Jan 29, 2015Holly Poeschl
Oshkosh (Wis.) West High School
By Dennis Read
Dennis Read is an Associate Editor at Training & Conditioning. He can be reached at: [email protected]
Holly Poeschl has twice experienced the physical and mental challenges that come with reconstructing an ACL. The two injuries, one in each knee, occurred 345 days apart and cost Poeschl both her sophomore and junior seasons of high school basketball.
But they couldn’t keep her out of the fray completely. Not only did she return to play basketball as a senior, she also recovered from each surgery in time to play softball, earning a pair of second-team all-conference honors.
Poeschl’s saga began at a basketball camp the summer after winning a state title her freshman year at Oshkosh (Wis.) West High School, when she suffered a non-contact ACL injury in her left knee, tearing both the ACL and meniscus. The injury occurred in June, but surgery was delayed so Poeschl could go on a school trip to the Bahamas in August. Between the injury and the surgery, Dan Gehri, MS, LAT, ATC, CSCS, then the Athletic Trainer at Oshkosh West, began prepping Poeschl for the rehab that would follow her surgery.
“It’s been my philosophy that if you operate on a sore, swollen knee, you end up with a really sore, swollen knee after surgery,” says Gehri, who is now an Athletic Trainer/Physician Extender at ThedaCare Orthopedics Plus in Appleton, Wis. “The goal was to normalize the knee as much as we could to create a smoother rehab. First, we wanted to get rid of the swelling and effusion, and then we turned to improving range of motion and building quad strength.
“We didn’t want to damage any cartilage, so we did a lot of straight ahead work,” he continues. “Holly spent a lot of time on the bike and elliptical trainer. She did some treadmill power walking and a lot of squats. We also put a big emphasis on the hamstrings since they kind of keep the tibia pulled back like the ACL does. By the time of the surgery, she was pretty much functional except she couldn’t run, jump, or pivot.”
The gains made before the surgery accelerated Poeschl’s rehab progress. “She had that big swollen puffy knee again, but she had good strength in her core and trunk, so we didn’t have to spend much time addressing those issues,” Gehri says. “She also had good glute strength and strong ab and back extensors in place, so we were able to spend more time addressing her swelling and effusion and emphasizing the hamstring and quads.”
Gehri followed a fairly standard rehab protocol, breaking the process into two-week periods. After focusing on range of motion and flexion the first four weeks, in week five he introduced deep water jogging and aquatic therapy along with limited balance work using a two-by-four as a balance beam.
At eight weeks, Gehri began a new tubing protocol he had never used before. The program started with gentle exercises that intensified as Poeschl progressed through her rehab. “I took a 20-foot piece of tubing and tied it around each of us,” he says. “Then she’d spend about 10 minutes doing skips, lunges, side slides, and back pedals while she was pulling me. The exercises were designed to give her external resistance while allowing me to monitor her mechanics.
“She still did things like squats and leg curls in the weightroom,” he continues. “But I wanted to get her moving and work on some of her agility and coordination. I think that was a hindering factor, not only with her ACL, but athletically. So I really tried to work on improving her footwork and mechanics.”
At week nine, Gehri added a bit of court work to the workouts, staring with gentle slides. Week 11 brought the introduction of a full balance program using a wobble board. Initial balance exercises included two-legged squats, lateral walks, and balance touches.
Gehri had been using a standard preventative warmup with the girls’ basketball team, but he took these efforts a step further with Poeschl. He focused on functional activities designed to put her knees into proper positions while also improving her agility and basketball skills. At week 12, they added straight ahead shooting drills, progressing to slow cutting around rounded corners in week 16 and sharper cutting exercises in week 20.
“We spent a lot of court time working on her basketball fundamentals,” he says. “Eventually, I’d shoot and she’d grab the rebound, take two dribbles, and make an outlet pass. We also spent 15 to 20 minutes practicing her footwork.”
According to Gehri, Poeschl’s hard work and upbeat attitude never diminished. “Holly worked two hours or more each day, and I don’t remember a single time when she felt sorry for herself or asked, ‘Why me?'” he says. “She just said, ‘I love to play basketball. I want to get back and contribute and if you say this is what I need to do, then that’s what I’m going to do.’ I tried to keep her looking at the big picture by telling her, ‘You’re only a sophomore. You have two more years ahead of you.'”
“I like challenges,” Poeschl says. “I’ve never quit anything in my life, and I looked at this as another road block I had to overcome. I didn’t want pity from anyone, I just wanted them to understand and support me.”
