Seasons of Recovery Part 1: Granby’s Kate Sarnacki began ACL rehab with small, slow steps

  • Three days after her anterior cruciate ligament surgery, Kate Sarnacki gets help from her mother, Kim, as she gets into a continuous passive motion device at her home in Granby, Oct. 2, 2016. GAZETTE STAFF/JERREY ROBERTS

  • Kate Sarnacki talks to her physical therapist, Katie Gillis, during her first appointment at Attain Therapy and Fitness in Belchertown. GAZETTE STAFF/JERREY ROBERTS

  • Kim Sarnacki, Kate's mother, holds Kate's crutches as she watches her first physical therapy appointment, Oct. 6, at Attain Therapy and Fitness in Belchertown. GAZETTE STAFF/JERREY ROBERTS

  • Kate Sarnacki gives a peace sign after her knee surgery Sept. 29 at Boston Children’s Hospital in Waltham. Courtesy Michael Sarnacki

  • Kate Sarnacki enters the waiting room on crutches at Boston Children’s Hospital before knee surgery in September. She’d need crutches for the next month after the surgery. Courtesy Michael Sarnacki

  • Kate Sarnacki with a teddy bear before her knee surgery in September.  She brought the same bear to her first ACL surgery in eighth grade and brought it again for good luck. Courtesy Michael Sarnacki

  • Kate Sarnacki’s leg slowly raises and lowers while resting in a continuous passive motion device at her home in Granby, three days after her anterior cruciate ligament surgery. GAZETTE STAFF/JERREY ROBERTS

  • Kate Sarnacki does homework at her home in Granby on Oct. 2, 2016, three days after her anterior cruciate ligament surgery. Her leg slowly raises and lowers while resting in a continuous passive motion device. GAZETTE STAFF/JERREY ROBERTS

  • Kate Sarnacki gets help from classmates Hannah Roux, left, and Olivia Murray at Granby High School, Oct. 7. She moved to her next class early before other students filled the hallways. GAZETTE STAFF/JERREY ROBERTS

  • Kate Sarnacki waits for students to exit her economics class so she can enter it with fewer obstacles, Oct. 7, at Granby High School. Olivia Murray, right, and Hannah Roux, third from right, helped her move to her classes. GAZETTE STAFF/JERREY ROBERTS

  • At Kate Sarnacki’s first physical therapy appointment on Oct. 6, Katie Gillis takes measurements around her knee at Attain Therapy and Fitness in Belchertown. GAZETTE STAFF/JERREY ROBERTS

  • Kate Sarnacki backs her wheelchair into her economics class amid classmates Emily Gosselin, from left, Casey Rougeau and Gabriella Toliaferro, Oct. 7 at Granby High School. GAZETTE STAFF/JERREY ROBERTS

  • At Kate Sarnacki’s first physical therapy appointment on Oct. 6, Katie Gillis measures the angle of the bend in her knee at Attain Therapy and Fitness in Belchertown. She could bend her knee only 30 degrees. GAZETTE STAFF/JERREY ROBERTS

  • Kate Sarnacki, center, reacts as an electrical stimulator is employed by her physical therapist, Katie Gillis, at Attain Therapy and Fitness in Belchertown during her first appointment, Oct. 6. Kate’s mother, Kim Sarnacki, looks on. Kate said the stimulation “didn’t hurt, but it felt weird.” GAZETTE STAFF/JERREY ROBERTS

Published: 5/12/2017 6:29:16 PM

Kate Sarnacki settled her feet against the resistance plate of a leg press machine. Her calves flexed against the weight, and she wiggled her toes in pink and baby blue sneakers before extending her legs on a rolling track.

Veins pulsed in her temples as she worked a piece of gum, keeping her motion in measured control.

“Can I go this slow, or can I go a little faster?” she asked.

“This slow is perfect,” said Katie Gillis, Sarnacki’s therapist at ATI Physical Therapy in Belchertown. “The slower the better.”

Sarnacki, an 18-year-old senior, has been a fixture on Granby’s soccer, basketball and lacrosse rosters since eighth grade.

But at soccer practice in early September, she suffered an injury common among young female athletes. A tear in her left anterior cruciate ligament (ACL) sidelined her just after her senior year started and set her down the long road to recovery and — she hoped — a chance to play again before graduating.

For the next three days, the Gazette tells the story of that journey.

In that physical therapy session last fall, Kate moved from leg presses to knee extensions to pulling herself on a rolling chair using just the muscles around her knees.

“I’m gonna be so sore,” Kate said.

Up to that point, most of Kate’s therapy had revolved around returning stability to her knee and regaining the ability to bear weight. Now that Kate could do that, Gillis also put her through an abdominal workout to build core strength.

It will be tough, the therapist said.

“Don’t underestimate me,” Kate replied.

‘A lot of people heard’

Kate felt her knee pop in the Rams’ Sept. 7 soccer season opener at Frontier Regional. A midfielder, she was defending a Frontier player and stuck her leg left out. While her knee didn’t give out from the collision, it felt unstable enough to leave the field.

