High School Sports: For Westminster's Ruby, 'a different kind of hard' in recovery from torn Achilles

Westminster High School senior lacrosse player Anna Ruby is undergoing intensive physical therapy after she injured her Achilles tendon during the Owls' state championship win over Mount Hebron last spring.

It’s 4 p.m. on a Wednesday, and Anna Ruby is lying face down on a table while Morgan Johnson kneads the back of her calf with a heavy cylinder made of steel.

This process is painful for Ruby, and she cringes as Johnson, her physical therapist at Evolution Sports Physiotherapy in Cockeysville, guides the rod down the back of her leg in order to assess the tightness of her muscle.


He stops when he reaches a defined scar that protrudes from Ruby’s left ankle.

The scar, which Ruby describes as a “great conversation-starter,” is hard to miss.

It’s a symbol of recovery for the Westminster High School senior, who suffered a torn Achilles tendon in the Class 3A girls lacrosse state championship game May 24 against Mount Hebron. The Owls won 9-5 to capture the program’s first state title, and Ruby scored a team-high three goals before leaving the game five minutes into the start of the second half.

Ruby said she felt a lot of pain in that moment, but a torn Achilles never crossed her mind.

“It feels like someone stabbing you in your heel and it shoots up your calf,” Ruby said. “It feels like you got cleated and then it feels like a Charley horse, so I was really confused when it happened. … It felt like my right foot with the tendon still intact was in a high heel because since the tendon was shot on my left side, it felt so flat. The difference between the two was drastic, so if you’ve ever walked in one high heel and one normal shoe, that’s what it felt like.”

Ruby, a Loyola University Maryland women’s lacrosse commit, was recommended to see Johnson by Maura Rowland, the Greyhounds’ strength and conditioning coach. Ruby started working out at Evolution Sports Physiotherapy in July, and goes two to three times per week.

The Times recently followed Ruby during one of her physical therapy sessions and tracked her progress as she went through her weekly routine.

4:20 p.m. — Johnson walks Ruby through a series of 30-second stretches.

“I know it’s not the most glamorous stuff,” Ruby said. “But, that’s the beauty of it.”

4:22 p.m. — Ruby walks for six minutes on a treadmill set to an incline, and Johnson tells her that she is in charge of her speed. She walks for two minutes on level 9, then increases the incline to 12. After another two minutes, she brings the incline back down again.

Ruby talks about her scar while on the treadmill, and she said it took about 10 weeks to heal. She has a keloid, an often lumpy or ridgy scar that raises after an injury has healed as a result of excessive protein in the skin during the healing process.

At the end of the day, she said, it’s something to be proud of.

The Achilles tendon is the largest tendon in the human body and it stretches from the bones of the heel to the calf muscle. According to WebMD, patients recovering from a torn Achilles can resume physical activity after 4-6 months, but a full recovery can take more than a year.

“I’m four-and-a-half months out from surgery right now and the nine-month mark would be March 1,” Ruby said. “As you know it’s the first day of [lacrosse] tryouts, so my goal is definitely to be back in nine months. If it’s later than that, ultimately my college career has to be put first. Although, I think we have another shot at states this year, so hopefully it will be nine months.”


4:30 pm. — Ruby does jogging intervals, in forward and back movements to absorb and drive her feet into the ground, using her calf muscles to make contact with the floor. By doing this, Johnson said, she extends the tendon as opposed to backpedaling or pushing to lower it.

Ruby adds pre-plyometric exercises such as high knee intervals and walking on her tiptoes to these forward and back motions. These exercises conclude with Ruby completing single leg dead lifts and lunges before she moves to the next phase.

4:38 p.m. — Johnson instructs Ruby through a series of stretches using a kettlebell, a weighted iron or steel ball with a handle attached. The challenge here, Johnson said, is to increase the hypertrophy of the calf muscle to help restore calf mass — it also gives Ruby a heavier workload.

“It’s a different kind of hard, that’s for sure,” Ruby said, as she completes four sets of these stretches with a single calf raise for 10 reps each.

4:45 p.m. — Ruby is given one minute of rest prior to performing single leg hops on a Shuttle MVP, a three-in-one machine used in general rehabilitation to provide levels of resistance for those recovering from surgery.

Ruby does four sets of 10 single-leg hops on either side of her body on this machine using about 25 percent of her body weight in the process.

4:50 p.m. — Johnson places a unilateral box on the floor for Ruby to complete a series of single-leg hops on the box in a squat position. Johnson tells her to start with soft, light jumps, four to the right, then four to the left with one minute of rest in-between.

Johnson said this is Ruby’s first exposure to these specific exercises, and the hops are set to help her work on pushing off and controlling her landing in a static position.

Ruby continues these hops on all four sides of the 6-inch box. The intent of these exercises is to challenge Ruby’s ability to land with a concentric phase jump. After a few minutes, Johnson asks Ruby if she’s doing all right. Ruby tells him she is, but her strength just isn’t where it needs to be — yet.

5 p.m. — Ruby does 10 reps of skater squats on each side of her body. When doing these, Ruby has to keep her neck neutral and maintain a straight back as she transitions her weight to each leg while lifting her other leg slightly off the floor.

Five minutes later, Ruby begins to push a 90-pound sled 80 feet down and back on the floor three times.

5:07 p.m. — Ruby returns to the table and lies face down as Johnson prepares to administer a dry needling treatment. Dry needling is a method often used to treat sports injuries and the small, individually-wrapped needles are placed on trigger points in the muscles or tissue to help calm them.

Johnson inserts the needles into different areas of her left leg and connects the needles to electromagnetic clips that generate a twitch in Ruby’s leg.

She can’t feel the twitch, she says, but she can feel the needles hit muscle as Johnson inserts them.

This continues for 11 minutes, and Ruby remains relaxed as her session winds down.


“When you’re in a circumstance like that, you’re either going to go with your resiliency and determination right away or you’re just going to drop everything,” Ruby said. “For me, I was so focused on the next step and wasn’t even accepting it that I was not going to be able to play for so long because that’s just what you want to focus on.”

Ruby said she wants to see factors implemented in team practices and lifting programs that can help reduce the risk of these injuries, and those similar to it.

Physical therapy has helped her embrace the importance of these exercises and it’s taught her discipline along the way.

“I don’t know why I had an Achilles rupture at such a young age,” Ruby said. “A lot of things like [knees] and a lot of ankle tweaks can be prevented with stuff similar to this where you're not really focused on how much weigh you can squat, but more of the tedious things and how you keep up with that.”