KEY BISCAYNE, Fla. — As Justin Sands watched his wife, the tennis player Bethanie Mattek-Sands, fight through months of an exhausting rehabilitation for a right knee injury, he pondered different ways to honor her fierce determination.
His best idea was to get a tattoo depicting an imaginary scar of his own, drawn along his own knee with a tuft of green grass representing the playing surface at Wimbledon where Mattek-Sands was injured last July, and the date of her gruesome fall written under it.
He had it all planned, but events overtook him and the ink stayed in the tube.
On Jan. 7, Sands, a former college football player, was hunting elk in a remote area of northeastern Arizona and came to a small incline. As he walked down the hill he thought to himself that his wife, who was gaining strength in her knee, would probably be able to handle the modest slope. Then, wham.
He slipped and caught his right foot, and his burly frame hurtled down over his knee. The damage was obvious. At the very moment Sands was thinking of his wife’s recovery from a shattering knee injury, he tore the rectus femoris muscle above his right knee and part of his quadriceps tendon.
“Why were you even thinking about my knee?” Mattek-Sands said with a laugh during a recent interview at the Miami Open, where she made her return to the WTA tour. “It’s ridiculous.”
But it is actually not so absurd. A fixture on the women’s tennis tour, Sands can usually be found at his wife’s side. He attends almost all of her matches and training sessions, and he was immediately on court consoling her that day at Wimbledon when Mattek-Sands, the No. 1-ranked women’s doubles player at the time, screamed out in a combination of pain and fear after her right knee buckled.
Six months later, Sands followed his wife onto the operating table for the couple’s second right knee operation in less than a year. And for the past few weeks, they have been doing their recovery work in tandem. They hook up to the same electric wave-therapy machine, they warm up and stretch together, and they do some of the same exercises, like the agonizing wall-sits to build strength in their quad muscles. And, of course, they have matching scars.
The family that rehabilitates together stays together.
“It’s pretty similar how you rehab for the two injuries,” Sands said.
Sands, who runs his own insurance business, was a defensive lineman at the University of Albany and later tried out for the Arena Football League and N.F.L. teams as a long snapper. He never made it, but he knows about training and recovery — he had previous knee injuries as a player.
It was while working out at a gym in Arizona that he met Bethanie Mattek. They had three dates, became engaged, and were married shortly after, in November 2008. Since then they have been almost inseparable, even in rehab.
Mattek-Sands is ahead of her husband’s recovery, although Sands can now walk without a limp. But the scars remain, including the mental one. When Sands recently described his injury and pointed to his knee, his wife recoiled and looked away. “It’s too soon for me to look at other knee injuries,” she said.
Squeamish as she may be, Mattek-Sands was strong enough to return to tournament play last month. She played singles and doubles at the recent Miami Open, where she lost in the opening rounds of both draws. She was also given a wild card to play in last week’s WTA tournament in Charleston, S.C. She lost in the first round of the singles to Aleksandra Krunic, 6-2, 6-2, on Monday, illustrating the challenge she still faces in her return from such a painful injury.
“My knee felt good, and that was the most important thing,” she said in Key Biscayne. “It felt solid whether I was up at net or running side to side.”
She partnered with Andrea Sestini Hlavackova in doubles at Charleston. But Mattek-Sands said she still intended to “get the band back together,” and that means renewing her successful partnership with Lucie Safarova of the Czech Republic. Together, they won five Grand Slam doubles titles, including three in a row from the 2016 United States Open through the 2017 French Open, a month before Mattek-Sands’s injury.
It happened on July 6 at Wimbledon and was far more public than her husband’s injury. As Mattek-Sands approached the net following a backhand service return, her right knee buckled, rupturing her patellar tendon. The kneecap shot up into her upper leg, and as she lay on the grass, she grasped her knee with both hands and screamed out, repeatedly pleading for help.
Dr. David Altchek later performed the operation to repair the tendon and reattach it to the kneecap. Because the procedure involved the bone, Mattek-Sands said, the pain recalled the agony of the original injury, tears and all.
“I was bawling,” she said of the days post-surgery. “I was in an excruciating amount of pain.”
It eventually subsided, but for six weeks she had to keep her leg straight and she needed help to get out of bed, to sit in a chair and just to get around. Once she began rehabbing in earnest last year, Sands was by her side, working out for much of the process.
It was during that period that he developed the concept of the scar tattoo, imagining how cool it would look on his knee. But between taking care of his wife, working his own business and hunting, he never found the time.
“Now I don’t need it,” Sands said. “I have my own scar.”