Despite Poeschl’s hard work, a return to the basketball court her sophomore year was not in the cards, and she watched her team lose by two points in the state quarterfinals. But she was able to play softball in the spring, keeping the starting position she earned as a freshman.
Still, returning to the basketball court remained Poeschl’s major focus. She was hoping to be back at full strength for her junior season and attended summer camps to polish her game. Those plans, however, took a major detour when, 345 days after her initial injury, she tore the ACL in her right knee when she was caught in a pileup under the basket at a summer camp.
“I don’t remember exactly how it happened,” she says, “but as soon as I hit the floor I knew what happened and I pounded my fist on the floor. I wasn’t sad, I was mad. It was the most frustrating thing. After spending all that time working on my left knee and building up the muscle around it, I thought I’d be fine, but I guess not.”
Gehri, who had left Oshkosh West during the offseason, took the injury as hard as Poeschl. “It was devastating,” he says. “But a little part of me was relieved when I found out it was a contact injury. I would have felt just awful if we had done all that work and she had a non-contact injury caused by a mechanical or strength issue.”
For her second rehab, Poeschl followed the same basic outline as the first. Her experience, though, allowed her to be a bit more independent the second time around. “I did a lot of it on my own the second time because I knew exactly what I had to do,” she says. “But there were points where I got more frustrated because I had been through it once and I worried, ‘What if I go through all this and hurt my knee again?’ I started to doubt it a little bit and slacked off at times, but then I’d snap back out of it and start working really hard again.”
Poeschl did much of the work during her second rehab at Mercy Oakwood Rehab in Oshkosh under the supervision of Physical Therapist Liesl Storm, PT, CSCS. Storm disagrees with Poeschl’s self-analysis and says she saw very little slacking off. “She was very, very dedicated,” Storm says. “I never had to worry about her missing her home program and she was very accountable for everything she did. She would even go above and beyond what was asked of her, but never in a negative way.”
There was some thought that Poeschl might be able to return in time to catch the end of the basketball season. “I finally got cleared to return two days after we lost in the regionals,” Poeschl says. “As much as I would have liked to play before that, I wasn’t going to risk it for one game. Plus, I felt it wouldn’t have been fair to my team for me to go out and play when I hadn’t been practicing with them.”
After a successful softball season in the spring of 2006, Poeschl finally made her long-awaited return to the basketball court the following fall. But the two years away from the game had taken a toll.
“I had played in some tournaments over the summer, but my first varsity game was really weird,” she says. “I got a standing ovation, and I was extremely emotional and very nervous. I had high expectations, but not playing competitively for two years changes so many things. Everybody else progressed so much more and I wasn’t at the point I had hoped I would be for my senior year.”
Despite the rust from two years away from the game, Poeschl started several games at center and served as a team captain. Playing for a new head coach, the team went 12-10 before losing in the regional final.
Early on in her high school career, Poeschl had envisioned a possible college career, maybe as a two-sport athlete. But now she’s moved her focus to softball and hopes to be a member of the team at Carroll College in Waukesha, Wis., where she matriculated this fall. Poeschl thinks the injuries may have actually helped make her a better softball player.
“If I hadn’t been injured, I probably would have wanted to play both sports in college,” she says. “I would have put a lot more effort into basketball and less into softball and probably would have been mediocre in both. I think concentrating on softball will benefit me more than if I had tried to do both.”
She also believes the injury helped make her a more well-rounded person. “It definitely helped me mature,” she says. “I had always made good grades, but after the first injury I got involved in more activities and learned there was more to me than a basketball and softball player. If the injuries had never happened, I would have been too focused on sports and not explored so many different things.”
Looking back at her rehab, Poeschl believes that were two specific things that made the biggest difference. “What helped me the most was people pushing me past what I thought I could do,” she says. “They helped me realize that I was going to come back and be in good shape again.
“The other big thing was staying connected with the team,” she continues. “I know some coaches have injured players sit on the bench in street clothes and keep stats, but I never had to do that. I got to change into warmups and sit on the bench. I did pretty much everything the rest of the team did, except play. And not feeling isolated from the team really helped.”
Poeschl may have even found a long-term calling out of the injury. Although she has not yet decided on a major at Carroll, she is strongly considering physical therapy or exercise science as a career.
“I worked with such wonderful people,” she says. “I wouldn’t be where I am today without them, and I have the utmost respect for them. If I could do what they did for me, and help someone as much as they helped me, it would be really rewarding.