Glenn and Margie Master, of Ventnor, are starting to get to know Dr. Ryan Buccafurni of Integrity Physical Therapy in Northfield pretty well. Probably better than they ever wanted to.
They are the parents of four children, Megan, Katie, Ryan and Matt — all former, current or future athletes at Atlantic City High School — and three of their kids have suffered anterior cruciate ligament (ACL) injuries in the past 18 months.
“It’s unbelievable, three in about 16 months,” said Buccafurni, who has been tasked, along with his team, of rehabilitating Megan (21 years old), Ryan (17) and now Katie (18), who recently became the third Master athlete to tear an ACL. “Generally speaking, that’s rare, but there is some evolving literature that there may be genetic predispositions and doctors are looking into different genes that may be associated with it but we’re not 100 percent sold on that idea. We do see some trends, however. We had another family where four of their kids all tore their ACL and it was a similar scenario, where within five years of each other they all went down.”
Ryan — a rising senior who has played just one season of high school baseball for the Vikings because of his injury and the 2020 coronavirus pandemic wiping out his junior season this spring — was the first to go down when he hurt his knee playing basketball in early 2019. Then Megan, a rising senior and softball pitcher at University of the Sciences in Philadelphia, tore hers back in March, before her third college season was stopped because of the pandemic. Katie is a scholarship recruit to Central Connecticut State and most likely will miss most of her freshman season next spring, if it is even played.
“I heard a pop and my leg just kind of gave out. I didn’t know what happened, but I feared the worst. I tried to go back into the game but I couldn’t walk. The doctors told me they didn’t think it was a torn ACL,” Ryan said. “I wasn’t think about (the baseball season), I just wanted to get my knee better. I assumed I still had two more years to make a name for myself, but now with the coronavirus I only have one more year.”
“He went to Urgent Care that night and they didn’t think he tore it, so that got our hopes up a little bit, but we took him to the ortho the next day and they knew it was torn,” Glenn said. “In June (of 2019), three months after the surgery, we went to South Carolina for one of Katie’s tournaments and he was throwing a football, we were having a catch with the baseball and he was moving around pretty well. We actually had to slow him down.”
Megan tore her ACL while fielding a ground ball outside the pitching circle, as her knee gave out when she pivoted to make the throw to first base.
“We were in Florida and at that point we had about 15 games in. I was fielding a ball, I left the circle, I went to turn to throw to first and my knee gave out. It was really scary. I wasn’t really in pain, but it was scary because I couldn’t put weight on it without my knee giving out. I was trying to be positive, but I didn’t think it was going to end well. I learned within a week or two that it was torn,” she said. “You can’t really prepare for it but seeing Ryan get through it and seeing him come back stronger than ever was good to see. I was worried and wasn’t sure how it would go, but seeing him successful after going through it was reassuring. I’ve been asking him a ton of questions throughout the process, like when he got off crutches, how soon could he walk again — just trying to figure out the timeline of everything. And seeing him now a year after it happened, I know that I’ll be OK soon.”
There are no shortcuts when it comes to ACL rehab, it’s a nine-month grind that now Katie Master will have to go through, following in her sister’s and brother’s footsteps. She’ll likely have the surgery in September with Dr. Bradford Tucker of Rothman Institute, who performed the surgeries on Megan and Ryan. Matt, age 14, so far has been spared of a devastating knee injury.
“The goals are the same (for both boys and girls) and those are to get range of motion and make sure you don’t lose extension. Getting the knee straight is always really important, and the bear of it is always maintaining mobility and full extension. By achieving full extension, that allows you to get the quadricep strong. The bear of ACL rehab is getting the range of motion and then getting that quad kicked on. Blood flow restriction therapy has been a game-changer as far as early ACL rehab, and getting that quad kicked on,” Buccafurni said. “The biggest thing is, these kids are athletes and we know that with their mentality, they are going to come back stronger than ever. As long as they believe and trust the process, and you develop a good team around you, the quicker we get them into surgery and get the rehab process started, expect them to return to play in nine months. We haven’t had somebody fail our return to play testing in a long time and nine months is kind of the gold standard right now.”
“I went to physical therapy within two days after having the surgery and went three times a week and just grinded. It was painful at first. The first six weeks is probably the fastest recovery, but then it kind of slows down. After about two months I didn’t think it was going to get better, but slowly it got better. After about three months I could start jogging. I wasn’t fearful of that. It was around seven months when I passed my test, but they wanted me to wait until nine months to really go full out. I feel 100 percent now. I don’t think there is any difference at all, it’s really just in your mind, thinking you might get hurt again,” Ryan said. “It was tough to go through, but I just had to think about the future, so I just grinded and kept going.”
Megan, who is studying to become a physical therapist, is right in the middle of her nine-month rehab stint and hopes she will be ready to go when her college season begins in February.
“I think as the winter comes to an end and the spring starts I should hopefully get cleared for my senior season (in 2021). I should be good by next February. I’m going to be a little nervous, but I just have to trust the recovery, and I’ll have to get back into the circle eventually. I’m a little worried with taking so much time off, but I’m hoping I’ll come back even stronger because I’ll be working on my legs and strengthening them,” she said. “It’s weird because when you’re on the other side and just watching your brother go through it, you don’t realize how serious it is. It’s tough, but I’ve been trying to stay positive and trying to find small things to be positive about. (In early June) I made a lot of improvements and I think I’m on the road to a good recovery.
“The positive I took out of it is that I’m going through as a patient what I want to do as a physical therapist. I think that will help me.”
Glenn and Margie — who herself was a star softball player during her days at Atlantic City and is in the school’s athletic hall of fame — have done their best to keep a positive attitude throughout what has been a grueling process for the family.
“As a mom, one of the biggest things we tried to do for (Ryan) was to get him out socially and being active. We didn’t want him stuck in the house, which was advice someone had given us, to make sure everything is as normal as possible,” Margie said. “I think he appreciates the game a lot more now, too. He sees things a little differently.”
“There are no shortcuts to this rehab, but (Matt) really handled it better than we did. He’s a pretty chill kid and he didn’t complain. He just did his rehab and worked hard, and he’s moving now better than he was before. He’s in better shape, he’s stronger, and even during the quarantine we’d go to the field four days a week to hit. He and Megan both were working really hard, and Matt has really matured a lot through this process. He’s making us proud,” Glenn added. “The Rothman people did the surgery and then he went to Ryan Buccafurni for rehab, and they are both fantastic. He’s done the rehab for both Megan and Matt, and they really are good and we appreciate all the time they’ve put in with them.”
Ryan says he is stronger now than he’s ever been, and that’s not surprising to Dr. Buccafurni.
“It’s possible to come back even stronger. We rehab ACLs extremely aggressively, especially in our athletes,” Buccafurni said. “Your traditional rehab program goes from getting range of motion into a strength and conditioning program. By six-to-eight week post-op, our clients are working their butts off. By eight weeks post-op they are sometimes back squatting, dead lifting. We transition into strength and conditioning principles very quickly.”
While Megan and Katie are rehabbing hard now to get back to their respective college softball diamonds, Ryan has just one season of high school baseball left to make a name for himself, and he’s eager to take the field again next spring. He’s been out there all summer with his travel team, Triple Crown Baseball out of Egg Harbor Township.
“I’m playing all summer and I’ll be training throughout the winter, so hopefully I’ll be ready to have a great season,” he said. “It will be amazing to get back out there for Atlantic City. I have to carry the legacy (of my sisters). I’ve waited three years now, so it will be even better than it would have been two years ago to step onto a varsity baseball field.”