Doctors play key role in getting athletes back on field

• Karaline Boso was grateful for support she received from her doctor after tearing her ACL.
• More knee ligament injuries now are being identified in middle school athletes.

Degrees of knee ligament injuries exist, but Karaline Boso had the big one.

The now Johnstown junior suffered a torn ACL during her freshman season of basketball, and because it completely separated from the bone, she needed a full replacement. Boso was a promising three-sport athlete, also playing volleyball and softball, and her high school career now was in jeopardy almost before it had started.

Luckily, Boso found a support system in the form of her doctor. Dr. Jeff Gittins, an orthopedic surgeon at OrthoNeuro in New Albany, was with Boso every step of the way, repairing her knee and monitoring her through a long recovery process.

"Of course, I was very upset," Boso said. "(Gittins) told me how it was going to be done and make my knee more capable. I really appreciated how he helped me out through the process because of course I was terrified."

With knee ligament injuries so common in high school female athletes, doctors and athletic trainers can be an athlete's best friend, but they often are seen as a last resort.

Frequently, athletes or parents are afraid the doctor will not tell them what they want to hear. Surgery could mean the end of a season or a career, but it could also mean a chance to live a long life with a healthy knee.

"Patients hear about 30 percent of what we tell them, so there is a lot of repetition involved," said Dr. Rod Comisar, an orthopedic surgeon for SportsMedicine GRANT & Orthopaedic Associates. "I tell them, 'I have to think about how I would treat you if you were my daughter. Think about the here and now but think about 10 years from now.'"

The relationship with athletic trainers and doctors often can start before an injury has occurred, and that trust can play a big role in future decision-making. Licking Heights athletic trainer Eric Bortmas has close to 20 students in his student-aide program, and Comisar often walks the sidelines with Bortmas at Heights' home football games.

Comisar is not the big bad wolf. Several local athletes in recent seasons have decided to attempt to play through either torn ACLs or MCLs, and Comisar is not completely against it. It, however, has to be a special case.

"In rare cases sometimes with a senior, we might talk about a period of rehab and bracing," said Comisar, who noted athletes can be lulled into a "false sense of security" when the injury appears to begin to heal without surgery.

"I tell them that a lot of patients can't do it. They give out again and we shut them down, or they may feel like they can't trust and just don't give it a go."

Granville senior Abby Barker returned to softball this past summer about six months after her ACL injury. For Boso, however, it was a much longer recovery because of the severity of the injury.

More than two years since the surgery, Boso is healthy, but still does not possess the same amount of explosiveness and agility as before.

Dr. Kevin Klingele, the Surgical Director of Sports Medicine and Chief of Orthopedic Surgery at Children's Hospital, said he and his colleagues are seeing cases of ligament injuries in early middle schoolers.

"If you had a 14-year-old who twisted her knee on the soccer field, we didn't really realize she could get ACL tears in such a high proportion," Klingele said. "Those were probably rehabbed, they weren't picked up and they were sent back on the soccer field. The knowledge is markedly improved to treat these younger athletes in a much more aggressive and better way."

Licking Valley's Kori Caughenbaugh suffered a knee injury in the middle of the basketball season, but she missed just a handful of games. With no plans to compete in college, Caughenbaugh wanted to see her senior year through to the end, first finishing basketball and now competing in softball.

"You have to know your limits and really understand what you can and can't do," Caughenbaugh said. "You really have to have faith in what you are doing and put everything you can into it all of the time. You can't go into anything scared because you are going to get hurt."

Boso remembers the pain and the work since, and she certainly does not wish that on anyone.

She was in the gym when Caughenbaugh's teammate Sierra McConnell played the last game of her high school career this past March. McConnell had attempted to put off her third ACL surgery as long as possible before her knee gave out in a game against Johnstown.

"Since I know what it feels like, when I see injuries like that happen, I will just be sitting there thinking that I hope for the best for them," Boso said. "I know what it's like to go through it. I think a lot of people underestimate what you have to go through."

Snyder is a sports writer for The Advocate. Tell him what you think at ksnyder@newarkadvocate.com.