![Macomb Lutheran North freshman Emiliana Manzo](/sites/default/files/2023-10/231003_HFHS_2H.png)
Macomb Lutheran North Standout on Mend After Knee Injury
October 3, 2023
Macomb Lutheran North freshman Emiliana Manzo has already achieved a long list of accomplishments, including a 3.8 grade-point average while juggling two sports she loves.
As a point guard, she led her basketball team to an undefeated season in its division. She is also a center attacking midfielder, sometimes playing forward, on the 2009 Nationals Girls Academy Blue soccer team, ranked No. 1 in Michigan and 14th in the country.
In June of 2022, Emiliana hit a detour on her sports journey when she was participating in a club soccer national championship in Oceanside, Calif. With a few seconds left in the game and her team up 2-1, she ran 20 yards full speed to get to the ball. Hyperextending her left knee, she felt two pops. It was the first time she experienced an injury.
“I was screaming and crying and got taken off the field on a golf cart,” explains Emiliana. The trainer felt she was OK. Fortunately, she had the next day off and her knee was feeling better. The following day she played again, and 20 minutes into the game she knew there was an issue.
“Someone hit me from behind and I heard the pop again. I knew there was a problem.”
Emiliana’s father Vince Manzo said she experienced swelling, and the athletic trainer thought she may have a meniscus injury; however, she was able to continue to walk around during the championship in California before heading home.
Finding the Right Provider
Back in Michigan, Emiliana saw a few surgeons during her evaluation to seek treatment. When she met with Vasilios Bill Moutzouros, MD, chief of Sports Medicine at Henry Ford Health, she felt she met the right match.
“He treated me like an athlete and made me feel really comfortable,” she says.
Vince adds that both he and Emiliana were also appreciative of something Dr. Moutzouros said during her evaluation: “He emphasized to Emiliana that she was an athlete before this injury, and she would be an athlete after the injury.”
A detailed evaluation by Dr. Moutzouros revealed Emiliana had a complete anterior cruciate ligament (ACL) tear and medial and lateral meniscal tears. The meniscus, a C-shaped piece of tough, rubbery cartilage, acts as a shock absorber between the shinbone and the thighbone. It is one of the most common knee injuries. The ACL, one of the strong bands of tissue that help connect the thigh bone (femur) to the shinbone (tibia), is also prone to injury during sports when there are sudden stops or changes in direction.
Emiliana required physical therapy to get the swelling down and increase mobility before surgical repair.
Dr. Moutzouros reconstructed her ACL with her own patellar tendon graft and repaired her medial meniscus.
“She handled the surgery well and has been working very hard in her rehabilitation,” he says. “Her high-level soccer experience likely helped in her recovery as her range of motion and strengthening advanced so quickly.”
Understandably, Emiliana was nervous and scared when she went into surgery but expressed appreciation for the little things from Henry Ford like hearing “great music” as she was entering surgery, which gave her a sense of calm.
“That’s when I knew I picked the right doctor,” she said.
The Road to Recovery
As part of her recovery, after surgery which took place in July of 2022, Emiliana has undergone six months of physical therapy to increase mobility and strength training to get her leg strong again.
She also participated in the Return to Sport Program at the Henry Ford Center for Athletic Medicine to optimize recovery.
“We loved it,” says Vince. “It gave us peace of mind.”
Dr. Moutzouros explains that ACL prevention and rehabilitation programs are critical, especially for women because they have a four times greater risk of ACL tear than men. He says performance training post-surgery, along with an injury prevention program for those playing cutting sports, can markedly reduce the likelihood of future ACL injury.
“At Henry Ford, we work with physical therapists across the Midwest as well as our own. They do a great job in following our Henry Ford specific post-ACL reconstruction protocol,” he says. “After therapy runs its course, we strongly encourage our athletes to undergo performance training to allow a smooth transition back to sport.”
Nick Parkinson, supervisor of Athletic Training and Sports Performance at Henry Ford Health, emphasizes that the return to sport program is designed to bridge the gap between rehabilitation and returning to full activity in your chosen sport.
“Many times, insurance limits rehabilitation to regaining activities of daily living and not necessarily rebuilding the skills needed to play a sport or return to activity,” Nick says. “This program provides an affordable option to fill this need and return athletes to competition at the highest level.”
As for Emiliana, who hopes to play soccer in college and pursue a career in the medical field, she says this experience has taught her to not be afraid of injuries and treatment. She has also used the experience to volunteer for a program through the Girls Academy which serves as an advisory board to come up with ideas to help with mental and physical issues girls her age may be facing.
“For other kids who experience injuries, I’ve learned that this does not define you,” she said. “You can push through it, recover from it and be way better than you even were before.”
To find a sports medicine doctor or athletic trainer at Henry Ford, visit henryford.com/athletes.
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Health & Safety: A Look Back, Gallop Ahead
By
John E. (Jack) Roberts
MHSAA Executive Director, 1986-2018
August 7, 2015
By Jack Roberts
MHSAA executive director
We are just completing year six of eight during which we have been addressing the four important health and safety issues that, for ease of conversation, we call the “Four Hs.”
During the 2009-10 and 2010-11 school years, our focus was on Health Histories. We made enhancements in the pre-participation physical examination form, stressing the student’s health history, which we believe was and is the essential first step to participant health and safety.
During the 2011-12 and 2012-13 school years, our focus was on Heads. We were an early adopter of removal-from-play and return-to-play protocols, and our preseason rules/risk management meetings for coaches included information on concussion prevention, recognition and aftercare.
