Riley’s Story

As 17-year-old Riley Pendleton sprints up and down the basketball court practicing with the Lincoln Prep Tigers, there’s little sign she’s suffered serious back-to-back leg injuries. The brace on her right knee is the only clue.

But it’s taken months of hard work and dedication to reach this point—months that have meant hanging out with her physical therapist, instead of her teammates—months of dedication to the sports she loves, track and basketball.

First time for physical therapy

Riley’s first serious sports injury happened when she didn’t get to properly stretch before running at a track meet in the spring of 2018.

The result was a painful strain to her left quad muscle. The injury put an end to her spring running season, but served as her introduction to Sports Medicine at Children’s Mercy.

“I first met Riley when she came to Children’s Mercy to rehabilitate her quad strain,” said Julie Perrini, DPT, ATC, physical therapist with Sports Medicine. “She is a very competitive track athlete, but after about a month of traditional therapy, she had some trouble regaining full use of her quad.”

To get Riley back on course, Julie worked with her at the Children’s Mercy Adele Hall Campus where the therapy pool floor can be adjusted to different depths.

“Riley was having difficulty performing specific exercises on land, like lunges and squats,” Julie said. “Exercising in the pool helped her get into running form quicker.”

Accelerating recovery with dry needling

As part of her therapy, Julie also recommended Riley try dry needling to loosen her quad up, and help her regain its full use.

Dry needling involves a small, solid microfilament needle which is inserted into a trigger point by a trained physical therapist. A trigger point is a tight spot within the muscle tissue that develops due to injury, overuse or dysfunction.
Dry needling can decrease pain, reduce muscle tension and improve range of motion, allowing the therapist to target issues that cannot be felt manually.

“It only took a couple of dry needling treatments to improve the flexibility in Riley’s left leg,” Julie said. “Following the treatments, she was able to do deeper squats and lunges, and progressed quickly to return to running.”

“Dry needling helped my quad a lot, and I recovered quicker,” Riley said. “I really liked it.”

In all, Riley worked with Julie for five months, from April to October 2018, rehabbing her quad and meeting her goal to be ready for Lincoln Prep’s 2018-19 basketball season.

A season-ending lay-up

Julie went to see Riley play at one of her first basketball games of the season, and she looked great! But on Dec. 12, 2018, that all changed for the guard.

“I was making a lay-up when the center from the opposing team made contact with me under the basket while trying to block the shot,” Riley explained. When she landed, Riley felt her right knee pop, and she was on the court in pain.

“I hoped I had just tweaked it,” Riley said. “Our athletic trainer was at the game and took a look at it immediately.”

“I iced Riley’s right knee for about 10 minutes, then re-checked it,” said Mary Helfer, ATC, the certified athletic trainer from Children’s Mercy based at Lincoln Prep.

“Unfortunately, it was obvious that she had really injured it.
“Having an athletic trainer on site is key when a student-athlete like Riley is injured,” Mary added. “I scheduled an appointment for her the next day with Children’s Mercy Sports Medicine. That immediate medical assessment is key to prompt treatment.”

After seeing Brian Harvey, DO, Children’s Mercy primary care sports medicine physician the next day, Riley headed to physical therapy for crutches training.

“I went to the front desk to help the next patient with training,” Julie said. “I was surprised to see it was Riley. I was disappointed she had been injured, but was glad that I would get to work with her again.”

On Jan. 2, 2019, Riley underwent an MRI that confirmed she had torn her anterior cruciate ligament, or ACL. The cruciate ligaments control the back and forth motion of the knee. The ACL also provides rotational stability for the other structures in the joint.

Donna Pacicca, MD, the Children’s Mercy orthopedic surgeon who saw Riley, thought she also might have torn her meniscus.

The meniscus is one of two wedge-shaped pieces of cartilage that act as "shock absorbers" between the thighbone and shinbone. The menisci are tough and rubbery to help cushion the joint and keep it stable.
While Riley waited for surgery, Julie helped her deal with the new injury, this time working to regain range of motion and strengthen her right leg in preparation for the ACL reconstruction.

Riley’s rehab

Feb. 14, 2019, was a big day for Riley, but not because it was Valentine’s Day. That’s the day Dr. Pacicca reconstructed her torn ACL and meniscus in an outpatient procedure at the Children’s Mercy Adele Hall Campus.
Following surgery, Riley was anxious to start rehabbing her knee, but because her meniscus tear was so severe, she couldn’t bear weight on her leg for two weeks.

When she did start therapy again, Riley struggled to bend her right knee. “When a patient has a meniscus tear, getting that range of motion back can be difficult on land, so we went back to the pool,” Julie said.

“The pool is warm and the buoyancy of the water helped Riley perform normal exercises, like squats and lunges, quicker than she would have been able to on land,” Julie explained.

“We also have basketball hoops in the pool that simulate shooting baskets. That makes the experience feel more competitive for someone like Riley.”

After therapy sessions once a week for the first six weeks following surgery, Riley progressed to therapy twice a week, and Julie continued adding more and more difficulty to her workouts. “Riley definitely became more driven once I put a basketball in her hands,” Julie said.

“My favorite drill was when Julie would take a resistance band and we would both get in it, then we would take turns getting into a defensive squatting position and would try to take the ball from one another,” Riley said. “That drill put me back into the basketball mindset.”

Over a 30-week period, Riley’s therapy advanced gradually. She had BioDex testing at regular intervals at Children’s Mercy Sports Medicine at Village West. BioDex is a high-tech device used to evaluate strength, endurance, power and range of motion of the major joints and muscles in patients before surgery and after rehabilitation.

Though at times, Riley wasn’t sure she’d be ready for this year’s basketball season, by the end of September, she realized she would be able to play again. “When we started working more on agility and jumping, I got the confidence back in my knee,” she said.

Back on the court

Riley credits Julie with helping her recover from both her quad and ACL injuries.

“We had a really good working relationship, and I feel like that helped me to recover,” Riley said. “Julie pushed me to work harder than I wanted to. She wouldn’t let me mentally check out.”

“I can definitely empathize with Riley,” Julie added. “I played competitive soccer in high school and suffered a concussion that took me away from the field for several months. It’s tough to have something you love so much stripped away, especially for someone with such a competitive spirit.”

But Julie said Riley also faced rehab with a great attitude that helped her throughout the process.

“Riley always came to her therapy sessions ready to work. She is fun-spirited and outgoing. She would come into rehab, introduce herself to the other therapists and ask them how they were doing. She showed a genuine interest in everyone here. That says something about her personality.”

Riley’s rehabilitation sessions with Julie officially ended in October, and she began working out with her team in early November. “I feel like I’m at 80 percent compared to before the injury,” Riley said. “I’m continuing my therapy exercises at home. Working out with my team will help me get back to playing competitively.”

For now, Riley is only practicing with the Tigers. She hopes after the first of the year, Dr. Pacicca will clear her to return to play.

“I feel like my team really needs me,” Riley said. “Last year, we went to state, but finished a runner-up. In addition to myself, we had two other key players injured. If I had been able to play, I could have helped my team. That’s what I want to be able to do this season.”

Beyond high school, Riley hopes to attend college, perhaps running track or playing basketball if she can, but her ultimate goal is to one day become a physician herself.

“I used to think I wanted to play ball professionally, but I’ve changed after this experience,” Riley said. “My favorite courses in school are biomedical. I want to pursue pre-med.”

Julie said Riley has shared her goals with her, and she supports her ambitions.

“The thing that impressed me most about Riley was that in spite of the fact that she knew she had a tough road ahead, she always kept working. She is a very resilient person, and that will serve her well in sports, and in life.”