After not finding evidence of injury, a doctor cleared Kate to return to practice after the game. But a week later, she stepped awkwardly during a corner-kick drill and felt her left knee collapse.

As she fell to the grass, three loud cracks rang out across the field.

“A lot of people heard, so that was gross,” she said.

Sarnacki started to cry from the intense pain. She had torn her right ACL four years earlier in eighth grade and hadn’t cried at all.

“We definitely knew something was wrong because she started crying, and she never cries,” recalled Granby freshman Summer Molin.

This time, the damage was much worse than eighth grade. Not only had Kate torn her ACL, she had also ripped her lateral collateral ligament (LCL) and medial collateral ligament (MCL) — essentially, her knee’s support structure. She also cracked her tibia when the collapsing ligaments allowed it to slam into her femur.

The following Saturday, Kate underwent an MRI to give doctors a look at the damage. Her father, Michael Sarnacki, received the results Sunday night but didn’t immediately share them with Kate. She was at Fenway Park watching the Red Sox play the Yankees, and he didn’t want to spoil her outing.

Kate was hoping for the best. Perhaps, she thought, it would only be a tear of the meniscus, an injury much less severe than her previous one.

Her dad broke the bad news Monday morning.

“I don’t think it was as much of a surprise to us that it was as bad as it was,” her mom Kim Sarnacki said. “To her, it was like she was dealing with it for the first time.”

The diagnosis signaled a starting point. After overcoming her initial shock, Kate vowed to salvage part of her senior year and return to play lacrosse in the spring.

The ACL is a band of ligament that provides stability in the middle of the knee, but it can partially or fully tear when the joint is pushed beyond its natural limits. Between 100,000 and 200,000 ACL tears occur in the United States every year, according to a study by the University of Colorado Hospital.

The same study said women injure their ACLs four to six times more often than men playing the same sports. Female athletes’ knees undergo more stress because they are naturally turned inward and are less able to absorb shock when jumping and landing, said Dr. Mark Galland of the Orthopaedic Specialists of North Carolina.

Women also tend to have an imbalance in strength between their quadriceps and hamstring muscles, according to the CU Hospital study. They are more likely to use their quadriceps muscle to slow down from a sprint, which causes instability in the knee.

On Sept. 29 at Boston Children’s Hospital, Kate was set to undergo surgery to repair her knee by Mininder Kocher, the hospital’s associate director of sports medicine and a Harvard professor who performed Kate’s first ACL surgery.

“These are the best surgeons in the world that are doing cutting-edge stuff,” Michael said. “You have a tremendous comfort level to know whatever can be done is done.”

As rain fell outside Boston Children’s Orthopedic center in Waltham, Kate’s iPhone lit up with good luck texts from her friends and teammates. After wishing their daughter well and watching her wheeled into the operating room, her parents passed the three hours she was in surgery with cafeteria food, magazines and crossword puzzles. Eventually the doctor called them back.

Kocher had repaired the ACL with a graft of Kate’s hamstring rather than replace it with a cadaver’s. He pronounced the procedure a success.

With her knee wrapped in bandages and a brace to keep her from re-injuring the joint, Kate’s recovery began. It was time to get to work.

Couches and wheelchairs

Kate spent most of the four days following surgery in bed and on the couch. She took a Percocet every four hours and kept her knee in a continuous passive motion machine.

The machine moved her knee slowly between the angles of bend it’s allowed at various stages of recovery. Those first few days, it kept the knee from bending past 30 degrees or straightening past zero degrees.

Kate passed the time watching TV — she’s partial to reality shows and Grey’s Anatomy — taking naps and balancing optimism for a spring return with the reality of knowing the length of the road ahead.

“The beginning really was devastating,” she would later say. “I was set to have a great senior year, and I was set to round out everything I started for myself.”

When Kate returned to school the next week, she had to use a wheelchair. She left classes early to avoid traffic in the hallways and waited outside classrooms so she could be the first to enter and back into an open spot.

“I can’t really sit in any desks,” Kate explained. “I’m pretty good at maneuvering it around. People help me a lot.”

Physical therapy began Oct. 6, a week after surgery. Gilles took off Kate’s brace and examined the surgery scars after Kate explained how the injury happened. She outlined Kate’s progression with the brace and useful exercises for the immediate future. After three weeks, the therapist explained, she would be able to bend her knee to 90 degrees.

“I’m really waiting for those weeks,” Kate said.

Because of the multiple ligament tears and the tibial fracture, Gilles told her this recovery would be slower than her previous ACL.

“Which I’m already sick of,” Kate said.

The appointment finished with a brief session of electrotherapy. Gilles attached electrodes to Kate’s skin, sending pulses of electricity to stimulate the muscles beneath to alleviate soreness. Then she wrapped the athlete’s knee and attached the brace.

“You look good,” Gilles said. “You’re right where you should be.”

“This is going to be fun,” Kate said.

She gingerly exited the office on crutches behind her mother opening doors. Kim held the car door open while Kate positioned herself in the passenger seat. They drove home toward the sunset as the horizon displayed its first ribbon of orange.

Kate still had a long road ahead.

Kyle Grabowski can be reached at

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