knee

CORTINA D’AMPEZZO, Italy — Lindsey Vonn’s downhill run lasted 13 seconds. The question of whether she should have been racing at all with a ruptured anterior cruciate ligament will be debated for years.

What was going on in the mind of the legendary 41-year-old ski racer, whose violent crash resulted in her being airlifted off the course and in surgery hours later Sunday with, at minimum, a fractured left leg?

Was it a calculated risk or stubborn foolishness?

“She’s so tough mentally that as long as physically she was OK, she was going to do it,” said Stacey Cook, a retired racer and Vonn’s former teammate on the U.S. Ski Team. “I think the harder part is wrapping your mind around putting yourself at risk again. And that’s never been an issue for her. She’s always been willing to, like, put it on the line… She was always the, like, extra fearless one.”

American Lindsey Vonn completed an alpine ski downhill training session in Cortina d’Ampezzo, Italy, without incident on Friday, two days before she crashed.

(Marco Trovati / Associated Press)

What’s more, Cook said, consider what was at stake.

“It isn’t common in everyday life to go another week with an ACL injury, putting yourself at risk,” Cook said. “It’s always common to take care of it right away. But there’s more on the line for the Olympics than that.”

Dr. Neal ElAttrache, who lives in Los Angeles and is a preeminent sports surgeon, doesn’t count Vonn among his current patients but he has scoped her knee twice to remove scar tissue. He’s also in contact with members of her medical team, as he trained Dr. Tom Hackett, a renowned orthopedic surgeon at the Steadman Clinic in Vail, Colo., who works with Vonn to manage her knee health.

“These aren’t amateur people who were helping her make this decision,” said ElAttrache, who specializes in sports medicine at Kerlan-Jobe Orthopaedic Clinic and is renowned for his treatment and research of knee, shoulder and elbow injuries.

ElAttrache said the typical risk-reward calculation was not in play.

“Everybody knew going into it that there was only one way that this was going to come out good, and that’s if she not only made it through the race, but performed well,” he said. “If she didn’t ski a Lindsey Vonn race and was at least competitive at the top of the leaderboard, it would be considered a failure. There wasn’t a lot of upside, except for Lindsey.”

This combination of images shows American Lindsey Vonn crashing during an alpine ski women’s downhill race at the Winter Olympics in Cortina d’Ampezzo, Italy, on Sunday.

(Jacquelyn Martin / Associated Press)

Vonn’s crash came near the top of the Olimpia delle Tofane course where she had won 12 World Cup races during her storied career, six in downhill and six in super-G. She was on the podium there a total of 20 times before these Olympics.

Cook said the first turn on the course, which Vonn was traversing when she got into trouble, is actually much steeper falling away from the skier than it looks on TV.

“It’s like dipping into a double-black-diamond and trying to come back out of it for a second,” Cook said. “What the racer sees in that section is way different than how it looks on TV. The way it feels is a lot different.”

The racer is traversing the hill perpendicular to the fall line, almost moving in an upward direction.

“It’s a very tough turn,” Cook said. “And the next gate, you can’t see it until you’re pretty much on top of it. You might as well put on a blindfold because you can’t see anything in front of you.”

She said you have to be there to truly understand the difficulty of negotiating the turn.

American Lindsey Vonn crashes during the alpine downhill during the Winter Olympics in Cortina d’Ampezzo, Italy, on Sunday.

(Handout / Getty Images)

“To the average fan, you would stand on top of it and just go, ‘Um, no. Not doing that.’ ”

ElAttrache has studied video of the crash and said there’s no obvious indication the knee in question caused Vonn to fall.

“It’s unclear that her fall was due to an instability event in her knee … and when you look at it, you don’t see that she was weight-bearing on that knee and that she had an instability event that led to the fall,” he said.

An executive from the International Ski and Snowboard Federation told reporters Monday that Vonn was simply “incredibly unlucky” in the crash.

“It was a one in a 1,000,” said Johan Eliasch, FIS president. “She got too close to the gate, and she got stuck when she was in the air in the gate and started rotating. No one can recover from that, unless you do a 360. … This is something which is part of ski racing. It’s a dangerous sport.”

Vonn had a chance to compete on one of her favorite courses and cap her career with a meaningful Olympic moment.

“This was not about proving anything to anyone,” said Dr. Armando Gonzalez, Vonn’s mental coach, in an interview with the Los Angeles Times two days before the fateful race. “It was more about defying the odds that were placed against her and being a competitor that always found a way, no matter what, no matter if it was pain, no matter if it was noise from the outside, she’d always find a way.”

ElAttrache made a comparison between Vonn and star NFL receiver Odell Beckham Jr., who was playing on a compromised ACL when the Rams won the Super Bowl in the 2021 season. Beckham understood the risks, but was somewhat at an advantage as a receiver because he knew the routes he would be running, as opposed to being a defensive back who has to react abruptly to what the player he’s covering is doing.

