Warrior Girls: Protecting Our Daughters Against the Injury Epidemic in Women's Sportsby Michael Sokolove
Amy Steadman was destined to become one of the great women's soccer players of her generation. "The best of the best," Parade magazine called her as she left high school and headed off to the University of North Carolina. Instead, by age twenty, Amy had undergone five surgeries on her right knee. She had to give up the sport she loved. She walked with a/i>
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Amy Steadman was destined to become one of the great women's soccer players of her generation. "The best of the best," Parade magazine called her as she left high school and headed off to the University of North Carolina. Instead, by age twenty, Amy had undergone five surgeries on her right knee. She had to give up the sport she loved. She walked with a stiff gait, like an elderly woman, and found it painful to get out of bed in the morning.
Warrior Girls exposes the downside of the women's sports revolution that has evolved since Title IX: an injury epidemic that is easily ignored because we worry that it will threaten our daughters' hard-won opportunities on the field. From teenage girls playing local soccer, basketball, lacrosse, volleyball, and other sports to women competing at the elite level, female athletes are suffering serious injuries at alarming rates.
The numbers are frightening and irrefutable. Young female athletes tear their ACLs, the stabilizing ligament in the knee, at rates as high as eight times greater than their male counterparts. Women's collegiate soccer players suffer concussions at the same rate as college football players. From head to toe, female athletes suffer higher rates of injury, and many of them play through constant pain.
Michael Sokolove gives us the most up-to-date research on girls and sports injuries. He takes us into the homes and hearts of female athletes, into operating theaters where orthopedic surgeons reconstruct shredded knees, and onto the practice field of famed University of North Carolina soccer coach Anson Dorrance.
Exhaustively researched and strongly argued, Warrior Girls is an urgent wake-up call for parents and coaches. Sokolove connects the culture of youth sports the demands for girls to specialize in a single sport by age ten or younger, and to play it year-round directly to the injury epidemic. Devoted to the ideal of team, and deeply bonded with teammates, these tough girls don't want to leave the field even when confronted with serious injury and chronic pain.
Warrior Girls shows how girls can train better and smarter to decrease their risks. It makes clear that parents must come together and demand changes to a sports culture that manufactures injuries. Well-documented, opinionated, and controversial, Warrior Girls shows that all girls can safeguard themselves on the field without sacrificing their hard-won right to be there.
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Amy Steadman was no cosseted suburban child. She grew up in the far western part of North Carolina amid scenic waterfalls and rugged rock formations, an excellent setting for a girl of her temperament. "She was wired at birth," her father, Ned, a high school science teacher, recalls. "She was inconsolable until she could walk, and as soon as she could walk, she ran. If she saw a hill, she took off and sprinted up it. It was just something within her."
Three-hour car trips took six hours because of the stops required to give her time to burn off energy. Her birthday parties were always the same: an overnight camping trip to a favored spot where she liked to dive off a fifty-foot ledge into a lake. For show-and-tell one day in the fourth grade, she came dressed as the football coach Knute Rockne. She begged her parents to visit the campus of Notre Dame, in South Bend, Indiana, until they finally relented. "She wanted to see the temple of football," her father says. "She loved football. She would have played that if she could."
She played sports in the school yard with friends, often as the only girl, and was not happy unless she returned home scraped up and caked in mud. She joined her first organized team in fourth grade, a boys' squad because her area had no girls' soccer, and it was not long before the coach was telling her parents they needed to find her a higher level of competition.
Don Scarborough, a college soccer coach who happened to be coaching Amy because his son was on the team, believed she played as if the game had been preprogrammed into her. "It was almost like she could play soccer before she ever got on a soccer field, you know what I mean? You could throw a ball at her feet or body or head and she intuitively could handle it. She didn't need to train to learn a skill; she got it the first time. She needed something beyond what our county parks-and-recreation league could offer her."
Ned Steadman had run track and was still an avid hiker, but neither he nor his wife, Carol, had ever been high-performing athletes. Their daughter was a marvel and a mystery to them. Where had she come upon those bountiful gifts? Carol's father and two brothers were good ballplayers, so the Steadmans joked that maybe the athletic genes had skipped a generation and Amy got them.
At first, they had had no interest in rearranging their lives just for the sake of Amy's soccer. They had another child, a younger son. Ned had his teaching, and Carol worked as an aide at the local elementary school. It took two years for them to finally put her into a girls' league in Asheville, which was forty-five minutes away. There they almost immediately began to hear the same refrain from coaches: This isn't enough for her. You need to put her with better players.
