Updated April 29, 2019 12:54:22 The injury that forced the death of former Olympian and Olympic gold medallist Jodie Foster in March 2017 will be remembered for many years to come, but it is likely not as a consequence of her knee.
A new study shows that the injury that left Foster with a torn ACL also damaged her bones and ligaments, rendering her unable to move her body and leaving her unable, for the first time, to exercise.
Key points: She was only allowed to use one leg to lift her feet to the floor, and she lost most of her upper body muscles, leaving her incapable of doing much in her environment.
This was the first study to examine whether these structural changes contribute to injury risk and progression The study found she was able to use only one leg in the event of an ACL tear, but had lost most her upper-body muscles, rendering the athlete unable to do much in the environment of her care.
The researchers, from the University of Western Australia, found Foster suffered a torn anterior cruciate ligament (ACL) injury that occurred in her right knee while training for the Rio 2016 Summer Games in August 2016.
ACL tears are caused by an acute compression of the inner and outermost layer of cartilage, resulting in the release of a fluid called “the extensor digitorum longus” (EDL).
This fluid is a key part of the “stabilised” cartilage matrix, which helps the joint to remain in place when the muscles contract and the ligaments contract.
“This finding has important implications for the development of the design of ACL rehabilitation programmes in athletes,” the researchers wrote.
“The ACL injury may have been caused by a transient disruption in this stabilised matrix, leading to a temporary loss of stabilised ligaments and a loss of functional flexibility.”
The study used the knee’s unique structure as a model to look at how the ACL rupture affected Foster’s bones and joint.
The knee was constructed with a joint that was a perfect copy of the human foot, with its own biomechanical principles.
The scientists found that while Foster was able, under certain conditions, to lift and run on her left foot with only one hand, she was unable to use this left foot in any kind of controlled way.
“While the anterior crux of her ACL was not damaged, the anterior ligament was not stabilised and was consequently more prone to tearing,” the authors wrote.
The team said that this would be a problem for athletes who were training on their left foot, because there is a tendency to train on one side.
“We propose that the anterior ACL was initially unstable, leading directly to a loss in functional flexibility,” they said.
“A functional injury to the anterior posterior cruciata may lead to instability of the anterior anterior crucus and subsequent damage of the ACL, which may lead both to further injury and disability.”
The researchers said the injury could have been prevented had Foster used her left leg more often and had she been able to get to the same fitness level she did.
“An athlete’s flexibility is important for sport performance and rehabilitation, and this finding is particularly important for athletes at risk of ACL injuries,” they wrote.
Foster’s death, which happened when she was 22 months old, remains a controversial case study in the rehabilitation world.
It has been argued that Foster was not suffering from a pre-existing injury but rather had a degenerative form of her injury, but this remains disputed.
Foster had not been injured since she was 12 and was able again to run on a treadmill, which is not a normal activity for her age, the researchers noted.
The ACL tear in Foster was the most severe case of the condition, and the researchers said she lost her ability to walk with a limited range of motion in her legs, and her ability “to do any movement beyond a very limited range.”
Foster, who had been in her 20s when she sustained the injury, was taken to the University Hospital in Adelaide to have a CAT scan done and her condition improved after an operation to repair her torn ACL.
The doctors were also able to examine her ligaments using a computerized tomography (CT) machine, which was “one of the first times CT has been used for ACL reconstruction in the past 20 years”.
The team concluded that the ACL tear was the “most severe and debilitating” of its kind to ever be found.
It was also the first ACL injury that could be predicted and corrected by using a digital tomography scan.
The findings of the study are published in the journal ACL Surgery.