The Naperville North girls basketball team (7-2) is hoping to solidify a successful season and defend their DuPage Valley Conference champions title. Before they do so, they must overcome a lot of unknowns. The program welcomes new head coach Erin Colletti, a relatively young roster with three freshmen on the varsity line-up and returning senior captains Nikki Kwilosz and Kara Rivard who are recovering from anterior cruciate ligament (ACL) injuries.
Both Kwilosz and Rivard have the responsibility of leading their team while dealing with their own adversity. Last season, Kwilosz tore her ACL at the Fremd Shootout in December. Just a couple months later, Rivard sustained the same injury at a college showcase in March playing for her travel team. The next several months of their lives were overtaken by their injuries.
“When I was injured, I felt like the most important aspect of my life [basketball] was just completely stripped away from me,” Rivard said.
ANATOMY OF THE ACL TEAR
Why females are at higher risk
Arvin Roque, an assistant athletic trainer at Naperville North who does physical therapy work with Kwilosz and Rivard, has treated five ACL tears throughout the seven years in his current position. While they are rare, he has seen more ACL injuries with female athletes compared to male athletes. This trend has been universal and can largely be attributed to anatomical differences.
The anterior cruciate ligament (ACL) is an essential ligament that holds the knee in place and keeps the tibia from sliding out from under the femur. Robert Matlock, M.D., who is board certified in orthopaedic surgery and treated both Kwilosz and Rivard, describes the ACL as rope-like. Pulled taut, it can handle a lot of force.
In females, who usually have wider hips and knees that angle sharper inwards, the forces on the knee applied during strenuous movements are comparatively greater than that in males. The femoral notch, where the ACL attaches to the femur bone, also tends to be narrower in females.
“There’s less room for their ACL to live,” Dr. Matlock said. “Their ACLs tend to be a bit smaller in diameter and obviously the larger the ACL, the stronger it’s going to be.”
Numerous other factors are at play in an ACL injury, including hormones, which can cause ligaments to be more lax, and affect how athletes jump and land. Female athletes tend to have a quadricep dominant landing, meaning they land more straight-legged. This tendency puts higher stress on the ACL and makes it more likely to tear. According to an article published in the Journal of Orthopaedics, neuromuscular function and core stability also affect the likeliness of an ACL rupture.
The common mechanism for ACL injury, according to Roque, is a plant-and-twist action. In basketball, it is often a rebound-and-pivot or a catch-and-turn.
“The hamstring and the quad can’t handle the force,” Roque said. “It lets the tibia and femur move too much that it results to a tear.”
INJURY
Kwilosz and Rivard, mechanically-speaking, were injured during the same motion. Attempting to catch a pass from behind her, Kwilosz landed on her right foot. Her knee went in, and her foot went out.
“I just felt a big pop,” Kwilosz said.
Rivard’s injury occurred during the last five minutes of a college showcase game. She tried to strip the ball from an opponent, but instead they collided. “As I came down, all of my force came down on one leg,” Rivard remembered. Walking off the court, her knee felt unfamiliar to her as other leg muscles compensated for the injured ACL.
After a couple of doctors' visits, it was evident that surgery was necessary to restore their knee function. Surgery might be scary to most people, but for Kwilosz and Rivard, it was something that had to be done in order to continue the sport they love. However, the process did allow both players to learn more about the game and themselves.
“Time off from basketball that first few months, it really showed me who my real supporters were,” Rivard said. Later, she added, “It really makes you understand the game more, watching it from an outside perspective, and also appreciate it much more.”
RECOVERY
With an approximate recovery time of nine months, returning to normal play can prove to be a challenge for players who suffer ACL tears. Kwilosz and Rivard were both eager to recover and worked hard to get there; months of physical therapy and conditioning allowed them to do so. Along the way, there were adversities that could have slowed them down, including Kwilosz falling and reopening her scar just two months after surgery, but they pushed through nonetheless.
Both players began physical therapy at Athletico a week following their surgeries, starting off with simple exercises such as bending their knee, putting pressure on their foot, and walking on an Anti-Gravity Treadmill (AlterG) that controls the percentage of body weight applied while walking. As physical therapy progressed, squatting and bandwork were introduced. Eventually, they were running, jumping and using a normal treadmill with 100% of their body weight. In the process, they were taught how to jump and land safely, along with how to strengthen the muscles surrounding their knees.