In the first half of the Super Bowl against Cincinnati, Beckham suffered a complete ACL tear and was incapacitated.

Often, ElAttrache said, an ultra-elite athlete will apply a different calculus when deciding whether to play with an injury such as a compromised ACL.

He said Vonn, having endured multiple injuries and surgeries to both knees, understood the risks to her own body the way few athletes do. And whereas most skiers would be hamstrung by a fear of injury that could endanger their career, Vonn is an established icon willing to accept risks others might not. In short, it might not make sense to many, but it made sense to the battle-tested Vonn, who has “earned the right” to make those types of decisions.

What’s more, she had performed well on the same course the day before.

“If you have somebody like her, who’s earned the right to try it, if that’s what she really wants to do, she was going into that race as one of the best skiers on the U.S. team,” ElAttrache said. “She was driving that ship.”

MILAN — One short week after Lindsey Vonn crashed in Crans-Montana, Switzerland, and tore her left anterior cruciate ligament, she was tearing down the hill in Cortina d’Ampezzo, Italy, a light knee brace warping the fabric of her racing suit the only obvious sign of anything amiss. When she finished the training run Friday, clocking the third-fastest time for a U.S. woman on the day, she casually fist bumped an American teammate at the finish line.

She made the feat look effortless. Sports medicine experts can say it’s anything but.

“It’s atypical to be able to compete without an ACL, at anything, but especially at a high level like Lindsey Vonn’s going to compete at,” said Clint Soppe, a board certified orthopedic surgeon and sports medicine specialist at Cedars-Sinai. “So this is very surprising news to me as well.”

The ACL, which connects the shin bone to the femur, is a main stabilizing force in the knee and protects the lower leg from sliding forward. Straight-line movement doesn’t stress the major knee ligament and some day-to-day tasks such as walking are easily accomplished without an ACL. But what Vonn is doing is far from normal.

“If you add cutting, pivoting, changing directions, in 95% of humans, you need an ACL to do that,” said Kevin Farmer, an orthopedic surgeon and professor at the University of Florida’s department of orthopedics and sports medicine. “She’s obviously fallen into that 5%.”

Farmer calls the rare group “copers.” They overcome the lack of an ACL by strengthening and engaging other muscles. It’s primarily the hamstrings and quadriceps, but everything, including the glutes, calves, hips and core, counts.

Vonn will have had just nine days between the Olympic downhill race and her injury when she stands at the start gate Sunday. But the 41-year-old has had her whole career to develop the type of strength and control necessary to carry her through the Games without an ACL. She’s already done it before.

Lindsey Vonn concentrates ahead of a downhill training run in Cortina d’Ampezzo on Friday.

(Marco Trovati / Associated Press)

Vonn skied on a torn right ACL for more than a month until withdrawing just before the 2014 Sochi Olympics. In 2019, she won a bronze medal at world championships without a lateral collateral ligament and three tibial fractures in her left knee. She said this week that the same knee feels better than it did during that bronze medal run.

“She’s dealt with knee injuries in this knee before, so she’s been able to develop mechanisms and strategies,” Farmer said. “She probably doesn’t even realize that, but just from years of practicing with a knee that’s not normal, her body has developed mechanisms of firing patterns that allow her knee to have some inherent stability that most people don’t have.”

For athletes who suffer major injuries for the first time, pain often prevents them from firing their muscles, said Jason Zaremski, a nonoperative musculoskeletal and sports medicine physician and clinical professor at the University of Florida’s department of physical medicine and rehabilitation. But Vonn, whose injury history is almost as long as her resume, looked calm during training, her coach Aksel Lund Svindal told reporters in Cortina on Saturday.

So even if she’s one ACL short, Vonn’s team knows she has more than enough of the intangibles to get her not only down the mountain, but into medal contention.

“Her mental strength,” Svindal told reporters in Cortina on Saturday. “I think that’s why she has won as much as she has.”

Vonn completed her second training run Saturday with the third-fastest time before training was suspended after 21 athletes. She was 0.37 second behind compatriot Breezy Johnson, who is intimately familiar with what Vonn is attempting.

Johnson, a medal contender for the United States who led the second training run at 1 minute and 37.91 seconds, attempted to ski in Cortina without an ACL in 2022. She had one successful training run, but crashed on the second one, sustaining further injuries that forced her to withdraw from the Beijing Olympics.

Johnson, like many, gasped when she saw Vonn’s knee buckle slightly on a jump during training Saturday. She said coming off jumps on this course are especially difficult.

“There are, I think, more athletes that ski without ACLs and with knee damage than maybe talk about it,” Johnson said at a news conference from Cortina. “… I think that people often are unwilling to talk about it because of judgment from the media and the outside.”

