Freeride athlete finds world-class care at Banff Mineral Springs Hospital

Casey Brown can still hear the sound of her back tire sliding out on the off-camber rock face, 14 metres (45 feet) above the desert floor in Utah. It was the end of a practice run at Red Bull Rampage, the world's premier freeride mountain biking event, when everything went wrong.

"I tried to correct it as much as I could," says Casey, a professional mountain biker from Revelstoke, B.C. "There was nothing I could do. I remember two major impacts — smashing into the ground and then tumbling and smashing into the ground again."

What followed was a dramatic nighttime helicopter rescue by the National Guard, a 20-hour drive back to Canada with her sister and two young nieces, and a complex surgery at Banff Mineral Springs Hospital that would give Casey her best chance at returning to the sport she loves.

Casey is one of many elite athletes who travel from across North America to receive care from Banff Sport Medicine, a team of healthcare professionals at Banff Mineral Springs Hospital whose goal is to provide world-class care for sport-related musculoskeletal trauma and reconstructive surgery. The program has built its reputation over 30 years through a collaborative, patient-centred approach to treating complex injuries.

The crash left Casey with a crushed tibial plateau (the top surface of her shin bone), a torn meniscus (knee cartilage) and damage to her posterior cruciate ligament (the band of tissue at the back of her knee). Dr. Mark Heard, orthopedic surgeon and director of Banff Sport Medicine, reviewed the video footage of Casey’s accident to understand exactly what happened.

"She hucked about 45 feet and then augered in on the landing," says Mark. "Basically, she hyperextended her knee and drove her femur (thigh bone) into the front of her tibial plateau. With the amount of energy she had, in this high-energy injury, she actually went down and broke into her tibial plateau." 

Casey arrived in Banff on a Thursday for a consultation. By Friday afternoon, she was in surgery. The team's ability to respond quickly is part of what sets the program apart, says Mark.

"I spoke with site administration and told them this was the best option for Casey, and we were able to move forward quickly," he says. "This hospital is super supportive of giving excellence in care, especially when dealing with sport injuries like this for athletes who wouldn’t get the same level of care elsewhere.”

The surgical team used arthroscopic techniques to rebuild Casey's knee, watching the joint on a high-definition monitor while lifting the crushed bone back into place with specialized instruments. They filled the gap with human bone grafts from a bone bank and secured everything with a stainless steel plate.

"We basically make a raft under the joint," Mark says. "To have the raft not sink, the plate goes down to the good part of the tibia about four or five inches, and then we put screws in. We buttress the reduction."

While Casey was under anesthesia, the team also removed a bone chip from her ankle and took out a plate inserted in her collarbone after a previous injury that had been bothering her.

"One of the options would have been to say we're just going to focus on your knee. You have to deal with that at another time," says Mark. "But Banff Mineral Springs is a can-do hospital. We want to give you the best patient care."

Margie Smith, site administrator at Banff Mineral Springs Hospital, says the relationship between the hospital and Banff Sport Medicine has always been seamless.

"It doesn't even feel like a partnership,” says Margie. “They feel like part of our team here. We are really proactive in their research and work with them to keep operational costs down while still being leading edge so they can succeed in being the best at what they do."

Casey had been a patient at the hospital before, having had her collarbone plated in 2013 after a previous injury. That experience shaped her decision to return.

"Anytime I've gone to other hospitals, I have just never been treated as well," says Casey. "I’ve felt like I was kind of rushed through everything and ended up getting spit out the other side, not knowing a ton of what went on in there."

Although the hospital prioritizes positive patient experiences, Margie also credits its unique circumstances as a lower volume site compared to other urban centres with enabling such standards of care.

"We are not over capacity with patients like other sites,” Margie says. “Our staff have the time to provide the level of care that is needed. Part of our stewardship here is not just the dollar; it's our people. We really try to look after our staff so that when they show up for work, they are able to give the best care."

Mark expects Casey to make a full recovery, with no restrictions or limitations on her return to competitive riding. He had her on a spin bike just five days after surgery to maintain mobility in her knee.

"The fracture itself is going to take about eight weeks (to heal),” says Mark. “The meniscus is going to take eight to 12 weeks. My estimate of return to full sports would be around three to four months."

But physical recovery is only part of the journey. Casey acknowledges that processing the mental side of such a traumatic crash will take time.

"It kind of reoccurs every time I try to fall asleep,” she says. “The incident just sneaks back into my mind. A traumatic crash like that one — this is probably one that I will need to get some help with because it was quite scary."

Mark has seen this pattern before in his decades of working with elite athletes. He now considers psychological readiness just as important as physical rehabilitation.

"Often some of the hardest barriers of return are the mental ones," he says. "We've got to reach out to people who have that toolbox to work through the trauma with athletes."

Casey is focused on healing, surrounded by family and friends in Revelstoke. She remains grateful for the care she received and optimistic about what lies ahead.

“Everything that happens to you is a lesson and a beautiful opportunity to learn, grow and become a better athlete and person,” she says. “Don't waste an injury. Make sure you learn the lesson.”