After being cleared six months post-operation, Kwilosz and Rivard were able to return to practices with no contact. While Kwilosz had her first contact practice in September and has been able to play nine games this season, Rivard is still working toward her reintroduction to full contact practice. Her goal is to return to play by early January.
Now, the pair spends their eighth hour early dismissal doing physical therapy with Roque and athletic trainer Jason “Mac” Majchrowski before practice with the team. At practice, the team engages in drills after their dynamic warm up, ranging from ball handling to shooting and passing. After this, they run through plays and game situations, oftentimes scrimmaging against each other. Kwilosz, despite being cleared, still feels the occasional discomfort in her knee during these drills.
“Even in the practice setting, or sometimes if I get super sore, I’ll come out and do half of my PT routine because that’s what’s going to help strengthen [my knee] more,” Kwilosz said. Physical therapy is a constant process, she admits, “PT never dies.”
The Mental Game
While strengthening exercises can demand a lot from them physically, both Kwilosz and Rivard agree that the hardest element of recovery is the mental game.
In one of her first practices back, Kwilosz was hit—hard. She fell down, but after getting up, found she was fine and there was no pain in her knee. This moment of realization is crucial for athletes, according to Roque, who said it allows them to rebuild confidence in themselves.
“Most of the time, physically, an athlete is ready, but mentally they’re not,” Roque said.
Physical therapy is important because the conditioning reminds athletes that they can withstand the forces of normal game play despite their injuries in a controlled setting.
“It’s all up here,” Kwilosz said as she pointed to her head. “It was so many squats and so much just pure strengthening, but at the end of the day, doing all that helped with the mental part.”
While having two impact players out with injuries is not ideal, Kwilosz and Rivard agreed that having each other to lean on was helpful in their recovery process.
“I hate to see my teammate go through the same thing I did, but honestly, it’s made us so much tighter,” Kwilosz said.
Having someone to do physical therapy with, a “PT buddy,” as Kwilosz referred to it, helped them keep each other motivated in their recovery. As a tribute to each other, both players have the other’s initial on their knee brace.
Growth & PRevention
Going forward, Kwilosz and Rivard’s experiences have increased attention toward preventing similar injuries in the future. A large role in injury prevention is foam rolling and stretching, which will help muscles maintain their flexibility to better absorb force. Roque also recommends hip strengthening exercises to take pressure off of the ACL. This season, the team has been lifting in the weight room more often to build lower body strength to prevent further injuries in other players.
As captains, Kwilosz and Rivard did what they could to strengthen the team in spirit while they recuperated physically. They often led with their voices, cheering teammates on from the sidelines.
“Their voices are loud and respected, and I think with their injuries, even though they’ve encountered adversity, [they] have been leading by example with overcoming that adversity,” Head Coach Erin Colletti said.
Together with all the seniors on the team, Kwilosz and Rivard are building a more inclusive atmosphere for underclassmen, too. Rivard recalls her freshman year when the seniors would take the ball from the varsity freshmen, referring to seniority.
“Our whole goal as a senior class has been to get rid of that, and make every single player equal,” Rivard said. “It doesn’t matter if you’re a freshman. If you’re a freshman and you can compete as a senior, then you have all the same rights as a senior does.”
The passion the seniors have for improving their program is evidence of an already tight-knit group. The team has been working together for months before the season began, lifting, going to open gyms and playing in summer and fall leagues. They bond over pasta parties and carpools, and have fun running an unofficial team Twitter account.
“On and off the court, we’re just so tight and I feel like it’s tighter than usual, more than previous years because we did a lot of preseason stuff,” Kwilosz said.
In addition to their camaraderie, the team also knows when to focus. With six experienced seniors, junior stand-out Greta Kampshroeder and talented underclassmen, Colletti feels that the team has a great opportunity to progress in postseason this year. Their team mentality is to be relentless and attack setbacks just as Kwilosz and Rivard did.
“We will make adversity our best friend,” Colletti said. “We will always strive to play the perfect game, but since we are not perfect, we will embrace any game of adversity that comes our way, and turn adversity into a positive.”
The Huskies will continue their season on the road against the Montini Broncos on Saturday at 5 p.m.
Credits:
Photos by Payton Schield. Illustration by Ellen Yandel. | Source: American Academy of Orthopaedic Surgeons