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The road back from a sports injury

  • Mascenic senior Jocelyn Ojala rehabs in preparation for  surgery on her torn right ACL on April 4, 2013.<br/>(Staff photo by Tim Goodwin)
  • Franklin Pierce University senior Amanda Saab gets treatment for her torn right ACL in the school's training room on April 5, 2013.<br/>(Staff photo by Tim Goodwin)
  • Franklin Pierce University senior Amanda Saab gets treatment for her torn right ACL in the school's training room on April 5, 2013.<br/>(Staff photo by Tim Goodwin)
  • Franklin Pierce University senior Amanda Saab gets treatment for her torn right ACL in the school's training room on April 5, 2013.<br/>(Staff photo by Tim Goodwin)
  • Franklin Pierce University senior Amanda Saab gets treatment for her torn right ACL in the school's training room on April 5, 2013.<br/>(Staff photo by Tim Goodwin)
  • Franklin Pierce University senior Amanda Saab gets treatment for her torn right ACL in the school's training room on April 5, 2013.<br/>(Staff photo by Tim Goodwin)
  • Franklin Pierce University senior Amanda Saab gets treatment for her torn right ACL in the school's training room on April 5, 2013.<br/>(Staff photo by Tim Goodwin)

A torn anterior cruciate ligament is one of the more notable injuries in sports.

And it is also one of the most feared injuries for any athlete. In most cases, the words “torn ACL” mean surgery, periods of pain and a lengthy rehabilitation process. The ACL is one of four major ligaments in the knee that connects the femur and the tibia bones, and when it is torn the strength of the knee can be greatly compromised.

Physical therapist Hunter Burgess, owner of Performance Health & Fitness in Peterborough, said people fall into three categories when it comes to an ACL injury. About a third of the population is known as ACL dependent, another third is ACL independent and the rest fall somewhere in between. Generally quite a bit of pain is involved when the injury occurs, but the extent of it all depends in which group a person falls.

Someone who is ACL dependent will not be able to put any weight on it and will experience a lot of discomfort and pain, while an ACL independent person may be able to function almost normal without much pain.

For Amanda Saab, a senior at Franklin Pierce University, the injury to her right knee came on a simple jump stop as the women’s basketball team was practicing over winter break. Saab had torn the same ACL during her senior year at Salem High School and immediately knew something was not right. She was able to walk it off and said that if it had been a game she would have likely kept playing.

Saab had hoped it was only hyperextension, but when she woke up with her knee swollen and unable to really walk, she realized the extent of the injury. The pain wasn’t overwhelming, but enough to call her parents.

“I woke up at three in the morning and my knee was completely swollen,” said Saab earlier this month. “That was when I knew I tore it.”

An ensuing trip to the doctor confirmed her injury.

For Mascenic senior Jocelyn Ojala, her torn ACL came on a non-contact play during a Jan. 30 basketball game against Wilton-Lyndeborough . While she had never had a serious injury before, despite being a three-sport athlete, Ojala immediately feared the worst. An MRI showed a tear of her right ACL.

“As soon as I did it, I figured I tore my ACL,” said Ojala. “It hurt a lot and I couldn’t put any pressure on it.”

At first, the pain was bad for Ojala. She was taking Advil and Ibuprofen regularly and could not do a whole lot. Driving was difficult, and getting up and down stairs was next to impossible.

“It was like an annoying pain that was there, and then I’d move it and it would be a shooting pain,” Ojala said.

Burgess has dealt with a lot of ACL injuries. He likes to see patients both before and after surgery because getting the muscles around the knee as strong as possible is crucial to ensuring proper rehabilitation. Prior to surgery, Burgess has three big things he wants a patient to do. First is to ice and elevate, to decrease the swelling. Next is to increase the range of motion by straightening and bending the knee. And by the end, he wants to see a patient be able to independently do a straight leg raise while lying on their back.

“If you can get those three things going into surgery, you’ll be a lot better off,” said Burgess.

He uses the 1-to-10 pain scale with patients . While there is pain involved with the process, Burgess stresses the importance of strength training. So he is constantly asking what the pain is like and generally does not want to see it go over a six.

“It’s a matter of seeing what the knee will tolerate,” said Burgess. “There’s a pain tolerance that we have to work within. A lot of times rehab is uncomfortable.”

Saab had her ACL surgically repaired in January 2009 and was medically cleared by May. At that time, she still had her college basketball career ahead of her, but when it happened again in December, 2012, surgery would have ended her playing days.

“I felt I was in the pinnacle of my career,” said Saab. “Since it was my senior year, there was no way I could end it like that.”

So Saab elected to rehab the injury for a chance to play again. For a month, she received treatment just about every day and dealt with the pain that came with it. Her knee was sore quite a bit after her treatment sessions with FPU head athletic trainer Cynthia Arman, but she was determined to get back on the court. She used a lot of ice and was in constant communication about how her knee felt.

“You have a lot of ups and downs,” said Saab. “You’re so scared something else is going to happen. Now that I look back, I don’t know how I did it.”

Ojala sat out the final five games of the regular season, but with Mascenic making the playoffs for the first time in her career there was no way she was going to watch from the bench. And with the use of a brace, Ojala gutted it out.

“The knee hurt quite a bit and I was just holding my breath the whole time that I didn’t hurt it even worse,” said Ojala of her final game on Feb. 19. “But I didn’t want to end my career limping off the court against Wilton.”

She had been working to strengthen her knee with the use of an elliptical machine and a cardio bike.

“I couldn’t even ride the bike at first,” said Ojala. “It was probably a good week on the elliptical before I could even do the bike.”

Saab also used a brace when she finally returned to the court on Jan. 15 against New Haven. It was difficult to get back out there, but it was worth it. Exactly two months later, in her final FPU game, Saab scored a career high 24 points in FPU’s loss in the opening round of the NCAA Division II tournament.

“Playing on it was tough, but I wouldn’t do things I knew that would bother my knee,” said Saab. “I just wanted to make sure I got through the season without my knee falling apart.”

Ojala had surgery last Wednesday when it was determined that she in fact completely tore the ligament.

“He said the surgery was a success and I should make a full recovery,” said Ojala on Monday. “I’m definitely glad I had the surgery. It wasn’t as bad as I thought it would be.”

Ojala began physical therapy last Friday,.

Saab is still deciding when to have her ACL reconstructed for a second time, as she continues to rehab.

“I don’t really want to go through the surgery process, but I’m going to do whatever is best for my future,” said Saab.

Burgess recommends that younger people elect for surgery to stabilize the knee for the future. While the recovery and rehab process can take anywhere from six to 12 months, it is better for patients who plan on leading an active lifestyle.

“The ACL is one of the more stabilizing ligaments in the knee,” said Burgess. “In my eyes, it’s about the patient’s level of activity.”

The pain and discomfort can be difficult at times, especially in the days following the injury and surgery, and at various points in the rehabilitation. But in the long run, the end goal is for the pain to go away and to have a healthy prognosis for the future.

Tim Goodwin can be reach at 924-7172 ext. 226 or tgoodwin@ledgertranscript.com. He’s on Twitter at @TimGoodwinMLT.

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