Joey Armao's Reflections
Football has been one of the pillars in my life for almost ten years. I started playing Pop Warner Football in fourth grade, and quickly found my positions of choice to be middle linebacker and fullback. In my sophomore year in high school, however, I was pulled up to varsity as the starting middle linebacker, marking the end of my days on the offensive side of the ball. I was glad to make that small sacrifice to be able to spend the year with the Saint Ignatius varsity squad, especially as defense has always been my first love.
The sport has provided me with discipline, inspiration, exercise (too much at times!), and lasting friendships. I have put much into and gotten much out of the game, and I have learned the tough lesson that great rewards do not come without great costs.
On Saturday, October 11, 2003, during a home game against St. Francis midway through my junior-year football season, I sustained a "terrible triad" knee injury. On the third series of the game, a pile of linemen rolled into the outside of my left knee, completely tearing my ACL and MCL, and damaging my Medial Meniscus. Many of my friends have since asked me, "Did it hurt˜a lot?" My answer, of course, is that there was certainly a pain involved, but what really stands out in my memory is the despairing moment, one of those slow-motion realizations, immediately before my knee was forced to "bend sideways." However, in the minutes that followed the injury, pain was not the chief occupant of my racing mind ˆ what stands out more in my memory is the emotional and psychological pain as I instantly thought that I would never play football again. The tears I shed were not from any physical sensation, but rather for the uncertainty of my future with the game that had been such a major part of my life for so long.
An M.R.I. confirmed the suspicions of the Doctors who had initially examined me that I had the infamous triad knee injury. I went to a number of orthopedic surgeons to discuss my recovery options, and nearly all of them assured me that I could play football my senior season if everything went smoothly. I was somewhat encouraged by their words, but felt less and less reassured as I spent the next month immobilized and watching from the bleak sideline as my teammates finished the season. But if I wanted to keep my dreams alive, I had to keep moving toward recovery; thus, I fixed my mind firmly on my distant goal, and refused to let doubts, fears, or frustrations affect my attitude.
I looked into several of the Bay Area's top knee surgeons, comparing their experiences with competitive athletes, surgical methods of choice, and connections with rehabilitation programs. I ended up choosing Dr. Kevin Louie (of California Pacific Medical Center), who specializes in patellar tendon ACL reconstruction, the method considered to be the "gold standard" for athletes. Dr. Louie was recommended to me for his knowledge, skill, and experience, and I have never been anything but thankful that I chose him as my surgeon. On November 19, 2003, Dr. Louie performed my reconstructive surgery, thus beginning my long road to recovery.
Being elected captain by my teammates during the off-season inspired and motivated me to rehab relentlessly and never lose sight of my goal to return to the game at full strength. I had already begun "prehab" with Chris Chorak, the owner/founder of Presidio Sport & Medicine, a physical therapy center that works with most of Dr. Louie's patients. In prehab (before surgery), Chris had me focus primarily on muscular workouts for my lower body in attempt to hold off atrophy as much as possible going into the surgery. I was very limited in what I could do, because in contrast to many ACL patients, I was also battling a completely torn MCL as well as some bone bruising and swelling in the knee joint from the traumatic impact that caused my injury. Thus, my main method of muscular sustenance was straight-leg-lifts. While I did see considerable atrophy in my left leg, Chris helped me to ward off complete muscular deterioration. Now, over a year later, my right thigh is still perceptibly larger than my left, although I am continually closing the gap with squats, plyometrics, sprints, and other forms of training.
A week or so after surgery, I began light rehab with Chris three times a week after school. I remember the day she took my surgery gauze off (about 10 days post-surgery, the first time I had laid eyes on my new Frankensteinian scars). Chris could tell by the cleanliness, healthy coloration, and extraordinarily low swelling that Dr. Louie had done a great job on the surgery, and we were off to a good start.
As my knee progressed, Chris increased the intensity of my visits, each one-hour session consisting of a preliminary stretching/massage/range-of-motion warm-up, a strength or balance workout, and finally 10 to 15 minutes of post-workout "stim. and ice" to keep the swelling down. Chris's exercise routine for me included single leg quarter-squats, single and double leg press, single leg balance on a BOSU ball, and stationary bike work.
During my rehab, I spent many long afternoons in the weight room while my teammates still had the pleasure (as I saw it with my changed perspective) of practicing. I would work my upper body relentlessly, doing every lift I could think of that did not put stress on my knee. I was thus able to keep my blood flowing and maintain general fitness in my state of incapacitation. After surgery, I continued with my independent upper body program, and I also began to perform conservative leg exercises at school. When I did not have rehab with Chris, I worked with my Saint Ignatius school trainers, Marla Bottner and Robert Assadurian, and the head of the strength and conditioning program, Coach Tony Calvello. Marla and Rob helped me stay on Chris‚s rehab program on the weekdays that I did not have appointments at Presidio Sport and Medicine. Marla, Rob, and the school facilities offered me the equipment I needed when I was not with Chris, including electronic stimulation, ultrasound, ice and heat packs, and all the machines of Coach Calvello's weight room.
