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The Show Must Go On
By Jeff Yip
In the fall of 2001, the dream was on the verge of being realized. The arduous process of filming had begun and Lee had tapped Yeoh, a Malaysia-born actress and former ballet dancer, to portray the virtuous woman warrior in Crouching Tiger, Hidden Dragon. But the project’s future was thrown into doubt when, in the closing stages of filming the first action sequence, Yeoh suffered what she termed “a bad fall’’ and injured her left knee. “You go into self -denial,” the down-to-earth star recounts from her Hong Kong office. “You hope it’s a sprain, but when you turn right and your knee is swinging left, you know it’s not normal.”
But the production gods were smiling. Yeoh, in New York City to do a shoot with celebrity photographer Annie Leibovitz for Vogue, had friends at Johns Hopkins in Baltimore. “One thing you must have is friends who are doctors and lawyers. Especially doctors,” she says with a chuckle. “Anyway, they says the best person to see would be Andy Cosgarea.” Four days after her injury, she was at Johns Hopkins to see Cosgarea. “I just wanted to make sure it was OK,” Yeoh says. “Well, we had an MRI and it was not even a little tear! It was completely torn.”
That is usually a season-ending injury for college and professional athletes. But not this time, says Cosgarea, assistant director of Johns Hopkins’ Sports Medicine Division and an associate professor in the Department of Orthopedic Surgery.
“The options were to try to limp through the end of the filming or do surgery,” says the youthful surgeon-educator. “This movie was something she’d wanted to do for a long time. She could wear a brace, and they would have to modify what they expected of her. Her concern was they might have to bring someone else in. [Director Ang Lee] apparently was very willing to work with her. He wanted her and no one else. She felt this duty to him.”
Says Yeoh: “I had to call my director. But I realized this was something that had to be done.”
“We had a deadline of just under 3 months,” Cosgarea says. “They had contracts to get all the shooting done before Christmas. It was now or never. We opted for a very fast-track approach. Three months is the bare minimum. Most people wouldn’t be ready in 3 months. We had to really push the limits. We had to get the surgery done quickly, get it done well, and provide her with the best possible therapy.”
Yeoh’s knee was painful, swollen and inflamed. Outpatient surgery was performed 10 days later, once she had regained nearly normal knee motion. “We did an endoscopic anterior cruciate ligament (ACL) reconstruction using patellar tendon autograft,’’ Cosgarea says. “The ACL was avulsed off the femur and she had some minor chondral damage under her patella.’’
Cosgarea is quick to credit his star patient and Johns Hopkins physical therapist Diane L. Dallap for the remarkable postoperative course.
“She was placed in a knee immobilizer postoperatively and advanced to full weight-bearing within 1 week. By 1 week, she had five degrees of hyperextension and 120 degrees of flexion,” he says. “She stayed in Baltimore for 3 weeks and was in physical therapy daily. We never had to try to motivate her. We spent more time trying to slow her down than motivating her.”
To hear Dallap tell it, Yeoh, an “elite athlete,” does not sound far different from Yu Shu Lien, the selfless knight-errant she plays in Crouching Tiger, Hidden Dragon.
“She’s strong and has a strong personality, as well,” the physical therapist says. “Yeoh is a very determined lady, and has a very high threshold of pain. She is also extremely muscular and fit, and very down to earth. She’s not what you think of when you think of a movie star. She’s very kind. She’s not ostentatious.”
Ever the professional, Yeoh came in the day after surgery. “We don’t usually start patients until 7 days after surgery,” says Dallap, who worked with Yeoh on strengthening exercises, electrical stimulation to make the muscles fire, retrograde massage to help with swelling, and stretching and icing. “We were trying to get her quadriceps firing again,” Dallap says. “We were working on range of motion, controlling the swelling. Her sessions were about an hour, to an hour and a half. I saw her every day. That’s not normal. Usually patients come in three times a week. But we saw her 5 to 6 days a week.”
Muscles and Determination
Anyone who has seen Crouching Tiger, Hidden Dragon, where Yeoh’s martial arts scenes become a flashing whirlwind of fists, feet, legs, and leaps, will not be surprised with Dallap’s observation that the lithe actress “had great range of motion. Because of the amount of muscle that Michelle does have, and the amount of control, she was able to develop the muscle sooner. People will often have problems getting the quadriceps to fire due to the amount of fluid. She was able to do that early.’’
Yeoh concedes she poured on the coals. “In the beginning I tried to see Diane every day. But Andy says overpushing it is not good. So I was with Diane at least three times a week—sometimes even four. By the end of 3 weeks, I went back to Beijing for three days. I returned to Johns Hopkins to work with Diane and Andy gave us clearance to go back to Beijing.”
“She came back at 5 weeks post-op,” Cosgarea says. “Her motion was five degrees of hyperextension, 145 degrees of flexion. She had excellent quadricep tone and strength.”
Yeoh went to Bejing to rejoin filming, which had been adjusted around her lay-up. Dallap kept in touch with her patient via email and phone calls. Finally, in late October 2001, Dallap flew to Asia to treat Yeoh and acclimate the new therapist to the rehabilitation program.
“It was very important for me to be with someone I had confidence in as you move on to a new stage, learning to walk and move a little faster,” Yeoh explains. “When you have someone you’ve been working with, it builds your own confidence.”
“I did go to the set with her two or three times,” Dallap says of her charge. “Part of my role was acting as a gatekeeper, so to speak, to make sure she wasn’t doing something that was detrimental to her knee. But for the most part, they understood and were very cautious, if anything.”
A Journey to Beijing
Her duties also helped open up a new world for the 26-year-old therapist, who had never been overseas. “It was terribly interesting to be on the set; they were very generous and provided me with a tour guide who took me to the Forbidden City and a lot of tourist sites, which were fabulous.”
At the 3-month mark, Yeoh says, “Dr Cosgarea flew to Beijing for literally 1 night to check on my knee so I could go back to filming and to talk to Ang about what things we had to watch.
“At the moment it’s stable,” Yeoh says of her knee. “After the shoot, I’ve been back to see Dr Cosgarea. The surgery is definitely stable. It never really got a chance to rest. I’m back up to 80%. With all the muscles it just takes time to build up again. I’m working with another physiotherapist and she’s also in touch with Dr Cosgarea and Diane. Even today they still monitor what I do.”
The teamwork paid off. In January, Crouching Tiger, Hidden Dragon was awarded the Golden Globes award for best foreign film (it was not eligible for best film). Ang Lee was named best director.
Lee’s grand morality tale—about strong women and the ultimate price paid for dedication—has not been lost on his star, who refused to let her injury jeopardize the vision of her director and colleagues. And having recovered faster than some football and basketball players, Yeoh has already set her sights on the next goal. “I have a big project coming up in July, which doesn’t leave much room for physical disabilities.
Jeff Yip is a contributing writer for Orthopedic Technology Review.
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