After a block, a hard landing and a team celebration, Nicole Hughes, a middle blocker, felt pain in her right knee at a volleyball tournament in Indianapolis, which was only the third tournament of her competitive club team's season.

"I knew it hurt but I didn't think I did anything serious," says Hughes, 17, now a senior at Pioneer High School in Ann Arbor, Michigan, who has aspirations of playing volleyball in college and for the United States Olympic team.

But her swollen knee the next morning told another story.

Her mother, Bernadette McClair, left Indianapolis and drove her to the emergency room at C.S. Mott Children's Hospital in Ann Arbor where she had an X-ray, and the following day an MRI, and soon after, an appointment with Eileen Crawford, M.D., an orthopaedic surgeon with MedSport, Michigan Medicine's sports medicine program.

Crawford informed Hughes that she tore her ACL, a ligament that connects the shin bone to the thigh bone, and had a slight tear to the meniscus – the cartilage between those connecting bones. It meant she would sit out her senior season at high school, but if she worked hard in recovery, she might be able to return to her club team in January 2020.

"She lives and breathes volleyball," McClair says. "She has such a passion for it that after she would practice for hours."

LISTEN UP: Add the new Michigan Medicine News Break to your Alexa-enabled device, or subscribe to our daily updates on iTunes, Google Play and Stitcher.

McClair and Hughes felt better about her future after discussing her options, says Crawford, who was a collegiate national champion rower, an experience that helps her understand the goals of a competitive athlete recovering from injury.

"At that first appointment, we talked about what the injury meant and why – based on her active lifestyle and her athletic goals – we treat these injuries surgically," Crawford says.

After several weeks of physical therapy to prepare the knee for surgery and subsequent rehabilitation, Crawford completed an arthroscopic ACL reconstruction to Hughes' right knee in early March.

Hughes now sees physical therapist, Andrew Swartout, and athletic trainer, Angela Mierzwiak, twice a week for therapy at MedSport's Domino's Farms location.

One of them always attends her appointments with Crawford, too. "They keep me in the loop and together, we make sure Nicole continues her progress," Crawford says. "It's one of the benefits of MedSport – the team works together."

Overcoming struggles

Hughes initially struggled emotionally after the surgery, McClair says. She was so accustomed to moving constantly that having to baby her knee for the first week after surgery proved challenging. She felt depressed, isolated and in pain from the blood thinner injections she was required to receive.

"With Nicole I can definitely see there is a mental component to the healing process that sometimes we don't focus on enough," Crawford says. "We have to remember that these patients are really young and they haven't been through anything like this before, even though it's a routine part of my day and my team's day."

Crawford explains that athletes may not initially realize how an injury may impact their following year, but when they do, it may also be mentally difficult for a sports player to accept.   And it's important for parents to be aware of the emotional health of their child during this time. 

"Although Nicole doesn't usually let it show, this has constantly been on her mind.  She's not somebody who's really pushing to go back sooner than she should, though. She's been cautious with her recovery and wants to make sure she's ready."

MORE FROM MICHIGAN: Sign up for our weekly newsletter

After seeing her youngest child hurting, McClair decided to act as an informational source to other families undergoing similar injury experiences. She began putting together a documentary on Hughes' injury and recovery, which she hopes will raise awareness about the impact injuries have on young athletes and their families.

"It impacted us in ways that we weren't prepared for, so we want to help others figure out a way to get through something like this and come out stronger, not just physically, but mentally too," McClair says. "I had to be Nicole's biggest cheerleader and fight for her."

Hughes' teammates have visited her during her recovery and put together a care package, which buoyed her spirits, McClair says. She also gets pep talks at A2 Fitness Professionals where she goes for conditioning twice a week with owner Demond Johnson and trainer Ahmad Samaha. They work with her on core strength and conditioning, providing encouraging but powerful workouts that force Hughes to mentally overcome her challenges too, McClair says.

Another unexpected form of therapy came from comfort dogs that McClair arranged to stop by their home. "It's all part of her healing process," McClair says.

A winning future

Hughes is continuing her physical therapy and hopes to undergo a "return to sport" test when her MedSport team thinks she's ready. Her club team, excited for her potential return, has a spot reserved for her in January.

"I want to heal well, so I'm not rushing anything but I do want to get back to volleyball," says Hughes, who regularly holds at least one volleyball of the four different volleyballs in her home. She hopes to commit to a college that has a respected volleyball team as well as a great psychology program, her intended major.

"I am making it my job to heal 100 percent," Hughes says.

McClair anticipates the documentary will be available by early 2020.