In addition to being a lifelong soccer player, 30-year-old Marcelo Cunha spends nearly every day on the field as an assistant coach at University of Massachusetts Boston (UMass Boston) and Boston Regional Director for FC Flair, a local youth soccer club. Whether he’s demonstrating drills, coaching young athletes, working with college players, or competing himself, his ability to move isn’t optional — it’s essential.

When he tore his anterior cruciate ligament (ACL) during an amateur soccer league game, the injury threatened not only his ability to play the sport he loves, but also the hands-on coaching style that defines his work. After doing research on options other than ACL reconstruction (ACLR), he connected with Dr. Scott Sigman, an orthopedic surgeon at Orthopaedic Surgical Associates in Chelmsford, Massachusetts, and learned about the BEAR Implant, a procedure designed to help the body heal its own ACL rather than replacing it with a graft. We spoke with Marcelo and Dr. Sigman about why he chose the implant, how his return to coaching soccer at 2 weeks post-surgery went and how his recovery is going.

Q: How did you tear your ACL?

Marcelo: While I was playing soccer, I hyperextended my knee and locked it out causing it to dislocate. I heard a pop and was in pain right away. I knew something was wrong based on the mechanism of how it happened and how much swelling there was. I got an MRI, which confirmed the ACL tear.  

Q: How did you learn about the BEAR Implant and why was it the right option for you?

Marcelo: My mother-in-law Suzanne works for Dr. Sigman as his nurse, so she suggested I have a consultation with him regarding the BEAR Implant. I knew it was new technology and that it was minimally invasive compared to ACLR. I also knew it wouldn’t require a donor site or graft and could help me to heal my original ACL. After speaking with Dr. Sigman, I started looking into clinical trial results.

I chose the BEAR Implant because it would be my own body healing my own ACL. The minimal pain after surgery, potential for reduced time of being in pain post-surgery and not having to cut open another part of my body for a graft pushed me to get it. I also knew that if it didn’t end up working for me, I could still pursue ACLR in the future.

Q: Tell us about your job and why your knee is so important to what you do.

Marcelo: I’m an assistant soccer coach at UMass Boston and I am the Boston regional director for FC Flair, a local youth soccer club. In both coaching positions, I have to demonstrate drills for my players. My legs and by extension, my knee, is one of the most important tools that I use, and it’s 100% crucial to my profession. Since I also coach younger kids, I have to teach technique and all the fundamental aspects of it. I really do have to get in there on the field and demonstrate how some stuff is done.

Q: What kinds of movements are involved in coaching soccer?

Marcelo: Starting with warmups, I’ll do dynamic stretches, sprinting, running, moving, cutting, and then go into actual technique. I’m demonstrating kicking, planting and stopping the ball in order to show a defensive posture. Sometimes I also help train the goalkeepers, so I’m kicking balls at goalies and jumping to simulate a player heading a ball.

Q: What, in your opinion, is most notable about the BEAR Implant?

Dr. Sigman: The most notable thing early on is that BEAR Implant patients often experience remarkably reduced pain during the first six weeks of recovery compared to traditional ACL reconstruction. When you avoid harvesting a tendon from elsewhere in the body, patients frequently recover more comfortably and regain confidence earlier in the rehabilitation process.

Beyond that, the concept itself is profound — we are preserving and restoring the patient’s native ACL anatomy rather than replacing it with another tissue source.

Q: Why was Marcelo a good candidate for the BEAR Implant? Why do you recommend the BEAR Implant for coaches like Marcelo?

Dr. Sigman: Marcelo was an excellent candidate because he had the right injury pattern, excellent tissue quality, and a strong commitment to rehabilitation. Those factors are critical for success with ACL restoration procedures.

For someone like Marcelo — a soccer coach who remains highly active and engaged physically every day — preserving native anatomy is especially appealing. Coaches are constantly demonstrating drills, pivoting, moving laterally, and interacting dynamically with athletes.

The ability to restore the patient’s own ACL while potentially minimizing donor-site morbidity makes the BEAR Implant particularly attractive for highly active individuals who want to return to movement naturally and confidently.

Q: How has rehab been going?

Marcelo: I did a lot of prehab to strengthen my body because I had 2.5 months between my ACL injury and BEAR Implant surgery. I was lucky to have my mother-in-law as my nurse post-surgery and received the best aftercare surgery. I’d 100% recommend the BEAR Implant over ACLR because I have had minimal pain and no issues throughout my experience. I’m not kidding when I say I had zero pain after surgery. I didn’t take any pain medication beyond the initial ibuprofen immediately post-surgery.

