerned response is different, and involves a challenging of beliefs. If somebody believed my story was possible, there would be no challenge – what happened would simply be aligned with their view of the world. But when someone believes that you must have a functioning ACL to play sport, for example, there’s conflict.

Competing ideas create tension.

If we regard a person as sensible and credible, then we expect and hope that the things they say align with our beliefs. We want to respect this person, but we struggle when what they are saying doesn’t match our view of the world. An inability to reconcile these two ideas creates the tension.

The concerned response usually starts with scepticism. Questions are asked, to verify my story. Do you mean it heals by itself? Do you mean you won’t jump anymore, or you’ll take it easy on the court? So you’ll eventually have surgery, right?

These are not questions borne of curiosity. They are questions that people ask when they are attempting to confirm that what I am saying actually does fit with their belief system. If someone does not believe that it is possible to function with a torn ACL, for example, their questioning is an attempt to make sense of the situation.

If I told them that, yes, the ACL healed by itself, then this would fit their worldview – that physical activity cannot occur with a damaged ACL. If I told them that yes, I would just take it easy on the court and I wouldn’t jump or run, then that would fit their worldview also – that you can’t function normally with a torn ACL.

Let’s imagine that I simply admitted that I might be mistaken. This would resolve the tension immediately, because now the two ideas exist together – my credibility and their beliefs. If I did otherwise, the tension would remain.

Otherwise, the tension can only be resolved in a few ways. Firstly, the person could change their beliefs about my credibility. They can choose to believe that I am deluded, misinformed or misguided. This is not an easy option, because even though there is no need to challenge their own worldview, they would feel an uneasiness about our relationship.

The second option would be to change their beliefs. In this situation, perhaps the person decides that, actually, maybe it *is* possible to do this and function without an ACL. But this change of belief can be jarring, especially if the belief contrasts with our worldview and is rooted in our own identity.

Why would someone bother to be concerned?

For many people, this would be a non-issue. They’d say to me “That’s cool, if it works go and do whatever you want.” These are the people who don’t really have strong opinions one way or another.

But for the folks who show concern, it’s much more interesting. Why would someone be concerned about my choice? Maybe it’s because they believe I might hurt myself further. But if this was the case, wouldn’t you do your own research, and then point out the flaws in my position or find a better option so that I might change my decision? This wasn’t happening – what I was seeing was simply a showing of inert concern instead.

No, what I think is really happening here is that my chosen approach is rubbing up against deeply held beliefs about how the world works. And this isn’t really about ACL rehabilitation – it’s deeper and wider than that.

It’s about our own beliefs about personal agency – do we believe we can influence our lives? Or is what happens to us just about luck, because so many factors are out of our control?

It’s about our beliefs about expertise and authority – is the highest-ranking medical expert the one that you must listen to? Or are there other sources of knowledge that may be credible too?

Could I be wrong?

Ultimately, for certain people this may link back to their own choices and experiences. If I believe that certain aspects of life are largely out of my control – a luck of the draw – then this story might challenge my beliefs. Could the way I view the world be wrong? This can be a deeply unsettling thought for anybody.

Turning this back on myself, it’s obvious that the reason I resonated so strongly with my chosen approach was because it reinforced my own views about how I see the world. I believe that I have agency, that I can influence the outcomes, and that self-discipline is key to success.

But what would happen if my decision turns out to be a mistake, many years down the track? Then I will potentially face a rude awakening that would challenge my worldview, too.

And when we put this lens on situations where we feel concern for the choices of others, we may start to realise that the concern is not necessarily for them, but for us, and the implications of our own choices and beliefs.