Recovering from an ACL tear a tough journey

Susan Hartley had the phone up to ear, her husband Todd’s voice unsteady on the other end.

AJ Reynolds/Staff
Georgia midfielder Tori Cooper tore her ACL during her senior year of high school. She made a quick recovery and returned to playing soccer after eight months.

He struggled to speak.

Susan leaned her head back and slid down the wall.

“He just knew that it happened, that it was torn again,” Susan Hartley said.

Bella Hartley, their youngest, had torn her anterior cruciate ligament for the second time in 11 months. And Todd Hartley had it on video.

Hartley, the two-year captain of the two-time defending state champion Wheat Ridge High School team in Wheat Ridge, Colo., had been through this before.

And her emotions from the first go-round were still fresh.

“I didn’t cry in the (doctor’s) office, but after we left I was bawling,” Harley said. “Obviously tearing an ACL is a terrible experience.”

It was senior night at Westminster in Atlanta when Jenna Buckley swooped into a bad tackle. Contact made, ACL torn.

A Georgia coach in the stands, there to watch Buckley play, sat next to Buckley’s parents. He heard Buckley let out an agony-filled scream, watched her pound the ground.

“But the best part was I stayed on the sidelines for the whole rest of the game and was cheering on my team,” the now-redshirt senior said. “I didn’t leave to go see a doctor until afterwards. And we won.”

Ansley Morgan, like Buckley, tore it her senior year going into a tackle. She heard a pop, but kept playing. Basic agility moves — cutting, decelerating, shifting — were painful. But after a doctor’s visit, she found a seat on her team’s bench, reduced to acting as a spectator of a game she had played her entire life.

“To have something stripped away from you that you love so much, it’s just devastating,” the Frederica Academy product said.

‘Rebuild the supporting structures’

Of the 29 names on the roster of the Georgia soccer team, six have suffered a torn ACL. Two, Hartley and Laura Eddy, have torn the same ACL twice. Most in high school, their senior years after committing to play for the Bulldogs at the next level.

“It’s one of the most difficult things to witness,” Georgia coach Steve Holeman said. “I’ve seen numerous times when I’ve actually been there, at the practice, at the game where the girl tears her ACL. Your heart sinks.”

The injury can happen when an athlete receives a blow to the knee, shifts or twists in a way that overstretches the ligament. After the initial injury, an athlete faces a journey of nine to 12 months of recovery. Physical recovery and mental recovery.

First comes the surgical repair of the torn ligament, which holds the knee in place and prevents the shin from sliding behind the femur, according to the National Library of Medicine. The ligament provides support for change of direction and deceleration.

An athlete is faced with three options when it comes to surgical repair: a hamstring graft, patella tendon graft — both from the athlete’s own body — or a cadaver graft.

Steve Bryant, an associate athletic trainer for Georgia, said the method chosen can vary from athlete to athlete.

He said the cadaver graft is typically the lesser used method.

“The patella tendon is gonna give you a little bit more painful rehab right off the bat … but it will give you a very, very secure and tight graft or repair,” Bryant said. “Versus the hamstring, you’re maybe not going to be so painful coming off the hamstring repair.”

Hartley and Eddy chose the hamstring graft the first time around. Hartley chose to use the patella tendon the second time, and Eddy went with the cadaver graft. The middle third of the patella tendon is usually harvested from the athletes non-injured knee and used as a make-shift ACL.

Post-surgery, Bryant said athletes are then faced with the first big hurdle: regaining the range of motion in the knee.

“It’s painful. I always tell athletes, ‘If you can gut it out, then you can push through … that first month of rehab. Then you’re gonna rock ‘n’ roll with it after that.’”

Not only does the repair method vary with each athlete, but the physical therapy and rehabilitation program also varies, Bryant said.

He said Georgia has a basic protocol in place for the injury, but it is tweaked and changed based on the severity of the injury and the individual athlete, all while trying to keep the same basic timetable intact.

“Anything that’s in black and white and concrete, it’s not gonna stand because we’re all different,” Bryant said.

Tori Cooper, who tore her ACL her senior year of high school, was back on the soccer field in eight months, earning split playing time last season at midfielder. It took Buckley about two and a half years to get her knee back to as close to full strength as it could get.