I’m currently 4 months into rehab and am progressing faster than expected, but also not rushing things. I’m still within the parameters of what I should and can be doing and can be doing. I was able to bear weight right away, walk and wean off the crutches relatively soon.

I’ve been cleared to run, jog and to jump vertically, but no lateral jumping yet. Overall, my strength has been progressing very well. It was surprising how well my body responded to the physical therapy. Initially, the mental aspect of recovery was tough. I’ve been taking each day as a challenge and opportunity to learn something new and improve upon those skills. I think I’d feel more pressure if I was a college athlete still and needed to get back to playing within a certain season. Since I’m a coach, I’m more focused on learning about my body and getting better every day.

Dr. Sigman: What has stood out most about Marcelo’s recovery so far has been his consistency, discipline, and positivity throughout the rehabilitation process. Successful ACL recovery is never just about surgery — it is truly a partnership between the patient, surgeon, and physical therapy team. Marcelo has embraced the process fully and respected the progression milestones. That mindset is often one of the biggest predictors of a successful outcome.

Q: When was Marcelo cleared to return to work as a soccer coach, what criteria did you use? What milestones are you working toward for the next level of clearance where Marcelo is able to handle the ball?

Dr. Sigman: Marcelo was cleared to return to coaching at 2 weeks post-surgery. He was able to return to many aspects of coaching relatively early because coaching itself exists on a spectrum of physical demand. Early on, we focused on allowing him to resume leadership and instructional responsibilities while protecting the healing ligament biologically.

Return-to-work decisions are never based solely on time. They are based on objective milestones including:

• Resolution of swelling
• Restoration of range of motion
• Quadriceps strength recovery
• Functional movement testing
• Dynamic balance and neuromuscular control
• Psychological confidence in the knee

The next phase of rehab for Marcelo will include progression toward higher-level soccer-specific activities including controlled ball handling, cutting, pivoting, and reactive movement patterns. Those milestones require continued strength symmetry, movement quality, and demonstration of excellent knee control under dynamic conditions.

Q: How did you adapt your coaching style after being cleared to return to coaching 2 weeks-post surgery?

Marcelo: My initial instructions were don’t touch a soccer ball, don’t jump into drills and coach from afar. Given these restrictions, I had to adapt to be more visual and painting the picture for the players better. Honestly, it’s made me a better coach because I’ve had to learn how to describe the soccer skills without demonstrating them.

Q: What was it like going back to the field and coaching for the first time?

Marcelo: At first it was a little weird, but then I quickly learned what I could and couldn’t do and also how to protect myself. The biggest challenge has been trying to avoid the kids and college players from accidentally running into me while they’re playing. I’ve learned to keep my distance and stay farther off the field than I normally do. Within the limits of my current clearance, my BEAR Implant knee feels fine and I’m back in my groove. Obviously, I miss being out there and running around with them, but I’m happy I get to be coaching again so soon after surgery.

Q: How does the return-to-work timeframe differ following the BEAR Implant vs. ACLR? How do you assess return-to-work readiness for someone returning to a physically demanding job like coaching vs. someone who sits at a desk?

Dr. Sigman: One of the major differences I see clinically is that many BEAR Implant patients appear more comfortable early in recovery compared to traditional ACLR patients, likely because we are not harvesting a graft from another part of the body. That early comfort can positively impact mobility, confidence, and rehabilitation progression. That said, biologic healing timelines still matter tremendously. Even when patients feel better, we remain disciplined about protecting the healing ligament.

Return-to-work readiness is highly individualized. Someone returning to a desk job may be ready relatively quickly because the physical demands are low. A coach, however, must demonstrate the ability to move unpredictably, react dynamically, and tolerate rotational forces safely. For physically demanding occupations, we emphasize functional testing, sport-specific movement quality, endurance, proprioception, and confidence before advancing activity.

Q: Have you noticed differences between your BEAR Implant recovery and people you know who had ACLR and how has that impacted your experience?

Marcelo: I’ve been in the soccer world for a while now and have a lot of buddies who have had ACLR with every graft you can think of. The overall consensus among those with ACLR is that their rehab was more painful initially. When people saw me up and about early on and moving the way I was moving with a decent range of motion, they were really surprised I just had surgery.

Q: In addition to coaching, can you tell us more about your connection with soccer?

