ACL Injury 101

Sports participation results in 70 percent of anterior cruciate ligament (ACL) tears and the majority of these occur in 15 to 45 year olds. Approximately 70 percent of ACL injuries are noncontact injuries that occur during a sudden change in direction with a planted foot (i.e., cutting) or stopping rapidly. In the United States there are between 100,000 to 250,000 ACL ruptures annually.

The ACL is one of the main stabilizing ligaments of the knee and helps provide the hinge that allows the knee to remain stable while moving. When an ACL tear occurs the athlete often reports hearing a pop and usually cannot walk on the injured limb. During the injury it is common for the knee to partially dislocate, resulting in bruising and sometimes a small fracture at the back of the tibia and on the femur. Also common is a sprain of the medial collateral ligament (MCL) which is located on the inside of the knee. These injuries result in a painful swollen knee that is tender outside and deep within the knee.


Female athletes are two to eight times more likely to rupture their ACL than male athletes. This is primarily due to mechanical reasons, such as weaker core muscles and hamstrings. Another factor that can increase the risk of ligament rupture is the interface between the player’s shoes and the playing surface that results in higher friction. For example, longer cleats or more cleats on a shoe resulting in better traction and more friction. High risk sports include soccer, basketball, volleyball, skiing, and football.

Prevention programs have been developed based on analyzing the mechanism of injury of ACL ruptures as well as the kinematics of female body position during landing and cutting compared to males. The goal of these programs is to train the athlete to keep her center of gravity forward and on her toes, as well as encourage better leg rotation and control. These programs may reduce the incidence of ACL rupture by up to 50 percent. Typically a prevention training protocol should be done at least 2 to 3 times a week and last 15–20 minutes. As an added bonus these programs often improve an athlete’s performance such as jump height and speed. Speak with your sports medicine professional about exercises and programs to help prevent ACL injuries.

What is Frostbite? And How Do I Prevent It?

Athletes participating in outdoor winter sports, such as alpine and cross-country skiing, snowboarding, and mountaineering, are at increased risk for developing frostbite. Frostbite is a condition in which prolonged exposure to cold temperatures cause an injury resulting in tissue damage— starting superficially with the skin and potentially spreading deeper to blood vessels, muscles, tendons, and even bone.

Ice Skating

What Does Frostbite Feel Like?
Many people who are developing frostbite experience early symptoms such as numbness or a tingling sensation in the skin, such as the “pins and needles”
that you can feel after a hand or foot falls asleep. The affected body part may also be extremely painful, feel itchy, or have a burning sensation. The skin can initially appear white or grey with a surrounding area of redness, and as frostbite progresses, blisters may form and the skin will feel hard, waxy, or numb.

Who is at Risk?
While anyone can potentially develop frostbite, both the very young and the elderly are at particularly high risk and should take special precautions to prevent over-exposure in cold environments. In addition, athletes with medical conditions such as diabetes or heart conditions can be at increased risk due to decreased blood flow to the skin.

How Cold is Too Cold?
Generally, the risk of frostbite is low when the outside temperature is above 14°F (-10°C), but that risk can go up significantly with prolonged exposure, increased elevation (>17,000 feet), and increased wind speed.

How Do You Treat Frostbite?
Preventing injury begins with protection from the elements, which requires getting out of the cold as soon as possible and replacing all wet clothing with dry, warm, insulated layers. Immobilizing the extremity to prevent damage to the cold, stiff skin and muscles can prevent further injury. Once inside, rewarming the affected extremity should be done rapidly by immersion in a warm water bath at 104°–107.6°F (40°–42°C) for 15 to 30 minutes until thawing is complete.1,2 If warm water is not available, body heat can be used to rewarm the hands or feet, such as tucking them in your armpits. When successful, the skin becomes soft and pinkish again. Avoid rubbing or massaging the skin to avoid damaging the skin or rupturing blisters.

An Ounce of Prevention
While outdoor winter sports provide an excellent opportunity for physical exercise and competition, they can be dangerous if athletes are not properly prepared. Useful tips to help prevent frostbite include:
• Check weather forecasts to prepare for inclement weather or avoid extreme weather.
• Wear adequate clothing to protect from the cold and wind—dressing
in loose-fitting layers, including fabric that wicks away body moisture and sweat is best.
• Cover exposed skin with gloves or mittens, a hat, scarf, and face mask, if needed.
• Minimize alcohol consumption and tobacco use.
• Stay active! Physical activity maintains core body temperature as well as increases blood flow to the hands and feet.

Jammed Fingers:When Is It Time To See A Doctor?

