Sophisticated treatment program helps young athletes recover from ACL injuries
Like many 12-year-old boys, Eric Agamaite loves to play sports outside and video games inside.
Soccer, basketball and football are his favorite sports, and he rattled off the “Call of Duty” and “Assassin's Creed” franchises as being among his favorite video game titles.
Last August, Agamaite ruptured his anterior cruciate ligament at a soccer clinic before tryouts for North Allegheny's Marshall Middle School team. He underwent surgery on his right knee in September, and since October he has been rehabbing with the help of those at The Children's Institute of Pittsburgh's satellite facility in Wexford.
There, Agamaite has participated in all sorts of rehabilitation activities, which range from the traditional to the new-age. One advanced tool he uses is the Interactive Metronome, a sophisticated, computer-based program that emits a steady beat to which he must make various toe-tapping responses, all while a soccer game measures his results on the screen in front.
The Interactive Metronome is a little like the Nintendo Wii — which also gets some play by individuals at the Wexford branch — and that helps make it an effective instrument for a youth like Agamaite, whose ACL injury is part of a larger, alarming trend seen throughout youth sports.
“I've enjoyed it,” Agamaite said of his rehab process. “I mean, it's pretty goal-oriented. I've had lots of stuff to strive for. They give me specific guidelines and say what I need to do every week.”
In October 2011, researchers from the Children's Hospital of Philadelphia presented findings that suggested a more than 400 percent increase in sports-related knee injuries — including ACL issues — suffered by children and adolescents at their institution over the previous decade.
During surgery and rehab, ACL damage in young people presents unique challenges to medical professionals, who face the risk of disturbing the growth plate in the knee. Not many physicians would operate on Agamaite without going through his growth plate, but Dr. Jan Grudziak of the Children's Hospital of Pittsburgh was one of them.
While the Agamaites did not take the decision to have surgery lightly, Eric couldn't bear the alternative.
“There was no way I was going to stay out of sports for as long as I needed to so I could grow enough,” he said. “I would have been waiting three years to get back into sports.”
To reach that goal, Agamaite has physical therapy at the Wexford facility twice a week and performs exercises at home during the other five days. He works with Janice Belt on Mondays and Stephanie Brink on Thursdays.
His treatment includes stretching and testing, as well as sessions on the Interactive Metronome and time spent in the Universal Exercise Unit, a versatile apparatus that's common in Europe but rare in the United States. The presence of those two devices demonstrates the Wexford satellite's commitment to providing the best care for its young clients, who generally receive one-on-one attention.
“I think we try to actively seek out modalities or equipment or things like that that are kind of on the cutting edge,” said Ellen Kaminski, the physical therapy coordinator. “You have to be really creative, so I think that's what we do, is try to be creative and maybe break down their sport's skill, if they can't do the whole sport yet, into smaller things.
“We really do our best to bring the fun into therapy as well.”
For Agamaite, treatment also includes agility and other soccer-specific drills. There's plenty of cardio involved, making his sessions similar to practice, and he certainly appreciates that.
“We have ways to get the kids engaged in a manner where they'll want to participate and find it's enjoyable to come to therapy,” Belt said. “Eric is a hard worker. Not many kids will work as hard as he does.”
Staying motivated can be difficult, but it's crucial for those rehabbing an injury. Agamaite is determined to participate in a soccer camp this coming July. He often thinks about how nice it will be to return to the sport he loves most.
Video games have kept Agamaite entertained during his recovery, but he can't wait to play soccer again.
“I'm hoping to be better than ever when I get back,” he said with a grin.
Mark Emery is a freelance writer.