Angel City's Christen Press announces she will have a fourth surgery to repair knee

Angel City FC championed forward Christen Press as an experienced, versatile player when the team made her its first signee in 2021. Now, one year after tearing her right anterior cruciate ligament, Press’ return to the pitch has been postponed by a fourth surgery.

Press announced Sunday on social media she’ll be undergoing knee surgery again. Her announcement comes days before the U.S. women’s national team begins World Cup play in New Zealand against Vietnam.

Up until the U.S. World Cup roster was announced last month, Press said “there wasn’t a day that passed over the last year that I didn’t believe I could be there. Even after three surgeries.”

This is the most transparent Press, 34, has been about her injury — though she did not indicate when she would have her latest surgery.

Read more: Angel City's Christen Press has torn ACL and will miss rest of season ... maybe more

“This time, I want to share how I’m doing from the bottom,” she said.

Press signed a three-year contract reportedly worth $700,000 with newly formed Angel City in 2021. This deal made her the best-paid player in the league at the time. But eight games into Angel City’s debut season, Press tore her ACL during the team’s 3-2 victory over Racing Louisville in June 2022. Over the first eight months since the initial injury, she underwent three surgeries.

“Some call these setbacks,” Press said in her post. “But I don’t like that language because it implies there is another path that I should have been on. And those are expectations I do not accept.”

Press had been eager to represent her hometown of Los Angeles after an international career that includes two World Cup titles. She brought experience as well as 64 career goals in 155 international caps that ranked her ninth in U.S. soccer history.

Press’ recovery timeline is unclear. A first-time ACL reconstruction surgery, with no co-injuries, has a standard healing period of eight to 12 months, according to Dr. Alan Beyer, the executive medical director and orthopedic surgeon at Hoag Orthopedic Institute. “Especially in a sport like soccer with a lot of cutting and a lot of twisting,” Beyer said.

Complications like meniscal tears and cartilage damage can require further operations. While its unknown whether Press has co-injuries, these second, third and now fourth operations have the ability to impede her motion for the rest of her career.

“The more surgeries any joint has, the more prone it's going to be both to scar tissue and arthritis,” Beyer said. “So it's not great that you got to have four surgeries on your knee to take care of the problem instead of one.”

Read more: USWNT star Christen Press becomes first player to sign with Angel City FC

Having the muscle tone, balance, and strength of a world class athlete is one thing Press has on her side, Beyer said. It’s the passion elite athletes have for their sport that can complicate their recoveries.

"They are sometimes unrealistic,” Beyer said. “We've come a long way in reconstructing ACLs in the last 40 years that I've been in practice. But we're not miracle workers. And you can't always make everybody as good as they were before their injury.

“And unfortunately, we've gotten so good that people sometimes think, ‘Oh, well, this is no brainer, I'm going to be fine.’ And not everybody turns out fine.”

Angel City, still a fledgling team, also has young talent in the form of 18-year-old forward Alyssa Thompson. She is one of just six teenagers in the league.

Without Press on the field this season, Angel City (4-6-5) sits in 10th place in the NWSL standings. They have four active forwards, including Thompson, Simone Charley, Katie Johnson and Sydney Leroux.

Angel City came within four points of making the playoffs in their debut season, landing in an eighth place finish in 2022.

While Press shared that she’s “not anxious to get back on the field,” that her “identity isn’t lost by not playing,” and that “most days [she doesn’t] even miss it,” she made it clear she’s not done with soccer.

“And despite the fact that, on paper, this is an athlete’s recovery nightmare, I feel in my heart that to climb the mountain — yes, even one more time — is the dream.”

This story originally appeared in Los Angeles Times.