When the Game is Taken Away

Olivia Schultz

Part 1 of a 3-Part Series on Youth Injuries Sports Injuries.
Click here for Part II.
Click here for Part III.

It’s June 2009 and the U17 girls team I am coaching is getting ready for the USYS Midwest Regionals.  It’s a late summer night and we are in the midst of a friendly with an older team preparing for our trip to South Dakota to play the Region’s best just two weeks away. Ten minutes into the second half, Olivia, one of our central midfielders, goes down with a knee injury while turning with the ball as a defender challenges.

Nearly 18 months, two knee reconstructions (one on each leg), and hundreds of hours of rehab later, Olivia has her eye on stepping back onto the field as a college freshman this fall. It’s been a long journey for a talented but unassuming  athlete invited in to U17 US National Team camp one month and then spending the greater part of the next two years wondering if she’ll be ever be able to play the game she loves again.

The story that follows is one that is sadly becoming commonplace in youth athletics: Young athletes suffering season-ending injuries, experiencing major surgeries, and building patterns of overuse leading to problems lurking in the distance.

This is part one of a 3-part series examining injuries in youth soccer in an age of year-round participation and sport specialization.

Part 1: The personal journey of a college-bound athlete navigating her way through two ACL reconstructions in the peak of college recruitment.

Part 2: The youth sport injury epidemic and the reasons why young athletes are breaking down physically.

Part 3: Why training smarter not harder is key for players, coaches, and parents to understand to help avoid injuries.

Down, But Not Out

I’ve learn how important soccer is to me. I have learned not to take it for granted because it can be gone in only a few seconds.
Olivia Schultz

In June 2009, Olivia Schultz was 16 years old and a whirlwind two years of State High School soccer finals, US Soccer national camps, Adidas ESP events, and similar good fortunes came to a screeching halt in a matter of seconds.  Her team is finishing up a scrimmage as a final prep for their trip to South Dakota to play in the Midwest Regional Championships, an annual goal and summer highlight of thousands of youth soccer players across the country in their respective regions.

“I was about to receive a ball and was tackled at the same moment I was turning,” says Schultz as she remembers back to the beginning of a now eighteen-month journey from injuries.

I heard a pop, something similar to the sound of someone cracking knuckles and went down from there.

At the time, it didn’t register with Olivia that she had a serious injury, “I thought I may have just fallen wrong or twisted something in my knee, but I was told to get it checked out. I didn’t know much about ACL injuries until this point. I didn’t really know anyone personally who had torn an ACL.”

An appointment with an orthopedic surgeon confirmed that a major stabilizer in her knee, the anterior cruciate ligament (ACL), had been torn. An injury that occurs to over  200,000 people each year with females being up to 8 time more likely to fall victim to it. The reality and significance of the injury had not yet set in.

“I was actually more concerned with missing Regionals that year,” said  Schultz. “I really was having trouble believing that I wouldn’t play for an entire six months.”  She would also miss the team’s trip out to the Surf Cup that August in San Diego and the opportunity to showcase her skills in front of the University of San Diego, the school on the top of her list as she had a keen interest to play in college.

Dr. Aimee Klapach, an orthopedic surgeon at Sports and Orthopaedic Specialists in Edina, performed the surgery upon Olivia’s return from Regionals with her team. Klapach came highly regarded to Olivia and her parents from her background as a former Division 1 athlete herself and her experience in successful ACL reconstructions in a number of high-level soccer players in the Twin Cities area.  Olivia was in and out of surgery in less than two hours and went home that evening; but the marathon of physical therapy and rehab was just starting.

“The rehab process was long, tedious and draining,” explained Schultz. “It included exercises to prepare for surgery and then six months of range of motion, strengthening, agility work, and ball work. The toughest part was definitely the mental side. I knew I could handle any physical activity; it was more the whole (mental) aspect of returning to play that was hard.”

Olivia was injured at the peak evaluation time for college recruiters. Coaches who had identified her at earlier events when she was a freshman and sophomore wanted to see her play again after the injury. “It screwed up my timeline and I felt rushed to get back so college coaches could see me play again,” said Schultz.

Olivia returned to the field in December, about 6 months after the surgery on her right knee, and a number of coaches were pleasantly surprised by her level of play upon her return; a testament to Olivia’s relentless effort and hundreds of hours of rehab over the previous months. “It took quite a few weeks, but eventually I played at a higher level than before the injury,” said Schultz.

