http://cposm.com/index.php/blog/ en kentyngrey@yahoo.com Copyright 2012 2012-02-03T23:49:56+00:00 http://cposm.com/index.php/blog/comments/injury-prevention-for-football-players/ http://cposm.com/index.php/blog/comments/injury-prevention-for-football-players/#When:23:49:56Z Given the prevalence of injury in the sport, understanding the steps that can be taken to prevent injury is of the utmost importance.  A warm-up is a vital part of injury prevention in any sport, but is especially important when the sport involves so many high-intensity sudden start-stop movements. A warm-up should increase the player's heart rate in order to increase blood flow to all parts of the body; it should also stretch the muscles slightly to ensure that they are neither cold nor inflexible when intense movements begin.  Ideally, a warm-up consists of 5 minutes of cardio activity such as jogging, cycling, or other high-heart rate activities. This should be followed by stretching. Today, most physiotherapists recommend dynamic stretching which involves high-intensively movement combined with stretching, to more closely resemble movements made in sports. This sort of stretching involves drills like running with high knees, heels to bum and cariocas.  Given the prevalence of tackle in football and other high-contact activity, proper protection and gear is highly important. High quality helmets, shoulder, thigh, and knee pads, gloves, mouth guards and everything else will help decrease the change for injury during a game or practice.  Although often disregarded by amateur athletes, rest is an important part of any training program. During play, football player's bodies need rest to recuperate from the damage done to cardiovascular, respiratory, and muscular systems. Generally over-training and a lack of adequate rest between training sessions, results in poor technique and overuse injuries. Highly-trained athletes rely as much on their physical training as they do on proper nutrition and hydration. Without a good diet, specifically fit to your training needs, you'll find your muscles depleted, unable to fully recover after training, and prone to injury. Dehydration prevents adequate blood flow to your muscles and, likewise, makes you prone to injury. Sports Injuries, Football 2012-02-03T23:49:56+00:00 http://cposm.com/index.php/blog/comments/non-leg-injuries-in-football-players/ http://cposm.com/index.php/blog/comments/non-leg-injuries-in-football-players/#When:23:37:43Z In addition to the common leg, knee, and ankle injuries sustained by football players, there are also several injuries that occur outside of the region - mainly in the shoulders and hips.  A hip pointer is an unusual, though very painful, injury that occurs exclusively in athletes who play sports with helmets. When a helmet collides with the iliac crest or the hip bone of another player it can cause varying levels of damage to muscles, tendons, and ligaments but usually causes bleeding and bruising in the abdominal muscles. This normally occurs during game play when a player tackles into you using the strength of his helmet. AC Joint (or acromioclavicular) separation occurs when the two bones forming the upper shoulder joint are separated from one another. This is caused by damage to the ligaments connecting them and is usually related to a fall on an outstretched arm.  AC joint injuries are graded on a scale from 1-6 using the Rockwood scale.Grade 1 is a simple sprain to the AC jointGrade 2 involves rupture of the AC ligament Grade 3 rupture of both AC and CC ligaments which often results in a superior displacement. From this point onwards the scale and grade of injury depends on the degree of displacement of the clavicle.Grade 4 involves posterior displacement Grade 5 superior displacement, to a greater degree than grade 3, with an increase in coracoclavicular space by 3-5 times the norm. A step deformity may be apparent with grade 3, 4 & 5 injuries. Grade 6 involves full rupture of both AC and CC ligaments with the clavicle being displaced inferiorly. Shoulder dislocation is a common traumatic injury across a wide range of sports. It is generally caused by a direct hit to the shoulder or a fall by a player. This commonly occurs during tackle. The player will immediately feel severe pain along with a sensation of popping out. Generally the player should see a doctor immediately about popping the shoulder joint back in before futher damage is sustained.  