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Torn ACL: Nahomi’s Story

Meet Nahomi


As she was growing up, you could find Nahomi Sanchez on the soccer field almost any day of the week.

“Monday through Friday I had soccer practice, then I played games on Saturday and Sunday,” said the 16-year-old junior at Lincoln College Preparatory School. “I love the adrenaline rush I get when I’m on the field, running and kicking the ball, and I’m good at it.”

But on October 9, 2019, as Nahomi was playing futsal with her soccer team, she found herself facing a painful injury—an injury that usually requires reconstructive surgery, followed by months and months of physical therapy.

“I had just received the ball, but thought I saw someone behind me, so I started sprinting,” the middle forward said. “When I went to cut and turn, my cleat dug into the turf and my left leg twisted. I heard a ‘pop’ and immediately went down.”

Nahomi’s dad had to carry her off the field. “On a scale of 1 to 10, 10 being the worst pain I’ve ever felt, it was a 12.”

Right away, Nahomi’s left knee began to swell, so she went to the emergency department at the Children’s Mercy Adele Hall Campus.

“The doctor in the emergency room thought I had torn my ACL (anterior cruciate ligament), but she said I would need additional testing to be sure,” Nahomi added. The cruciate ligaments control the back and forth motion of the knee. The ACL also provides rotational stability for the other structures in the joint.

A few days later, Nahomi got the call confirming what she feared most—she’d torn the ACL in her left knee, and the timing couldn’t have been worse.

“It’s my junior year, and that’s usually when colleges make scholarship offers,” Nahomi said. “I didn’t want to miss that. I was just really scared about what all this meant for my future.”

Sidelined


After getting her MRI results, Nahomi saw Donna Pacicca, MD, a pediatric orthopedic surgeon at Children’s Mercy. Dr. Pacicca agreed it looked like Nahomi had torn her ACL.

And though Nahomi’s parents were with her, during the appointment, Dr. Pacicca spoke directly to her patient.

“It was my injury,” Nahomi said. “Dr. Pacicca asked me about my goals and I explained that I wanted to return to play as soon as I could. I didn’t want to miss out on my junior year and a possible scholarship.

“Dr. Pacicca explained the surgery and recovery process so that my parents and I knew what to expect.”

But before her December 4 surgery, Nahomi needed to strengthen her left leg, so Dr. Pacicca referred her to Julianne (Julie) Perrini, DPT, ATC, physical therapist with Children’s Mercy Sports Medicine.

Expert therapy, close to home


Though Julie is based at the Children’s Mercy Adele Hall Campus, thanks to a recent collaboration between Children’s Mercy and the YMCA of Greater Kansas, she also sees patients at the Cleaver Family YMCA, located at 70th and Troost. That location was much more convenient for Nahomi’s therapy sessions.

“Collaborating with a community organization like the YMCA helps Children’s Mercy extend our reach and make our services available to children in every corner of Kansas City,” said Marshaun Butler, Vice President of Clinical Support Services, Children’s Mercy Hospital Kansas Operations, and Chief Diversity Officer.

“Being at the Y has been really helpful because of the equipment and space,” Nahomi said. “We have the whole gym to work in. Plus, it’s a very home-like atmosphere.”

Julie, who sees patients at the Y on Tuesday and Thursday afternoons, said the community members enjoy interacting with the student-athletes, and the students have the opportunity to use equipment they are already familiar with.

“Many of our patients live nearby or attend schools in the neighborhood. It’s wonderful to have the Y as a local resource to help our patients get stronger and ready to return to sport,” Julie said.

In Nahomi’s case, Julie worked with her about three weeks prior to her surgery, helping her regain the strength and flexibility in her left knee, and it paid off.

“When I first saw Julie, I couldn’t bend my left knee,” Nahomi said. “But two weeks into therapy, I could bend it easily. Julie was very understanding, motivating and helpful.”

To be certain she was ready for surgery, Nahomi had to undergo extensive Biodex testing at Children’s Mercy Sports Medicine. Biodex is a device used to evaluate strength, endurance, power and range of motion of the major joints and muscles in patients before surgery and after rehabilitation.

“I think Nahomi was very nervous about the testing,” Julie said, “but she did great and was ready for surgery.”

Options for recovery


On December 4, Nahomi went into surgery expecting Dr. Pacicca to reconstruct her ACL, followed by six to nine months of intense physical therapy, but plans have a way of changing.

“Nahomi had a partial tear to her ACL,” Dr. Pacicca explained. “She had a stable examination, a tiny meniscus tear, and her ACL was mostly intact. Based on her stable exam, it wasn’t clear that doing an ACL reconstruction would be better for her than allowing her to rehabilitate her injury.”

And there are risks either way you go. “Reconstruction doesn’t guarantee you’ll never have another tear, nor does it reduce the risk for arthritis,” Dr. Pacicca said. “Once you’ve torn your ACL, even a partial tear, you’re at increased risk for a re-tear, or an ACL tear on the other side. What to do in these cases can be a hard call.”

After discussing what she had found with Nahomi’s parents, they chose not to have surgery, and instead to continue with physical therapy.

To Nahomi, that was good news. No surgery meant that she would be able to get back to therapy quicker with Julie, fast-forwarding her rehab to just three months, instead of six to nine.

Getting back in the game


Now Julie is helping her patient regain the strength in her left knee, working on jumping and cutting and focusing on injury prevention.

“When Julie tells me that we’re going to play with the ball today, it really motivates me because I miss running, kicking the ball and shooting,” Nahomi said.

“Nahomi is very determined to be ready for the spring soccer season,” Julie added. “She’s a hard worker and wants to reach the highest challenge, whether that’s in the classroom or on the soccer field.”

“Julie has become like a friend,” Nahomi added. “She reminds me of what I need to do to get back to full strength and back in the game.”

And if all goes well, that’s where she’ll be just in time for the spring soccer season.

“Nahomi should be ready to repeat her Biodex testing at the end of February and can return to play if Dr. Pacicca clears her,” Julie said.

Nahomi can’t wait!

“My knee feels good right now. It doesn’t hurt and I can run on it. I feel like I am ready to play,” she said. “But I wouldn’t be where I am without Julie, Dr. Pacicca and Children’s Mercy.”

Watch Nahomi's story below:

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