It has happened to all of us at some point. You’re playing sports and a ball glances off the tip of your finger. Or you reach for something and jam the tip of your finger. Typically there is a lot of swelling and discomfort afterwards. But when is a jammed finger something more than a sprain and needs to be evaluated by a doctor?

The finger is a brilliantly designed machine with tendons running on both sides that allow you to flex and extend at each joint. Covering those tendons is
a sheath that allows smooth movement and pulleys that keep the tendons where they need to be for added mechanical advantage.
So when you jam your finger there are a lot of structures that could be damaged.

Injuries can occur at any of these structures. Most injuries are soft tissue injuries that heal well without surgery or immobilization.

However, there are several symptoms that should raise your suspicion for a more serious underlying injury and may require evaluation:

playing volleyball

Is your joint not sitting in a normal position?
If so, you may have an underlying dislocation or fracture that needs to be seen at the emergency room or urgent care center. Joints need to be in a normal anatomic position to prevent further damage and preserve function.

Can you flex and extend through each of your finger joints?
If not, you may have an injury to either one of the flexor tendons, extensor tendons, or bones that they attach to. This needs to be evaluated on an urgent basis as well, as the sooner it can be evaluated and repaired the better chance of avoiding a loss of function.

Barring any of the above symptoms, jammed fingers should reliably improve over the course of a few days with rest, icing for swelling, and anti-inflammatories for pain control. Depending on the location of the injury and the structure injured, your finger may need to be immobilized for a period of time. Immobilization can include taping the injured finger to an adjacent finger, a splint for the end of the injured finger to keep the joint extended, or a cast that extends to the forearm. Periods of immobilization vary depending on the structure injured.

Prompt assessment and treatment are the keys to ensuring that serious injuries do not result in any disability and and maximize the opportunity for a full return of function.

Recovering After Knee Replacement Surgery

recovering after knee surgery


A successful recovery after knee surgery has a lot to do with your rehabilitation process and physical therapy. Although it may be difficult to get on your feet the day after knee surgery, it is important to do so to begin building up your mobility in your artificial knee. Here are a few tips on what to do to have a successful recovery.


It is important to know that the first few days will be the most difficult – you will be tired and in pain, and won’t be able to get around as easily as you did prior to the injury. However, your physical therapy will begin after surgery to help you with basic mobility, like standing, sitting, and moving from room to room.

Light Exercises to Regain Mobility

In order to gain mobility back in your knee, you must do light exercises 10 to 15 minutes at least 2 to 3 times a day. With the help of a loved one and/or your physical therapist you can begin strengthening your knee muscles a little at a time.

Stay in Touch with Your Surgeon

Follow up with your knee surgeon to make sure your knee is in great condition. Continue taking prescribed medication, continue to elevate the knee, and continue following the light exercises. Do not stop taking your medication or antibiotics if you start feeling better, it can create a setback in your recovery time.

Due to advanced medical techniques and extensive background in knee orthopedics, patients now see a shorter recovery period. Within six weeks, patients see a dramatic improvement in their knee function. Schedule a consultation with a knee surgeon for your total knee arthroplasty in Los Alamitos.

Healing Tips after Rotator Cuff Surgery

Rotator cuff surgery Beverly Hills relates to repair of the four tendons and the related muscles that stabilize the shoulder joint. The rotator cuff allows a person to raise and rotate their arm. Surgery to the rotator cuff typically involves removing loose fragments of tendon, bursa, and other debris from the space in the shoulder where the rotator cuff moves. Sometimes, a surgeon will need to shave or remove bone spurs from the shoulder blade to make room for the rotator cuff tendon. Also involved in the surgery is sewing the torn edges of the supraspinatus tendon together and to the top of the upper arm bone.

A surgeon can choose to take a variety of approaches to repairing the rotator cuff. Sometimes, non-surgical treatment will help a great deal. For those who have been unable to regain full function and strength with other treatment, surgery is a good option.

After the rotator cuff surgery, patients may be allowed by their doctor to begin passive exercises that move the arm. About 6 to 8 weeks after the repair, and with the assistance of a physical therapist, a patient may begin active exercises. Each patient will go into the surgery with unique tears and the surgery can be complex. It is important to listen to your body and allow the repair the time it needs to heal.

The wellness experts at Livestrong remind patients that healing time from a repair procedure can differ a bit but it may be wise to think of the process in two phases. During the first phase, rehabilitation should be built around the healing of the rotator cuff. In the second phase, rehabilitation should be centered on gradual strengthening. Livestrong offers the following exercise and healing tips for patients to explore after rotator cuff surgery:

  • Pendulum Exercises
  • Passive Range of Motion Exercises
  • Active-Assistance Range of Motion Exercises
  • Active Strengthening Exercises

It is important to work with your surgeon and physical therapist to ensure that the shoulder is healing properly. Also, physical therapy and support during the healing process can certainly improve function and mobility. Sports injury treatment is advanced and individualized in the approach to treatment.