For such a physical, contact sport, football players can sustain a wide and varying degree of injuries. While injury may not be unavoidable, it is entirely possible to mitigate some of the injuries using proper prevention techniques. Sports Injuries, Football 2012-02-03T23:37:43+00:00 http://cposm.com/index.php/blog/comments/football-related-injuries/ http://cposm.com/index.php/blog/comments/football-related-injuries/#When:18:15:40Z Football players are often large men with significant muscle mass, athletic prowess, and a need for sharp start-stop movements. The players commonly make dynamic and explosive movements causing strain on the muscles. Beyond that, football is generally a rough sport despite all the helmets, pads, braces and supports. All of this can lead to injuries to many parts of the body including ACL injuries, MCL injuries, Hamstring strain, hip pointer, shoulder dislocation, and AC joint injuries. The most common injuries in football are to the ankle and knee. The major of injuries sustained are minor and only 11% of injuries are classified as severe. That said, it is estimated that 85% of high school football players will be injured at some point during their school career. The majority of injuries associated with football occur in the legs, knees, and ankles. Of course the injuries vary by degree, but some can be quite serious and require significant downtime and even surgery.  Ankle sprains are commonly sustained when running and changing direction suddenly or when tackling or being tackled. An inversion sprain of the ankle occurs when the ankle rolls over (so that the sole of the foot faces inward). High-velocity movements like these can cause varying degrees of damage to the ankle muscles. Collateral ligament sprains of the knee are an extremely common injury in football. They occur when a player is bearing weight with a slightly flexed knee as a tackle comes in from the outside. It causes damage to the inner collateral ligament ACL injuries are a very serious injury that requires surgery and significant physical therapy in order for a player to be able to fully regain movement and function in the joint. Most players who damage their ACL report hearing a loud POP or SNAP and then feeling their knee give away underneath them. If you believe you may have sprained your ALC, a trip to the doctor is necessary. The doctor will need to take a scan of your joint to discern whether the damage is soft tissue or bone and give a proper diagnosis.  The hamstrings are the most commonly torn muscles in football. This tear often happens during a burst of speed when the hamstring muscles are either not properly warmed up or are fatigued. This reminds us that a proper warm-up and conditioning routine is of the paramount importance for athletes of all sports, but especially for football where sudden bursts of speed are common. Strains are graded 1, 2 or 3 depending on severity.Grade 1: May have tightness in the posterior thigh. Probably able to walk normally however will be aware of some discomfort. Minimal swelling. Lying on front and trying to bend the knee against resistance probably won't produce much pain. Grade 2: Gait will be affected - limp may be present. May be associated with occasional sudden twinges of pain during activity. May notice swelling. Pressure increases pain. Flexing the knee against resistance causes pain.  Might be unable to fully straighten the knee. Grade 3: Walking severely affected - may need walking aids such as crutches. Severe pain - particularly during activity such as knee flexion.  Noticeable swelling visible immediately. The meniscus are two rings of cartilage that sit on to of the shin bone or Tibia. A meniscus tear is not uncommon in football and usually occurs during a tackle where there is a twisting motion, usually with the foot placed firmly on the ground. As athletes become older, they also run the risk of injuries suffered because of the degeneration of cartilage. This is especially important to take note of if you also have a history of previous knee injuries. Sports Injuries, Football 2012-01-31T18:15:40+00:00 http://cposm.com/index.php/blog/comments/beating-old-age-with-new-joints/ http://cposm.com/index.php/blog/comments/beating-old-age-with-new-joints/#When:21:00:30Z   You are invited to attend a FREE Seminar "Beating Old Age with New Joints" You don't have to constantly feel achy, sore and creaky. Joint replacement can be a viable option to returning to an active lifestyle. Learn when to get a joint replaced, what happens during the procedure and what to expect during recovery. Join Peter W. Callander, M.D., board-certified orthopedic surgeon to the San Francisco ballet troupe, as he discusses advanced technologies and break-through treatments for hip and knee replacements, including: Hip resurfacing, an alternative to total hip replacement Using MRI's and X-rays to create custom instruments for your knee replacement implant These advanced operative techniques lead to a faster recovery, aided by CPMC's post operative care team of physical therapists and nurses specialized in treating joint replacement patients. California Pacific Medical Center Saturday, January 21, 20122333 Buchanan Street 10 - 11:30 a.m.San Francisco, CA Enright Room Refreshments will be served.Register by January 16th: 415-600-7488 or www.cpmc.org/jointcare     2012-01-07T21:00:30+00:00 http://cposm.com/index.php/blog/comments/mcl-injuries-from-alpine-skiing/ http://cposm.com/index.php/blog/comments/mcl-injuries-from-alpine-skiing/#When:20:35:03Z Since the early days of skiing, knee and lower leg injuries have been an ongoing concern. Because of the high velocity and twisting, turning, and falling that occurs while skiing, injury to the tibia and fibula