It's an alarming trend happening every day on playing fields and basketball courts: a young girl jumps, or pivots, and collapses in excruciating pain.
Teenage girls are suffering serious knee injuries like ACL ruptures at much higher rates than boys playing the same sports.
The "why" is pretty complicated. There are a lot of differences between boys and girls. Their hormones, the way their knees line up, even differences in the mechanics of how they land from a jump.
Whatever the cause, Diarra Oden - a young but serious basketball player - was hit by knee injury we used to only hear about in adults and she's in sixth grade. Diarra has torn the anterior cruciate ligament, or ACL, in her right knee.
Pediatric orthopedic surgeon Cliff Willimon operated on Diarra at the Atlanta's Outpatient Surgery Center at Meridian Mark.
We're seeing youth athletes that are getting adult-type injuries at their teen or preteen years with potentially adult-type consequences"
- Pediatric orthopedic surgeon Cliff Willimon
"We're seeing youth athletes that are getting adult-type injuries at their teen or preteen years with potentially adult-type consequences," said Willimon.
Diarra started with gymnastics, then softball and then found basketball.
A sixth grader at Marist, from a family of athletes, she now plays basketball year-round, for both Marist and a recreation league team.
"I like playing defense, because it gives me self-esteem when I get to steal ball from others, and the crowd and stuff," said Diarra.
Diarra was trying to steal the ball in June in a tournament game when it happened.
"It was like a twisting...and then I heard a pop after that. But it was like really quick. I didn't know what was going on," said Diarra.
But Diarra's mom, Trudy, knew Diarra she didn't get up.
"Because normally, she'll get back up, her and her sister both will jump right back up. She didn't get back up," said Trudy Oden.
"I screamed really loud because it hurt," said Diarra.
A sudden cut, plant or pivot is all it takes to rupture an ACL. Sports injury experts say whether you blame it on hormonal changes or anatomical differences, girl athletes are at much higher risk of knee injuries.
Suffering anywhere from double to five times as many ACL tears as boy in basketball, volleyball and soccer.
Dr. Willimon says most of the girls he sees are year-round athletes who get hurt right after a growth spurt.
"Muscular growth and coordination tends to lag behind coordination. So there's probably this window of opportunity in which they're being exposed to high levels of opportunity of athletic play, a higher chance of fatigue," said Willimon.
Diarra's ruptured ACL couldn't be repaired, so Dr. Willimon created a new one, using tendons taken from her hamstring. It's all done with a tiny camera and light to see inside her knee,
The doctor anchored the new tendon to her thigh bone and then connected it to her shin bone. The whole procedure takes only about an hour.
The hard part is what comes next. Diarra will spend her basketball season in the physical therapy room.
"It's going to take like seven to nine months for me to go back to playing sports," said Diarra.
"We're going to be prayerful. And I know she's a strong girl, she's going to be OK," said Trudy Oden.
Trudy says she knows of two or three girls in Diarra's league who all suffered the same knee injury, so she was familiar with that cry of pain she heard from Diarra back in June.
Children's Healthcare of Atlanta has certified athletic trainers who are now working with schools to teach injury prevention.
Part of the solution is conditioning and strength training, but Willimon says time to rest also important.
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