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The days after ACL tear rehab

By Amelia Rayno, Star Tribune, 01/17/11, 9:47PM CST

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Tearing an anterior cruciate ligament can cause psychological as well as physical pain. Several area stars are battling back, attacking rehabilitation with their usual determination.


Mia Loyd begins her regular post-surgery rehab at TRIA Orthopedic Center with her therapist, Cindy Schlafmann. Mia is beginning her recovery from ACL surgery she had three weeks ago. Richard Sennott, Star Tribune

DeLaSalle star Mia Loyd's eyes were deeply set in focus, her gaze straight ahead.

She wanted to get this perfect.

She wanted to make this one count.

A successful athlete is distinguished by the extent of her hard work, right?

But there wasn't a basketball in sight.

Moments earlier, Loyd had taken off the chunky metal brace that supported the junior's crushed knee and enabled her to walk, and climbed gingerly onto the trainer's table at TRIA Orthopaedic Center in Bloomington.

Loyd – like at least three other high-profile high school girls' basketball players in the state – is rehabbing from an anterior cruciate ligament (ACL) tear that has cut her young season short and forced her to refocus her efforts from the basketball court to the training table, where she was doing leg lifts at her weekly appointment.

But the painful exercises that let these girls begin to rebuild lost muscle and ligament are only a fragment of the battle. Forced into a sudden interlude away from their sports -- which also happen to be their hobbies, their scholarship opportunities and their passions -- the athletes confront the physical and emotional challenges of attacking rehabilitation as intensely as they have always attacked the game.

"It's so weird," Loyd said. "As an athlete, I've worked so hard to get where I was, and then to sort of just have it go away ..."

Her voice trailed off and her face again grimaced as she pulled her straightened leg slightly off the table, an exercise to help reattach the quad muscles to the knee. The physical pain wasn't her greatest concern.

"It hurts most that I'm going to have to work 10 times harder just to get back to where I was," she said. "And then 10 times harder than that to actually get better."


Mia Loyd is helped from the floor after injuring a knee in first half of a game against DeLaSalle in December. Marlin Levison, Star Tribune

The block

Coming back from a torn knee ligament is a long process – typically six to nine months – but it's not exactly uncommon. In fact, torn ACLs have become so frequent in teenage girls that TRIA instigated a new program last summer called PlayStrong to train girls to help prevent such debilitating injuries. The routine is a mix of warmup exercises, stretching, strengthening, plyometrics and agility training to better support the female body in rotational sports such as basketball.

"Girls are two to eight times more likely [than boys] to tear their ACLs," said Dr. Anne Moore, one of the doctors who headed the program. "That's pretty significant. If women were two to eight times more likely to have cardiovascular disease, people would really be researching that heavily."

Girls and women have smaller ACLs and larger hips, which researchers believe contribute somewhat to the disparity, but the crux of the problem is the way female athletes naturally cut and land after jumping – often more rigidly and with more pressure on their knees than their male counterparts.

"I went up for a rebound and came down and heard a loud pop," said Sidney Dirks, a junior at St. Peter, who tore her ACL in the first scrimmage of the season. "I never thought it would happen to me." Then teammate Ann-Marie Brown tore hers at the end of December.

"When we found out for sure, we were like, 'Oh my gosh,'" Dirks said. "It's crazy ... to have two in one year and both from the starting lineup."

The power forward

For these girls, being told to sit out nearly an entire basketball season can be devastating – particularly if it's their senior season, as it is for Brown and Eastview's Amanda Beckman.

When Beckman – who is running track for the Gophers next year – got her results from TRIA and they showed a tear, she started crying.

"Sports is basically my life," she said.

Brown, who signed to play basketball at Wisconsin, echoed that sentiment.

"It was my greatest fear," she said. "So when it happened, I wasn't in pain, I was just so mad."

But the day after getting her MRI, Brown's father sat her down and mentioned a couple of names: Tom Brady and Jerry Rice, two athletes who returned to their sport after ACL tears, only to become as good as, if not better than, they were before.

"I thought, 'I'm just as capable of overcoming this,'" Brown said. "But I know if I want to be a better player, I need to work as hard as they did, because it's not like they ever gave up."

That mentality, Loyd said, inspires a commitment to recovery many less-motivated individuals never completely make. Her deep-seated passion for the game incites a drive to return. And the qualities that have made her a good basketball player – boundless determination and an unremitting grit – propel her to do the work she needs to return.

As with basketball, Loyd's trainer – Cindy Schlafmann, the physical therapy manager at TRIA – said a patient's outlook is only as good as the work they do. It's a concept the ultra-competitive Loyd is familiar with: If you want to succeed, you have to put in the time.

"Right after surgery, I ... felt sorry for myself," she said. "But my mom said, 'I'll give you a week, and then you gotta come on.' I know I have to work really hard to get back, so I'm going to do it."


Mia Loyd begins her regular post-surgery rehab at TRIA Orthopedic Center with her therapist, Cindy Schlafmann. Mia is beginning her recovery from ACL surgery she had three weeks ago. Richard Sennott, Star Tribune

The assist

In Beckman's mind, she's three plays ahead.

From the Eastview bench, she sees things unfolding, developing. It's as if everything moves more slowly on the court and becomes easier to dissect. During a timeout, she'll pull a younger teammate aside and point out a defensive scheme. On a great play, she'll wildly cheer.

"Before, I led by playing and working hard," said Beckman, who tore her ACL over the holiday tournament weekend between Christmas and New Year's Day. "I can't do that now, so I feel like it's my job to help keep everyone positive on the sidelines and, hopefully, see things we can't always see as players."

Beckman isn't the only one adjusting to a role resembling an assistant coach. Brown said she's learned "so much more, basketballwise" on the bench. Loyd recognizes truths her coach, Faith Johnson Patterson, always harps on and find teammates accept them more readily from a fellow player.

"Seriously, she's unbelievable," Johnson Patterson said. "She's out there, coaching and teaching and yelling and cheering on her teammates. She's a natural leader, but she's definitely more vocal now."

Without any scoring potential, this kind of off-court assist is one of the few ways the girls can remain involved with their team and keep from feeling useless, or bitter.

"I wake up every day and realize I can't go hop around," Brown said. "When I go to practice, and people are complaining about being sore and say, 'I don't want to run today,' I say, 'Give me your knee, I'll go run for you.'"

The rebound

Loyd's left leg is now 2 inches smaller than her right, an unsettling measurement to a girl who prides herself on years of amassed muscle and strength.

"They will atrophy pretty quickly," Schlafmann said. But beyond the physical hardships of coming back – Schlafmann said muscle actually returns rather quickly – stands a greater barrier: rebuilding self-confidence.

"From a therapy standpoint, when we get to the point where we can actually do stuff, it's kind of the psychology part that's the hardest," she said. "You have to learn to trust that knee again."

Trying to blend an aggressive rehabilitation with the necessary caution against returning too soon can be difficult. Once on the court, these girls know only one speed.

"When I get back, I know starting out it's going to be hard not to be cautious," Brown said. "But I've always gone with the mind-set that you have to go 100 percent, all of the time. You can't be scared to go in and attack."

Johnson Patterson has seen it before, so she knows it can happen. She has had six players tear ACLs during her 16-year coaching career at Minneapolis North and DeLaSalle. Of the four players who returned, three went on to play in college.

"I think about it a lot now because I've experienced it so much," she said. "To be clear from this injury, you have to really go through a major workout. And because of this, they come back very strong."


Mia Loyd

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