UConn's Ralph guides Doty

Caroline Doty has had three knee surgeries and said recovery from the last one has been tough. Bill Streicher/Icon SMI

Inside UConn assistant basketball coach Shea Ralph's office, behind the closed door, there is common ground.

The pain and frustration, limitations and loss, can be talked through.

Caroline Doty knows it's a place where she can share, vent and be completely understood.

The UConn senior guard has endured three surgeries to repair the torn anterior cruciate ligament in her left knee and rehabilitated after each procedure. It's been a series of stops and starts that have robbed her of practices, games and the entirety of the basketball skills she once had.

The scars are not just on the surface of her skin.

"It's never a bad thing to ask for help; I've learned that," Doty said.

In Ralph's office, Doty has more than an assistant coach or even a willing listener. She has a sister of sorts. There are few people who would empathize more.

Ralph is still paying the price for the five torn ACLs she suffered as a player. There is swelling, immobility and pain. She makes accommodations for things she simply can't do anymore and knows more surgery will be needed.

"I knew this was going to be the deal," Ralph said.

Doty has a birds-eye view of what might be in her future, as she works through the experience, getting ready for her final collegiate season.

"It's hard coming off an injury because you tend to think you can be the same as you were before the injury, but that's impossible," said Doty, who came to UConn in 2008 as a high school All-American and Pennsylvania player of the year. "It's tough to accept that you will be different."

ACL injuries have been prevalent in women's basketball for years, one of the most common and devastating injuries in the game. Players who crumple to the floor in agony when the ligament tears return more often than not. Sometimes more than once, and after multiple surgeries, as improving procedures extend careers that might have ended with the first injury 15-20 years ago. But there is penance to be served for continuing to play. In cases like Ralph's, the physical impact will last a lifetime.

Doty is still playing, in some part, to prove she can.

"I'm not as explosive as I was before the injury," Doty acknowledged. "I only noticed this after my third ACL recovery. The first two I felt as good as new and very, very strong, but now I find it hard to kneel and stop on the dot when I need to. And I get swelling when I endure too much impact after a long period of time. The little things I have noticed can be replaced by becoming a smarter player."

Ralph, who was captain of the Huskies' 2000 national championship team, understands Doty's refusal to accept an ending she doesn't write on her own.

Ralph's five ACL injuries before the age of 23 ended her chance to play professional basketball. She was able to finish her collegiate career on her own terms and was drafted by the Utah Starzz in 2001. But she never played a WNBA game.

"I can't think of a worse thing than living with regrets," Ralph said. "I always knew I had to come back. I wasn't going to be happy if I didn't play as long as I could.

"I would do it 10 times over. The way I look at it, this is the hand I've been dealt. But I had some really great experiences and I was able to achieve a lot of my goals. I wish I could have played longer."

Ralph has paid a physical price for the time she did play. Her knees, simply put, are shot.

"I've had three [ACL injuries] in my left knee and two in my right," Ralph said. "If I was in my 50s, I would have had knee replacement by now."

But Ralph is only 34. And her physical activity on "repaired" knees is seriously limited.

She can't run outside. She said she has to be cognizant of keeping her weight down because even a five-pound gain will put pressure on her knees. Basketball? Out of the question.

"I haven't played since I graduated in 2001," Ralph said. "I couldn't play if I wanted to. There's no way I can go side-to-side. But I try not to think of it in terms of the things I can't do."

On bad days, she is forced to ride a stationary bike.

"I hate it, but I'll do it," Ralph said. "I'm big into circuit training and I can get on the treadmill, but I don't run for more than three minutes at a time."

Ralph experiences severe bouts of osteoarthritis in her knees. She takes supplements of glucosamine and chondroitin, vitamins and fish oil but still wakes up some mornings with significant swelling.

"Some days I can tell when there is going to be a bad storm or rain, because I get this dull pain," Ralph said. "People say it's bull, but it's not. The bad days are when it's really swollen."

Ralph said she woke up one morning during last spring's NCAA tournament and "something didn't feel right." By the end of the Huskies' practice, "my knee was so fat, I couldn't bend it."

The doctor told her pieces of cartilage flake off and float around as you age.

"I've figured out through baptism by fire the things I can and can't do," Ralph said. "I stick to things that I know won't hurt me."

Well, except for high heels. Luckily, she spends most of her time on the Huskies' bench sitting.

"I'm just not a flats girl," Ralph said.

Ralph knows she needs more surgery, knee replacement almost certainly. Her goal is to make it to her 40th birthday before that happens.

"They have done everything they can do for me that I will let them do," Ralph said.

Ralph said she is placing some faith in advancing medical treatments.

"If not, it would be a downer," Ralph said. "I saw some of the best doctors in the country. For one of my doctors, I was his first ACL failure. And I ended up tearing four of his ACLs. They all warned me, gave me the statistics and let me make my own decisions. I'm at peace with those decisions and these are the consequences."

Doty watches Ralph deal with the long, permanent aftermath of her situation. She said she hasn't discussed her own potential long-term limitations with doctors.

"Whenever I asked, they said they will discuss possible issues when they approach," Doty said. "I'm not worried about it. I'm worried about winning a national championship."

Ralph said she has never tried to force her own experience, or reaction to it, on Doty.

"Everyone has a different experience," Ralph said. "Caroline's experience is different than mine. She's experienced different levels of pain, things that didn't upset me, upset her. All I can tell her is, 'This is how I handled it.' I think I can be more of a sounding board than anything else. She knows I understand."

Doty depends on that understanding more than ever. Coming back from her third injury, last season, was the most difficult. She started all 37 games for Connecticut but averaged the fewest minutes of her career at 20.6 a game. She averaged five points.

She spent a lot of time in Ralph's office behind that door.

"We have an understanding that if I'm struggling I will come to her," Doty said. "This past year was tough and the door was always open for me. I'm lucky to be in a position where I have Shea there with firsthand experience to get me through the days I struggle, because people who say they don't are either lying or something really special. This is the place I was meant to be."