"It all began mushrooming," Ned Steadman says. "Other people saw what was coming way before we did. She was probably in the third grade when the pediatrician said after he examined her, 'I'll see you in the Olympics.' I said, 'Please don't say that.' I'd been around high schools and heard that said of kids, and it was never true."
In junior high school, Amy began playing for the Greensboro Twisters, a top club team halfway across the state, two and a half hours away. By the time she reached high school, she was playing for a team in Atlanta, four hours away. Don Scarborough teased Ned: "You didn't want to take her to Asheville, and now Amy's playing in Atlanta?"
Ned Steadman took most of those long drives with his daughter all through the Southeast and as far away as Dallas. He would try to talk about the game on the way home to rehash and analyze it and perhaps learn more about a sport he knew little about but she was rarely interested. Sometimes Amy would say, "I played OK," which Ned learned to translate as "I played great." Usually she was quiet in the car. She listened to music on her headphones or slept. It was not false modesty on Amy's part or even teenage sullenness. She was spent. And truly not interested in the periphery of sport, the rankings and the awards and accolades. That was for others. For her, it was all about the personal competition, not the postgame commentary.
Ned and Carol Steadman were immensely proud of their daughter's accomplishments but ambivalent about her fierce independence. They certainly had not pushed her into soccer, and she was the opposite of one of those kids of whom you had to wonder, Is she playing to please her parents or because she truly loves it? She loved it.
But as Amy rose into the elite levels, she inhabited a world her parents could not enter. She was guided by coaches, mentors, and her own passion. It was not that different from what happens with a lot of good young athletes as they climb the ranks of their sport their decisions, increasingly, are directed from outside the home. Often mothers and fathers hesitate to be too involved, not wanting to be seen as clamoring or insistent as stereotypical sports parents. It is a difficult thing to balance: coaches may know a sport, but they are rarely the best judges of what is best for a child.
The Steadmans watched and listened from a respectful distance, picking up what they could. Amy was not a mystery to them: they knew what she cared about and what motivated her; they knew that her deepest passion was her sport. It was just that she kept the details to herself. "We didn't know too much about the soccer," Carol said. "She was her own person." Ned adds, "That's the way she wanted it, and we respected that."
The local newspapers the Transylvania Times in her hometown of Brevard and the bigger Citizen-Times in Asheville picked up on her story as she began to climb the ranks of U.S. soccer and make national teams. "She Packs a Big Kick," one of the headlines said. After she set conference records at a track meet and was named "high school athlete of the week," the story noted how remarkable her performance was, considering that all her soccer travel barely left her time to train for sprinting. She just dropped in on track meets and dominated.
Amy, as always, was thoroughly unimpressed by it all. She cared about the next game, about winning every single "one v. one situation," as she called them every race in which she and an opponent were in furious pursuit of the ball and the victor would be determined by speed and heart. That's what soccer was for her: one challenge after another, each of them deeply personal. "All those write-ups and other hoo-hah, they don't mean anything," she told her father. "They don't get you playing time."
Anson Dorrance loved everything about Amy's game. "Her discipline was off the charts," he says. "She had speed and a high pain threshold. She took physical risks she was fearless. This is a positive problem. You want players who are hell-bent for leather. And she had a sophistication to her game. She knew how it was supposed to be played. She had everything you could possibly want. She was a coach's dream."
He got a particular kick out of Amy's being a state high school sprint champion, observing, "Not bad for a white chick."
For all her love of mixing it up on the field, Amy was a wholesome-looking beauty, unadorned and natural looking, very much the girl next door if the girl next door would bury you on her way to a soccer ball. Her loveliness made the nickname she acquired playing soccer all the funnier: "the Killer."
In addition to being a fast runner, Amy was a young woman in a big hurry. In the middle of her sophomore year of high school, she took the SATs and scored a perfect 800 on the math portion. She decided early in her junior year to forgo the rest of high school and enroll at North Carolina. Other talented female players had done the same at various NCAA schools, including former UNC star Mia Hamm, who arrived in Chapel Hill in what would have been her senior year of high school. While it would be difficult for a boy that young to compete on equal footing with a twenty-two-year-old college senior, it is far easier for young women, who by that age are further along in their physical maturity.
Amy's force of will was so strong that no one could ever really stand in its way. One of her elementary school teachers told the Steadmans they had never seen such a focused child. "She was intense in everything she did," Ned says. "She set getting the 800 in her math SATs as a goal. As soon as the scores were available, we had to call the test center to see if she had accomplished it."
