It wasn't until the pain from also partially tearing her medial collateral ligament kicked in that she really started crying.
"It was excruciating pain," said Rabin, a soccer player from Park City. "I pulled my leg up to my chest and then I couldn't straighten it. My coach picked me up and carried me off the field."
One year later, Rabin is back playing soccer, traveling with her club team and recently attending an Olympic Development Program region camp in central California.
Although it was hard for Rabin to be physically unable to participate in the sport that was the center of her life, Rabin says having an injury as serious is a torn ACL is just a part of the game.
"I think it just happens," Rabin said. "You could be in the wrong situation or you get hit wrong. When you play a sport, you get injured, then get back in the game."
Torn ACLs and MCLs were once only associated with college and professional athletes. Rabin was 15 when she tore hers and she's hardly the first female athlete in her early teen years to have such a serious injury.
The Murray-based TOSH - The Orthopedic Specialty Hospital - saw a 60 percent increase in the number of girls ages 13-17 who had ACL reconstructive surgery between 2003 and 2007. The number tripled for females between the ages of 18 and 22.
That increase reflects the rise in female participation in sports but the numbers also reveal that some adolescent girls across the state are getting seriously injured at the rates of athletes in sports like football. Young female athletes are more at risk than boys to get injured in the sports that both sexes play and they don't even realize it.
"You don't see boys run down the field and plant to cut left and see them fall down with an ACL injury like you do with the girls," said Jim Walker, the sport science director at TOSH. "Sometimes, things happen, like a car crash; you can't avoid it. But the noncontact ACL injuries, that's where girls' rates are much bigger than the boys'."
The differences
There are a number of factors that make girls more susceptible to sports-related injuries than boys. Research done last year at Ohio State and the Nationwide Children's Hospital in Columbus, Ohio, reported that high school girls who play basketball suffer concussions at three times the rate of boys. In soccer, it's about 1.5 times the rate of boys. The research indicates it takes less force to cause a concussion in females, possibly because they have smaller heads and weaker necks.
Kristi Spence, a researcher and sports dietician at TOSH, has studied the relationship between eating patterns and menstrual irregularities and compromised bone health - the female athlete triad.
"If girls are not eating enough, there's not enough energy availability to support exercise in addition to the metabolic functions that your body requires," Spence said. "They're still building bone mass and if those hormones aren't being produced, bone mass is being compromised."
Improper eating habits that may cause young female athletes not to reach their peak bone mass may also cause osteoporosis.
"More injuries are happening because of a combination of things. Girls are getting more involved in sports and more seriously at a younger age," Spence said. "Your appetite lags and there are mixed messages out there, a pressure to maintain a body type."
Walker participated in a study linking hormones and ACL tears and found that hormones make their ligaments looser. As menstrual hormones fluctuated, a high estrogen level and the result of that - knee laxity - would kick in about three days later. Knee laxity makes the joints looser, which can expose girls to a higher risk of hyperextension.
Repercussions?
When Rachael Ritter tore her ACL playing in a soccer game, she almost didn't think twice about it. She heard a popping sound from her knee. She felt the pain. She walked off the field to the bench. Yet, she still thought she could play. The only thing keeping her from doing so was her knee kept giving out.
"Every athlete has to get hurt one time in their career," Ritter said. "Every team that I've ever been on had at least one girl tear their ACL."
Ritter's injury is virtually an afterthought now. She tore her ACL last summer and is back on the field. Recently, she still played in a brace, but she says that she's back to pre-injury form.
All that matters to Ritter is she is able to play now, but what will happen in the future? Will she be a college freshman with a knee that feels twice that age?
"Yeah, it's crossed my mind, the future of my knee," Ritter said. "[But], everything is getting a lot more competitive. It's how it goes."
How Ritter's knee will hold up in the future has also crossed her mother's mind. Dianna Ritter can relate to her daughter. She also tore her ACL, playing basketball when she was in college. She knows what awaits her daughter - not being able to play like she used to and always having it in the back of her mind.
"There are things that I can't do, just playing a game of basketball. I think twice about driving to the basket," Dianna Ritter said. "I worry about [and think], 'Gosh, she's just 15 years old and she has already gone through this major thing.' "
It's hard to say how other athletes like Ritter who have had serious injuries at a young age have dealt with their injuries in their 30s and 40s - simply because not enough time has gone by yet.
But one thing is certain: There will be more and more girls who will have to deal with the repercussions of it later in life.
Being prepared
Walker said the answer to limiting the amount of girls suffering from serious injuries is simple: Girls should spend as much time in the weight room and conditioning as they do on the field or on the court.
"The girls become very skilled in their sport, but there's not time to actually train," Walker said. "That's the most important thing there is in preventing injuries. If you don't have the ability or skill set to avoid that or compensate for it, you're going to get hurt."
Walker trains athletes one leg at a time, because rarely is an athlete on both feet at the same time.
Plyometric, ladder, planting and cutting drills and strength training are techniques that can vastly improve an athlete's balance and agility and strengthen the muscles and joints where girls tend to get hurt most often.
Female athletes strive to be as competitive in their respective sports as their male counterparts, but there's one aspect that the girls haven't caught up in.
"The boys grow up [used to the idea] that the weight room is part of training and girls don't," Walker said. "If more sports find the weight room, that would address a lot of the issues, especially with the girls. You can't optimally perform unless you're conditioning, no matter how well you can handle a ball."
mthach@sltrib.com
The Orthopedic Specialty Hospital
* http://intermountainhealthcare.org/xp/public/tosh/
Pain by numbers
* Prep female basketball players suffer concussions at three times the rate of their male counterparts.
* High school female soccer players suffer concussions at 1.5 times the rate of their male counterparts.
* For girls age 13-17, the number of girls getting reconstructive knee surgery at The Orthopedic Specialty Hospital in Murray increased by 60 percent between 2003 and 2007.
* For girls age 18-22, the number of girls getting reconstructive knee surgery has tripled.
Information from research done by Ohio State University and Nationwide Children's Hospital in Columbus, Ohio and The Orthopedic Specialty Hospital in Murray.
