For Jayde, the pain wasn’t the worst thing. She could handle falling to the ground, the hyperventilating, the “popping” sound, even the needles. The worst pain was hearing the words, “you’ve done your ACL.” She knew what this meant. It would stop her from continuing a victorious season of netball, a game she had poured her heart and soul into. A game, I, as her sister, knew how much she loved and dedicated her whole life to. Little did she know how much this injury would affect her.
The year was 2012. Jayde was only 13 years old and was one of 220,400 Australian girls participating in netball outside of school. Not only was she playing for her local club, she was also playing at the state level for her age group, as well as playing netball for her district.
According to a study by The Medical Journal of Australia from 2000 to 2015, nearly 200,000 Anterior Cruciate Ligament (ACL) reconstructions were performed. The study also found men aged from 20 to 24 are at the greatest risk, while for females it’s those aged from 15 to 19 years old.
Struggling with an injury is enough to take a toll on anyone’s mental health, let alone those who are still young.
So how much impact can ACL injuries have on mental health?
A clinical psychologist who works in the world of psychology and sport at Edith Cowan University says they are a devastating injury.
Dr Craig Harms says these injuries can have a significant impact on psychological well-being.
“People need lots of support, psychological support,” he explains. “Particularly young people because it’s often at their early stages of their career.”
It was the first five minutes of a game at Wanneroo Districts Netball Association against her team’s fiercest rivals. A game that would see them going to the grand final only two weeks later. Jayde Wilson was eager to play well to ensure her spot in the grand final.
It all happened in slow motion.
A poor pass was thrown Wilson’s way. She jumped to catch the ball. As she tried to catch it, she fell and twisted her knee.
“When I first did it I knew I had done something bad,” she explains softly. “When you hurt it, when you do your ACL, you kind of feel it in your knee and you hear like a pop or a crackle sound, so I knew I had done something really bad. It wasn’t painful, it was just the fact that I had felt the injury happen. I started hyperventilating, thought I was going to vomit.”
After three or four days of excruciating pain, she finally went to the doctor. She was instructed to go have an MRI scan. She had to wait four or five days to receive the news she dreaded the most.
At first, Wilson was unsure whether to go through with surgery. It took her three weeks to finally have it done.
She had a lot of support from her family and friends and it improved a lot of her relationships.
Although she didn’t hear much from her team mates, she said it was the girls she had made state with who were most supportive.
Both Wilson’s local club and the district team offered her support and wanted her to coach junior teams.
“I really hated it to be honest,” she says with a bitter tone. “Coaching just made me want to be playing and not being able to play, yeah affected me quite a bit. Going out to the courts every Saturday, not being able to play, seeing my old team playing, winning, it really sucked.”
After about nine months of intensive rehabilitation, Wilson got approval from her physiotherapist to play a game of netball for her school, a day that will haunt her forever.
It was during this game, she unfortunately tore her ACL for the second time. She knew there was no going back.
Being told she could never play netball again was enough to crush her motivation. She still did the rehab, but with less effort this time.
“I went from training three or four times a week, to not being able to get out of bed,” she says, looking down at her knee. “I put on about 10 kilos and when you’re 15 or 16, weight is quite a big thing in a lot of girls’ minds. It affected me because I think my self esteem went down. Being a fit, young person, going to not being able to do much, it really affected me.”
Harms says it’s easy for athletes to put on weight during this time.
“As an athlete and you’re injured, you can’t keep eating at the levels you had before,” he says.
Wilson also didn’t feel like getting out of bed. She felt like she was the heaviest out of all her friends. She was lethargic. She was on heavy medication to keep the pain under control, which made her tired. The second time around, Wilson was in year 11, an extremely important year in her schooling.
“I missed about three weeks with surgery,” she sighs. “So you know, I was behind in school. It affected my schooling. I was quite depressed. I didn’t really want to go to parties. It affected me quite bad. My friends would leave me and go sit downstairs at lunchtime and it would take me a long time to get down there, then they’d be talking about stuff I didn’t know. When you’re a teenager, those things matter to you, weight matters, friends matter. Not being at school, not hearing what’s going on, it matters.”
The second time around, Wilson’s support network was scarce. She still had the support from her family, boyfriend and a few friends, but had lost contact with everyone in her netball world.
Performance Boost Sport and Performance psychologist Shayne Hanks says ACL injuries can affect relationships in various ways.
“It depends on how invested the person was in their sport and whether they have other outlets to provide similar things that sport or exercise did,” he says. “Friendships can certainly be impacted if the person no longer trains or competes with a training squad.”
Now at 19 years old, Wilson’s experience in hospitals and with nurses has led her to pursue a career in nursing.
