Emily didn't think much of it when her right quad started tightening up during a soccer game one Friday night during her sophomore year in high school. It wasn't until after the game that she realized something was wrong. Without warning, her right leg gave out as she was walking to the bus.
"At first, I thought, 'This is weird,'" Emily recalls. "Then I was eating dinner that night, and I suddenly couldn't feel my leg. I also couldn't really move my foot at all."
Doctors in the emergency room at Children's Medical Center Plano could tell she had a strained right quad, but they couldn't explain the loss of movement and sensation. Emily wasn't in critical condition, so they referred her to a specialist at Children's Health℠ Andrews Institute for Orthopaedics & Sports Medicine.
"It was really hard the first night when doctors weren't really sure what was going on," says Emily, who was 16 at the time. Nothing meant more to her than soccer. Nothing this scary had ever happened to her. Yet there she was, heading home from the hospital with no idea what was happening to her. She'd have to sit tight for an entire weekend before seeing sports medicine physician Jacob Sexton, M.D., ATC.
Muddling through a muscular mystery
It wasn't the first time Dr. Sexton had seen a young athlete lose sensation and mobility in a leg or foot, but he had never encountered a case like Emily's without a clear cause, like a traumatic fall or the crush of a football helmet.
Dr. Sexton performed several tests to see if he could trigger Emily's reflexes, but nothing worked, not the stroke of a cotton ball, not the poke of a small stick. At this point, all signs were pointing to nerve injury, but it would take weeks for Emily to get an appointment with a neurologist for testing to get an actual diagnosis.
There was no time to waste, though. Dr. Sexton could tell how badly Emily wanted to get back onto the pitch, so he wheeled her to physical therapy. She'd spend the next several months working with Stephen LaPlante, MS, PT, ATC, Team Leader Sports Rehabilitation, and Kyle Utne, PTA, ATC, Physical Therapist Assistant.
"From the get-go, when they didn't even know what the root cause was, they told me, 'We're going to work on this, and you're going to be fine,'" Emily says. "I think that changed my mindset … I was ready for recovery."
Getting to work, mentally and physically
They got Emily started by doing "mental reps" — having her look at her foot, tell it to move, and not worry when it didn't budge. They'd move her foot for her, trying to remind the muscles what it's like to move when Emily tells them to.
Next, they'd line her leg with acupuncture-like needles hooked up to electric clips that would give her "baby shocks."
"The whole idea is to basically stimulate your nerve back to working fully again," Emily explains. "I couldn't feel it for most of the beginning. It was weird to look at because you just see your leg randomly jumping in different parts."
Once she started regaining sensation, her physical therapists would tell her, "I need you to act like you're squeezing and contracting this muscle while the machine is doing the contraction for you."
Emily got around on crutches for the first few weeks. Then she moved up to an ankle-foot orthosis (AFO), a brace that kept her foot in a flexed position so she could eventually graduate from crutches.
Baby steps forward, then a setback
Emily finally got a diagnosis about a month after starting physical therapy – sciatic nerve neuropraxia: a peripheral nerve injury that blocks the transmission of electrical signals along the nerve, cutting off communication with other parts of the nervous system.
One aspect of Emily's injury remains a mystery. She has no memory of the moment when her quad started tightening up. Dr. Sexton's theory is that she forcefully stubbed her right foot on the ground at some point when she meant to drill the ball, which could have strained her quad, causing swelling that put pressure on her nerves, first choking off the signals to her muscles, then cutting them off entirely, leading to the numbness and loss of movement.
No one could tell Emily how long it would take her to walk or play soccer, so she pinned her hopes on returning the following season. Then she got some somber news. The neurologist who diagnosed her, said it might take her two full years just to get back to walking again.
"I remember bawling my eyes out," Emily says. "I felt like I couldn't do anything, like I wasn't going to get there."
Recovering from any injury like this requires as much, if not more, mental and emotional fortitude as it does physical effort. It takes patience, which can be hard for anyone to muster, especially a young athlete desperate to get back to the sport she had loved playing for as long as she could remember.
"I knew she had the motivation. I knew she wanted to get back to what she loved to do," Dr. Sexton said. "Usually with these peripheral nerve injuries … they get better, but it's slow. So, from day one, I told Emily, 'The focus of your rehab on a daily basis is not to get better 100%. The goal you should come in with every day is to have a marginal improvement, and once you notice that improvement, then you're going to start seeing it snowball, and it's going to get better and better."
Pulling and pushing through
Emily didn't stay down in the dumps for long. She'd show up to PT with a smile on her face, motivated to do the work. She'd do her exercises every day and started regaining sensation in her leg and foot. She was at home the first time she managed to walk a few paces on her own. She was so thrilled, she recorded a video and texted it to Dr. Sexton, Stephen and Kyle.
"She always had a great attitude," says Dr. Sexton. "Every so often, I would go into PT and talk to her, and you could see her mood and her demeanor improve week by week as she started noticing those gains."
About two months after Emily's injury, she was pulling and pushing a 45-pound sled – even though she still needed her ankle-foot orthosis to walk. Her therapy involved cutting-edge technologies, like an anti-gravity treadmill – the same kind NASA astronauts use when they reacclimate to Earth after missions to outer space.
"It's basically like if you were to put your legs in a balloon and fill it up with helium, then it lifts you up," Emily explains. "You put little pants on and zip yourself in. It's airtight, then it fills up around your hips and your legs and it basically pulls you off the treadmill."
At first, she'd run with about 60 percent of her body weight, lightening the load on her leg and foot muscles. Over time, they'd reduce her body weight by less and less, until she was running on her own.
Another innovative therapy involved a blood pressure cuff that restricted blood flow to Emily's leg. Muscles have to work harder when less blood is flowing to them, which can lead to increased gains in strength.
From physical therapy to performance training
By early June, Emily started making the transition from physical therapy to strength and conditioning at Children's Health Andrews Institute Sports Performance powered by EXOS. Once fully recovered, her focus shifted to improving multi-directional speed and quickness, agility and mobility, nutrition and recovery habits.
Every step of the way, Emily's caring sports medicine and physical therapy team at Andrews helped her stay positive.
"Even when I was having bad days, they kept staying upbeat, and pushing me, and pushing me," Emily says. "I really don't think I could have gotten back, especially as fast as I did, without their continued support throughout the whole thing."
Emily got back on the pitch doing soccer drills just six months after her injury. Almost a year later, she earned a coveted spot on FC Dallas, a highly competitive club team. She hopes to follow in the footsteps of several friends who have played for FC Dallas before going on to play college soccer.
Emily feels a deep sense of pride and gratitude for all she's overcome since her injury. "I feel like I wouldn't be the person I am today without this happening to me," she says. "It made me so much more grateful for everything that I have."
Children's Health Andrews Institute for Orthopaedics & Sports Medicine is the only medical facility of its kind in Texas, offering a wide range of services to help young athletes recover from injuries, stay healthy and improve their game. Learn more about Andrews and our two locations in Plano and Frisco.