Torn: ACL injuries plague Northland athletesSeven months after it happened, Dillon Johnson remains perplexed as to why an innocuous jump ended with a torn ACL.
By: Louie St. George III, Duluth News Tribune
Seven months after it happened, Dillon Johnson remains perplexed as to why an innocuous jump ended with a torn ACL.
Johnson, a senior at Cloquet High School, was playing pickup basketball with friends last May on an outdoor court at Washington Elementary when his left knee “made an inward movement” upon landing his jump.
“I heard a pop, and for the first five minutes I couldn’t even stand up,” Johnson said earlier this week. “It hurt so much.”
Despite the intolerable pain, Johnson didn’t think the injury was too serious. How could it be, he wondered, when it occurred during such a routine movement?
“I just jumped and came down, that’s all,” he said. “Random.”
Months of rigorous rehab have Johnson patiently awaiting medical clearance to return to Cloquet’s basketball team. That could happen as soon as Friday for the Lumberjacks’ Wood City Classic. He admits it might take a few games before he can push the injury out of his mind completely.
“I’m going to try not to think about it, but when you have a major injury like that, it’s hard not to,” Johnson said.
Johnson is a 6-foot-4 forward and a key component for a veteran Cloquet team that has its sights set on a Section 7AAA title. If not for the injury, he likely would have surpassed the career 1,000-point mark.
Unfortunately, Johnson’s story is hardly distinct here in the Northland.
Pronounced impact locally
ACL is short for anterior cruciate ligament. It is one of four primary ligaments that stabilize the knee. The others: medial collateral ligament, lateral collateral ligament and posterior cruciate ligament.
Anecdotally, it would appear that knee injuries to area athletes, specifically ACL tears, have risen dramatically of late.
A partial list includes a multi-sport star at Superior, a pair of sisters at Mountain Iron-Buhl, a standout Grand Rapids basketball player and another Lumberjack from Cloquet.
At MIB, sisters Sarah and Patty Overbye both tore ACLs in the past year, Sarah during a prep game last January and Patty during a pacesetter tournament last spring.
Patty Overbye was just an eighth-grader when she suffered her injury. Sarah Overbye, who has returned to the lineup for the second-ranked Rangers, is a senior.
MIB coach Jeff Buffetta is all too familiar with the sight of one of his players on the bench with crutches. He says knee injuries are inevitable.
He also says they’re cyclical, and it’s hard to argue with a coach who had five players suffer ACL injuries during a three-year span in the mid-2000s.
“If you play hard and you play enough, you’re probably going to be a pretty good player, but you’re also going to be more prone to injury,” said Buffetta, who stresses proper mechanics and preventive muscle-strengthening to his players.
Superior’s Nick Mehlum will miss the entire basketball season after tearing his right ACL during a football playoff loss to Hortonville on Oct. 26. Grand Rapids’ A.J. Watland — one of the Thunderhawks’ best players — saw his prep basketball career end prematurely when he was injured in the offseason.
Mehlum’s injury was typical of most ACL tears. The junior quarterback was scrambling from the pocket when he planted his foot to make a cut. That’s when he felt something shift in his knee. It turned out to be his tibia and fibula.
Missing basketball is a big blow for Mehlum.
“I was pretty disappointed because I have been playing with essentially the same guys since sixth grade and this was going to be the first time we’d all be on varsity together,” he said.
Johnson isn’t the lone Lumberjack nursing a bummed knee. Grace Sinisalo will be lucky to return for even a small portion of her senior basketball campaign. Sinisalo dislocated her knee and partially tore her MCL during a summer soccer game and then reinjured the knee in the fall, also during soccer.
Jeff Ojanen, girls basketball coach at Cloquet, says he’s had four season-ending knee injuries in six years on the Lumberjacks’ bench. Incredibly, two of those occurred in the same game during the 2011-12 season when Amy Campbell and Krista Schmitz suffered ACL injuries less than an hour apart. Schmitz’s injury came on the final play of the game.
“It was very weird,” Ojanen said. “Obviously the first one, Amy goes down and you feel for her. Then Krista goes down and you think, ‘oh, no, it can’t be another one.’ ”
It was the second ACL tear in as many years for Campbell, who nonetheless is enjoying a stellar track and field career at St. Scholastica.
Temporary trend or new reality?
The local uptick of ACL injuries suggests a burgeoning epidemic.
That’s not necessarily the case, said Dr. Mike Gibbons, an orthopedic surgeon with a sports medicine specialty at Essentia Health in Duluth. Gibbons echoed MIB’s Buffetta by saying it’s a cyclical injury, replete with ebbs and flows.
Gibbons, though, did offer: “We’ve seen more in the last 10 years.”
The reasons for that are as complex and multi-faceted as the knee itself. There is no one singular explanation. Genetics, the increasing number of female athletes, overuse, sport specialization and an emphasis on year-round competition are among the chief contributors.
Instead of competing in multiple sports and thereby using a wider range of muscles, many of today’s athletes are specializing in one sport, and at a younger age.
The same muscles continuously are stressed.
“A major factor in the rising injury rate among youngsters is the current emphasis on playing one sport all year long, which leaves no time for muscles and joints to recover from the microtrauma that occurs during practice and play,” reads a New York Daily News report from August. “In addition, there has been a growing focus by coaches, parents and kids on more intense, repetitive and specialized training.”
Incidentally, Cloquet’s Johnson says he quit playing football before his junior year because, “I didn’t want to risk an injury for basketball.”
Because injury risks are greater during competition than in practice, Gibbons says, the mentality of playing a single sport competitively year-round is a recipe for distress.
The doctor alluded to a “big five” of sports that feature the highest risk of knee injuries. They are soccer, basketball, football, downhill skiing and hockey, all of which require consistent high-intensity running and/or cutting.
Female athletes are more vulnerable to ACL injuries. And because their participation in soccer has exploded the past decade, it’s no surprise that ACL injuries have increased.
In a 2009 story, ESPN, citing the Centers for Disease Control and Prevention as one of its sources, reported that: “Recent studies show that young female athletes are up to eight times more likely to tear their ACLs than young male athletes.”
Road to recovery
While other knee ligaments will regenerate after a tear, the ACL does not. Once it is torn, it’s gone (partial tears are rare). Surgery, formally called “ACL reconstruction,” replaces the torn ligament with a graft, which becomes the “new” ACL.
Recovery time varies. On average, an athlete is able to begin sport-specific exercises about four to six months after surgery, Gibbons says. A return to competition is dependent upon an athlete regaining enough muscle strength to pass a battery of standardized tests.
Surgery itself is not done immediately after the injury, but rather once the swelling in the knee subsides. In the case of Cloquet’s Johnson, that took about three weeks. If he’s able to return to the court this week, it will have been just more than six months since his operation. Both he and Superior’s Mehlum said rehab is a combination of individual workouts and those done with a physical therapist.
Gibbons says ACL surgery has a success rate of about 90 to 95 percent, much higher than it used to be.
“Most athletes will come back, but they won’t return at 100 percent,” he said.
There are exceptions to the rule, of course. Minnesota Vikings running back Adrian Peterson came back from a torn ACL, suffered in December 2011, to produce an MVP season and narrowly miss the NFL’s single-season rushing record in 2012.