were particularly common. Since the advent of release bindings on skis, leg injuries have become less common, while knee injuries still remain a cause for concern. In fact, knee injuries are thought to account for around one third of all Alpine Skiing-related injuries. The majority of knee injuries seen in skiers have to do with damage to the knee ligaments, in particular the MCL (Medial Collateral Ligament). The MCL connects the inner surfaces of the femur and the tibia. It functions as resistance against forces applied to the outer surface of the knee. The MCL is damaged when this force is applied to the side of the knee whilst it is bent. For example a MCL sprain may occur if a skier is "snowploughing" down a mountain (with bent knees) and he or she falls over without changing his or her body position. Obviously, the faster the speed, the more likely that the impact with cause a serious damage to the ligament. The treatment for an MCL injury is usually conservative. Most doctors agree that in the case of a Grade 1 or a mild Grade 2 sprain, pain and inflammation can be managed by use of an over-the-counter anti-inflammatory medication, a knee brace, rest to the injury (using the R.I.C.E. Method). For higher-grade sprains, a doctor should be consulted to ensure the highest quality of care and the best likelihood of a full recovery. Grade 1 Sprains. The ligament is mildly damaged in a Grade 1 Sprain. It has been slightly stretched, but is still able to help keep the knee joint stable.Grade 2 Sprains. A Grade 2 Sprain stretches the ligament to the point where it becomes loose. This is often referred to as a partial tear of the ligament.Grade 3 Sprains. This type of sprain is most commonly referred to as a complete tear of the ligament. The ligament has been split into two pieces, and the knee joint is unstable. The R.I.C.E. Method is used in Sports Medicine for minor injuries to soft tissue such as minor sprains or strains. If the injury is more severe than a Grade 1 sprain, you should consider seeing a doctor to evaluate the injury and decide on the best course of treatment for a full recovery. If your injury is severe, your doctor may prescribe physical therapy, in addition to anti-inflammatory medication and diligent use of the R.I.C.E. Method, to aid in your recovery. Rest. Reduce usage of the injured area for 48 hours. With a leg injury you may need to keep weight off it completely. Ice. Put an ice pack on the area for 20 minutes, 4 to 8 times per day.Compression. Swelling can be reduced using compression, such as elastic wraps, special boots, air casts and splints. Elevation. Keep the injured area elevated above the level of the heart. Use a pillow to help elevate an injured limb.  The best practice is to avoid injury in the first place! Skiers who focus on pre-season conditioning, making sure that ski equipment fits properly and that binding release settings are correct, are less likely to sustain injury in the first place. Sports Injuries, Skiing 2011-12-26T20:35:03+00:00 http://cposm.com/index.php/blog/comments/acl-injuries-from-alpine-skiing/ http://cposm.com/index.php/blog/comments/acl-injuries-from-alpine-skiing/#When:20:29:00Z Anterior Cruciate Ligament (ACL) Sprains are the second most common injury for Alpine Skiers today. Approximately ten to fifteen percent of ski injuries that occur are ACL injuries-and this number may actually be higher because many ACL injuries are actually misdiagnosed as the more prevalent but less serious MCL injury.  Today, it is thought that there are three main identified actions that cause Alpine Skiers to sustain ACL injury: the Backward-Twisting Fall, the Forward-Twisting Fall, and the Boot-Induced Anterior Draw.  The Backward-Twisting Fall, also called the Phantom Foot or the Flexion-Internal Rotation, is thought to account for 3/4 of all ACL injuries from Alpine Skiing. You'll recognize this action: it occurs when the back end of the ski acts to apply a combination of twisting and bending forces at the knee joint, often resulting in a backwards fall and a sprain of the ACL. Research has concluded that there are several actions that can result in this Backward-Twisting Fall. They include: 1.     Attempting to get up whilst still moving after a fall2.     Attempting a recovery from an off-balance position3.     Attempting to sit down after losing control The Forward-Twisting Fall, or the ‘‘valgus-external rotation," has become a more common action as more and more Alpine Skiers are using skis specifically designed for carving. For example, this motion occurs when a skier shifts his or her weight forward relative to the ski (such as while cutting an edge while turning). This bending motion causes the leg to twist and rotate outwards. If the force is great enough it can cause the ACL to sprain Finally, the last major action that we've identified as being a main cause of ACL injury is the Boot-Induced Anterior Draw. This action occurs when a skier lands off balance with the majority of their weight to the rear of their skis after a jump. If the skier extends his or her legs fully, he or she may land on the tail of the ski, causing the back of the boot to cause pressure against the calf. This in turn pushes the tibia forwards relative to the femur, causing damage to the ACL. There are, of course, other situations where this may occur, but the main mechanism is the extreme pressure on the back of the calf. Most skiers who have damaged their ACL report hearing a loud POP or SNAP and then feeling their knee give away underneath them. If you believe you may have sprained your ALC, a trip to the doctor is necessary. The doctor will need to take a scan of your joint to discern whether the damage is soft tissue or bone and give a proper diagnosis.  