Thanks to Chris's care and direction, and the support from school trainers and coaches, I improved steadily and unfalteringly through rehab, never experiencing a significant "tweak" or setback. By early- to mid-Spring I was able to jog in a straight line, although I was experiencing difficulties in balancing my gait. It was clear that my stronger right leg was shouldering the workload, as my right thigh would be twice as sore as my left the day after a jog. Chris thus increased left-leg-strengthening exercises in my regimen, which helped to rid me of my running limp and to effectively balance my leg strength (I say effectively, not absolutely, because, as I mentioned earlier, I can still see and feel a slight strength imbalance between my two legs).
Once I was able to jog, my health progressed rapidly. By the beginning of the summer, I was ready to join the football team's morning workouts (7:00-8:30, Mon.ˆThurs. all summer). Head coach Steve Bluford, defensive coordinator John Regalia, and former head coach Joe Vollert ran the majority of the workouts, which consisted of weight-lifting, plyometrics, form-running, agility drills, and speed training. My coaches helped to ease my way into the program, and by mid-Summer I was going full-speed in nearly every exercise, save squats, cleans, and left-legged jumping, all of which I refrained from doing. Overall, our team‚s summer workout program gave me the intense exercise I needed at that point in my rehab to be able to play football the upcoming Fall.
I continued to see Chris over the summer, but our sessions tended more toward stretching, stim./ice, and balance work because I was too fatigued from football workouts to do any more strength training. Dr. Louie all the while corresponded with Chris and scheduled me several checkups to monitor my progress and answer any questions or concerns that arose.
August finally rolled around, and our football team faced the much-feared and long-anticipated "double-days" , two padded practices per day for two weeks. I felt confident and utterly excited to get back to playing football. One of the big issues I faced was whether or not to wear a knee brace. My father and I had long talks with Dr. Louie to weigh the pros and cons of added bulk/support. We concluded that the brace was mainly a mental aid, not a physical necessity; I tried it out the first day, but because of significant discomfort, I stopped wearing it.
Another problem that arose was patellar pain, since the patellar tendon ACL reconstruction method cuts out parts of both the patellar tendon and the patella itself. I could not (and to this day still hesitate to) kneel on my left knee, and with each practice I felt more and more pain in my patellar tendon , a burning sensation accompanied by a stiffness that would hardly abate even with a thorough warm-up. After a couple of days, I began loading up on aspirin, which provided me with perceptible but unsatisfactory relief. I received some help from Marla and Rob, but I decided not to reveal the extent of the pain, lest I be made to sit out practice ˆ and after my experience junior year, I was resigned to never be left watching practice from the sideline again.
After the first week of practice, I found myself very frustrated. My return to the gridiron was not the picture-perfect moment of which I had been dreaming for so long. There were more than a few nights when I found myself thinking, "There's no way I am going to make it through the season, there's just no way." There was nothing more crushing to me than the prospect of having another season taken from me. Everything I had been doing, the main focus of my life for the last nine months, had been working toward my senior football season, and nothing horrified me more than the possibility that nine months of work could be wiped away in a millisecond.
As these menacing thoughts ran through my mind, I struggled to keep them from becoming a reality. I found inspiration in the passion of my teammates and coaches. I had not worked alone during rehab, I had not trained alone all summer, during the long off-season, everything we did, we had done as a team. Now that I felt weak, uncertain, and fearful for the first time in several months, I found strength in the team. Football is a tough game, and no doubt many of my teammates were fighting through pains of their own, so I thus resigned myself to play through my patellar tendon pain and hope that no greater damage would come from it.
From time to time, when my knee was particularly sore, Coach Regalia and Coach Paul Tonelli (my linebacker coach) would notice and make sure that I rested during any parts of practice that would aggravate my knee. This periodic rest, in addition to an increased dosage of aspirin and the end of double-days, was enough to abate my patellar tendon pain to the point where it would not affect my play. Dr. Louie had me fitted with a custom DonJoy knee brace, and we decided that it would be best for me to wear it as an added precaution on game days only. After our first game, I never looked back, expelling thoughts of the injury from my mind to keep myself focused on the season at hand.
Now that I am able to look back, I feel fortunate to have had such dedicated people helping me to return for a great senior season with an amazing football team. Coach Bluford led us to finish second in the highly competitive West Catholic Athletic League, propelling us into the top playoff division in the Central Coast Section. I was named first team all-league and honorable mention all-metro at middle linebacker. I also broke a school record with 135 tackles on the season, and I received St. Ignatius‚s J.B. Murphy Award, which recognizes great on-field effort, leadership, and performance.
What made our season special was that, beyond finishing as one of the top teams in the Central Coast Section, we put our hearts into the game day-in and day-out, forming friendships and creating memories that we will forever retain. I am blessed to have been a part of such a team, and to have benefited by the extraordinary efforts of my doctor, physical therapist, trainers, coaches, and teammates.