Four Games

For only four games, she felt like she was on top of the world; after one game, she was right back to where she started.

February 24, 2015

Laflammes+hospital+bracelets+over+her+three+surgeries.

Mia Laflamme

Laflamme’s hospital bracelets over her three surgeries.

“I tore it my third time, the fourth game into our season.”

Those four games meant the world to junior Mia Laflamme, because it only takes one game to take it all away. If anyone knows that, it’s her.

She’s been fighting a battle with her anterior cruciate ligaments (ACLs) since the eighth grade, keeping her from the sport she loves ever since she stepped foot in Biddeford High School. Her comeback was short-lived when she was finally able to play BHS soccer for the first time this past year, making it only four games into the season before she tore her right ACL again.

By the third time, Laflamme was a bit of a professional with dealing with torn ACLs, explaining that even after tearing the second one, she knew exactly what it felt like and recognized it immediately.

“You’ll never forget the feeling when you tear it in your whole life…if I tear it again I’ll know the exact feeling,” said Laflamme. “It’s this weird feeling that you won’t know until you tear it…and when it happens again you’re like ‘holy, that just happened again.’”

Those three moments of indescribable pain, a feeling Laflamme relates to “that instant relief” when you crack your fingers followed by “burning in your leg,” marked the beginning of a long road of surgeries, physical therapy, and games spent on the sidelines.

Laflamme’s mom, Judy Laflamme, who tried to help her daughter through this entire three–year process, found it particularly difficult to try to console her daughter who no longer felt like an athlete.

“Trying to be there when she didn’t feel part of a team anymore because she couldn’t practice nor play games with them was so emotionally draining,” said her mom. “She often felt left out of events because she could not physically participate…and as much as I would try to do things with her, it still did not make up for the fact that she could not fully participate as she would have liked to.”

Laflamme explains that because she was not being able to physically play soccer, the dynamic between her and her teammates completely changed.

“It’s a different feeling, you sometimes feel excluded because they have their cliques and they don’t mean to, but you’re always the one carrying the bags for them, they kind of want you to fill their waters and they expect it,” said Laflamme. “You kind of feel like a carpet, you get walked on a lot, and you don’t really feel apart of the team because they try as much as they want but you’re kind of distant.”

Sitting on the sidelines is a result of the ACL reconstruction surgeries that followed her first two tears, one on the left leg and the other on the right leg. Laflamme’s orthopedic surgeon, Dr. F. Lincoln Avery, explains what the routine ACL reconstruction surgery looks like.

“There are two basic parts to the procedure…one is procuring or preparing the graft tissue that is going to be used to reconstruct the ACL,” said Dr. Avery. “There are a variety of tissues from the patient they can be used such as patellar tendon or hamstring grafts.”

Dr. Avery explains that most of the time, the ACL must be reconstructed from other tissues because the torn ACL is typically unrepairable. For the next part, they must drill a hole into the knee where the ACL originally was and insert the graft into the tunnel, locking it into place with dissolvable screws.

Laflamme’s third surgery on her right knee, called ACL revision surgery, corrects the already reconstructed ACL and is much more complicated. This surgery uses other ligaments to fix the reconstructed ACL. Dr. Avery stresses that this surgery is very technical and difficult to perform.

“Because the positioning and orientation of the graft is so critical to its success, the general recommendation is that the surgeon needs to be doing at least 100-150 of these surgeries a year to be competent doing these accurately,” Dr. Avery said.

There are also many obstacles that surgeons face when performing this operation, most of which are a result of the fact that this is the second surgery on the same part of the body.

“Now there may be screws to remove, holes in the bone left from the dissolved screws, and very often malpositioned former graft tissues,” said Dr. Avery. “This can lead to intersecting drill holes that then makes positioning and fixation of the new graft difficult.”

Along with problems about repositioning the new ligament, Laflamme says finding a new ligament to help repair her ACL was difficult.

“For my first two I used the patella ligament, but for the last one I didn’t have enough in there so they were going to do a hamstring graft,” said Laflamme. “When they went to go get my hamstring out of it, it wasn’t strong enough or long enough…so they took a cadaver ligament, and they didn’t know what it was.”

In Laflamme’s case, her ACL didn’t tear completely the third time, but the same procedure applies. Dr. Avery, who only performed her ACL revision surgery and not her first two surgeries, still had to repair her reconstructed ACL.

“They think maybe the surgery wasn’t done right [the second time],” said Laflamme. “They don’t know exactly what happened, but it just kind of popped out of the top, so it never actually tore the ligament, but they still had to go in and fix it.”

Dr. Avery says that it is highly unlikely that an ACL reconstruction surgery would go wrong, as the majority of the thousands that he’s performed have been successful. However it is possible.

“For someone like myself who performs these surgeries regularly, the outcomes are around 96% in terms of successful return to the activities that the athlete was doing pre-injury,” Dr. Avery said.

Additionally, Dr. Avery thinks that it is fairly unlikely that someone will tear the ACL multiple times, and also knows that there are many long-term effects when that happens.

“Theoretically the new graft is stronger than the original ACL, so we don’t think of a successful surgery as being at a huge risk of re-injury,” said Dr. Avery. “Repetitive re-injuries and re-tears can lead to permanent damage to the knee…and subsequent arthritis and disability.”

Laflamme is also at a greater risk of tearing an ACL in the first place due to the fact that she is a women. Females are born with wider hips than males, and therefore put more weight on their hips than their knees. This makes females’ knees much weaker than males’, and along with the rapid increase is the amount of female athletes, it’s much more likely for females to tear an ACL.