Contact an experienced surgeon in rotator cuff surgery Beverly Hills for more information. A consultation with Dr. Dee can determine what treatment options will work best for you and put you on the path to healing.

Do you even lift (properly)?—Staying safe when Lifting Weights

Weight Lifting






Whenever you’re working out, you have a chance of being injured, but you can mitigate these odds through being safe and knowing proper form. Perhaps nowhere is this truer than when lifting weights. People love lifting weights, but many people (more than would care to admit) don’t know how to lift properly. So perhaps the new question ought to become, “Do you even lift properly, bro?” It’s a serious question worth asking.

What do you do before lifting?

When you’re lifting weights, what you do before you even start will determine your level of success and ability to stay injury-free. Men’s Health Magazine raises a number of good points about the proper pre-lifting routine, but one of their best reminders is about hydration. Human muscles are 75% water, which means they need h2o in order to function. The time to hydrate is before your workout, not during or after. You’ll also want to warm up gently. Never lift cold.

What to do during lifting?

  • Check that you have two towels. You’ll want one to wipe off weights as you go and one for when you’re finished. Don’t wipe your body off with the same towel used on machines and weights.
  • Use the proper amount of weight. What’s the proper amount? Not so much that you need momentum to lift and no so little that you can burn through a set of fifty reps like you’re lifting a kitten.
  • Move slowly. Most people try to race through their lifting reps like it’s some kind of…race. Well, it’s not a race. In fact, the beauty of weight lifting is that it requires slow, controlled movement to fully engage your muscles without risking injury and to maximize results.

Keep these basic tips in mind and stay safe and healthy. Remember; always check with your doctor before trying a new strenuous activity. If you’ve never lifted before, or are getting back in the game, keep in mind that your body will need time to acclimate to this type of workout. Go easy on yourself and have fun.

Common Injuries in the Top Three Youth Sports

Children need exercise for mostly the same reasons as adults, but for kids playing in organized sports there is an added bonus—playing as part of a team. Being a team member teaches children lessons about life and cooperation in a fun, friendly environment. For the 38 million youths signed up for official organized sports, there are bound to be injuries. Knowing what to look out for in three of the most popular sports when your child is on the field or court will help minimize potentially life-altering accidents.

Football Injuries

This all-American sport can be a lot of fun to watch and even more fun to play. The downside is that the number one football related injury is a concussion. Head trauma is no joke and should be taken very seriously. Make sure your child has all of the required, recently checked, up-to-date safety gear. Also, make sure the team coach is qualified to handle serious issues relating to concussions. After trauma to the head, knee injuries rank as one of the most common. Tears in the ACL/PCL can result in life-long problems if not properly treated.


Web MD points out that the world’s most popular sport is also the most dangerous for adolescents under the age of 15. Males can expect an average of 4 injuries per season, while females average 3.5 injuries per season. In 2006 there were over 180,000 injuries reported with a shocking forty-four percent of those injuries coming from players 15 years old and younger. The most likely injuries will occur at the knees, but soccer is known for concussions too. Be sure your child warms up properly before playing and cools down after a game.


You might think basketball players are less prone to injury than other athletes. While the injuries may differ between sports, basketball still has potential for serious injuries. The most common problems come in the form of sprains, jammed fingers, and bruises. These may not sound too serious, but they can cause sever damage is left unresolved, or ignored. Pay attention to what’s going on with your young player’s injuries and don’t assume that they should just shake it off.

Any time your child is injured you need to take it seriously. Be sure to have any issue looked at as soon as possible by a doctor specializing in pediatric sports injuries.

Alleviating Knee Pain with Yoga

Knee injuries are among the most common types of injuries that athletes suffer. Just last month Comcast Sportsnet Chicago posted an article that identified key players for multiple cities that have been sidelined due to knee injuries—the list spanned key players for Chicago, Oklahoma, Boston, Arizona, Tennessee, New York, and two Los Angeles stars from different teams, making it clear just how common and dangerous knee injuries can be for athletes.

Even if you are not an athlete, accidental slips, sharp movements, or abrupt changes in direction can cause tears in ligaments or fractures that cause pain and discomfort. The most important thing to do after injury is to have your knee specialist look at the extent of the damage to set you on the road to recovery as quickly and safely as possible.