“Seeing how much nurses do for people and how they can help,” she says with a bright smile. “Knowing how much they can affect people in hospital has led me to be like the nurses that helped me.”
Harms says it’s important to set goals for anyone who sustains a sport related injury.
“Set some goals that help you with your life,” he says. “Not just recovery goals, but also life goals.”
Wilson has also started playing social netball with a group of friends, however, she is taking a break due to concerns with her knee. She now knows when to draw the line.
Wilson says she is mentally in a better place and she has come to terms with her injury.
However, she is not alone.
Earlier this year the MJA published data highlighting ACL reconstructions among Australians under 25 years old increased more than 70 per cent between the years 2000 and 2015.
Bridget Hanavan was also playing netball when she tore her ACL, however unlike Wilson, netball was not her life.
She was 19 at the time, playing a game of social netball with her friends. She hadn’t played netball since year five.
“I got hit in the head with a ball, so I was a little woozy,” she says with a laugh. “Not long after that I tried to jump up for the ball and because I was still lightheaded, I landed in a way you would never usually land if you were more conscious and a bit more aware of your surroundings. I landed and my knee twisted the wrong way and there was a pop. I fell to the floor and I was in so much pain.”
Hanavan found out she had a second grade tear of her ACL, the day before she was meant to fly to Bali with a group of friends.
Being in Bali with an injury was limiting for Hanavan. She had to miss out on things that she usually loved to do. It also caused conflict with her friends, who thought they were doing what was best for her. “It’s my own injury, I can do what I want,” she would tell them. But reflecting on it now, she says she should have listened to them more.
Once Hanavan was home, she began physiotherapy. Her doctor told her she didn’t need surgery and the physiotherapy would instead help strengthen her knee. It was towards the end of the first month of physiotherapy when she attended a concert in Fremantle with her friends. She was walking away from the group, when she turned around to say something, her knee gave way and she collapsed to the floor in tears. Her injury was now a full tear. Surgery was compulsory.
Like Wilson, Hanavan’s support system was made up of her family, friends and boyfriend. They kept her company and reminded her to focus on the positives.
There was a stage in the first month where the injury was affecting her a lot more than she had anticipated before the surgery.
“When it first happened, I was in bed for a week straight, just doing the exercises,” she says. “I really wasn’t doing much and I missed out on a lot of things that my friends were doing. It was actually quite sad because I just felt really restricted and it was really starting to get me down, especially not being able to do things myself. The lack of independence was really starting to affect the way I would feel. I just felt like, ‘oh my gosh when is this going to be over, when am I going to be fine?'”
Harms says people who experience these injuries should find something they enjoy doing.
“Find some activities that are fun and enjoyable and throw yourselves into that because recovery from injuries is a tough thing and there are a lot of things you can do to help you cope in a much healthier way,” he says.
A year later, Hanavan says the experience has been character building in terms of perseverance. She says it has taught her when things are getting too hard, to prioritise things that are going to make you feel better and keep you healthy.
“Don’t do netball,” she says with a giggle.
But netballers aren’t the only people at risk.
A study published in 2011 of ACL injuries in Australia, estimated 1162 footballers needed ACL reconstructions each year.
Darcy Cruse was at his local football club training for an upcoming game on the weekend. They were doing a match-simulation drill and he was chasing someone on the opposing team. He went to turn right, when his knee gave way and he heard a snap. He knew straight away what he had done.
He was 19 at the time. It was only three months ago.
“I didn’t really believe it,” he tells me, looking to his knee. “Because I had knee injuries before, I thought it could be something I had already done.”
He thought he had put injuries behind him.
Unlike Wilson and Hanavan, Cruse says he hasn’t struggled with a decline in his mental health.
“I’ve found that I’m actually kind of mentally strong,” he says. “It was a challenge but I can either step up or get all sad about it. Obviously you’re going to be sad, but maybe don’t dwell on it for too long. I probably did for a couple of weeks before I realised what I needed to do.”
Harms says it’s normal to go through stages of anger and denial.
“Eventually someone gets to a point when they begin to accept their situation and what they need to do,” he says. “What can be really helpful at this point is to make sure, if you do have a significant injury, that you seek support.”
Cruse says his support system has mainly come from his family and close friends.
“They were just as devastated as me when it happened, so they’ve been supporting me pretty well,” he smiles. “You never think it’s going to happen to you. Never thought an ACL would happen to me. There’s no point dwelling on it, you’ve just got to move on.”
Cruse says he hopes to go back to some sort of sport once he recovers, but maybe not football.
You can listen to Jayde’s story below: