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Teenage girls suffering ACL injuries with greater frequency

Emma Brinker was having the season of her life.

With an 8-1 record, the East Aurora girls basketball team was ranked No. 1 among Western New York small schools, and the 6-foot-1 forward’s presence on the court played a huge part on a senior-laden group that was among the favorites to win the Section VI Class B title.

The junior averaged double-doubles through her freshman and sophomore seasons on the varsity team, scoring more than 15 points, grabbing 13 rebounds and blocking four shots per game. She was named to the All-Western New York first team as a freshman after the Blue Devils won a sectional title, and she was on the third team as a sophomore following a Class B-1 runner-up finish.

Last year, those numbers jumped to 20.4 points, 13 rebounds and 6.3 blocks per game, not to mention 2.5 steals and 2.3 assists per outing. Brinker was firmly on the Player of the Year watch list and colleges were taking notice.

Her season ended during the 10th game with a torn anterior cruciate ligament. That meant surgery and six months of rehab. She has returned for her senior season and is expected to be among the area's better players on a young team that hopes to hit its stride come time for the postseason.

“It was a humbling experience. All the work I’d done prior had to be redone,” Brinker said. “I had to learn how to run again and play again. My parents, coaches and physical therapist just kept staying positive. It wasn’t completely over. I had another season left.”

Brinker is hoping to be another success story among local girls basketball players who have had ACL tears, including Orchard Park's Danielle Hore, Starpoint's Elizabeth Bradley and Christian Central senior Charly Heron.

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ACL tears among teen female athletes have been on the rise in recent years. A July study by the University of North Carolina School of Medicine found a 59 percent increase in the number of ACL surgeries for girls ages 13 to 17 in the last 13 years. Depending on the study and the sport, female athletes are viewed as from six to 10 times more likely to suffer an ACL tear than male athletes.

Research shows that factors include:

  • Girls typically have a narrower intercondylar notch of the thigh bone that helps connect the knee
  • Due to changes caused by puberty, girls have ligaments that are more lax compared to boys
  • Because of the shape of the pelvis, girls land from jumps and change direction differently than boys with their knees less bent and stiffer

"The main message is that fortunately ACL injuries can be prevented," said lead study author Mackenzie Herzog, MPH, doctoral candidate in the Department of Epidemiology at the UNC Gillings School of Global Public Health. "There are exercise programs that have been shown to be effective, but we are concerned that they're not being implemented.

"The main barrier has been getting the message out there and having athletes and coaches keep this as part of their routine for an extended period of time."

The programs include a combination of balance, plyometrics, strengthening and stretching, which should be implemented 2-3 times per week at least for 15 minutes per session.

"The more the better," Herzog said. "The real key component is some type of feedback from the person providing the program. Various resources are available for coaches, trainers or parents to look through online."

Regardless of the reason for injury, the recovery is time-consuming and painstaking.

“The whole entire process was extremely difficult and that was the point in my life when I realized what hard work really was, and how much dedicating yourself to something really pays off,” said Heron, whose injury happened three years ago.

An ACL injury can be harder to deal with because it is often a non-contact injury not obvious to the eye.

For Brinker, the circumstances were not out of the ordinary. She was on a fastbreak ahead of the ball in a Jan. 12 game at Maryvale. She received the pass, took a jump stop before shooting and her right knee bent inward.

“I felt it pop, but I straightened it out and it felt back to normal,” Brinker said. “The trainer there didn’t think it was my ACL, so I thought, ‘Oh good.’”

An MRI the next day revealed that it was a torn anterior cruciate ligament. She couldn’t believe it, or at least didn’t want to.

“I was just trying to understand if there was any way I didn’t have to miss the rest of the season,” Brinker said.

There wasn’t.

The Blue Devils bowed out to eventual state semifinalist Fredonia in the B-1 semifinals, a 34-28 game that could have swung either way.

“I felt a little guilty,” Brinker said. “I totally did. I felt like it was my fault that we didn’t go as far as we should’ve. The toughest part was going to games and practice knowing I couldn’t help out the team.”

That couldn’t have been any further from the truth.

When not at physical therapy or a doctor’s appointment, Brinker was at every practice and game.

“She’s a leader on the team whether she understands that or not,” coach Gary Schutrum said. “She chose to be like an assistant coach on the sideline. She was really good with the bigs and helpful to them. She was really good encouraging her teammates.”

While Brinker became a mentor and a sense of motivation for her teammates, she had her own support system back home to aid her while on the road to recovery.

That included her mother, the former Anne Marie Granville, who played for the late Sister Maria Pares at Sacred Heart in the mid 1980s before heading to Georgetown, and her grandfather, Tom Granville, who’s at every game.

Brinker also drew motivation and words of encouragement from Hore, an AAU teammate who had been through the process, having torn the ACL in her left knee as a freshman at Sacred Heart.

The 5-foot-4 point guard transferred back to Orchard Park as a junior and was enjoying a nice start to the season, averaging about 13 points per game. It ended six days after Brinker’s did.

She crashed the offensive glass from the wing during a game at Lancaster and was tripped from behind. This time it was the ACL in her right knee.

“The trainer didn’t think it was an ACL tear, but I knew what it was as soon as I fell,” Hore said. “It made rehab easier because I knew what was coming. I knew it wasn’t going to be easy by any means, but I returned a month earlier this time than last time. The second time I definitely had a better attitude.”

The absence in the lineup forced Orchard Park coach Gary Janas to pull up a couple freshmen who simply weren’t ready for the speed and physicality of the varsity level. Hore took them under her wing.

“She worked with them verbally in practice and at the games became their biggest supporter,” Janas said. “Her role was making them feel comfortable and letting them know that it’s alright to make mistakes. ... She honestly became that assistant coach, pointing things out or suggesting things that I wouldn’t notice. I really got to know her more after her injury, always sitting by me on the bench and giving me advice and suggestions.”

Brinker and Hore were given 4-6 month timetables to return to the court, but that’s only for the physical recovery. It doesn’t take into account the mental hurdles.

Bradley, a Starpoint junior, knows. She missed her entire sophomore season after tearing her right ACL on the second day of tryouts.

“People say it takes four to six months, but that’s just to get back on your feet again,” Bradley said. “It takes longer to get there mentally. Almost a year it took me.”

“When I met her this summer she was very tentative at first,” said coach Jack Cappola, who’s in his first year with the Spartans after serving as the interim at Sacred Heart last season. “By the end of the summer I was like, wow, this girl can play. I’ve coached good shooters, ball handlers, and slashers individually. What I’ve had in three girls she does in one.”

Bradley also had a solid support system to keep her spirits upbeat. One of her older sisters, Emily, a senior at Daemen who runs cross country, tore her labrum at the same time. Erica, a sophomore at Nazareth, tore her ACL two years ago as a Starpoint senior.

“They were there for me throughout the whole process,” Bradley said. “It was a heartbreaking moment but my family, friends and coaches kept my confidence up through the whole process. Even the coaches from the other teams were there to support me.”

While the game Bradley, Brinker and Hore love was taken away from them for an extended period of time, all three learned that nothing can be taken for granted. Nobody knows when their last game is going to be, so make each moment count.

That was a lesson Heron learned when she went through her comeback journey.

“I was pretty devastated when I injured myself because basketball had always been my release since I was 7 years old, so I didn’t know how to deal with the pain at first,” Heron said.“But as the process went on I got stronger mentally more than I did physically, which I still carry with me day to day.”

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