The sickening pop was unmistakable.

Gymnast Justin Spring withered on the mat in both pain and frustration, lying just a few feet from the apparatus that caused his demise.

The timing could not have been much worse. In only four seconds, Spring went from securing a spot on the U.S. National team to possibly losing any shot at qualifying for the 2008 Summer Olympics in Beijing.

It was one of the most common, yet devastating injuries in sports – the tearing of the anterior cruciate ligament, commonly referred to as the ACL – that reared its ugly head at the HP Pavilion in San Jose, Calif., on that fateful August day.

“I was pretty emotionally upset and kind of like, ‘I can’t believe this is happening again. I just had three surgeries, this is the last thing I need to have right now before the Olympics,'” Spring said. “Of course my mom comes in, like, two steps into the room and starts balling her eyes out and I’m just, like, ‘Mom, the last thing I need right now is for you to come in and get me even more worked up.'”

For the casual viewer, it is hard not to look away as the former Illini comes up short on the twist and finishes with a straight-leg landing, immediately tearing his left ACL.

While Spring had already secured the title in the high bar before the mishap at the 2007 Visa Championships on Aug. 17, 2007, the injury brought about a harsh reality.

The Olympics were 11 months away. The recovery time for an ACL injury can range from six to seven months for athletes in high-performance sports like gymnastics. Add on the several weeks doctors recommend waiting before performing the reconstructive surgery, plus the inability to compete or fully work out in that span, and time certainly became a precious commodity.

“I didn’t know how bad it was, but I knew immediately that I was going to need surgery,” Spring said. “More so than anything, the first thought in my head was, ‘Oh my God, the Olympic trials are only eight months away. Is there time to come back from this?'”

Spring’s predicament is not uncommon for athletes, especially at the collegiate level. According to Arthroscopy: The Journal of Arthroscopic and Related Surgery, an average of 100,000 people tear an ACL in the United States every year.

Springing into action

Spring immediately contacted numerous doctors to determine the best course of action. After considering the different options, Spring and his doctors chose to perform an autograft surgery. During the surgery, tissue was taken from the patella tendon in Spring’s injured left knee and used to repair the torn ligament. However, it was anything but smooth sailing from that point on.

“I had such bad tendonitis, partially my fault,” Spring said of his recovery. “I was walking within a week, and of course typical athlete thinking, once you can walk you are fine, so I started taking flights of stairs. Walking was already pushing it, and because I did that my tendonitis flared so bad, and of course my physical therapist was so mad.”

The Burke, Va., native was fortunate it was a “best case scenario” – there was no other damage to his knee or ligaments. With Spring at a self-proclaimed 85 to 90 percent fully recovered, he was able to perform on every event with the focus now being on improving his endurance. After being out of the gym for two weeks following the surgery, Spring turned his focus to his core and upper body strength with his legs out of commission.

With an ACL injury, the road to recovery is long and difficult, regardless of the sport. When trying to work the body back to pre-injury build, the athlete faces continuous ups and downs, and it has been no different for Spring.

Regardless of the pain and challenges Spring has faced due to his numerous injuries, including those to his ACL, he remains upbeat and positive and looks to return to the top of the gymnastics world.

“You can take injuries a couple of different ways,” Spring said. “As soon as that happened I was done, and (people thought), ‘There’s no way he’s going to make it back in time.’ No one’s expecting you to be one of the top all-arounders in the country. That’s what I’m training for, and I really think that I can do that.”

Despite being out of competition since suffering his injury, Spring expects to make his triumphant return on Mar. 14 at the Houston National Invitational. Of course, Spring hasn’t been able to completely escape the injury.

“These are USA Championships. This was on CBS and everything. In the coverage they actually showed me tearing my ACL on national television, so I’ve watched myself do the injury a couple hundred times, and I don’t have a problem with that. I’m just like, ‘And there it goes, ahhh.’ It’s brutal.”

Though Spring was unable to compete for his spot with the U.S. National team due to the injury, he was able to keep his place on the team after successfully filing a special petition for injured athletes. With another possible shot at participating in the 2008 Summer Olympics, Spring has no plans to slow down until a gold medal is hanging around his neck.

Third time is (not) the charm

While Spring was fortunate not to suffer from a torn ACL while competing in college, others have not been so lucky, like Illinois women’s basketball player Audrey Tabon.

Tabon, a medical-redshirt senior, tore her right ACL during her senior year in 2006-2007. The Pittsburgh, Pa., native sustained the injury during the Orange and Blue Scrimmage before the season even started. While a single ACL injury is disheartening, this was the third one of Tabon’s basketball career.

During the summer before her junior year in high school at Oakland Catholic, the 6-foot-2 center tore her left ACL while playing AAU basketball.

“I just landed awkward, you know, just landed off-balance and that’s all it took,” Tabon said. “It was just that simple.”

After recovering, Tabon wasn’t able to stay healthy long, tearing her left ACL yet again, this time during her junior year in high school. Despite the two injuries, Tabon still worked her way to Illinois and Big Ten basketball. By the time Tabon injured her ACL yet again – this time the right one – she had the whole process down.

“The third time I told them, ‘Yeah, I just tore my ACL,'” Tabon said. “The initial reaction wasn’t so much the pain, but that ‘I can’t believe I did this again’ because I knew immediately what happened.”

After the first surgery in high school, Tabon said she rushed back and didn’t let her knee and ACL completely heal. She learned her lesson the second time, however, vowing to be patient and slowly recuperate to make sure she was ready to compete.

“You don’t take things for granted,” Tabon said of the lessons she learned from her injuries. “You have to go into every game thinking it could be your last because it really could be. Anyone who has had serious injuries knows that. You never know if you are going to get hurt or what will happen.”

It doesn’t seem that any of the ACL injuries slowed down her production. Tabon has continued to contribute to an Illini team that made it to the Big Ten Tournament final. The senior has seen action in 29 of 33 games, starting 11.

It’s science

For some, the thought of tearing an ACL three times is absurd. However, evidence has suggested that female athletes are at least eight to nine times more likely to tear an ACL. Steven Broglio, assistant professor in kinesiology and community health at the University, has seen numerous studies that have indicated a high correlation between ACL injuries and the female athlete.

“Some people think it’s in the landing mechanics and some people may think it relates to hip width,” Broglio said of the differences between male and female athletes. “There are all sorts of things being explored, but no one’s really come up with an answer yet.”

There are two types of ACL injuries, contact and non-contact. A contact injury occurs when, in a sport such as football, a player is running past the line of scrimmage and is hit as they plant their foot. The force of the impact results in the torn ACL. Non-contact can simply happen when an athlete plants his or her foot awkwardly and then turn and twist it.

“Athletes do a lot more dynamic motions than your average individual,” Broglio said. “An athlete has to plant and cut. That kind of sudden shift, unplanned motion, tends to be when those injuries occur.”

The risk of injury tends to depend on the sport. For women, basketball produces the most torn ACLs, which can be attributed to jumping and being bumped in midair. Broglio, who has a doctorate in exercise science, said women tend to land stiff-legged, resulting in their joints taking the brunt of the impact. As for men, they tend to “land with more knee and hip flexion to absorb the force.” As an athletic trainer, Broglio helps teach women how to land correctly through an intervention protocol.

While ACL injuries may discriminate by gender, the mental and physical hardship involved in returning from the injury is similarly grueling for each individual. Spring and Tabon are proof that, with the proper patience and determination, an athlete can leave the operating table behind and return to competing at a high level.