But Bryant said the most crucial part of rehab is working up the muscles in the leg of the injured knee.

“The knee has no muscles in it, so you have to rebuild the supporting structures. The supporting structures we look at right here, everything from the quad, the hamstring, and you can’t forget the calf,” Bryant said. “Everything surrounding this knee … that’s what supports the knee, that’s what gives you your strength and is all the supporting muscles in there. You have to do that before you can get them back out there again.”

Trust issues

Tori Cooper had to get on the elevator.

After arriving in Athens, she continued rehab on her injured knee. Georgia’s trainer made a suggestion to Cooper.

Go talk to a sports psychologist.

No, Cooper said — despite her ongoing fear.

“I was thinking, ‘(The coaches) are gonna want this player back and I’m gonna be scared to go into tackles. I feel like I’m not gonna be the player I want to be. I’m really scared to go out on the field,’” said Cooper, now in her sophomore season.

But after some thought, Cooper obliged. She sat down with the psychologist, poured out every thought she had.

“He said, ‘It’s like an elevator. If you have a big fear of elevators, what’s the biggest thing you have to do? Get on the elevator. … It’s gonna be easier (the second time). It’s just that first initial time is the hardest part,’” Cooper said.

The next practice Cooper played with abandon, making tackles with ease as she finally regained the trust back in her knee — the trust she was so scared would not come back.

That mental hurdle, an athlete re-establishing trust in his or her own body, can be an internal battle that is difficult to fight.

Awareness of every little move is heightened.

“Even watching our team play, I notice every little thing on people’s knees,” Eddy said. “But I forget that before it happened the first time, I was perfectly healthy, really stable. I just have to remember that by the time I finish this (second) rehab and have done everything that I’m supposed to do properly that I’m gonna be able to do agility stuff that I need to be able to do to play. It’s just hard remembering that I’m gonna be OK.”

But the knee Buckley has today will not be the knee she had prior to the injury. Two and a half years of “terrible” rehab later, Buckley had to accept she would not be the same.

“I am at 100 percent of what I can be post-surgery,” Buckley said.

The first time she played after the injury, Buckley laced up and threw on the same cleats she wore the night it happened.

“I have put in everything I can and gotten to the best that I can be right now,” she said. “But I’m always gonna be in pain and my knee always hurts.”

Hartley, who is back to playing but in the process of getting on the field without needing a knee brace, said it’s a little hard to tell herself she will be OK after suffering the same injury twice.

“I’m still a little skeptical,” Hartley said. “I don’t feel like I’m 100 percent. I probably say I’m around 70 or 80 percent right now. Each week gets better.”

Susan Hartley, Bella’s mother, said Bella has done everything her doctors, trainers and coaches have asked her to on her way back to full-strength. Pushing herself to each stepping stone before reaching the next phase of recovery.

But with each bit of confidence regained, worry remains.

“You cringe a little on the side every time she gets the ball,” she said. “Every time she goes down … our world stops and we get a little stressed out.”

Full strength

There are good days and bad days. Some days, the injured knee is not even a thought, just a story from the past that is occasionally told. But when the bad days crop up, it’s hard to not fixate on that one wrong step, creating even more setbacks.

Since a handful of the Georgia soccer players have this commonality, relating to one another turns into a natural process.

One teammate sends an encouraging text to a struggling teammate. The underlying message: You will step onto the field again and play with confidence.

“Jenna Buckley and Laura Eddy, (they’ll) come up to you and just pick you up,” Bella Hartley said. “You don’t even have to approach them. They see that you’re having a bad day and they’ll encourage you without you even asking.”

And witnessing the comebacks, Holeman sees change in his players. For the better.

“It’s rewarding. You see someone like Buckley … it just makes things that much better,” Holeman said. “They have a special respect for the game. They don’t take anything for granted. I think they see the game a lot differently once they recover from an ACL. They realize how fortunate they are. They’re not gonna whine about running because they’re glad they can run.”

Sometimes it’s not hard to find motivation to recover. It’s a drive to finally get back onto that freshly cut grass, without a brace.

To walk without crutches. To be in a game situation. For your team.

“You’re playing for something bigger than yourself, playing for Georgia,” Morgan said. “It’s a D-I SEC school. It can’t get any better than that.”

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