INDIANAPOLIS — Sage Karam pranced, limbering his arms and legs. It would have been a familiar ritual for him in the wrestling room of Nazareth Area High in Pennsylvania.

But Karam, 21, was preparing for the first Indianapolis 500 practice, spastically releasing anxiety accumulated over nine months without racing.

“It’s the little things you don’t really even notice until you’re not there,” Sage Karam told USA TODAY Sports while sitting in a Dreyer & Reinbold garage bay. “Now I just want to feel the wheel again, sit there, hear the engine and all that stuff.”

But this May is also about guilt, ache and healing. Jody Karam, his dad, mentor and former wrestling coach, could see it all manifesting itself in that nervous dance. Jody calls Sage, who is outwardly brash, a really sensitive kid.

“It’s been nine months of roller coaster, up and down,” Jody Karam told USA TODAY Sports. “We’ve been all over the place.”

And back.

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Karam hasn’t raced in anything professionally since Aug. 23 — nine months ago — when his Chip Ganassi Racing Chevrolet spun off Turn 1 while leading at Pocono Raceway and crashed into a wall. The dislodged nose piece of Karam’s car struck Justin Wilson in the head as the 37-year-old slowed under caution and swung low to avoid the fray. Wilson died a day later after suffering a traumatic brain injury.

Karam was devastated. He didn’t understand how he should even feel, all of it amplified by his youth.

“The hardest was, of course, when Chip (Ganassi) called on Monday after the Pocono race, and he got the news about Justin,” Jody Karam said. “I was out on a bike ride, and I walked into a mess of a kid, and, as a dad, how do you handle that? You’re not prepared for that.”

‘It’s hard to look back on it’

Karam advanced to the Verizon IndyCar Series as a rookie in 2015 as prepared — or at least as equipped — as theoretically possible.

A former champion of the developmental Indy Lights series, he had raced sports cars for Ganassi and finished ninth for Dreyer & Reinbold in the 2014 Indy 500 before signing for a partial IndyCar season with Ganassi last year. Retired four-time series champ and three-time Indy 500 winner Dario Franchitti was assigned to be his mentor and coach. Karam slogged through a tempestuous rookie season. He crashed frequently and angered some of his peers.

But he came to Pocono invigorated. He enjoyed the notoriety of racing near his home, conducted a news conference with his dog, Max, was surrounded by upwards of 200 family and friends and was hazed on Twitter by fellow drivers for a shirtless photo he posted.

Then it happened.

“Cars were crashing the whole day. It was a wreck-fest,” Karam said. “I don’t know why. It was weird. My car felt really good. I was out front, clean air felt really, really good. It was starting to go loose, so I hit the weight-jacker to make it go to understeer … and the next turn I went in, the thing just stepped out … in such a weird spot, super, super late in the corner. Not where it would be maximum load, either. I was really confused as to why it would spin.”

IndyCar has declined requests from USA TODAY Sports to release the final accident report in Wilson’s case. The incident sparked a debate on the efficacy of canopies on cockpits, but there was a consensus that Karam was not culpable. Jody Karam told him that. Wilson’s younger brother, Stefan, told him that. But Sage Karam had to come to that realization for himself. And it didn’t come easily.

“I look back on the weekend all the time. It’s hard to look back on it, obviously,” Karam said. “But the thing is, that’s my – because I haven’t driven anything since then – that’s the oldest/newest memory in my mind still of racing. When I think back about racing, that’s the first thing that pops up, the last thing I did.”

Karam had been heavily criticized by fellow drivers Graham Rahal and Ed Carpenter for what they considered aggressive driving in finishing a career-best third at Iowa Speedway earlier last season, but both were among the first to contact him after Wilson’s death.

Carpenter could relate. Driver Paul Dana was killed in a prerace warm-up at Homestead-Miami Speedway in 2006, after crashing into the back of Carpenter’s car.

“We’re all people,” Carpenter told USA TODAY Sports. “I had been through a similar incident myself and know what that can be like and what emotions he was dealing with.

“Obviously, Sage and I had had issues earlier that year on the track, but that’s a whole different type of stuff. And he’s so young, I just wanted him to know how I felt and that there are people that are thinking of him and are there for him if he needed anything.”

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Jarrod Spencer, president and founder of Mind of the Athlete and a previous mental coach for Karam, says the driver has benefited from such support, which he considers the most important factor in recovering from a psychological trauma.

Karam hasn’t spoken to Wilson’s widow, Julia, but hopes to “when she’s ready. I don’t want to push that or anything.”

Karam spoke to Stefan Wilson, who will make his Indianapolis 500 debut Sunday, “when it was still fresh,” Karam said. “We put that behind. All the bad thoughts I had. I think, ‘What if I didn’t spin? What if I hit the wall differently?’ Like, ‘This is my fault. This is my fault.’ I put all that stuff behind me because of him. He was like, ‘Dude, this is a freak accident, there’s nothing you could have done.’ He was a huge part as well.”

But there was much to do.

“There was some really tough days, where yeah, he was thinking about quitting. No doubt about it. It was not good,” Jody Karam said.

Finding an outlet

Karam, who wasn’t scheduled to drive in the season finale a week after Pocono, had been working with Ganassi since mid-2015 to secure sponsorship without success. His ride was acquired by former Formula One driver Max Chilton, who brought sponsorship. Then Karam lost his seat in Ganassi’s Rolex 24 program the same way. He was adrift.

Karam doesn’t think he considered leaving racing; he doesn’t know what he would do. His father differs.

Either way, Jody Karam wouldn’t allow his son to return to Indianapolis to ruminate alone in his apartment, and two months after the accident named him an assistant on the Liberty High wrestling team he coaches. Karam found refuge and purpose in running 6 a.m. workouts.

“Once I stepped in the wrestling room, I put my phone down. I kind of isolated the whole rest of the world,” he said. And eventually, “I was able to start to laugh again.”

After reading his son’s journal — a breach of trust, Jody Karam admits — he “made it mandatory” that his son renew his counseling relationship with Spencer. Karam doesn’t blame himself anymore.

Improvement came and Karam was signed by F Performance Racing to pair with veteran Scott Pruett in a Lexus program in the IMSA series. The new program has yet to debut, making Karam’s return for a one-off with Dreyer & Reinbold on Sunday — he’ll start 23rd — a highly anticipated moment. That he was collected in a first-lap crash that ended his Indy 500 last year with Ganassi, even more so.

“My senior year of high school, my goal was I’m going to race in the Indianapolis 500, and I did it,” Karam said, the familiar confidence resurfacing. “Then it was, I’m going to win the 100th Indianapolis 500, and we’re going to do it.”

Pocono return might help

As much as he is focusing on the Indy 500, Karam wants — perhaps needs — to race at Pocono again. Even though a return would conjure so much he believes he has worked through and elicit questions and scrutiny, Spencer said that it would be key in his healing process.

“When there’s a traumatic experience like this, if the person is ready and has done the work or is doing the psychological work — and Sage has worked on his mind as hard as his body – I think it would be great if the opportunity presented itself,” Spencer said. ”Get back out there and create new memories. When that occurs the past ones fade a little bit more.”

Jody Karam said a methodical plan has been devised to facilitate a return if sponsorship can be acquired. It might be necessary.

“Pocono doesn’t have a great memory in mind, but it’s just another track,” Sage Karam said. “I think in order for me to put all this behind me, like completely, I need to go through Turn 1 flat again. It’s simple as that. And once you do that, yeah, you’re back for good.”