In an early season basketball game against Holy Redeemer, Marian's Ashley Fannick was driving toward the basket for a left -handed layup when she fell awkwardly to the floor. After being helped off the court, she knew exactly what had happened to her right knee.

Tests confirmed that Fannick had torn her anterior cruciate ligament (ACL). She will not play the rest of her senior season. To make it worse, this was Fannick's second time tearing her ACL, the other happened to her left knee during her freshman year while also driving to the basket during an open practice."I had to wonder," says Fannick, "Why did this happen to me again?""It would be upsetting to lose any player to this type of injury," says Fillies' coach Paul Brutto. "We really miss Ashley. She's athletic, a good shooter, and has provided senior leadership for our team."Fannick's dilemma is not an isolated case. According to the Center for Disease Control and prevention, an average of nearly 80,000 female athletes under age 19 experience a strain, sprain, or tear of the ACL each year. Surgical and treatment costs approach one billion dollars annually. The increase in musculoskeletal injuries in female athletes can also be attributed to their athletic improvements in the areas of speed, power, and intensity of play.Straight-ahead sports like swimming and track place less stress on the ACL than soccer, basketball, and volleyball where cutting, planting, and change of direction are required."Knee injuries are the most common cause of disability in female high school basketball players," says Steven Horwitz, a Chiropractic Sports Physician and Conditioning Specialist.Horwitz also reports that as many as 70% of all ACL injuries involve little or no contact with another player.Female athletes are nearly six times more likely to suffer an ACL injury than boys. A major reason for this occurrence is females tend to place more stress on their ligaments by landing flat-footed after jumps while males land mostly on the balls of their feet.Kim Nanovic, Clinic Coordinator for St. Luke's Rehabilitation Center in Jim Thorpe, says that a woman's body mechanics gives her a disadvantage when trying to avoid an ACL injury."Females have wider hips than males which often creates extreme angles down to their knees. If the knees have a likelihood to turn inward, then there is extra stress on their ligaments, especially the ACL."Joe Paluck, Clinical Exercise Physiologist for St. Lukes, says that a female athlete's hormones can contribute to an ACL injury."There are statistics that indicate ACL injuries are more likely to occur during a woman's menstrual cycle because their ligaments are more vulnerable to strains and tears due to hormonal imbalances and changes in estrogen levels."Brutto remains fearful that if knee injuries that happened to Fannick and also to junior, Savanna Krusinsky, who sustained cartilage damage, continue to occur to his other players, his roster will be further depleted."We walk on thin ice with our girls about knee injuries. In the preseason, we did different lower body exercises to strengthen ligaments, but as the season is played, we don't have as much time to continue that effort, " says Brutto.Rehabilitation for ACL injuries can take from six months to a year and demands intense physical effort, depending upon the severity of the injury."After my first ACL tear, I had to learn to walk again after surgery," says Fannick. "Bending my knee felt like trying to stretch a rubber band that just wouldn't budge."With determination and three days a week of rehab for three months, Fannick began to do some light running exercises."I was told that it would take at least six months to get myself back to normal," she says. "I was cleared to resume athletic activities after five and half months."Surgery, though highly recommended, is not a unanimous choice."Some people, usually non -athletes, reject surgical repair and I call those 'copers,'" says Nanovic. They don't want the surgery so the instability in their knee will remain for years. Anyone who wants to return to athletic activity after a serious ligament tear would need surgery, however, along with intensive rehab."Following swelling reduction and pain management, an injured athlete may have to rely on crutches and a brace to remain minimally mobile before having the operation to repair the ligament.During surgery a tendon from the hamstring or patellar is removed to reattach the ACL. In some cases, a graph from a cadaver can be used for the same purpose."Infections or other areas of the body could be compromised by removing and replacing tendons," says Paluck. "No issues occur using a cadaver, unless