Critics say Vonn is taking a spot from a healthy teammate or that she simply refuses to give up the sport for good. But Vonn has already come to terms with the end of her career. She said she came out of retirement with a partially replaced right knee simply wanting an opportunity to put the perfect bow on her ski racing career at a course she especially loves.

The stage is different, but the sentiment is familiar to Zaremski. The doctor has worked with high school athletes who beg for a chance to play a final game after suffering a torn ACL. Through bracing, taping and treatment, sometimes there are temporary fixes for the biggest moments.

“If we’re trying to get a huge event like the Olympics, I would never put anything past [Vonn],” Zaremski said. “She’s an amazing, once-in-a-generation athlete.”

Despite retaining Mateta, who is Palace’s top scorer with eight league goals this season, the Eagles paid a club record fee to sign striker Jorgen Strand Larsen from Wolves.

Palace were also on the verge of bringing in Everton winger Dwight McNeil until the deal fell through late on deadline day.

Glasner said he had “learned to accept situations” after Palace were also unsuccessful in finding a replacement for captain and centre-back Marc Guehi, who joined Manchester City earlier in the window.

“At the end of it, the club tried everything with huge offers and huge bids for a Marc Guehi replacement, but clubs said they don’t sell on deadline day,” Glasner said.

“Credit to the club that without getting any money for Mateta they still spent a big fee on Strand Larsen.

“On the other side, McNeil was the last one we thought we could finalise, but in the last minutes the terms of the deal changed again and the deal failed. I expected him and planned for him in the next day’s training.”

McNeil’s partner, Megan Sharpley, criticised Crystal Palace on social media for the way they handled the situation.

Everton boss David Moyes said the breakdown had “nothing to do” with his club and insists McNeil is “fine”.

“He’s in and he’s training as well, so Dwight’s OK,” Moyes said.

“We understand exactly where it went wrong, how it broke down. He knows everything about it and there’s no problems there.

“We had given permission for Dwight to go and have a medical and do all of the things required for it, so it was very hard to do much more than we have done.”

Northampton Saints wing Edoardo Todaro is facing a long lay-off after suffering a serious knee injury at a training camp with Italy.

The Italian Rugby Federation website say diagnostic tests had confirmed a torn cruciate ligament in his right knee.

“The player will return to his club where he will continue his recovery and rehabilitation process, supported by the Northampton medical staff in collaboration with the men’s national team medical staff,” a statement added.

Todaro, 19, has been a revelation for Saints, scoring 10 tries in 13 appearances –despite serving a two-match ban for an aerial tackle – after signing his first professional contract before the start of the season.

U.S. skiing great Lindsey Vonn says her “Olympic dream is not over” after crashing and injuring her knee during a downhill race that was meant to be her final warmup before the start of the Milan Cortina Games next week.

“I crashed today in the Downhill race in Switzerland and injured my left knee,” the 41-year-old former Olympic gold medalist posted Friday on her Instagram Story. “I am discussing the situation with my doctors and team and will continue to undergo further exams.

“This is a very difficult outcome one week before the Olympics… but if there’s one thing I know how to do, it’s a comeback.

“My Olympic dream is not over. Thank you all for all of the love and support. I will give more information when I have it. … It’s not over until it’s over.”

Taking part in a World Cup race in Crans Montana, Vonn lost control while attempting to land a jump on the upper portion of the course and slid into the safety netting. After receiving medical attention for about five minutes, Vonn slowly skied to the finish line, using her poles to support herself and stopping twice to clutch her knee.

She smiled and waved to the crowd after crossing the finish line and received a long embrace from teammate Jacqueline Wiles before entering the medical tent. She was later airlifted off the slope for further evaluation.

Vonn was the third skier to crash during the race, which was being held in difficult conditions with low visibility. The event was canceled after Vonn’s fall.

After nearly six years away from ski racing, Vonn made a comeback last year and has two victories and three additional podium finishes in five downhill races this season — all with a partial titanium implant in her right knee.

At the 2010 Vancouver Games, Vonn became the only U.S. woman to win Olympic gold in downhill skiing. She also won bronze medals in the super-G 2010 and downhill in 2018. On Dec. 23, Vonn announced on Instagram she had qualified for “my 5th and final Olympics!”

“When I made the decision to return to ski racing, I always had one eye on Cortina because it’s a place that is very, very special to me,” she wrote. “Although I can’t guarantee any outcomes, I can guarantee that I will give my absolute best every time l kick out of the starting gate. No matter how these games end up, I feel like I’ve already won.”

The opening ceremony for the Milan Cortina Games is Feb. 6. Vonn’s first scheduled event is the women’s downhill on Feb. 8. She had also planned on competing in the super-G and the new team combined event.

The Associated Press contributed to this report.