Eva Nemcova, Guard/Forward, Cleveland Rockers

From the WebMD Archives

NAME: Eva Nemcova

TEAM: Cleveland Rockers, WNBA; Messina, Italian League

POSITION: Guard/forward

INJURY: Torn anterior cruciate ligament (ACL)

OTHER ATHLETES AFFECTED

WNBA: Andrea Lloyd-Curry, Minnesota Lynx; Carolyn Jones-Young, Portland Fire; Elena Baranova, Miami Sol; NBA: Tom Gugliotta, Phoenix Suns; Derek Anderson, Los Angeles Clippers; Danny Manning, Milwaukee Bucks; NFL: Jamal Anderson, Atlanta Falcons; Ric Mathias, Cincinnati Bengals; Terrell Davis, Denver Broncos; Robert Daniel, Carolina Panthers; Tony Boselli, Jacksonville Jaguars; Curtis Enis, Chicago Bears; Baseball: Shane Spencer, New York Yankees; NCAA Women's Basketball: Shea Ralph, University of Connecticut; Peppi Browne, Duke University

PLAYER BIO

Eva Nemcova, the Rockers' leading scorer, is 27 and hails from the Czech Republic. In her fourth season, she is averaging 13.2 points, 2.9 rebounds, and 1.6 assists. She was a first-team all-league selection in 1997 and a second-team pick in 1998. Nemcova holds the WNBA record for consecutive free throws with 66, and had a free throw percentage of 91.7% this season. Last winter, while playing for Messina in the Italian League, she averaged 19.4 points and was the MVP of the 2000 Italian League All-Star game.

WHAT HAPPENED

Nemcova tore her left ACL in the first half of Cleveland's loss to the Los Angeles Sparks. She drove to the basket, planted her foot, and twisted it. She was surprised to find out how bad the injury was because she felt nothing at the time.

WHAT IS A TORN ACL?

The anterior cruciate ligament (ACL) is one of the ligaments inside the knee joint that stabilizes the knee throughout its full range of motion. The specific function of the ACL is to keep the bones in the knee from slipping forward and from rotating. It is used in pivoting maneuvers -- for example, when running or quickly moving laterally. The ligament is directly behind the kneecap, in the center of the knee.

The ACL can be injured in many ways. The most common is a combination of bending the knee and forced rotation of the lower leg. Also common is force applied to the outside of the leg pushing inward, such as a clipping injury. This is the type that makes some of the horrific highlights on the news. Athletes usually describe a sharp burning, severe pain and the inability to move or put any weight or pressure on the leg.

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DIAGNOSIS

A sports physician can easily diagnose a torn ACL. By moving the knee and testing its motion, doctors can determine that the ACL has been damaged. Also, if there is blood found inside the knee joint, there is a 70-80% chance that the ACL is torn. An MRI (magnetic resonance image) also can detect the injury.

TREATMENT

Just 5-7 years ago, torn ACLs commonly ended athletes' careers. For athletes and other patients involved in pivoting sports or labor-intensive jobs, ACL reconstruction surgery is recommended. For less active people, there is nonoperative treatment. Instead, they can strengthen the quadriceps and the hamstrings and wear a brace. But neither exercises nor braces can give them full support, stability, or strength. The surgery commonly entails taking a graft of another ligament either from the patient or from a cadaver. That graft is then placed in the knee, where the original ACL had been, and fixed in place using a screw, glue, or a staple. During the recovery period, the body incorporates the new ligament, which eventually replaces the ACL.

PREVENTION

There is no sure way to prevent ACL injuries in contact sports. However, recent studies have shown that female athletes are at a higher risk of sustaining ACL injuries than male athletes. There are several theories on this, but most sports medicine doctors believe that if women are trained adequately, the frequency of these injuries will decline.

RECOVERY

The average recovery period is 6-8 months. The patients are walking quickly after the surgery, and physical therapy begins within 2 weeks. At that time, the patient begins stationary bicycle exercises and quadriceps and hamstring strengthening. In 10-12 weeks, patients can begin jogging on a treadmill, swimming, and golfing. After about 4 months, the patient can begin pivoting maneuvers and drills. The athlete should be able to return to his or her sport after about 6-8 months.

LONG-TERM OUTLOOK

With modern treatment, a torn ACL is no longer career ending. Treatment works very well and allows athletes to compete at the same level that they had in the past. Some athletes recover from the injury and say that it did not change their performance from their pre-injury level. Others may feel that they lose some of the maneuverability or explosiveness that they had before the injury. Nemcova will have surgery and hopes to play again by January or February.

WebMD Feature

Sources

Medical information provided by Michael J. Ciccotti, MD, director of sports medicine at the Rothman Institute at Thomas Jefferson University Hospital in Philadelphia. Ciccotti is also the team physician for the Philadelphia Phillies.

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