In February of her junior year, about two months after she returned to the field, Olivia committed to the University of San Diego.  When asked what she learned from the injury, Olivia talked about the effects of playing so much in the months that led up to the injury, “I learned that I needed a break from soccer. I don’t think a six month break was fair, but after playing so much for almost a year straight, the break from my injury helped me love the game even more. I became excited for every practice, scrimmage, and game which had never really happened before. I wanted to play the game so much that it made me want to play better than before.” Then came Round Two.

I couldn’t believe this had happened again. It was shocking that I would be out again and I was dreading all of the rehab that I would be doing for a second time.
Olivia Schultz

In May 2010, Olivia and her team are coming off of a successful spring season in the Midwest Regional League and Olivia’s comfort on the field is at an all-time high.  She is back in her familiar central midfield role in her team’s first State Cup game. Her second injury occurred like 80% of ACL tears do; without direct contact – a result of the body’s inability to control or absorb forces to the knee.  “I was defending a girl who had the ball. I lunged with my left leg and my knee gave out and I heard a pop again…like the last time. Immediately, I couldn’t believe this had happened again. I was looking forward to Regionals again and my senior year of high school soccer. It was shocking that I would be out again and I was dreading all of the rehab that I would be doing for a second time.”

Olivia and I talked about a week after her second injury and I asked her if she was getting back on the horse again or hanging up her shoes, a choice that would certainly be understandable.  In her mind she was down, but not out. Would her college coach feel the same way? In the age of early college commitments, nothing is binding until the National Letter of Intent is signed, which occurs the first week of February of senior year for soccer players. That was ten months away in Olivia’s case; certainly coaches could back out. Statistics show that approximately 1/3 of individuals return to their previous level of play and 1/3 return to play but not at previous levels, but 1/3 never play competitively again following just one ACL surgery.

Two injuries certainly put a lot of question marks in the eyes of a coach. Will they return to their previous level of play? Will the athlete get injured again? Athletes need to really examine why they are choosing a school. It’s easy to get caught in the hoopla of a soccer program when things are going smoothly. A matter of seconds and two major injuries makes the importance of choosing a college for what it can help you do outside of soccer very clear. That same day, I asked Olivia if she would still choose the University of San Diego to attend after high school if she couldn’t play soccer. “Absolutely.”

Olivia put a call in to Ada Greenwood, the head coach of the Toreros at the University of San Diego, “I was scared to tell him what had happened because I wasn’t sure what his reaction would be. When I talked to him, he was completely understanding. He said he would not take away my scholarship money or anything as long as I took my time rehabbing and making sure I was completely ready to play at USD. I was extremely happy to hear that.”

Dr. Klapach performed the surgery on Olivia’s left knee in May, giving her matching scars on each knee that Olivia jokingly refers to as Scarrie and Slash. “It was definitely a lot harder the second time around,” she said. “I was tired of the same routine as last time, and I definitely wasn’t as motivated to get back. We have taken more time with the second one. There is no rush to get back, but the mental aspect has been even worse. My mind sometimes tries to psyche me out.”

Her goal is to get back to where she was before the second ACL injury, which she feels was the peak of her playing career. “I want to have a great soccer career at USD and see where that takes me. I play soccer because it is something I love to do, it gives me an outlet in life…and maybe someday I would have the chance to play in a professional league.”

What has she learned from the past two years?

I’ve learn how important soccer is to me. I have learned not to take it for granted because it can be gone in only a few seconds.  But also I have learned to take care of my body better, giving it breaks when it needs rest. Even though the two ACL surgeries seem horrible, I’ve seen the silver lining in both of the outcomes; no matter what happens, good things will always come from a situation. Keeping strong, both from within and definitely with the support of others, is key to getting through anything tough…whether it’s an ACL injury or anything in life.
Oliva Schultz

Olivia is finishing up her second bout of rehab and will beginning training with her team again this month with the target of playing in a competitive game this spring and as a Torero this fall.

Up Next: Why young athletes are breaking down physically and what makes someone like Olivia prone to a season-ending injury.

About the Author: Julie Eibensteiner PT, DPT, CSCS is a physical therapist and owner of Laurus Athletic Rehab and Performance LLC, an independently owned practice specializing in ACL rehab and prevention in competitive athletes.  In addition to being a regular contributor to IMS on topics of sport injury and prevention, Eibensteiner holds an USSF A License, coaches a U18G MRL team for Eden Prairie Soccer Club, and assists with the Men’s and Women’s soccer programs at Macalester College.