Late afternoon, Nov 18, 2015 – Freshman Zach Sabol sprints down the court during a routine fast-break drill in an Emmaus High School boys’ basketball practice. Then he accidentally collides with a teammate, and...
“Suddenly I’m planting my right leg trying to stop,” says Sabol, who stands 6-foot-7, 230 pounds. “I could feel my leg giving out, and I just went down.”
The then-15-year-old could see his right kneecap seemed to be dislocated. It wasn’t. Sabol actually had fractured the upper portion of his tibia. It had flipped and rotated 90 degrees, pushing the patella out of the way and tenting the skin, causing a sharp spike of bone to be palpable and visible.
“When I reached him, the bone area below his knee was really white, and it looked like it was about to come through the skin,” says Liz Del Re, one of two Lehigh Valley Health Network (LVHN) certified athletic trainers at the school. “I immediately thought it was a fracture, so I just tried to stabilize Zach and keep him calm.”
The other trainer, Edward Zellner, didn’t need a closer look when he rushed in to assist Del Re. “I could tell from the awkward bend of his knee that this wasn’t good,” Zellner says.
An immediate transfer
Within minutes, an ambulance rushed Sabol to Lehigh Valley Hospital–Cedar Crest’s emergency department. There, LVHN orthopedic surgeon Scott Sexton, MD, with LVPG Orthopedics awaited.
“Zach’s injury was rather uncommon,” Sexton says. “Because the tibia was fractured and tenting the skin, we performed open reduction internal fixation of the tibia that evening, using rigid screws to stabilize his fractured bone. That meant he didn’t need casting and could begin rehab sooner.”
In fact, Del Re and Zellner started working with Sabol just days after surgery, using gentle massage to reduce considerable swelling from the knee down. By Nov. 30, Sabol was cleared for range-of-motion exercises, and by Dec. 10, he was performing straight-leg raises with weights.
“His youth and conditioning helped him bounce back quickly,” Del Re says. “If he was a few years older, he may have torn knee ligaments too. But as a teenager, his ligaments are still pliable enough to withstand such trauma. That was huge in terms of his recovery time.”
A quick start to rehab
In January, Sabol was still on crutches when he began physical therapy at LVH Rehab–Cetronia Road. The treatment focused on fortifying the muscles around the knee and shinbone. After just two weeks with Grubb, Sabol left his crutches at home.
Physical therapy started with stretching and strength training, then moved up to jumping and landing exercises. Under the guidance of the physical therapist and athletic trainers, Sabol advanced quickly. By early February, he was jogging and working on lateral movements. By mid-February, he was shooting baskets and participating in some drills. By Feb. 29, he was taking part in scrimmages as Emmaus prepared for the state playoffs.
“He begged us to let him play in the playoffs,” Zellner says. “We had to prove to him he wasn’t ready. The last thing we wanted was a re-injury.”
Planning his comeback
Zach formally finished rehab in the spring. He started playing some Amateur Athletic Union (AAU) basketball with a regional team based in York, and then began training to play tight end on the 2016 Emmaus football team.
“What remained was the mental challenge of a 15-year-old putting all this behind him,” says Matt Sabol, Zach’s father. “It was almost 30 years to the day of his injury that I blew out my knee in that same gym. I think my experience helped him to embrace his adversity, which in the end would make him mentally stronger. We talked a lot about that.”
The younger Sabol was eager to make up for lost time. “I knew basketball was my future,” he says. “Mostly, it just felt really good to be back.”
In his sophomore season, Sabol became starting center on Emmaus’ varsity basketball squad. In a game against Allen High School the following year, he landed wrong on his left foot and sustained another injury—a syndesmotic or high ankle sprain, which is one of the most potentially serious and common basketball injuries there is.
“This is not a garden-variety sprain because it’s above the ankle in the ligament connecting the leg’s tibia and fibula bones,” says Gabe Lewullis, MD, orthopedic surgeon with LVPG Orthopedics and Sports Medicine. “Some cases require surgery; fortunately Zach’s didn’t.”
Still, the injury once again sidelined Sabol. He wore a walking boot to immobilize damaged tissues and worked with LVHN’s Emmaus-based trainers to heal.
“I played college and professional basketball and knew what he was going through,” Lewullis says. “As a physician I wanted to make sure he recovered safely from his injury but as a basketball player I understood his desire to compete on the court.”
Sabol dedicated himself to three weeks of daily exercise sessions to ensure a speedy recovery. “I was out about five games but made it back before district playoffs,” he says. “In state playoffs, we made it to the elite 8 and were ranked fifth in the state at the end of the year. The team did really well.”
Both his right leg and left ankle now feel completely normal but Sabol takes nothing for granted. “I’ve continued exercising for them,” he says. “That’s even more important after an injury to keep strong so you don’t end up right back where you started. Exercise is crucial to me.”