Barber: ACL tears on the rise among young athletes
So much of Owen McGarva’s high school experience had been defined by knee injuries that when it was time to buy a varsity letterman’s jacket, he depicted a pair of crossed crutches on the back, beneath his last name. The Jolly Roger of a wounded pirate. A bit of morbid humor in the face of adversity.
The first time McGarva, a senior at Maria Carrillo High School, wore the jacket to a basketball game was on Jan. 2. The Pumas were hosting El Molino High. Sometime during that contest, a teammate missed a shot. McGarva tipped the loose ball, planted his foot and began to pivot his body as he went to grab it. He felt something pop in his left knee.
“I hit the ground, and the first thing I did was make eye contact with my dad in the stands,” McGarva said.
Because he knew. The boy felt almost no pain in the knee. He strode across the court, over to the team bench, and sat down. He walked to his car after the game and drove home. Two days later, on Monday, he went to school. But McGarva had a good idea of where all of this was headed.
“I had a pretty substantial gut feeling I had done it again,” he said. “Even my parents were pretty hopeful for me, but I knew.”
An MRI exam would soon reveal a torn anterior cruciate ligament and torn meniscus, a piece of cartilage described as the shock absorber of the knee. This was a cruel blow to McGarva. A little more than two years earlier, he had torn his left ACL, meniscus and quadriceps muscle. And about 11 months prior to that, he had torn the same ACL and fractured his left tibia — all playing basketball.
McGarva, now 18, has been rebuilding his knee joint for most of the past three years. And when he begins college in the fall, he will probably be on crutches again. He’s scheduled for surgery to the meniscus on March 28, and expects to have the ligament re-attached next November.
McGarva is an extreme case, to be sure. But he is not alone among teen and preteen athletes dealing with the devastation of a shattered knee and what it means for their relationship to sports.
“Oftentimes with these kids, it’s a huge part of their identity,” said Todd Weitzenberg, a doctor of physical medicine and rehabilitation sports medicine at Kaiser Permanente Santa Rosa Medical Center. “Whether or not they’ll return to sport is in question. The ligament can’t be repaired; it must be reconstructed. The recovery takes nine months to a year, so they basically lose a year of their sporting life.”
What troubles a lot of health professionals and coaches is that these injuries appear to be increasing in frequency. ACL tears are the skinned knees of the 21st century.
A study published in Pediatrics, the official journal of the American Academy of Pediatrics, in March 2017 found an increase of 2.3 percent in ACL tears among patients aged 6 to 18 over the previous 20 years. The jump was most noticeable in females 6 to 16 and males 15 to 16. Another study, conducted in the state of New York and written up in the American Journal of Sports Medicine in March 2014, reported an increase in ACL reconstruction surgery among 3- to 20-year-olds from 17.6 per 100,000 in 1990 to 50.9 per 100,000 in 2009.