Athletes with devastating injuries safely return to sports through innovative program

Vanessa Fry was getting ready for a race at Louisiana Downs in Shreveport when the young jockey’s horse threw her into a metal rail. “My hip and my femur broke in three places. Everything that touched the metal railing splintered.”

She needed three operations. Not only was her career as a jockey on hold — she couldn’t exercise like she used to. No more seven-mile runs. “My whole life I was an athlete, and I was no longer an athlete. So that was hard to take.”

Oceanside High School soccer star Korbin Heyward could relate. The Charleston, South Carolina, athlete was at a tournament in Texas when she took a hard hit. “I was in my national finals game when I got kicked right on the side of my knee, and my knee shifted in. I heard three pops, and it pulled,” she said.

“I dropped. I got up and tried to walk, but I dropped again. So I knew something was wrong.”

 

Something was very wrong. Her ACL, a ligament that stabilizes her knee joint, and her meniscus, the cartilage that serves as a shock absorber for the knee, were torn. “I thought I would never walk again.”

But both she and Fry, the jockey, were resilient. They endured medical procedures and did physical therapy.

However, they would need something extra to feel whole again. It would come in the form of a new program that got a boost when it caught the attention of judges at the Medical University of South Carolina’s version of the TV show “Shark Tank.” Employees pitched ideas to judges, who included hospital leaders. The winners walked away with funding.

The pitch

Physical therapist Stephanie McGowan, an assistant professor in the Department of Rehabilitation Sciences in the College of Health Professions at MUSC, made the winning pitch for what’s become known as the Bridge Program. It’s a science-based, transitional program for injured athletes who finish traditional physical therapy — but aren’t ready to safely return to sports.

Bridge Program therapists use technology and physical tests to analyze their patients’ movement and performance. That lets them tailor the rehab to the athlete’s needs, reducing the risk of reinjuring the part of the body that was hurt — or suffering an entirely new injury.

McGowan knows firsthand how important sports are to athletes. “I played lacrosse and field hockey. Then after college, I did long distance running — marathons.”

 

She turned her love of sports into a career, earning a doctor of science in physical therapy degree so she could teach students and see patients. McGowan said being an athlete has multiple benefits.

“Exercise tempers obesity and improves cardiovascular health, and the motivation athletes receive from being part of a larger peer group cannot be matched in individual training. Exercise through sport is healthy play time, and often outdoors, which provides unparalleled mental health benefits.”

So embracing a national trend toward data-driven, specialized physical therapy for athletes was a natural next step for McGowan. At MUSC’s Shark Tank competition, she and her team won $15,000 to help turn her idea for the Bridge Program into reality. And the good news didn’t stop there.

High-tech help

“The College of Health Professions’ physical therapy division matched that $15,000, which allowed us to purchase a portable 3D motion capture system. This system lets us analyze an athlete’s movement in three planes, which helps us make decisions about the focus of future rehabilitation and provides key information about whether an athlete is ready to return to sports safely,” McGowan said. 

 

“While the athlete performs a sport-specific task, an avatar appears on the physical therapist’s monitor so changes can be monitored in real time. The portability means that we can perform this analysis on a football field, a volleyball court or a trail run, and we don't need to be in a research lab setting to do that.”

That’s not all that makes the Bridge Program stand apart, McGowan said. “We’ve incorporated multiple outcomes tools from the latest evidence in the field of ‘return to play’ progression and testing.”

That includes:

• The Biodex for isokinetic testing. It isolates muscle groups to look for imbalances and asymmetries.
• Functional movement screen tools, such as the Y balance and inline lunge device. They assess single limb flexibility and stability.
• Blood flow restriction training cuffs. They work like temporary tourniquets, reducing blood flow to a targeted area. When used during exercise, they can improve muscle strength with lighter loads than normally used and help minimize the kind of atrophy typically seen after surgery.
• Self-reported outcome tools such as the Tampa Scale of Kinesiophobia and the ACL Return to Sport survey. “They really tap into how the athlete feels about returning to play,” McGowan said.

The Bridge Program also emphasizes teamwork. “We've got the athlete, parents, coach, trainer, physician and physical therapist involved in decision-making. And we've taken most of the guesswork out of it since we are using the latest science in the field to ensure our athletes meet certain criteria before heading back to play too soon,” McGowan said.

Returning to play

Six years after she was thrown from her horse at a Louisiana race track, Vanessa Fry moves with the grace of the athlete she’s returned to being. At a recent visit to a physical therapist at MUSC Health, Fry jumped in and out of what looked like a train track on the floor. “It’s called ladder drills,” she said.

She made it look easy. And while she hasn’t returned to horseback riding yet: “I’m eager to. I’m ready to test these legs out.”

 

Fry has been able to return to running and even doing obstacle course races, which was part of her goal. And she’s using her experience to help others. She earned a physical therapy degree from the College of Health Professions at MUSC and works with patients at the Ralph H. Johnson VA Medical Center in Charleston. 

Heyward has returned to play, too. Now a high school senior, she plans to stay on the soccer field in college. She, too, recently returned to MUSC Health.

McGowan put 3D sensors on Heyward to measure her progress. “We start with a walking calibration so the system can recognize her body structure and make an avatar of her. This is similar technology used to create action films,” McGowan said, as Heyward moved around the therapy room.

“All right, you’re ready to go. Let’s go right over to the jump box here. All I want you to do is step off the box, land in a squat, then go up and land in a squat again. Pick a leg, any leg,” McGowan said, as Heyward easily moved up and down.

The physical therapist watched on a computer monitor as the motion capture system did its work. “That’s her avatar and there she is. There are all of the data points I’m collecting along the way that indicate the direction and amount of motion of her lower limbs while she’s performing each task. The system collects the data that I tell it to collect.”

Heyward credited the program, including its group therapy option, with turning what could have been a career-ending injury into a temporary issue. “Honestly, I feel great.”

McGowan called helping athletes such as Heyward and Fry return to intense physical activity richly rewarding. “Being able to help them and being a sounding board, a safe space — just being that place where they can come in and just let loose. And also, being the person who lifts them and keeps them going. It's a lifelong relationship.”