By Jim Catalano
Jim Catalano is an Associate Editor at Training & Conditioning.
Training & Conditioning, 11.3, April 2001, http://www.momentummedia.com/articles/tc/tc1103/legacy.htm
The Mantle clan of Oklahoma has a long, unfortunate history of knee injury. Its best-known member, baseball legend Mickey Mantle, tore up his knee early in his career and lost much of the blinding speed and baserunning ability that had characterized his climb to the major leagues.
“All the Mantles who have played sports have had knee problems, so maybe it was a matter of time,” says Michelle Mantle after rehabbing back from a major injury. As a multi-sport athlete at Picher (Okla.) High School, Michelle, Mickey’s third cousin, had been able to avoid the family knee jinx until her junior basketball season, when she tore her left ACL.
Even though he went on to enjoy a Hall of Fame career, Mickey Mantle never really recovered from his initial knee injury. Michelle, however, was able to benefit from modern ACL reconstruction techniques and innovative rehabilitation machines and was much more fortunate. In fact, she went on to better her junior season numbers in both softball and basketball—and track is just around the corner.
For her determination to successfully return from knee surgery, Mantle has been chosen as Training & Conditioning’s High School Female Comeback Athlete for 2001. Also honored are the members of her comeback team: Ron Forristal, MD, Orthopedic Surgeon at Grand Lake Orthopedic & Sports Medicine in Grove, Okla.; John Burns, MS, ATC, and Matt Brannon, ATC, Athletic Trainers at Integris Physical Therapy & Sports Medicine in Miami, Okla.; Stacy Clark, PT, Physical Therapist at Integris; Travis Norwood, Head Girls’ Softball Coach at Picher High School; and Richard Bassett, Head Girls’ Basketball Coach at Picher High School.
Mantle was having a successful junior basketball season, and the team was gearing up for the Class A playoffs, when on Feb. 4, 2000, her left knee gave out. “There were about eight seconds left on the clock and she was trying to prevent a shot,” Bassett says. “She moved back to her right, trying to make the other girl turn, and when she did, she fell to the ground. I thought she just lost her footing or twisted her knee. But when she tried to get up you could see she was in pain.”
“I didn’t know what was wrong, but I couldn’t stand on it,” Mantle remembers. “It didn’t really hurt and it didn’t swell, but it was really loose, and I couldn’t put any pressure on it. My mom took me to see John Burns after the game, and when he told me it was my ACL, I was really upset. Nothing like that had ever happened to me before, not even a sprained ankle. I was very disappointed—I felt like I was letting the team down.”
Burns notes that Mantle’s reaction was a typical one for a first injury. “She was saying ‘Why me?’ and ‘It’s the end of the world,’ and all the usual things,” he says. “But once she got over that and accepted that she needed surgery, she went into it totally committed and did everything we asked.”
Mantle was referred to Dr. Forristal for evaluation, and he diagnosed an ACL rupture, which was confirmed by an MRI. On Feb. 24, 2000, he performed ACL reconstructive surgery using a semitendinosus hamstring graft.
Two weeks later, Mantle began a largely traditional ACL rehab program focused on reducing swelling and restoring range of motion and strength, but with a little twist. Two weeks after beginning the program, she had minimal swelling and full bilateral ROM, and after a month, much of her strength had been restored.
The “twist,” which the Integris team credits for much of Mantle’s quick recovery, was being able to immediately begin functional training using unweighing. Mantle was placed in a lift-and-harness system that takes weight off the athlete until a biomechanically optimal and pain-free status is obtained.
“It allowed us to put her in functional situations very early in the rehab process, even though the ligament was still healing from the surgery,” Burns explains. “It’s similar to exercising in a pool in that it takes excessive load off the joint. We had just gotten the unloader and Michelle was the first athlete we started on the machine as part of her immediate protocol.”
Mantle began with squats and forward gait training two weeks after surgery by using a treadmill with the unloader. A week later, she added unilateral squats, lunges, and backward walking. The following week, high knees and lateral shuffles were added, with cariocas introduced the next week. All of these exercises were performed unloaded and pain free. On April 6, just six weeks after surgery, Mantle started unweighted jogging.
Over the next month, Mantle continued to perform on the unloader as the weight of her body was gradually reintroduced and the speed of her activities increased. By May 5, 10 weeks after surgery, she was jogging forward and backward and performing quick lateral shuffles pain free with full bodyweight.