As opposed to the MCL injury, the ACL injury usually requires ligament repair surgery if the skier wants to maintain the same or a similar level of activity after injury. But, most all doctors agree that the rehabilitation and physical therapy both before and after any surgery is as, if not more, important than the surgery itself.  As always, the best course of action is to avoid injury in the first place. We recommend that you maintain a good level of physical conditioning both during the ski season and during the off-season, that you understand these high-risk motions and actions to attempt to avoid them, and that you make sure that your ski equipment and particularly your ski bindings are in good working order.  Avoid these high-risk situations and you may just save your ACL:1.     Don't fully straighten your legs when you fall. Keep your knees flexible.2.     Don't try to get up until you've stopped sliding. When you're down, stay down.3.     Don't land on your hands.  Always keep your arms up and forward.4.     Don't jump unless you know where and how to land. Land on both skis and keep your knees flexible. Sports Injuries, Skiing 2011-12-26T20:29:00+00:00 http://cposm.com/index.php/blog/comments/back-pain-and-spinal-disorders/ http://cposm.com/index.php/blog/comments/back-pain-and-spinal-disorders/#When:19:58:15Z Most cases of back and neck pain resolve with minimal medical intervention. In fact we strongly recommend that you see your Primary Care Physician who can usually initiate treatment. Very few people with back and neck pain need a surgical procedure. There are a wide variety of non-surgical treatments that are usually successful in treating back and neck pain. Some of the most common non-surgical treatment options are physical therapy/exercise, medication, spinal injections and alternative medicine. Physical therapy combines passive modalities with therapeutic exercise to rehabilitate the spine and other parts of the body. Examples of passive modalities that physical therapists administer to patients include: heat/cold therapy, ultrasound, manual traction, inversion tables, transcutaneous electrical nerve stimulation (TENS), massage therapy and aquatic therapy. Physical therapists will often teach patients a home program to follow which can include: Stretching exercises to increase flexibility. Strengthening exercises to improve the spine's ability to absorb stress and strain. Postural modification to rehabilitate the spine and prevent re-injury. We use a wide variety of medications to choose from to treat back and neck pain. Some medication is available over-the-counter (OTC) and other types must be prescribed. In general, medications to relieve back and neck pain include: NSAIDs (Non-Steroidal Anti-Inflammatory drugs) help to decrease inflammation and promote healing. COX-2 Inhibitors (a type of NSAID) may allow patients to take higher doses without the accompanying gastrointestinal side effects from conventional NSAIDs. Acetaminophen, an analgesic used exclusively for acute pain. It can be used alone or in combination with NSAIDs. Muscle relaxants are often prescribed for severe pain. However, some experts believe that NSAIDs are just as effective. Opioids are carefully prescribed for back pain due to their addictive nature. These drugs are not a first line of treatment, but may be used in select situations. We do occasionally refer patients to undergo a spinal injection procedure. Spinal injections serve two purposes - to relieve pain and secondly as important diagnostic tools the doctors use to help determine the cause of the pain. Two common types of spinal injections are: Facet Joint Injections help to reduce inflammation and pain originating from one or more facet joints. These joints are located at the back of the spine and are important to movement. Another type we frequently use is the Epidural Steroid Injection or ESI. ESIs deliver pain relieving medications into the epidural space. The medicine flows through the space, coating the nerve roots and the outside lining of the facet joints. We do not use spinal injections as the only remedy to relieve pain. Rather, spinal injections should be part of a treatment plan that includes other therapies such as physical therapy and therapeutic exercise. Talk to the physicians at CPOSM to see if spinal injections might be right for you. Alternative medicine encompasses a wide variety of treatment options, many of which originated