After season-ending ACL injury, Boston skier is Olympics-bound

ACL tear

What happens when an adrenaline-addicted athlete slows down?

Julia Marino thrives at high speed and from great heights. In 2009, 17-year-old Julia was at the top of her game. Coaches and fellow slopestyle skiers had pegged her as a rising star on the World Cup circuit. Salomon, a top winter sports gear manufacturer, had signed on as her sponsor. Then, during the first event of the season, she crashed.

Crashes are common in slopestyle. Skiers hit jumps at speeds up to 35 miles per hour, flying up to 50 feet in the air to perform aerial tricks.

Julia landed awkwardly on one ski, heard a resounding pop in her left knee and felt the “most intense pain” of her life. She braced herself and skied to the medical tent.

The on-mountain medical crew insisted she wasn’t injured. But Julia and her mother doubted the diagnosis.

An MRI at Boston Children’s Hospital confirmed the family’s worst fear. Julia had torn her anterior cruciate ligament (ACL), and her season was over. Although Julia wanted immediate surgery, Martha M. Murray, MD, orthopedic surgeon and co-director of the Female Athlete Program at Boston Children’s, advised waiting several weeks until the swelling subsided before undergoing ACL reconstruction.



Prescription for patience after ACL tear

Murray’s medicine was a bitter pill for Julia. Competitive athletes, anxious to return to their sport, often push for fast-track treatment and accelerated rehabilitation.  Murray recommends a more gradual approach, focusing on long-term recovery and re-injury prevention.

“When a competitive athlete like Julia is injured, we have to focus on making sure she can return to her pre-injury performance level. Elite athletes are typically eager to get back to their sport. It’s our job to help them hold off until they are strong enough,” says Murray.

She performed Julia’s ACL reconstruction six weeks after the injury and recommended an extended rehabilitation, lengthening the conventional three-week course on crutches to four weeks.

“I trusted her,” recalls Julia. She complied with the doctor’s orders and focused on physical therapy and training to rebuild her strength and reduce her risk for future injuries.

Doctor and patient formed a new team that included Christopher Haslock, Julia’s coach, and Eric Kaloyanides, Julia’s trainer and owner of AthleticEvolution.

Six months after her surgery, Julia underwent functional strength testing to assess her ability to return to skiing. Murray cleared limited off-season training in the summer of 2010, but restricted her time on skis. “It was difficult to stay on the sidelines, but I had seen what happens to athletes who come back too soon,” says Julia.

Inside slopestyle

Although slopestyle is an individual sport, competitors are often friends, and a team-like camaraderie permeates the slopes. Athletes are linked by their love for the sport, commitment to intense training and shared aches, pains and injuries.

Slopestyle skiers, particularly females, face high risk for ACL injuries, because the sport requires competitors to land hard at high speeds. If a landing is just the slightest bit off, the knees may twist and pivot, which are classic risk factors for an ACL injury.

Another common risk factor is skiers’ dogged pursuit of on-snow training and relative lack of strength and balance training. “Building up total body, core strength and balance can help the body better absorb impacts,” says Kaloyanides.

Julia had watched dozens of skiers grapple with ACL injuries and recovery, with many re-injuring the torn ACL or opposite knee. A handful of her friends have had four or more ACL tears.

She hoped that by taking it slowly she could avoid re-injury.

The payoff

By 2012, Julia had regained her strength … and then some, nabbing second place in the Freestyle Ski World Cup Finals in Sierra Nevada, Spain, in March 2012.

Now her sights are set on the Sochi 2014 Winter Olympics as a member of the Paraguay ski team and what she calls, “the biggest season of my life.”

As Julia chases her dreams, Murray reveals her take on why she reached new heights on the rebound. “She’s a surgeon’s dream come true. She has worked incredibly hard to strengthen and return to skiing. Her hard work makes her successful.”

Request an appointment with a specialist in the Boston Children’s ACL Program.