Nine months after surgery to fix a severe shoulder injury, former University of Washington star Hope Solo is healthy and will be in goal for the United States in the World Cup.

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The agonizing pain was starting to subside and finally, 24 hours after major shoulder surgery, Hope Solo was falling asleep.

Just before reaching that blissful slumber, however, there was a rude knocking at her hospital-room door. No time to rest. Rehab was waiting.

“That was the most painful moment in my life,” said Solo, a goalkeeper for the U.S. women’s national soccer team. “The only reason they made me do rehab on Day 1 was because I had to play. I had to be back.”

The 2011 FIFA Women’s World Cup was nine months away. She needed to be back in six to have time to prepare.

Solo, 30, had been playing with a 360-degree tear of the labrum — a devastating, potentially career-ending injury for overhead athletes (e.g. volleyball, tennis). The injury was even more complicated with a biceps tendon detached from her shoulder, broken bones, a worn-down joint and a lack of cartilage, among other issues.

“It was as bad an injury in the shoulder that an athlete can have,” said Bruce Snell, a Gig Harbor-based athletic trainer for the U.S. women’s national team.

Renowned orthopedist Dr. James Andrews performed the operation, and nine months later, Solo is 100 percent healthy. To get there, it took countless hours of grueling treatment and seemingly never-ending therapy for the Richland native and former University of Washington star.

When the United States kicks off its first World Cup game at 8:45 a.m. Tuesday against North Korea, expect Solo to be back in the net where she belongs.

Playing through pain

Athletes are supposed to be tough, Solo told herself. Her right shoulder had been throbbing for three years, but she refused to sit out in any practices or games.

Competitive spirit trumped reason, and once she made the decision to play on, she never questioned it.

“I should’ve listened to my body,” Solo said.

Every day was a struggle — until she reached her threshold during a practice last September with the Atlanta Beat of Women’s Professional Soccer. Her team was preparing for a shooting drill and Solo, who was supposed to be in goal, walked off the field.

The pain was too much to handle, and after years of denial, Solo couldn’t fight it anymore. It was time to get her shoulder fixed.

The admission that she needed surgery was “the hardest part,” but a mental relief.

“Once I made it, I was all business,” Solo said. “It was time to get to work. It gave me something to focus on while my team was trying to qualify for the World Cup, traveling from tournament to tournament.

“I was sitting at home, but I wasn’t sitting at home feeling sorry for myself. I locked in on my rehab. I committed myself to getting back in shape. I focused everything I had into it. That’s what kept me going. My whole life has been about beating the odds and I certainly wasn’t going to not give it my best chance at getting back at the World Cup.”

That meant spending hours and hours in Gig Harbor at Northwest Sports Physical Therapy with Snell and Dave Andrews. Solo is deeply grateful for the help she received, but trying to chop a nine- to 12-month recovery in half took sacrifice. Sometimes, that meant six hours a day of excruciating work.

“She’s a champion in that respect,” said Snell. “I’ve worked with a lot of athletes and have been doing this for 28 years. She’s certainly worked as hard as anybody I’ve ever had, and as testament to that, she was back playing in six months.”

Leading the way

Tony DiCicco knows a thing or two about winning at the highest level of women’s soccer.

As coach of the U.S. national team from 1994 through 1999, DiCicco led the Americans to an Olympic gold medal in 1996 and the 1999 Women’s World Cup championship. To win, he says, you need a top goalkeeper.

“And Hope Solo right now, in my opinion, is the best in the world,” said DiCicco, an analyst for ESPN, in a teleconference. “She’s a great athlete. She has a great mentality when she gets in goal.”

And great stats.

The 5-foot-9 Solo is second all-time in U.S. history in games, wins and shutouts for a goalkeeper. She has lost just one game in goal for her national team in the past six years. Since her return, Solo has played 315 minutes for the U.S. leading up to the World Cup and hasn’t allowed a goal.

“Having her back and confident was always a question mark, and the fact that she’s playing as well as she has been is good news for the U.S.,” said Julie Foudy, an ESPN analyst and former U.S. national-team star.

“Confident” is a common adjective when it comes to describing Solo. Others say “headstrong,” perhaps even “arrogant.”

Whatever the quality, Snell thinks it is part of what makes Solo successful on the field and made her able to get through a challenging rehab — which required some risk-taking due to a tight deadline.

“We took a few liberties and moved a little quicker, because time was of the essence,” said Snell. “There’s a World Cup only every four years, so it made for a difficult proposition. It was hard work, painful work and not necessarily fun. Hope needed that bravado, or whatever we call that, to get to where she has.”

Solo has gotten used to the descriptions by now. It has been four years since she infamously criticized Greg Ryan, her coach during the 2007 World Cup, after a surprise benching in the semifinals.

Some notable outbursts on Twitter make it easy to view Solo as outspoken, fairly or not.

“Yeah,” said Solo, followed by a deep exhale. “I don’t know what it is. A lot of these words thrown out are from people who, to be honest, don’t even know me. At the end of the day my confidence comes in my work. It comes in paying attention to the details in my play, watching video and really putting in the work and the hours out on the field.

“If I didn’t have the work ethic that people don’t know about, then I think there’s no way I’d be where I am right now.”

Joshua Mayers: 206-464-3184 or jmayers@seattletimes.com