there is a worry about taking on someone else's DNA."Nanovic notes that rehabilitation begins with simple stretching exercises and then becomes more strenuous with plyometric routines. When it is determined that the athlete has achieved 90% of the ligament's strength, a running program can be initiated. Before that, walking and jogging in a pool may be recommended.There is good news for many female athletes after rehabilitation."Some come back with a stronger ACL because it was a weak area before the injury occurred," says Nanovic. "And most of these types of injuries, despite the long rehab period, are not career ending.""You can't think about reinjuring the knee when you come back," says Fannick. "You just get used to wearing a brace and compete as hard as you can."Coaches like Marian's Brutto have expressed interest in providing a more structured preventative program. Nanovic agrees that physical training for high school female athletes should include ACL injury prevention."It can start with a simple screening," she says. "Have a female athlete jump off a raised platform and if she lands with her knees pulling inward, that can be a sign of weakness in the ligaments."An article from the journal: Sports Health: A Multidisciplinary Approach specifies key issues in preventative training.1. Proper leg muscle strength training2. Proper neuromuscular balance and speed training3. Proper coaching - jumping and landing to prevent straight knee stress4. Proper footwear -necessary traction that minimizes rotational frictionBut for athletes like Ashley Fannick, the idea of preventative training comes a little too late. In fact, she has decided not to have this ACL repaired until after her senior night at Marian so she can participate in the festivities just like the rest of her teammates. For now, she goes to every game and for those who don't know about her disability, they couldn't tell because she dresses in full uniform, bounces a basketball and takes phantom shots at the hoop before the opening tip off."Although I cheer on my teammates during the games, it kills me to watch," she says.She will do anything to stay involved with her basketball career.And that includes her singing of the National Anthem, which she does wonderfully before every girls' home game.**********TIS' THE SEASON ... The Lehighton boys and Palmerton girls both won tournaments over the holiday season.The Indians, who are 9-2 on the season, captured the Slatington Rotary Tournament by defeating Palmerton and Jim Thorpe. Jordan Knappenberger, who was named the tourney's MVP, hit for 26 points in the title game.The Lady Bombers, now 10-2, won the Indian Holiday Classic with wins over Lehighton and Jim Thorpe. It was the fourth year in a row Palmerton won the holiday tourney. Three members of the team Madison Mummey, Jade Farquhar and Abby Reimer were named to the all-tourney team. The trio combined for 57 points in the team's 71-48 victory in the championship game.**********DISCIPLINE, DISCIPLINE, DISCIPLINE! ... The Panther Valley and Palmerton girls hooked up in a "friendly" game on Jan. 3.In the contest, which took just 52 minutes to play, the two teams combined for only three fouls all by Palmerton. The Bombers' fouls also came in the first half, meaning there were no fouls called after halftime.The game featured just two free throws, which were taken by PV's Christina Dacey.**********MUST LIKE OVERTIME ... The Pleasant Valley boys enjoyed 18-point halftime leads in each of its last two games, but the Bears were forced to go to overtime in each contest.On Dec. 29, PV raced to a 39-21 advantage against Tamaqua before the Raiders rallied. The Bears eventually won the contest, 67-64, in OT.Against Allen on Jan. 3, though, Pleasant Valley wasn't as fortunate. A 32-14 lead at the break evaporated in the second half and the Bears wound up losing, 70-66, in triple OT.**********WELCOME BACK ... Several varsity girls' players have returned to the lineup after missing games this season.Tamaqua's Paige Demetraides is back after missing her team's first eight games of the season. Demetraides, the team's leading scorer a year ago, made her return Jan. 6 against Pottsville.Lehighton also recently received two of its starters back when Allie Rossino and Riley Durishin were back in the lineup this past Tuesday against North Schuylkill. Both Indians had been out with ankle injuries. Rossino had missed the previous three games while Durishin was out for two. The pair played in all of the Indians' 22 games last season.Weatherly's Jess Polchin was out the first six games of the year but is seeing action again. The Wreckers' key player saw action in 19 games last season.