Emma Sexton was a standout soccer player as a junior in high school in 2019 when she blew out her right knee. Then the COVID-19 pandemic happened, just as she was recovering from surgery performed by Novant Health orthopedic surgeon Dr. James Romanowski to repair the torn anterior cruciate ligament, better known as the ACL.

While her club teammates were signing bigtime Division I college scholarships to play for schools like the University of Georgia, North Carolina, Kentucky, Clemson and Wake Forest, she was left wondering what to do.

“I honestly thought (my soccer career) was going to be over because my rehab schedule ended my senior year, and everybody on my team had pretty much committed by then,” said Sexton, 20, of Fort Mill, South Carolina. “I was honestly just defeated.”

Sexton started applying to colleges to go as a regular student as she recovered from surgery. Once back healthy, she decided to play in one final tournament with her club team, Charlotte Soccer Academy. It was there, in 30 minutes of action on her surgically repaired right knee, that a coach from Lander University saw all he needed to see.

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Fast-forward to today: Sexton just completed an eight-goal season for the Division II program in Greenwood, South Carolina, where she led her team in scoring and was named first team all Peach Belt Conference.

And as a junior, she has been playing on two surgically repaired knees. She tore her left ACL as a sophomore at Lander in September 2022. After going through the lengthy rehabilitation twice now, she has all the more proof of what worked to get her back in action: determination, successful surgery and using Novant Health’s “bridge” program throughout her rehabilitation.

Recovery from a torn knee ligament typically takes even the highest performing athletes nine to 12 months to recover. The bridge program helps patients close the gap between traditional physical therapy and returning to full competition as an athlete. It can also help patients keep out-of-pocket costs down by continuing to bill insurance.

After first trying a rehab clinic closer to home, Sexton switched to Novant Health Sports Performance - Arboretum, even though it required a long drive from her home in Fort Mill.

“I felt like I was actually working out hard, and I felt like I was actually getting better,” Sexton said. “And I was enjoying it, even though I had to drive 45 minutes right after school every day. It was worth it.”

After building up the strength in her knee with a physical therapist, she transitioned to working with a sports performance coach on soccer-specific needs like agility and endurance.

“The personal relationship I have with the people there working with me – they were very friendly,” Sexton said. “And they were good at what they were doing.”

Dr. James Romanowski

Her team of physical therapists and trainers were in regular contact with Romanowski, her surgeon at Novant Health Orthopedics & Sports Medicine - Matthews, who performed both of her operations. Under his guidance, Sexton took the full 12 months of recovery in 2020. But by the second operation, working with physical therapist Hunter Peacock, she was back to action in just nine months.

The program “got her back to playing soccer at a very high level,” Peacock said. “She’s really committed. She worked really, really hard in here, and she worked hard on her own. That would be my key. She’s a dedicated person. When she sets a goal, she gets it.”

Peacock stayed in regular contact with Romanowski, who’s also a team orthopedic surgeon for the Charlotte Hornets. Peacock tailored her program to her specific operation and required recovery.

Romanowski repaired Sexton’s knee with a portion of her quadriceps tendon. At the time of her first operation in 2019, he was the only surgeon in Charlotte performing it that way. The more typical method is to use a portion of a patellar tendon from the knee or a hamstring tendon.

The advantage of using the quadriceps tendon over the patellar tendon was that there would be less post-operative knee pain, Romanowski said, and studies have shown that the quadriceps tendon has proved to be just as strong.

“The proof was in the pudding,” he said. “She did well with it. And I had mine done as well – actually the date we did her first surgery was on a Wednesday. I had mine on a Thursday.”

Romanowski said he injured his knee snow skiing in Montana. “I was like ‘Come on,’” he said, laughing – and he’s backing skiing again, too.

He found out firsthand just how important the procedure, the recovery and the commitment of the patient can be.

“It’s nice when you have familiarity and high levels of communication between the surgeon and the physical therapist,” Romanowski said. “If there are any concerns, it’s easy to communicate with myself or other surgeons. We use the electronic medical records system for all their physical therapy notes, and they can reach out to us by messaging through the digital system for any concerns, and it makes it a more seamless process.”