Orthopaedic surgery is all about drilling, sewing, crocheting, and tying knots. The image above is me tying down a suture outside of the shoulder. I am using a tool called a knot pusher, which really looks like a crochet hook. I then push the knot into the shoulder joint to tie down the rotator cuff to the humerus.

The wrist is a super complicated part of your body. There are eight little bones that make up the wrist joint.

1. Scaphoid
2. Trapezium
3. Trapezoid
4. Capitate
5. Hamate
6. Pisiform
7. Triquetrum
8. Lunate

The medical term for growing pains in the knee is called Osgood-Schlatter Disease. Osgood-Schlatter Disease occurs in kids when they go through rapid vertical growth phases, typically sometime between 11 and 16 years of age. During this growth phase the bones grow faster than the tendons. The tendons tug on the growth plates were they are attached to the bone.

The most common site for growing pains is the front part of the knee. There is a growth plate in the front of your knee. If your shin bone grows very quickly where the tendon attaches to the growth plate or bone, the tendon can pull and elevated the growth plate off the major shaft of the tibia or shin bone. This will bother kids when they jump or run. The pain may occur until the growth plate completely closes which is typically age 14 for girls and age 16 in boys.

The treatment is supportive. Supportive means it’s OK to play through the pain. We recommend ice, anti-inflammatory medications as needed, and sometimes even a patellar tendon strap can help. Once the growth plate has closed the growing pains go away.

Image below is an x-ray of a patient with Osgood-Schlatter Disease. The red arrow points to the growth plate that is elevated off of the shaft of the bone. Typically the kids will complain of pain right in that area. Sometimes you may actually see some swelling from the localized inflammation.

Your biceps muscle turns into a thin tendon that attaches to your forearm. Rarely can the tendon tear off the bone, where it attaches in the forearm. When that happens the biceps muscle looks very flat and can migrate closer to your shoulder because the bicep muscles are no longer anchored at the end distally. The image with the blue arrow reveals how the patient for the biceps muscle has moved towards the shoulder and you can see some bruising where the tendon ruptured.

That image with the green circle and arrow is the end of the torn biceps tendon. The green arrow shows where the tendon should be attached in the forearm.

The purple arrow shows the tendon after I have placed sutures around it. I have already secured a metal suture anchor that is attached to the bone where the tendon is going to be attached. I’m now placing the sutures around the tendon and will pull the biceps tendon back into the form and attach it down to the bone in the forearm .

1. Warm up properly.

If you are a black diamond skier, warm up on some blue runs. If you were a blue level skier, warm up on some green runs.

2. Be aware of your surroundings.

While nothing is better than skiing with your air pods in your ears listening to your favorite Alpine ski playlist, listening to your surroundings is very important. When you’re on the chairlift for example, and the lady sitting next to you is nervously asking your husband how to get off the chairlift…that is a conversation you want to hear. Because when you’re getting off the chairlift, you want to make sure you are no where near her as you exit.

3. Make sure your equipment is properly fitted.

Check that your bindings are not too tight for your ski boots based on your ski ability. If you wipe out, you want to make sure your skis pop off your boots. A ski that does not detach can catch in the snow and tear your ACL.

4. Listen to your body.

When your legs are tired, you’re done for the day. I know everybody wants 10,000 vertical feet of skiing before 10 AM and 30,000 vertical feet of skiing before 3 PM, but if at 2 o’clock your legs are tired, end your day. It’s very important that you’re not skiing with tired legs.

5. Make sure you’ve worked on strengthening your hamstrings in the gym.

Your hamstrings protect your ACL. So hit the hamstring curl machine prior to heading out west or jumping on that chairlift. Also, when you’re riding a bike, make sure you are clipping into your petals and pulling back during the up stroke of your pedal stroke on the bike because that will strengthen your hamstrings.

The top image is a normal ACL(a happy skier’s knee) and the bottom image  is a torn ACL (a sad skier’s knee).

What does a ballerina’s foot look like on an X-ray when they are on their toes? The top image is you and me walking. The bottom left image is a ballerina en pointe. The most common injury among dancers are foot problems. I see metatarsal stress fractures, bunion deformities, flexor hallus longus tendinitis, and other foot related issues. Looking at this image can give you a reason why….

A meniscus is a structure located in your knee joint that functions as a shock absorber. You have two of them in each knee and they are prone to tearing. When the meniscus is torn, it produces a sharp stabbing pain and sometimes it will cause your knee to click or even lock. Many times swelling is associated with a meniscal tear.

The treatment for a meniscal tear is a knee arthroscopy. That is the procedure where I go in and remove the torn part of the meniscus. On occasion the meniscal tear can actually be repaired or sutured back together but that is only rare. The reason why the meniscal tears are typically not repaired is because the meniscus does not have a good blood supply. So if I place sutures in the meniscus it would just not heal. There is a part of the meniscus that is very vascular and has a good blood supply. If the tear occurs in that area then the meniscus can be repaired versus just removing the part that is torn.

The meniscus has shock absorbing qualities but once it is torn,  the area where the tear is located no longer provides any shock absorbency. The only thing the torn meniscus provides is pain.