As someone who has her sights set on playing professional soccer one day, Sarah Hughes knows the importance of being aggressive on the field.
"Obviously, it is really hard to do, but I think I have some potential," she said. "You have to work hard for what you want."
Her aggressiveness often leads to wins. During a long stretch in 2013, however, it also led to a string of injuries that repeatedly put Sarah's determination to the test.
"She just always has been competitive," said Sarah's mom, Jennifer. "She has to win the ball, which I think sometimes gets her in trouble."
One After Another
During a soccer tournament in February 2013, Sarah, who plays defense, was going for the ball before falling and hitting her head on the turf. Not usually prone to clumsiness, Sarah said she had a little help making it to the ground from an opponent.
"She definitely pushed me. I remember that," she said. "I fell back and hit my head pretty hard."
Sarah didn't start feeling any symptoms until she attempted to play the next game in the tournament. At that point, it was clear something was wrong.
"We went back for the second game and I could just tell there was something a little off," Jennifer said. "She just quit and dropped to her knees and held her head. It was very, very scary."
Sarah's pediatrician diagnosed her with a concussion and told her to take a break from both soccer and mental strain, like school work and excessive time in front of screens. After about a month, once her symptoms had started to fade, Sarah returned to the soccer field.
Not long after, she received a second concussion.
"Oh no, not again," Jennifer said. "It was almost the same exact same scenario. I took her straight to Children's."
The symptoms of the second concussion presented themselves quickly and in severe fashion.
"Think about having a really, really bad headache every day for a long period of time," Sarah said. "It is kind of like when you first wake up and you turn the lights on. That is how I felt every day."
Jennifer took her daughter to see David Popoli, M.D., a sports medicine physician at Children's. His goal was to get Sarah the physical and mental rest she needed so the symptoms would subside and she could return to soccer.
"She came in with headache, nausea, dizziness, feeling dazed and having a hard time doing well in school," said Dr. Popoli. "The second concussion tends to be very severe and tends to last longer."
On top of staying off the soccer field, Sarah had to continue to avoid doing anything that may strain her eyes or require mental exertion. This included watching TV, talking on the phone, working on the computer or texting friends.
As difficult as it was for her, Sarah stayed disciplined. Sometimes, it seemed symptoms were going away only to return, pushing her comeback even further.
Ultimately, Sarah missed about five months of prime soccer playing time because of the concussions. But that would not be the end of her obstacles.
'Eye on the Goal'
While competing in a camp a week after returning to soccer, Sarah was once again knocked to the turf.
"A girl near me tackled the ball at the same time," she said. "She missed the ball and kicked my ankle. It was instant pain."
Sarah again had to put her soccer career on hold and recover, this time from a torn ligament in her ankle. She went to physical therapy at Children's twice a week to help her recover and build strength back in her ankle.
Throughout it all, Sarah kept taking the steps she needed to get back to her sport. This came as no surprise to her mom.
"She had her eye on the goal of what she wanted," Jennifer said, "and I knew she would make it happen."