Marissa Siebka lay on the Slippery Rock High basketball court, clutching her left knee.

She knew what had happened as she writhed in pain on that January night in 2015. The junior guard for the Slippery Rock High girls basketball team felt and heard the telltale pop of her anterior cruciate ligament snapping.

Rockets' coaches John Tabisz and Amber Osborn knew it, too.

“She's done,” Tabisz said. “She's done.”

Osborn, then an assistant under Tabisz and currently the head girls basketball coach at the school, had a difficult time focusing on the rest of the game.

“I was sick to my stomach,” she said. “Whether it's the best player or the worst player, you hurt for them.”

Unfortunately for female high school athletes, that scene has been a familiar one, especially on the basketball court.

ACL injuries are alarmingly prevalent among girls prep basketball players. They are eight times more likely to suffer the injury than their male counterparts.

There have been a litany of studies conducted that have produced just as many conclusions as to why females are at such a greater risk to suffer the devastating injury, such as the angle of the hips, smaller ACLs and greater quadriceps/hamstring ratios and even differences in hormone levels.

What it comes down to for many athletes who have suffered the injury is one indelible fact.

“If it's going to happen,” said Slippery Rock High junior Emma McDermott, who suffered her torn ACL last winter. “It's going to happen.”

And it has happened at epidemic levels at Slippery Rock High.

[naviga:h3]ACL Five[/naviga:h3]

Siebka, McDermott, Steph Croll, Jenna Whitmer, Sedona Campbell.

That would be a pretty good starting five for the Rockets. That group combined to average 54.5 points per game during their best high school seasons with Siebka and Whitmer in the running for the Butler Eagle Girls Basketball Player of the Year.

They also all suffered ACL injuries in the last three seasons.

“When Marissa was a sophomore and Jenna Whitmer and Sedona Campbell were freshmen (in 2013-14), you're thinking, 'They're going to win three District 10 titles,'” said Grove City girls basketball coach Chris Burtch, who also teaches at Slippery Rock. “Who would have thought they'd only have one season together?”

Siebka was hurt during the 2014-15 season. Campbell missed the entire 2014-15 schedule and Whitmer was injured before the 2015-16 campaign and played just five games at the tail end of the year.

Croll made it through her high school career with her ACL intact. She tore hers during the first minute of a post-season all-star game.

Another player on the basketball roster, Hannah Willison, also suffered an ACL tear while playing soccer.

McDermott was hurt 14 games into last season when a player landed on her back and buckled her knee.

For the sophomore, who had hit her stride in the games leading up to the injury and was playing significant minutes, it was devastating.

“I knew I wasn't going to be able to be on the court for at least six months,” she said. “Basketball is such a huge part of my life, it was tough. It was also tough because I couldn't play with my teammates or my sister (senior Elena McDermott). I loved playing with them.”

Like most who suffer a torn ACL, Emma McDermott had a gut feeling it was torn.

“It's such a distinct feeling,” she said. “I just remember thinking, 'Don't let it be my ACL. Don't let it be my ACL. But I knew.”

In a bit of irony, the Rockets tried to be proactive when it came to preventing such injuries.

The team traveled to Revolution Physical Therapy in Cranberry Township to learn from Butler High School graduate Lyneil Mitchell exercises to help reduce the risk of an ACL tear.

Each player was also evaluated to determine the likelihood that they would suffer the injury.

“Sometimes I think you just can't prevent it,” Osborn said. “Sometimes there's nothing you can do.”

“If there was a team that shouldn't have ACL injuries,” Burtch said, “it would be Slippery Rock.”

Yet it did happen — in bunches.

The Rockets weren't alone. The list of Butler County girls basketball players who have suffered the injury is a virtual all-star team.

[naviga:h3]No Immunity[/naviga:h3]

ACL injuries do not discriminate.

Freshmen, sophomores, juniors, seniors. Stars and role players. Experienced players and burgeoning stars.

All are at risk.