If you are still lucky enough to be in the stages of preventing injury before it happens, leg and knee strengthening through Yoga is something to consider. For the nearly 11 million Americans who complain about knee pain to their doctors, Yoga has been an unexpected helper that not everyone is willing to consider.

The misconception about Yoga is that you have to be incredibly flexible or be able to perform complex physical contortions. The truth, however, is that there are multiple levels that all help to strengthen muscles, tendons, and ligaments that we don’t usually work out or take care of. What Yoga does, that other types of workouts don’t do as well is keep your joints properly aligned as you build strength.

Of course, when considering Yoga it is best to stick with the basics if you are new and to find others in your area with more experience for guidance. Yoga can help you to build flexibility and strength which will help you to avoid injury, or it can help you as a great tool for recovery post injury.

If you’ve never considered Yoga in order to strengthen your knees and ligaments, then perhaps trying it out to see if it’s for you could save you potential knee problems in the future. Yoga is a great physical work out whether or not you decide to move past the initial levels.

You cannot always protect yourself from injury, but having stronger knees and legs can definitely help with prevention. Remember that they key is to be safe and to take care of your body. Regardless of whether you already suffer from knee problems, you are considering Yoga for strengthening, or you’re simply curious about other safety measures the best course of action is always to contact a specialist.

Tackling a Knee Injury Like NaVorro Bowman

Anyone who watched the NFC Championship game between the San Francisco 49ers and Seattle Seahawks likely cringed when they saw the replay of NaVorro Bowman’s goal line stand. With a trip to the Super Bowl on the line, Bowman ripped the ball from the hands of Seahawks wide receiver Jermaine Kearse before two players collapsed on the side of his left leg. The play was ruled a fumble, recovered by Seattle running back Marshawn Lynch. But the truly startling part of the play was the vicious injury Bowman sustained to his left knee.

Knee injuries are more common than even some athletes recognize. The knee is stabilized by a series of ligaments, allowing for a wide range of motion in the joint. Athletes routinely make a number of sharp movements with their knees, especially in sports like football, where players regularly make cuts and direction changes. However, when the knee is moved out of its normal range of motion, strains and tears can occur in the ligaments.

In Bowman’s case, he suffered a sprain to his medial collateral ligament (MCL) and a torn anterior cruciate ligament (ACL). ACL injuries are considered among the most severe for athletes (this is the same injury that sidelined star Minnesota running back Adrian Peterson in 2011). Fortunately for Bowman, surgery to repair a torn ACL has come a long way in recent years. In fact, Peterson famously recovered from his ACL repair in record time and nearly broke the single-season rushing record the very next year. What was once considered a career-ending injury is now very treatable.

If you are unfortunate enough to suffer a knee injury, it is important to seek medical attention. Mild sprains may heal without treatment, but it is important to rule out more serious problems. In the event of a knee injury, keep your weight off of that leg and schedule an appointment to see a doctor. Most people can recover from these types of injuries quite nicely with the proper treatment, although no one should expect to compare to Adrian Peterson.

Are ACL Injuries Declining in the NFL?

Despite some high-profile players being sidelined this season, the National Football League is reporting a decline in injuries to the anterior cruciate ligament, one of the primary ligaments of the knee. ACL injuries are often considered the most severe knee injuries and usually end a player’s season. In a report to its Health and Safety Advisory Committee, the NFL has said that these types of injuries are down compared to recent years, a good thing for professional football players and fantasy team owners alike. However, in the same report, medial collateral ligament injuries saw no change from recent years.

Many people have speculated that new rule changes designed to reduce head injuries have resulted in an increase in knee injuries, as players are now forced to hit lower than they were before. However, the data do not seem to bear this out. As more information is gathered over the years, it will become easier to compare injury rates before and after the rule changes.

As specialists in sports orthopedics, we see injuries to the ligaments of the knee all the time. These injuries can be extremely difficult, even for people who aren’t professional athletes. They can end a professional football career, but they can also keep a lifelong recreational athlete from keeping an active lifestyle. Fortunately, there are numerous treatments for ACL and MCL injuries, and you don’t have to Adrian Peterson to get the most out of them.

Watching out for knee ligament strains and tears is important for people of all activity levels. In the first 13 weeks of the current NFL season, 32 percent of ACL injuries were not caused by player contact. That means that you don’t have to get hit by a linebacker to suffer this kind of injury. In fact, outside of football, more ACL strains and tears are the result of sudden changes in direction than physical contact. If you enjoy sports like football or soccer, where players frequently change direction over short distances, it’s important to train properly to minimize your risks. Exercises that emphasize power, agility, and flexibility can reduce your chances of begin sidelined by an ACL strain. Of course, if you do suffer an injury, we have a wide range of treatments to get you back on your feet.