The anterior cruciate ligament (ACL), lateral collateral ligament (LCL), medial collateral ligament (MCL) and posterior cruciate ligament (PCL) may be the four most foremost connective tissues in the body of an athlete.
Apart, each has its own job providing support and range of motion in our knees. But together, they allow the strongest of athletes to jump, stop, cut, hop, dance and wiggle in every sort of direction.
So while other injuries can be just as devastating, the news of a player severely damaging anything in the knee often brings a death knell to an athlete's season.
Just ask Brion Sanchious, Taylor Carrico and Maddie Waldrop -- three local athletes who all heard tough news in 2016.
Sanchious, Murray State's bruising power forward, was going up for a rebound against Belmont during last year's Jan. 14 matchup in Nashville, Tennessee. He went up for the ball, came down and felt his right knee fold itself.
Carrico, Carlisle County's do-it-all sophomore guard, was in the middle of powering her team through a district championship on Feb. 26, 2016, when she felt her left leg pop following a layup attempt and a soft-touch foul on the play.
And Waldrop, Murray's senior tower in the post, was scrimmaging against Graves County on June 29 of last summer when she, too, went up for a rebound like she often does and came down awkwardly and noticed her right leg didn't feel right.
Sanchious and Waldrop were both diagnosed with torn ACLs, while Carrico "escaped" with significant damage to her PCL.
All three were shelved for no less than six months. Sanchious and Waldrop pushed through surgical repairs and therapy, while Carrico could only train and wait for the healing to begin.
"I couldn't stretch it or nothing," Sanchious remembered. "I put ice on it, and I was hoping I could come in later in the second half. It still wouldn't budge. I think that's when I realized maybe I did something bad to it."
"I felt like it was just hanging," Carrico noted of her PCL. "It was a terrible feeling. Every time I think about it, it just gives me a cringe."
And Waldrop, who had torn her left ACL in seventh grade, was quickly filled with dread -- having already experienced the regroup-and-rebuild mentality in middle school.
"This time around, it was mentally a lot harder," she said. "I had to have more talks with (assistant) Monica Evans to 'keep my head up.'"
The next step
Eric Frederick, Murray State's head athletic trainer, notes most athletic knee injuries occur in a non-contact situation.
Maybe it was a sudden stop or a rapid change in direction. Maybe the landing for a large jump caused too much pressure and created a buckle. Maybe the playing surface was less forgiving.
In any case, Frederick insists the recovery process for athletes suffering knee injuries isn't "a cookie- cutter deal," as each athlete must assess total weight, sports requirements, athletic position and any post-operative delays in order to create a successful action plan for recovery.
"The rehab process over the last several years has really advanced," he said. "We've learned that we can push kids a little quick here and there, as long as we stay within certain boundaries of the process.
"Really and truly, the most important time is the 3-to-4 month period after the surgery, because that's when the new ACL graft is revascularizing and getting strong and really taking on the role of the ACL."
Once players get past the fourth and fifth months of rehab, Frederick notes it's time to get into more sports-specific rehabilitation. Running. Cutting. Lifting.
Waldrop worked the leg press, rode a stationary cycle and retaught herself how to run. Carrico went through daily physical therapy to strengthen her knee and donned a brace for shootarounds. Sanchious, who opened his therapy focusing on upper-body strength, then moved to lower-body workouts to support his 7-foot-2 wingspan.
And all three returned this past season to varying degrees of success, but had to battle the demons of not hurting their knee again.
The psychological part
"The last thing you want to do after six or seven months out of rehab is tear it again," Frederick said. "Everybody wants to get back for a season or for an end of a season. Developing the confidence usually takes a full year to get out of it."
Frederick is right; Carrico, Sanchious and Waldrop will all tell you this past 12 months has been a struggle trying to return to form on a consistent and nightly basis. Sanchious notched 30 starts for the Racers and averaged 3.5 points and 3.9 rebounds on 23.5 minutes per contest. Waldrop played 20-plus games and averaged 12.3 points, and Carrico played in 26 matchups and rang up nearly 15 points per game.
And none of them agree it was their cleanest effort.
"This season was probably not the best for me, because I feel like I played better in eighth grade," Carrico said. "This year, I just had a lot of things on my mind because I didn't feel like I was the same. I had an injury, and it takes a lot coming back from that. I wish I could've played better."
Waldrop shared the sentiments. "Early on, I wasn't proud of the way I was playing," Waldrop said. "It was just more mentally tougher than physically."
Frederick knew Sanchious was in for a battle. "I told Brion that this summer and spring is going to be huge (for him)," Frederick said. "He didn't have this (time) last year. He jumped in cold turkey this fall in the middle of October, so he didn't get any of the fall pre-season stuff."
It can get better
Former Murray State guard Jewuan Long may best be remembered as the 2011-12 Ohio Valley Conference Defensive Player of the Year and a key cog in Murray State's 31-2 season under then rookie head coach Steve Prohm.
But during his 2008-09 sophomore season, he suffered an ACL tear on a non-contact play against Morehead State, driving and stopping in the lane before pulling up to make an outlet pass.
Long noted it took a considerable amount of time to really get back to playing his brand of basketball, and added it was nearly two full years of playing just to realize he could resume to old ways.
But once he did, he stopped thinking about his knee and more about just making the next play in the game.
"What drove me to get back was a combination of two things," he said. "Having to sit out and watch my teammates compete without me was very frustrating. You could cheer teammates on, but I wasn't out there.
"The rehab that you have to go through is very intense. You have to be dedicated, and it's something I did every day. You just have to have the right mindset."
â ¢ Pain with swelling
â ¢ Loss of full range of motion
â ¢ Tenderness along the joint line
â ¢ Discomfort while walking
â ¢ Grade 1 Sprains: The ligament is mildly damaged, and it has been slightly stretched. Ligament is still able to help keep the knee joint stable.
â ¢ Grade 2 Sprains: The sprain stretches the ligament to the point where it becomes loose. This is often referred to as a partial tear.
â ¢ Grade 3 Sprains: Most commonly referred to as a complete tear of the ligament. The ligament has been split into two pieces, and the knee joint is unstable.
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