By the time Dorrance suggested that she leave high school early and come to Chapel Hill, her parents were accustomed to letting her make her own choices. The coach assured them that she was ready athletically and academically. "I realized at that point that Amy's dreams are going to be realized," her father recalls.
All her parents asked was, Are you sure this is what you want? But they knew she had already made up her mind.
By that time, Amy was already a seasoned veteran of youth national teams and had competed internationally in England, Sweden, and the Netherlands. She had been playing with the American team that would compete in the first women's under-nineteen World Cup in Vancouver, and although a final roster for that tournament was not yet set, she was one of the core players and seemed to have a guaranteed slot. "I kept doing well at every one of the training camps," she says. "Some girls would be invited in once, but then not for the next one, but I never really had that problem." When she wasn't training with the national team, she still played for her club team in Atlanta and it was in a game for her club, before she could set off for Chapel Hill, that she first hurt her knee.
Amy recounted her injury history for me as we sat on a couch in a lounge area of the Dean Smith Center, UNC's indoor athletic complex. She was twenty-one years old, five years past her first ACL tear. She lived just a short walk across campus, but her boyfriend had dropped her off because she was not moving comfortably. Later, when she could not reach him by cell phone for a ride, I asked if she wanted me to drive her back, and she said, quietly, "Yeah, I guess I do."
That first day we talked for close to three hours. Her tone at first was flat and unemotional, which I soon realized was her way of trying to maintain her composure. What caught me off guard was my own reaction: I can remember no other time in three decades in journalism when I have had to fight back tears of my own during the course of an entire interview.
"It was a miserable game and we weren't playing well," Amy began, describing the club game in Atlanta. "So my coach just decided to throw me up top" move her from defense, her usual position, to striker. "There were like ten minutes left. With me being fast or whatever, he wanted to see if I could make something happen.
"It was really surreal the way it happened. A ball was being played in to me, and I jumped in the air because it was high. As I kicked it, the defender pushed me in the back. It wasn't a real hard push, but I landed on one leg, my right leg, and I could just feel it hyperextend. I didn't hear anything, but I felt something. It was more than a pop."
She had probably landed in similar fashion on one leg and off balance dozens or perhaps hundreds of times before with no negative result. But this one time would be life changing.
"I lay on the ground, but it didn't hurt that much. So I got up and tried to keep playing, but every time I came down on my right leg, it was like there was no support. It collapsed underneath me. There were like five minutes left in the game, so the coaches took me out and helped me over to the sidelines, and people were saying that maybe I'd just strained it. I didn't know enough to think differently, so I was hoping that was the case."
She sat on the bench for the few minutes until the game concluded, then hobbled to the car for the four-hour drive home with her father. About halfway, they made a rest stop. "I didn't notice my knee swelling until then," she recalled. "But when I got up to go to the bathroom, it was just huge and I couldn't walk. I knew I had done something pretty bad, but I didn't know too much about ACLs. I figured I would get it looked at and they'd tell me what the problem was. In Brevard, things move kind of slow, so it took like two weeks to get an MRI and for them to tell me I'd torn my ACL. So at that point, I had to call Anson and the national team coaches and tell them what happened."
Amy underwent reconstructive surgery in early November 2001, a couple of months after turning seventeen. Her surgeon grafted a new ACL from part of her patellar tendon in the same knee. The U-19 World Cup was scheduled for late the following summer, less than ten months away. And after that, she was to begin her first season as a Tar Heel a member of the famed UNC women's soccer team.
"To be on that World Cup team was my ultimate goal at the time," Amy says. "I just wanted it so bad. I had ten months to recover and get back to close to 100 percent, or I wasn't going to make the team. I still had two months at home before going to UNC. I couldn't run yet, but I rode the bike and I swam. I worked out like three or four hours a day. I was really determined, and being so young, I didn't know anything about patience. So I was doing this really, really aggressive rehab program."
In her understated way, Amy says that she had "a lot of complications with that first one." What she describes sounds more like a nightmare than a set of complications. "They give you pain pills, and basically, I unknowingly got addicted to them. I was in so much pain that I couldn't sleep without them, so I took them regularly. I couldn't go to school for like two or three weeks, because I couldn't keep anything down. Everything I put in my mouth came right up.
"I finally had to be hospitalized and get an IV because I was dehydrated, and I got a huge lecture from the nurses about how I had to eat. I went down to a hundred and five pounds from a hundred and twenty pounds. I could do upper-body work at the gym, but I felt like all the weight came out of my legs because I couldn't do anything with them yet. It was like my legs were wasting away."