“Over the decades we are seeing more female injuries obviously as well,” said Dr. Avery. “Re-tears are acute problem if they occur and we tend to see more recurrent tears again in the female population, particularly soccer and basketball players.”

The next step for Laflamme was physical therapy, which took up the most time in her road to recovery. However, the length of time varies from her first two surgeries and her third one.

“The other two were six months, and this one, they were talking about it being ten, but it’s more going to be…about six to seven months…since I’m on a really good track right now and my knees are really strong,” explained Laflamme. “It heals in six but they wanted to give this one some extra time.”

That six to ten months consists of stages of rehabilitation, starting with the simplest of tasks administered by physical therapists (PT) like Mike Hersey, of Sports Performance Center, who was Laflamme’s PT for her injuries.

“Initially the focus is on range of motion and what we call neuromuscular re-education,” said Hersey. “After an injury the brain and muscles are not working like they used to so we do exercises to facilitate muscle activity.”

To increase range and motion, Laflamme says she did “little things like just being able to lift up your leg, trying to get your legs straight, [and] trying to get your leg bent 90 degrees.” She did this, she says, “because you haven’t used it in a week and you’re not going to be able to walk on it for awhile, so they want to keep it at least mobile.”

The next phase focuses on “slowly bringing up your strength,” says Laflamme, which then leads into “more intense things like incorporating more of your body and movements,” by doing exercises like stairs, squatting, jumping, and landing.

“Then we focus on running and agility to return to prior level of activity,” Hersey said.

In Laflamme’s case, she went through physical therapy for two different surgeries, but Hersey does not typically change his workout routines drastically from an ACL reconstruction to an ACL revision surgery.

“It is really an individual basis… [and] depends on why they had the revision to begin with and the type of ACL graft that was used,” said Hersey. “We definitely spend a lot more time focused on mechanics the second time around.”

Along with problems with mobility, Hersey sees emotional damage with ACL patients, especially athletes, making his job about more than exercises and physical improvement.

“It is difficult…athletes want to be on the field or court [and] are frustrated and scared usually, [which] are normal feelings to have,” said Hersey. “We focus on reassurance that they are going to be fine and try to have them focus on rehab as a sport with goals to attain.”

Laflamme’s mom noticed that her daughter carries this emotional baggage through her injuries and reinjuries.

“The emotional impact of these ACL tears on her have been very difficult,” said her mom. “Mia was an incredible athlete, and she still is, but the emotional toll she has endured knowing she cannot kick the ball or run like she used to was very difficult on her.”

Her mom also noticed that her daughter was very tough on herself for not being able to play for BHS Varsity Girls Soccer, and as a result, she was asked to keep a close eye on her daughter.

“She often felt like she let her team down and she would get very frustrated at games knowing she used to be able to help her team out when they were not doing well in a game and now she could just sit and watch and give verbal encouragement instead,” said her mom. “We were asked to watch for signs of depression in her and were told she may need counselling to help her through this difficult emotional time, but Mia amazed us all with her strong determination and positive attitude.”

Her moms says that Laflamme wasn’t the only one who was affected emotionally, and that the entire family reacted differently to her injuries. Being a mother, it was a difficult thing to endure.

“It was heart-wrenching to see my daughter in so much pain, both physically and mentally,” said Laflamme’s mom. “As a mother, you want to be able fix things for your children and let them know things will be all right, yet there is nothing I could do to fix her knee and her dreams of becoming a college and possibly a professional athlete…[which] were dashed more and more with each ACL tear.”

Though it might be difficult to see the light at the end of this tunnel, her mom says that there have been some positive things that have come from this traumatic series of events.

“By having endured this much struggle and heartbreak at such a young age, yet overcoming the pain of crushed dreams, she has found that even though life may not work out as you planned, you can find something in the misfortune that leads to another dream,” her mom said.

Nonetheless, her mom is extremely pleased with everything that Laflamme has accomplished and “the amazing struggle” that she has overcame time and time again.

“I am always proud of my daughter in anything she does, but I am especially proud of the young woman she has become because of all these ACL injuries,” her mom said.

That transformation she can credit to the three-year process that changed more than the strength of her ACL.

“Things happen for a reason, and I believe Mia will do amazing things with the life lessons she has learned through her injuries,” said her mom. “It is in the journey that you find your strength, and my daughter has found amazing strength in her journey.”

And for Laflamme, her journey doesn’t stop with those four games.

“People are always asking ‘are you going to play again?’ and I’m like ‘this is my senior year, I want to play one more time, if I tear it again I tear it, but I have to go out with a bang,’” said Laflamme. “I just take it like you want to live everyday, and I can’t hold back.

Leave a Comment

The Roar • Copyright 2024 • FLEX WordPress Theme by SNOLog in

Comments (0)

The Roar intends for this area to be used to foster healthy, thought-provoking discussion. Comments are expected to adhere to our standards and to be respectful and constructive. As such, we do not permit the use of profanity, foul language, personal attacks, or the use of language that might be interpreted as libelous. Comments are reviewed and must be approved by a moderator to ensure that they meet these standards. The Roar does not allow anonymous comments, and The Roar requires a valid email address. The email address will not be displayed but will be used to confirm your comments.
All The Roar Picks Reader Picks Sort: Newest

Your email address will not be published. Required fields are marked *