Once those short-term goals were achieved, Mantle began sprint and overspeed training using the unloader with treadmill speeds up to 12 mph. “She’d jump on the treadmill and be sprinting at 12 miles per hour in an unloaded state with 50 pounds off of her,” Burns explains. “Then we gradually loaded her back up so she was doing fully loaded sprint training. At about 12 weeks, she was fully loaded and doing pretty much all the functional training. We also had her doing some strength training, but mostly focused on running and plyometrics.”
Three months after surgery, Mantle began a six-week jump-training progression that helped to improve her vertical jump and explosive power. “It was ground-based plyometrics,” Burns says, “where we really focused on neuromuscular control and co-contraction of the lower legs, trying to teach her how to jump and land correctly.
“We worked on trying to keep her knee over her foot while maintaining balance, and on landing soft, recoiling, and exploding again,” Burns continues. “We also did progressive jump training, where she worked her way up to bounding on one foot up and down, and doing tuck jumps. Then we added a cone, and she jumped over that repeatedly. Next, we added a box. Then we added a mat so there was proprioceptive training from landing on a cushion. Not only did that program improve her neuromuscular control and help protect her ACL, but it also improved her vertical jump.”
During her rehab, Mantle sat out the spring track season as well as summer basketball and softball. But she was committed to her rehab, staying focused on making it back for softball in the fall.
She was soon rewarded: five months following her surgery, Mantle was cleared to return to full unrestricted softball activities. In early August, she participated in a summer softball camp. “I was afraid I would forget stuff,” she says. “I had been in the batting cage just the week before but during the first couple of games, I felt like I had to start all over again. It was really frustrating.”
Norwood admired Mantle’s determination during rehab, but admits he was tempted to play it safe with her. “You watch the work she did to return to competition, and the last thing you want to do is put her in a situation where she’ll get hurt again,” he says. “The first time she got on base, I sent her to home plate and she had a close play at the plate. I remember thinking, ‘I hope she doesn’t get hurt.’ But she never hesitated at all.”
In her very first game back for Picher, Mantle had another knee-related scare. “I dove for a ball and my bursa sac just burst,” she says. “It swelled up right away, which scared me. But they iced it for an inning, then I went back in. That was the last problem I had with the knee.”
Mantle went on to have an outstanding softball season, leading Picher to 27 wins with a batting average of .425, a slugging percentage of .575, 16 runs batted in, 38 steals, and 38 runs scored. She was named All-State and first-team All-District and All-Region. “She stole 15 more bases than in her junior year, and her batting average was almost identical against better competition,” Norwood says. “We won 27 games again, and she was our leader and made a lot of plays at shortstop for us. She was the main reason we were successful.”
Coming back on the softball field was Mantle’s first challenge, but basketball loomed as a much larger hurdle. “There’s a lot more lateral sliding and stop-and-go running in basketball,” Bassett notes. “At first, Michelle was a little leery because she could feel a little movement in that knee. John Burns said it was just her hamstring, which was still a little atrophied, and that she’d have to strengthen that so the knee would be tight. After he told her that, we started working on stretches and exercises, and never looked back.”
Mantle admits she was a little cautious about getting back on the court. “I was worried about it at first, especially when we played in the gym where I got hurt. But my knee didn’t give me any problems.”
The 5’3” Mantle had a remarkable season for the Gorillas, leading them into the state playoffs with an average of nearly 16 points per game. She was the team’s leading scorer for a third year and was named the conference’s best defensive player a second straight year.
Bassett thinks that Mantle’s rehab really paid off on the court. “She’s even better than she was last year,” he says. “She never lifted a whole lot until she hurt the knee and saw how much lifting helped make a difference in being stronger and more flexible. She didn’t lose any speed laterally or vertically. In fact, she averaged about 1.5 more points per game than last year.”
As soon as basketball season ended, Mantle returned to the weight room to get ready for spring track, where she competes in the 100- and 200-meter sprints. She’s a potential state champion, according to Burns.
In the fall, Mantle will be enrolling at Northeastern Oklahoma A&M Junior College, where she has been recruited to play on the softball team. She’s looking forward to continuing her athletic career, and says that the injury gave her a new outlook. “I never really had to push myself that hard before I got hurt,” she says. “After that, I had to push just to come back, and that showed me not to take anything for granted.”