centuries ago. A few of the most common alternative medicine treatments used for back pain include: Acupuncture, biofeedback techniques and chiropractic care. There are many other types of alternative therapies. If you decide to try one of these, be sure that it is administered by a reputable practitioner. Also, be sure to talk to your physician about any of these therapies before you begin, to make sure they will not interfere with your other treatments. The physicians at California Pacific Orthopaedics & Sports Medicine are trained in the evaluation and treatment of spinal disorders. Please call to make an appointment to discuss your condition   2011-12-19T19:58:15+00:00 http://cposm.com/index.php/blog/comments/anterior-cruciate-ligament-injuries/ http://cposm.com/index.php/blog/comments/anterior-cruciate-ligament-injuries/#When:19:45:10Z Have you ever been kicking a soccer ball around and suddenly feel your knee buckle under you? Have you ever had to catch that rebound ball and stop on a dime to keep the ball in the court? Have you ever overextended yourself just a little bit to return that serve? Every day athletes across the county injure themselves. Oftentimes it's small muscular strains or sprains but every once in a while, an athlete will find they've torn a muscle or sprained a ligament. Every time you change direction rapidly, stop suddenly, slow down while running, land a jump incorrectly, or are hit with a direct contact or collision, you risk injuring your Anterior Cruciate Ligament. The Anterior Cruciate Ligament (or ACL) is a muscle that connects the Patella (the kneecap) to the Tibia and Fibula (leg bones). It's a crucial muscle in the function of your knee joint - especially in facilitating the "back-and-forth" motion that we all use when we walk, kick or bend our knees.  As you might imagine, athletes who engage in high intensity sports are more likely to injure themselves in this way- we most often see the injury in soccer, football and basketball players. An injury to the Anterior Cruciate Ligament can cause intense pain and ultimately be detrimental to the function of the knee.  Those with a sprained ACL will notice swelling to the knee over the course of the 24 hours following the injuring incident, loss of complete range of motion in the knee, and ongoing pain associated with movement of the joint. When a ligament is damaged, it's classified as a sprain. According to the American Academy of Orthopedic Surgeons, there are three grades of ligament sprain - going from a relatively mild stretch of the ligament (Grade 1) to a complete tear (Grade 3): "Grade 1 Sprains. The ligament is mildly damaged in a Grade 1 Sprain. It has been slightly stretched, but is still able to help keep the knee joint stable. Grade 2 Sprains. A Grade 2 Sprain stretches the ligament to the point where it becomes loose. This is often referred to as a partial tear of the ligament. Grade 3 Sprains. This type of sprain is most commonly referred to as a complete tear of the ligament. The ligament has been split into two pieces, and the knee joint is unstable." If you think you might have torn your Anterior Cruciate Ligament it is vitally important that you see a doctor immediately. With a physical examination and oftentimes an X-Ray, a doctor will be able to best assess what degree of sprain you may have suffered and suggest the best course of medical care.  Unless you live a sedentary lifestyle, most patients with a sprained ACL will require surgery to rebuild and reattach the ligament to the other muscles and bones in the knee joint.   2011-12-19T19:45:10+00:00 http://cposm.com/index.php/blog/comments/skiing-related-injuries/ http://cposm.com/index.php/blog/comments/skiing-related-injuries/#When:19:16:39Z Winter is finally here and with it the 2011-2012 ski season. Even with the increased popularity of alternative winter sports such as snowboarding, skiboarding, on-piste telemark skiing, alpine skiing remains the most popular snow sport by far. Approximately two thirds of all people on the ski slopes this year will be alpine skiers.  When you hit the slopes, it is important to recognize the risks of injury associated with a very physically-taxing sport such as alpine skiing. Skiing is a high velocity sport with significant amounts of twisting, rotating, and sudden stopping, all of which can result in injury. Over 75% of ski injuries result in a fracture or sprain—mainly in the legs and knees.  There are several factors that contribute to a person sustaining a ski injury:  Ski conditions. Accidents and injury are more likely to occur when weather conditions are poor, with low visibility, high winds, or icy-blizzard conditions.  Equipment. A beginner skier who does not own his own equipment must rely on rental equipment, which can lead to problems with size and fit. Properly adjusted bindings along with ill-fitting boots, skis, poles, and whatnot all contribute to accidents and injury.  