Alyssa Eyth still wears a bulky brace to protect her left knee.

“It's definitely difficult sitting on the bench,” Eyth said during the early days of her return from two separate knee injuries. “You want to contribute, but all you can do is cheer.”

Eyth lost her freshman season to a torn ACL and part of her sophomore year to a torn meniscus.

Karns City junior Olivia Mourer lost her entire junior season to a torn ACL suffered during and AAU game.

She was also lost for soccer season and is still trying to come back.

Union standout guard Lexey Shick also couldn't dodge the ACL bug.

All across the county, Western Pennsylvania and the country are similar refrains.

A recent study conducted by Contemporary Pediatrics showed 11.2 out of every 1,000 girls who play high school basketball suffered a torn ACL.

Only 2.4 out of every 1,000 boys who play high school basketball suffered the same injury.

“It's one of those things that when you talk to a coach of a team you don't know very well during summer camps or during the season, almost every coach you meet, especially a girls' coach, had someone missing because of an ACL.”

Some are luckier than others, however.

[naviga:h3]Setback to Comeback[/naviga:h3]

ACL injuries aren't all doom and gloom.

For some, the injury has brought everything into clearer focus.

“A setback is a setup for a comeback,” Shick said.

Shick was injured during an AAU basketball game in late May of last year and, like most who suffer the injury, she feared the worst.

But then she buckled down in physical therapy after her late June surgery three days a week and worked on her own two other days.

By October, she was back on the volleyball court as a senior for the Damsels in limited capacity and was cleared for full activity a day before Union opened its basketball season.

“Honestly, it kind of made me realize you can never give up on anything, that anything is possible,” Shick said. “I was cleared a month early.”

Shick said the key to her rapid recovery was knowing when to push herself and knowing when to back off.

“Some days I was sorer than others, but I knew when to stop,” she said. “I knew when to not overdue it and I knew my limit.”

It was a game in late January that she realized she was back and the worst of her injury was behind her.

“I finally felt like myself,” she said. “My parents told me I looked like the old Lexey.”

Shick will play in college this winter at Juniata.

She never thought she would play college basketball until the injury sharpened her desire.

“Honestly, the injury really made me want to work harder and achieve goals I never thought that I could do. I like proving things to myself and my family. It made me push and want it so much more.”

Lily Burtch, a junior for Grove City and Chris Burtch's daughter, was able to do something rare: play through an ACL tear.

She didn't set out to do that at first, but as she got stronger at physical therapy after her ACL snapped during a simple layup drill during open gym late last summer, doing that became a reality.

“We talked to the surgeon and asked, 'Has it ever been done before that a player has played volleyball on a torn ACL,'” Chris Burtch said. “He did a bunch of tests and said, 'Give it a try.'”

Lily Burtch did and had a solid volleyball season.

Feeling strong, she asked the surgeon if she could play a basketball season with a torn ACL.

“I thought, 'No way will I be able to do that,'” Lily said.

“The surgeon said, Give it a try,'” Chris Burtch said.

It was by no means easy.

“After every game, I'd take three ibuprofen and ice it,” Lily Burtch said. “I gave it 100 percent all the time. But 100 percent with a torn ACL wasn't the 100 percent I was used to.”Lily Burtch eventually opted for surgery and is still recovering.

She's hoping to be ready for basketball season this winter.

If she is, she will be in a very select company: players who have torn an ACL during their high school careers and not missed a game because of the injury.

“I feel really blessed,” she said. “It's incredible.”

[naviga:h3]The ACL Club[/naviga:h3]

Players who have suffered the injury feel like sisters.

They have a unique connection. They commiserate, compare notes and encourage each other through the dark times.

“It is kind of like a strange club,” McDermott said, laughing.

They also share one other important trait: they are determined to not let the injury define or limit them.

“I'm not going to let this thing that happened to me hold me back,” McDermott said. “Everything happens for a reason. Maybe for me, for us, it is to make us appreciate the sport so much more. I know I did.”