Marcelo: I’ve played soccer my whole life, progressing to high school, college, amateur and even going semi-pro before getting into coaching. Soccer is not only a huge part of my profession as a coach, but also my biggest hobby. I love soccer because I can express myself and it being a form of exercise releases a lot of stress buildup.

Aside from coaching, I also play in a men’s amateur team with recent Division 1 graduates and former pros and we won the BSSL McKenzie Cup Championship Fall of 2025. Being able to get back to full fitness and be competitive while playing soccer is the goal. That’s why I’m taking my rehab as seriously as I am because I still want to play and compete.

Q: What are your return-to-work goals and what milestones are you working toward?

Marcelo: I think my return-to-work goals tie hand in hand with my return-to-sport goals, because if I can play, I can coach. I want to get back to playing in my amateur soccer league and snowboarding. I want to be able to fully run on the field with the kids when coaching and be able to demonstrate the skills. I don’t want to be limited to standing there and telling them what to do. I’m currently working on single-leg plyometrics, single-leg lateral movements and gaining double-leg strength.

Q: How has the BEAR Implant technology impacted how you treat ACL tears?

Dr. Sigman: The BEAR Implant has fundamentally changed how I think about ACL surgery. Historically, ACL treatment meant reconstruction — removing torn tissue and replacing it with a graft harvested from another part of the body. The BEAR Implant allows us to restore the patient’s own ligament anatomy and maintain the native biologic environment of the knee. That is a major philosophical shift in sports medicine.

Marcelo’s story represents the evolution of modern sports medicine. For decades, we focused primarily on replacing damaged structures. Today, we are increasingly exploring ways to restore anatomy and support biologic healing.

The BEAR Implant represents more than a new implant — it represents a new philosophy. As surgeons, our goal is no longer simply to create a stable knee. We are now thinking beyond just restoring stability. The bigger vision is restoring function, preserving tissue, improving recovery experience, and potentially helping protect the long-term health of the joint.

Q: Do you have any advice for someone going through an ACL injury?

Marcelo: Pre-rehab is crucial and do your research on what option works best for you. I think it’s vital to make sure you get into a good mental state and have a different perception on ACL injury other than just dreading the rehab. There’s nothing you can do to avoid rehab, so make sure you’re consistent with your efforts because getting 1% better each day goes a long way.

Q: Have you had any coaching related milestones or accomplishments since getting the BEAR Implant?

Marcelo: This year our UMass Boston soccer team won a few regular season titles and a conference championship. We also won a game in the national tournament and made it to the round of 32.

Q: What are your goals with coaching soccer?

Marcelo: Short-term goals for the little kids are to keep seeing their progress and taking it season by season, day by day. I want to make sure those kids get the best of me as a coach so they can become better soccer players and better people too as humans. We have a successful youth program, and I think we’ve grown every year since I’ve been there.

For the college kids, the short-term goals are to win as many games as we can and win conference championships. The long-term goal is to land a head coaching position somewhere, and hopefully at UMass. Growing sustainably and making sure everyone is getting what they need from me as a coach is my long-term goal.

Learn more about the BEAR Implant and find a surgeon

The BEAR Implant is available across the U.S. Learn more about the BEAR Implant or find a surgeon in your area. If you’re a parent considering the BEAR Implant for your child, click here for more information. If you’re a BEAR Implant patient and would like to share your story, click here.

The BEAR Implant from Miach Orthopaedics was approved by the U.S. Food and Drug Administration in December 2020. It is indicated for adults, adolescents and children with a complete or partial rupture of the ACL, as confirmed by MRI. Patients must have an ACL stump attached to the tibia to construct the repair. Children with open physes must have sufficient bone in the femoral and tibial epiphyses on either side of the intended tunnel locations to avoid disruption of the growth plates. In patients 14 years and older who have an ACL injury with concomitant knee injuries, ACL restoration with the BEAR Implant reduces the risk of developing post-traumatic knee osteoarthritis (Kellgren-Lawrence grade 2 or higher), at 6-years post-surgery, compared to ACL reconstruction (ACLR) surgery using hamstring tendon autograft.

It is important to follow the BEAR Implant physical therapy program. Your surgeon can explain the program details.

Be sure to discuss your individual symptoms, diagnosis and treatment with your surgeon. The BEAR Implant has the same potential medical/surgical complications as other orthopedic surgical procedures, including ACL reconstruction. These include the risk of re-tear, infection, knee pain, meniscus injury and limited range of motion.

Visit miachortho.com for complete product information, including Instructions for Use.

ML-1459 Rev A 07/2026