- The Washington Times - Tuesday, July 26, 2005

RALEIGH, N.C. — Billie McDowell takes pride in always getting up after a fall on the court. When she couldn’t do it this time, she knew something was terribly wrong.

The North Carolina State University guard toppled to the floor late in the first half of the Wolfpack’s loss to Middle Tennessee last season in the first round of the NCAA tournament. She had driven to her left toward the baseline for a pull-up jumper when her left knee simply gave.

As she lay there writhing in pain, Miss McDowell was gripped with fear and worry.

“I’m the type of person, whenever I go down, I’m going to get up if I can,” she said. “That time, I just couldn’t move. I knew it had to be serious.”

Because the game was played in Dallas, Miss McDowell had to wait until the next day for the official diagnosis — and prognosis — and it was something she had dreaded for years.

Torn anterior cruciate ligament (ACL). Surgery. Months of difficult rehab.

“I kind of knew that’s probably what it was, but I just didn’t want it to be that,” she said. “But I kind of knew.”

This type of injury is nothing new to women’s basketball. According to statistics collected since 1995, the number of ACL injuries among female players is twice as many as among men. The phenomenon isn’t unique to basketball — in soccer, women are four times more likely than men to have this type of injury.

The reasons are varied and not completely understood, but none of that helped Miss McDowell. Earlier in her career at N.C. State, she got a firsthand view of the devastation of the injury, watching as roommate Jennifer Filipowski recovered from her second torn ACL.

“We always used to talk about it, and I’d say, ‘Man, I hope I never have to go through that,’” Miss McDowell said. “And now it’s happened to me.”

Studies have shown a variety of causes for making women more susceptible to this trouble, giving doctors, trainers and strength and conditioning specialists ways to possibly prevent some of these injuries. A few of the discoveries:

• A team of researchers at the University of North Carolina, led by Atlanta physician Spero Karas, discovered female athletes tend to stand up straighter and more erect while running or jumping. They suggested this might lead to more torn ACLs.

• At the Medical College of Ohio in Toledo, Henry Goitz led an effort that found women were able to reproduce deep squatting positions as well as men, but women didn’t stay in this posture during competition. He cited fatigue as one explanation, and again, suggested this might be another cause for injuries.

• Finally, Paul Martineau, chief resident in the division of orthopedic surgery at McGill University in Montreal, was the primary author of a study that showed taking an oral contraceptive might help women reduce their chances of tearing an ACL.

“I don’t know that anybody really understands why all this happens,” said Letha Griffin, the team physician at Georgia State, who works at Piedmont Hospital in Atlanta.

“Even if we don’t know the ‘whys,’ let’s work with girls when they’re young, practicing running and jumping and cutting. And instead of only getting stronger, let’s show them how to balance better, which hopefully will cut down on these injuries.”

The information has reached N.C. State and athletic trainer Stephanie Aronson, who has been working with Miss McDowell during her recovery. She’s read the literature and seen the reports on ACL injuries, so much of her focus is on preventing them.

“That’s the good thing,” Miss Aronson said. “The scope of the athletic-training staff spreads pretty wide to the strength and conditioning staff, and we can work together to help our athletes.”

For now, Miss McDowell can focus only on getting better. She works out five days a week, sometimes spending two hours in the weight room, to get ready for next season. Her activity on the court has been limited to ball-handling drills, but this week, she might get to shoot free throws.

This is the longest Miss McDowell has gone without playing the game she loves, and she can’t wait to return.

“When I think about not playing, it just hurts,” she said. “I just wish I could be out there. But God makes everything happen for a reason, so I’m just going to work as hard as I can to rehab and get back out there.”

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