Inside Princeton guard Madison St. Rose’s recovery from a torn ACL

The result is a video promoting Incrediwear, which makes athletic products including knee and elbow sleeves. But it’s also a look into St. Rose’s recovery from a torn ACL she suffered in November 2024, just four games into her junior season.

St. Rose, a second-team All-Ivy selection as a sophomore and the 2023 Ivy League Rookie of the Year, is working out five days per week at Princeton this summer and is on track to return for the start of her senior season. With her plus a dynamic junior class, the Tigers should contend for their seventh Ivy League regular-season title in the past eight seasons — and a healthy St. Rose could be the Ivy League Player of the Year.

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Before the injury, the 5’10 guard had had a great start to the season, averaging 17.0 points, 7.3 rebounds, 1.8 steals and 1.3 assists per game. “She was certainly going to be our on-court leader, our captain, [our player] with the most experience,” head coach Carla Berube told The Next on Thursday. “That was where she was going to shine.”

But in the fourth quarter at Quinnipiac on Nov. 16, St. Rose drove from the wing into the paint and tried to take a midrange pull-up.

“I just remember that I couldn’t go up in the pull-up and I kind of just fell to the ground,” St. Rose told The Next on Tuesday. “And I was in a lot of pain.”

St. Rose grabbed her left knee, and Berube put her hands to her mouth on the sideline. The coach knew right away what had happened.

“It’s just a way that the knee plants and buckles, and you can just see it. So yeah, I knew it,” Berube said. “The first thing I was just thinking [was] like, ‘Make sure she’s OK, and get out there and support her and hold her hand and hug her — whatever you need to do.’ Because it’s terrifying and … just gut-wrenching.”

Lying on the floor, St. Rose suspected it was a serious injury, but her mind didn’t jump to ACL. She’d played through countless twisted ankles and other minor injuries before, and she held out hope that it wouldn’t be as bad as it seemed.

“All I could think about was playing and wondering if I was able to play in the Quinnipiac game, knowing that my team was losing,” St. Rose said. “But just knowing how bad my injury was and how long it took me to get off the ground, I didn’t think it was going to happen.”

St. Rose was eventually carried off the court, and the Tigers lost. Then St. Rose had to get through the roughly 140-mile bus ride home, in pain and wondering what was next for her.

An MRI later confirmed that St. Rose had torn her ACL, and she began to process that her season was over almost before it’d started. She’d never had that serious of an injury or even needed crutches before, and in hindsight, she said she hadn’t realized how her season could end in a split second.

But the fact that she couldn’t even walk was an inescapable reminder of her new reality.

“That was kind of the hardest part, getting that daily reminder that this is a really traumatic injury, and that it’s not going to be easy and it’s going to be a long journey,” she said.

“I think [for] any high-level athlete, it just takes a little while [to process],” Berube said. “There’s some OK days to start, and then there’s some not OK days, and that’s really normal, too. And normalizing that for her, I think, was important.”

St. Rose waited to have surgery until after her final exams in mid-December. She spent the month between her injury and her surgery strengthening her leg, which can help patients recover fully and return to competition. Eventually, her injured leg was strong enough that she could walk without crutches and do some defensive slides. She still couldn’t jump, but in many ways, she felt recovered.

Then she had surgery and was back to square one over winter break. She was on crutches for six weeks, and she had to redo many of the exercises she’d done pre-surgery — only now, she was worse at them.

“It was really, really hard to redo those exercises to do, like, quad reflexes and leg raises — basic movements that I typically don’t have to think twice about,” St. Rose said. “But I’m … trying to activate all of these muscles, and it’s not as fluid moving as I would like.”

St. Rose also had to reconfigure her life on campus. Her dorm was up a hill and didn’t have an elevator, making it essentially impossible for her to live there with her scooter and crutches. So she temporarily moved in with first-year guard Cristina Parrella, who had a dorm with an elevator and an extra bed in her room after a roommate moved out.

“Once I got off crutches, I think it was just so freeing,” St. Rose said. “I was able to do more stuff. I was able to get to my room. I was able to open the door without having people opening it for me. I was able to tie my shoes. … After that, I felt like the time kind of went by a little bit quicker.”

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Meanwhile, without her, a starting lineup that featured four sophomores found a groove. The Tigers went 21-8 overall and finished second in the Ivy League in the regular season at 12-2. They made the NCAA Tournament as an at-large team and lost to Iowa State in the First Four. It wasn’t the best season by their lofty standards — they didn’t win the Ivy League regular-season and tournament titles for the first time since 2017 — but they outperformed expectations after St. Rose’s injury and improved substantially throughout the season.

On the sideline, St. Rose charted some plays for the coaching staff. She was also a go-to resource for the young guards who were thrust into starring roles, including sophomores and top scorers Skye Belker and Ashley Chea.

“I appreciated a little huddle at the end of our bench that was Maddie and Skye and Ashley talking through things and helping each other out,” Berube said. “Just seeing [Maddie] still a huge part of the program and our success … spoke volumes about Maddie’s character [and] where Maddie’s head is and heart is. And that is uplifting others, impacting the people around her, and creating just a great environment, especially for the guards around her.”

That was a learning opportunity for St. Rose, too. With the graduations of several program-changing players and leaders in 2024, St. Rose had been asked to be a more vocal leader before her injury. Then she had to figure out how to do it when she couldn’t be on the court with her teammates.

“I definitely tried to be the most impactful leader, especially being one of the captains on the team,” St. Rose said. “A lot of the players that were on the floor, this was their first time really getting high-volume minutes. … So I really tried to just share my knowledge … [and] what I see on the court when I’m on the sidelines.”

St. Rose can’t play with others or take contact yet, but she has settled into a routine this summer with a Princeton athletic trainer. She lifts three days a week and runs and jumps on two other days. She is also focusing on her basketball fundamentals, including by doing ball-handling drills and using a shooting machine to get shots up. During Princeton’s Elite Camp for eighth through 12th graders in June, St. Rose was able to demonstrate and participate in certain drills.

She expects to begin gradually incorporating contact in late July or early August, starting with one-on-one drills and working her way up to 5×5. Both St. Rose and Berube said they expect her to be ready for Princeton’s season opener on Nov. 9, but she will likely need time to reacclimate to college competition.

“I don’t think you all of a sudden jump back to exactly the player you were,” Berube said. “… We’re not going to rush things, and we’re not going to throw a ton of minutes at [her] early. Let’s just take it slowly and just get better and more confident each day. … Every body’s different. Every knee is different. So we’ll see how she responds.”

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Though the 2025-26 season will be St. Rose’s last in a Princeton uniform, Berube wants to prioritize St. Rose’s long-term career and well-being. St. Rose will have another year of eligibility as a graduate student that she can use outside the Ivy League, and she said she plans to use that year. After that, she could have a long professional career.

St. Rose understands that, but there is also a lot that’s precious about her upcoming senior season. Her goal is to be on the court for the whole season and make every moment count.

“I’m going to just give my all-out hardest to [my teammates] and to the program,” she said. “… I am really, really excited, but then it’s also just a sad moment that I’m approaching my last year of being a Princeton women’s Tiger basketball player. I mean, it’s always going to stick with me, but it’s not going to be like I’m going to be wearing the Tiger jersey after this last season. So I’m just going to really try to make the most of it and appreciate every little moment I have … on the court.”