Athleticism. Reports of injuries are more common early in the ski season when skiers are out of practice. To a new skier who hasn’t developed the muscles associated with the sport or to an advanced skier who simply hasn’t kept in shape, the risk of injury is greater. Speed is a major cause of injury in skiing—especially when the skier is out of shape. A movement that might not otherwise cause injury is significantly more dangerous at the high speed seen on alpine runs.  Knee injuries are by far the most prevalent injuries, accounting for approximately one third of all ski-related injuries.  Among Knee injuries, damage to the Medial Collateral Ligament (MCL) is the most common skiing injury. This occurs when the lower leg twists outwards relative to the thigh, putting pressure on the MCL. While common, MCL injuries are often not serious as they tend to occur to beginner skiers who lack the strength and speed of more advanced skiers.  The Anterior Cruciate Ligament (ACL) injury is a far more serious injury that occurs when a traumatic force is applied to the knee in a twisting movement forcing hyperextension. This occurs most usually when skiers land jumps, ski moguls, or during twisting falls. This type of injury is usually sustained by more advanced skiers who ski at high speeds; although a novice skier could sustain an ACL injury if his or her bindings don’t release during a fall, even at low speeds.  The most important factor in keeping yourself injury-free is to make sure you are ready for the slope when ski season starts. 1.     Keep yourself in good shape throughout the year by participating in different sports and maintaining a general conditioning routine. Additionally, you should remember to warm up and cool down properly by spending a few minutes stretching your muscles before and after your day on the slopes. 2.     Follow all safety protocol on the ski slopes, including skiing on runs that match your fitness and skill level, wearing proper safety equipment, and making sure that all your equipment fits properly. 3.     Recognize when you need a rest—the majority of accidents and injuries occur after lunchtime when tiredness sets in for skiers. Taking a longer break and being aware of your energy levels could save you from injury.  The most important thing you can do if you injure yourself while on the slopes is to get in to see an Orthopedic doctor immediately. The sooner you start therapy, the more like you are to have a successful and full recovery.   Sports Injuries, Skiing 2011-12-19T19:16:39+00:00 http://cposm.com/index.php/blog/comments/how-to-prevent-runners-knee/ http://cposm.com/index.php/blog/comments/how-to-prevent-runners-knee/#When:18:27:57Z We’ve introduced you to Runner’s Knee and some of the non-surgical treatment options available to you in the last post. It is, of course, always best to try to avoid injury when possible. In that spirit, we wanted to introduce you to some exercise strategies that will help keep your body healthy and in tune (hopefully preventing injury while doing so).  Firstly, Stay in shape. You should never underestimate the power of good general conditioning – especially as the body starts to wear and age with time. A body in good shape is of key importance in controlling and preventing Runner’s Knee. In addition, those who are overweight may find that they put additional stress on their knees in everyday life and may be more susceptible to Patellofemoral Pain.  Secondly, Stretch. Stretching is a way of warming up your muscles before engaging in more strenuous activities. Before running or any other exercise, a five or ten minute stretch will help you avoid future injuries to your knees. When stretching your knees, prone or face-down stretching is the most effective method and will help keep the supporting muscles and ligaments in your knee flexible and less likely to be irritated or injured by exercise. For example, one exercise you can try that will stretch the front of your knee is to lay face down and grab your ankle with one hand, behind your back, and gently stretch it forward. Thirdly, all training should be gradual. Jumping into an intense exercise routine is one of the most predictable ways of hurting yourself and injuring muscles, bones, and ligaments. Start at an easy pace (whether you are running, lifting waiting, getting back into a sport) and gradually go for longer and harder workouts as your body gets used to the exercise Use proper running gear. Running shoes should have good shock absorption and construction. A good fitting shoe is key to keeping your joints aligned and uninjured. A good shoe salesman at a sports store should be able to help you buy a good pair of running shoes that fit both your needs and your feet.  Use proper running form – professional runners know what a difference good form makes. Make sure you lean slightly forward and keep your knees bent when running. This can help prevent stress on your joints. Additionally, it is better to run on a soft, shock absorbent surface such as a running track or treadmill rather than a hard, concrete or asphalt surface.  More information on Runner’s Knee or other knee pain ailments is available at the American Association of Orthopedic Surgeons website. 2011-12-07T18:27:57+00:00