Danielle Jackson thought she’d signed up for a meeting about officiating volleyball. But after walking into the room, she quickly learned it was about basketball officiating. She had gotten the time wrong.

Jackson might have walked out, until one of the men there inadvertently threw down the gauntlet with a sexist remark.

“One guy walked up to me and said, ‘Hey, do you even know anything about basketball? Do you think you can do this? Can you even run?’” recalls Jackson, of Greensboro. “I took that as a personal challenge.”

That was 17 years ago. Jackson played volleyball and basketball in high school and volleyball at Winston-Salem State University, a sport she said came just a little easier to her.

“It wasn’t as physical,” she said. “But I always loved basketball.”

She started officiating girls’ basketball at the recreational level and rose through middle school, high school and into the college ranks.

Jackson, who is in her 40s, estimates college officials run an average of 4 to 6 miles during the course of a game. There is constant stopping, starting and changing of speeds. That’s tough on an Achilles, the tendon that connects the calf muscle to the heel bone.

When severe Achilles tendinitis threatened to derail her NCAA women’s college basketball 2021-22 season, she was determined not to let it keep her down.

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The soreness in her right Achilles had gotten to the point where it was not only painful to push off trying to sprint, it was sore to the touch. She had to smother it in pain-relieving cream, just to get into the tights she wore under her official’s uniform.

In early January, with the heart of conference schedules looming, she knew she needed to have it checked.

“The way I was feeling, I didn’t even think I was going to make it through February,” Jackson said. “I was so distraught, literally in tears. I told my husband, ‘I cannot walk.’ I couldn’t go to the gym and work out. It was terrible …”

“I was afraid I was going to tear my Achilles because it was so tender,” Jackson said. “You hear the horror stories about how many weeks people are out with their Achilles.”

Achilles surgery typically keeps patients in a cast or walking boot for six to 12 weeks. But it can be months before they regain complete use of the leg and ankle.

Dr. Snow Daws is wearing a white lab coat and is smiling into the camera
Dr. Snow Daws

When Jackson met with orthopedic surgeon, Dr. Snow Daws of Novant Health Orthopedics & Sports Medicine Kernersville, she was eager to avoid surgery. Daws recommended trying oral anti-inflammatory medication and she put Jackson in a restrictive boot.

Daws let Jackson take the boot off to officiate games, which probably delayed the healing process, but it kept her hopes alive of finishing out the season. But the pain persisted.

Injecting a pain-reliever like cortisone was not an option. “You never want to inject a steroid around the tendon because it can cause it to rupture,” Daws said. So that’s when she suggested she try a high-volume saline injection.

“The injection of the saline goes in between the tissue that surrounds the tendon and the tendon itself,” Daws said. “Something about separating that layer with the fluid stimulates a healing response, or at least an anti-inflammatory response.”

Jackson weighed her options. “I am afraid of needles,” she said. “But I was desperate. I said, ‘Let's do it.’”

Dr. Jennifer Harvey
Dr. Jennifer Harvey

Daws’ partner, Dr. Jennifer Harvey, administered the injection. And within a matter of two weeks, one with a boot, one without, Jackson said, “It felt significantly different.”

“The biggest difference that I can remember is it was no longer sore to the touch,” she said. “Also, my calf (muscle) wasn't as tight. I will say that there were moments at the end of some games when I had to run a little bit more than others, I'd think, ‘OK, I'm glad it’s over. I need to rest my Achilles.’ But it was a significant improvement from what I dealt with prior to the injection.”

Jackson said she became more disciplined about treating her Achilles after games following the “RICE” regimen doctors recommend: rest, ice, compression and elevation.

Jackson was back on the court, not only for the rest of the regular season but into the postseason. Based on her performances along the way, she was chosen to officiate the women’s Division II national championship game, something only a handful of the most accomplished officials get to do.

“Cutting and running on a hard-floor basketball court is asking a lot of the foot and ankle and Achilles tendon,” Daws said. “There was one point during (the process) I thought, ‘She's going to have to have surgery or she's going to rupture.’ I was so happy that the injection worked great and she was so compliant with exercises and everything that we asked her to do. I was super pleased for her.”

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Jackson’s experience immediately comes to mind when Daws has other patients with Achilles injuries, who are good candidates to avoid surgery.

“(The saline injection) is something that we've added, at least in my practice, in the past year or so,” Daws said. “And we've had good results.”

Jackson’s run to the Division II national championship game set her up for a promotion this season into Division I, the highest level of women’s college basketball. She wrapped up her season in Lynchburg working the Atlantic Sun tournament. She said she hasn’t had any major issues with her Achilles all season.

She was able to focus on juggling her high-powered day job in risk management for Wells Fargo and officiating two to three college games per week. She likes that it helps her manage her weight – which is a great benefit – and that it keeps her feeling young.

“We always say, ‘We have to work triple as hard as (the players) do,’” Jackson said. “Because the athletes get younger and we get older.”