After that first injury, Amy says, "I probably screamed at my parents a couple of times. It's not like it was their fault, and I should have never done it. But I was just overall angry."
Her parents watched in awe as she pushed herself through rehabilitation, even as they had misgivings about her pace. The trainer for the UNC women's team, Bill Prentice, had sent an "accelerated rehab schedule," Ned Steadman recalls. "The physical therapist here in Brevard looked at it and said, 'Whoa.' But she wanted to be back on that U-Nineteen team, and that's what was necessary."
In the initial couple of weeks after surgery, ACL rehab consists mostly of excercises to restore the range of motion in the injured leg. One example: lie on your back, grasp the backs of both thighs, pull them to the chest easy for someone with a healthy knee but pain-ful for a patient just off surgery. The exercises are meant to be done intermittently throughout the day, starting out with relatively few repetitions, so that the recovering patient can gain strength and flexibility while leaving time for rest and healing. But Amy made her accelerated regimen even more ambitious by doubling or tripling the recommended number of repetitions for each exercise. It was the same with the stationary bicycle. When she was allowed to start pedaling it an hour a day, she went at it hard for two hours.
Ned remembers thinking, I'm tough, but I'm not as tough as she is. Asking her to back off would have been pointless.
Amy says, "If anyone would have told me after that first one that I should stop and do something different, play a different sport or whatever, or slow down my rehab, I would have said, 'You know what? The hell with you. I'm going to do this.' Nobody could have stopped me. Girls are so strong-willed when they're young, and to explain to them that they have this vulnerability it wouldn't work. We're like guys in that way. Even girls I know who have had their first or second ACL they think it won't happen again, and that they'll be back one hundred percent and it won't affect their lives."
After the lecture from the nurses, Amy began to put weight back on and regain her tone and strength. At the turn of the year, she moved to Chapel Hill to begin classes, during what would have been her junior year of high school, and she now had new teammates, as well as Dorrance, to push her. The UNC coach believed deeply in international soccer and wanted his players to compete for the U.S. teams, so Amy's ambition to get healthy in time for Vancouver was Dorrance's goal for her as well.
"The things I needed to get back were my speed and agility, and I worked a lot in the weight room," she says. The day she was cleared to finally begin running, she didn't set off on a light jog; she did a full sprint set. After five months of being unable to touch a ball, she felt that she had lost timing, so Dorrance took her back out on the field and personally put her through workouts. "Once they started letting me play," Amy says, "I just played every chance I could get. The thing I needed to do was get back my speed and agility. In Brevard, I had to do everything on my own, but here I had Anson and all these teammates to help me. I just felt so thankful."
That summer, the U-19 team gathered to train for a couple of weeks in Chula Vista, California. Amy needed not only to make the team but also to win back her starting position. The coach had changed the team's formation into a more attacking mode, so there were only three rather than four spots for defenders. "They said to me, 'We pretty much have our back three set.' It was disappointing."
Instead, she was given an opportunity to play left midfield. She wasn't sure about the position, because it involved much more running of the field, but she quickly grew to like it because it gave her an opportunity to score goals. "But it was heartbreaking for me because the girl who was supposed to be in that spot, she tore her ACL and she was out for the tournament. So that's how it became open for me."
There were other ACL victims and survivors. Out of the original forty in the "player pool" under consideration for that U-19 team, ten suffered ACL injuries in the two years between the time they were put into the pool and the tournament one out of every four. Some, like Amy, had made it back onto the field; others were still rehabbing and out for the tournament.
In Chula Vista, twenty players competed to be among a final eighteen who would compete in Canada. Amy remembers being called into a room after the final decision had been made. "They said to us, 'You're the team.' At that point, you start to bond with those girls 24/7. I was so excited."
She had not only won back a starting position but was named captain, a remarkable accomplishment for a young woman who not that long before had been so debilitated that she needed to be hooked up to an IV. Amy felt as though she had climbed an enormous mountain. All the pain had paid off. The team flew from its training camp to Seattle, then took a ferry into Canada. "I was so excited," she says. "It was just going to be the coolest thing ever."
Copyright © 2008 by Michael Y. Sokolove
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Michael Sokolove is a contributing writer for The New York Times Magazine and the author of Hustle: The Myth, Life, and Lies of Pete Rose. He lives in Bethesda, Maryland, with his wife and their three children.
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