Without leaving that behind, during the 2013-14 and 2014-15 school years, our focus was on Heat – acclimatization. We adopted a policy to manage heat and humidity – it is recommended for regular season and it’s a requirement for MHSAA tournaments. The rules/risk management meetings for coaches during these years focused on heat and humidity management.
At the mid-point of this two-year period, the MHSAA adopted policies to enhance acclimatization at early season practices and to reduce head contact at football practices all season long.
Without leaving any of the three previous health and safety “H’s” behind, during the 2015-16 and 2016-17 school years, our focus will be on Hearts – sudden cardiac arrest and sudden cardiac death.
Coinciding with this emphasis is the requirement that all high school level, varsity level head coaches be CPR certified starting this fall. Our emphasis will be on AEDs and emergency action plans – having them and rehearsing them.
On Feb. 10, bills were introduced into both the U.S. Senate and House of Representatives, together called the “Safe Play Act (see below),” which addressed three of the four health and safety “H’s” just described: Heat, Hearts and Heads.
For each of these topics, the federal legislation would mandate that the director of the Centers for Disease Control develop educational material and that each state disseminate that material.
For the heat and humidity management topic, the legislation states that schools will be required to adopt policies very much like the “MHSAA Model Policy to Manage Heat and Humidity” which the MHSAA adopted in March of 2013.
For both the heart and heat topics, schools will be required to have and to practice emergency action plans like we have been promoting in the past and distributed to schools this summer.
For the head section, the legislation would amend Title IX of the 1972 Education Amendments and eliminate federal funding to states and schools which fail to educate their constituents or fail to support students who are recovering from concussions. This support would require multi-disciplinary concussion management teams that would include medical personnel, parents and others to provide academic accommodations for students recovering from concussions that are similar to the accommodations that are already required of schools for students with disabilities or handicaps.
This legislation would require return-to-play protocols similar to what we have in Michigan, and the legislation would also require reporting and recordkeeping that is beyond what occurs in most places.
This proposed federal legislation demonstrates two things. First, that we have been on target in Michigan with our four Hs – it’s like they read our playbook of priorities before drafting this federal legislation.
This proposed federal legislation also demonstrates that we still have some work to do.
And what will the following two years – 2017-18 and 2018-19 – bring? Here are some aspirations – some predictions, but not quite promises – of where we will be.
First, we will have circled back to the first “H” – Health Histories – and be well on our way to universal use of paperless pre-participation physical examination forms and records.
Second, we will have made the immediate reporting and permanent recordkeeping of all head injury events routine business in Michigan school sports, for both practices and contests, in all sports and at all levels.
Third, we will have added objectivity and backbone to removal from play decisions for suspected concussions at both practices and events where medical personnel are not present; and we could be a part of pioneering “telemedicine” technology to make trained medical personnel available at every venue for every sport where it is missing today.
Fourth, we will have provided a safety net for families who are unable to afford no-deductible, no exclusion concussion care insurance that insists upon and pays for complete recovery from head injury symptoms before return to activity is permitted.
We should be able to do this, and more, without judicial threat or legislative mandate. We won’t wait for others to set the standards or appropriate the funds, but be there to welcome the requirements and resources when they finally arrive.
Safe Play Act — H.R.829
114th Congress (2015-2016) Introduced in House (02/10/2015)
Supporting Athletes, Families and Educators to Protect the Lives of Athletic Youth Act or the SAFE PLAY Act
Amends the Public Health Service Act to require the Centers for Disease Control and Prevention (CDC) to develop public education and awareness materials and resources concerning cardiac health, including:
- information to increase education and awareness of high risk cardiac conditions and genetic heart rhythm abnormalities that may cause sudden cardiac arrest in children, adolescents, and young adults;
- sudden cardiac arrest and cardiomyopathy risk assessment worksheets to increase awareness of warning signs of, and increase the likelihood of early detection and treatment of, life-threatening cardiac conditions;
- training materials for emergency interventions and use of life-saving emergency equipment; and
- recommendations for how schools, childcare centers, and local youth athletic organizations can develop and implement cardiac emergency response plans.
Requires the CDC to: (1) provide for dissemination of such information to school personnel, coaches, and families; and (2) develop data collection methods to determine the degree to which such persons have an understanding of cardiac issues.
Directs the Department of Health and Human Services to award grants to enable eligible local educational agencies (LEAs) and schools served by such LEAs to purchase AEDs and implement nationally recognized CPR and AED training courses.
Amends the Elementary and Secondary Education Act of 1965 to require a state, as a condition of receiving funds under such Act, to certify that it requires: (1) LEAs to implement a standard plan for concussion safety and management for public schools; (2) public schools to post information on the symptoms of, the risks posed by, and the actions a student should take in response to, a concussion; (3) public school personnel who suspect a student has sustained a concussion in a school-sponsored activity to notify the parents and prohibit the student from participating in such activity until they receive a written release from a health care professional; and (4) a public school's concussion management team to ensure that a student who has sustained a concussion is receiving appropriate academic supports.
Directs the National Oceanic and Atmospheric Administration to develop public education and awareness materials and resources to be disseminated to schools regarding risks from exposure to excessive heat and humidity and recommendations for how to avoid heat-related illness. Requires public schools to develop excessive heat action plans for school-sponsored athletic activities.
Requires the CDC to develop guidelines for the development of emergency action plans for youth athletics.
Authorizes the Food and Drug Administration to develop information about the ingredients used in energy drinks and their potential side effects, and recommend guidelines for the safe use of such drinks by youth, for dissemination to public schools.
Requires the CDC to: (1) expand, intensify, and coordinate its activities regarding cardiac conditions, concussions, and heat-related illnesses among youth athletes; and (2) report on fatalities and catastrophic injuries among youths participating in athletic activities.