As I’ve recently realized from personal experience, tearing your ACL can be quite painful. Obviously, there is the knee pain, swelling, buckling, and decreased ability to walk that go along with the acute injury. The physical pain, although unpleasant, usually lasts only a couple of weeks. What can be more problematic, however, is the mental and emotional pain that goes along with the injury.

Why did this happen to me? Do I need surgery? Am I going to be able to work again? Will I ever be able to play sports again? If so, when? Am I at risk for this happening again in the future?

These are just a few of the questions that people have for me when I am counseling them about treatment options for their ACL injury. My goal as a physician is to make sure that the patient has a stable and painless knee that allows them to perform activities of daily living. My goal as a sports surgeon is to try and get the athlete back to playing sports as quickly as possible.

As the sun comes out, so do our green thumbs. But gardening isn’t all soil and sunshine. It can be pretty tough on our bodies—particularly our knees and backs— thanks to prolonged kneeling and bending. But don’t put your spade and gloves away just yet. There are plenty of easy moves you can make to prevent injury while tending to your garden.

• If you will be in a kneeling position for a while, show your knees some love. Use knee pads or cushions, and try to kneel on just one knee at a time, placing half of your weight through the opposite foot. This will also provide some counterbalance to the spine. 
• Try to change positions as frequently as possible, especially if you are working in a small area for a period of time. Positions of prolonged bending or repetitive twisting can put a lot of stress on the discs in our spines. Use a small utility stool to sit on if possible. 
• When digging larger areas, try to use your legs as much as possible in a stable squatting position. If you are digging a large area, change the direction that you are facing so that you are not straining the same area for a prolonged period of time. 
• When removing tree roots or old plants, be sure to pull using your leg muscles instead of your back.
• Squat down to pull weeds out of the ground instead of bending from the spine only. This might seem like a little thing, but repetitive motions like this can be tough on our spines.
• Use a wheelbarrow or a cart to transport heavy plants and bags of dirt instead of carrying them.
• Pace yourself and spread gardening tasks over a few days if you are not conditioned for manual labor.
• Take frequent breaks to walk and stretch every 30 minutes.
• Focus on back and thigh stretches:
  • Back extension stretch: Place your hands on your hips in a standing position and lean backwards until you feel a gentle stretch in your low back. Repeat 5 times holding for 10- 15 seconds.
  • Thigh stretch: Hold onto a nearby tree to stabilize yourself. Grab one foot, bend knee and bring heel towards buttocks until you feel a stretch in the front of your thigh. Hold for 30 seconds 3 times each side.

Enjoy watching your garden grow without pain!

Read more Sports Doc for Sports Medicine and Fitness.

The sport of CrossFit  is a fitness phenomenon that has been slowly gaining momentum since its inception in 2003. So what is CrossFit? It’s a lot of things.

Coach Greg Glassman, CrossFit Inc.’s CEO, has spent the bulk of his adult life experimenting with and working to perfect the regimen. CrossFit defines itself as “constantly varied functional movements performed at relatively high intensity.” CrossFit athletes—from novice to elite—have experienced the high of physical achievement in a way unlike any other sport, hooking folks from Day One and creating an almost cult-like following.

A defining characteristic of the sport is also the community fostered by group workouts. The challenge and support that one derives from competing (yes, even everyday classes are competitions) against the athlete you were the previous week, against a clock, with others, in a high-intensity environment is unparalleled in any other sport. The cheers for the first athlete to finish a “WOD” (workout of the day) are exceeded only by the cheers for the last athlete to finish.  

I am watching the NBA Western Conference playoffs as I write this blog post. Many people saw these playoffs irrevocably altered when Kobe Bryant went down with an acute Achilles tendon rupture last month.

The list of NBA players who have ruptured their Achilles tendon includes Isiah Thomas (arguably never the same afterwards), Dominique Wilkins (as good as ever by some assessments) and Elton Brand. Probably more people in Philadelphia watched Ryan Howard become injured on the way to first base during the NL division series against St Louis in 2011.

You may, in fact, know someone who has had the misfortune of having their Achilles tendon completely tear. It is a serious injury with potentially a significant impact for an active person at any age and at any level of sports. You may also know that many healthy active people will have a problem with their Achilles tendon at some point in their athletic lives. So what is this injury?

We all marvel in the extraordinary recovery of athletes following injury.

Ray Lewis returned to play less than 3 months following tricep repair surgery. Adrian Peterson nearly broke the single season NFL rushing record less than a year after ACL reconstruction. Kyle Lowry played point guard for Villanova less than 4 months following his own ACL reconstruction. 

How is this possible?  Do these gifted athletes just work harder during rehab?  Do their bodies heal faster than the rest of us?

Everyone has at least heard about, if not attempted working out with the latest trends in exercise like Crossfit, Insanity, and P90X. The allure is exciting; building better bodies, getting in shape with a guided workout routine and in the Crossfit world, developing close social networks with people of common interests. While all of these methods can be highly beneficial in improving your overall health and fitness, they can also lead to injuries.

An increasing number of patients have been coming to physical therapy for injuries obtained during their workouts. Some are major blow-out types of injuries like ACL tears, Achilles ruptures, and rotator cuff tears while others present with lingering tendonopathies, back pain, and exacerbations of previous injuries. In my opinion, most of these problems can be avoided with proper preparation, education and preventative exercises.

These styles of exercise require high levels of fitness, strength, coordination and endurance. Most people’s bodies are not used to performing at such high levels, and jumping from a sedentary or low level activity level type of lifestyle to high level is the perfect recipe for injury. There needs to be a transition period or ramp-up into such high levels. This is best accomplished by first participating in a supervised low to moderate level fitness program to learn about proper form, body mechanics and safe strength training progressions. Once this is completed, these principals will apply to higher levels of exercise.

Wednesday’s press conference confirmed some of our worst fears when Roy Halladay announced he would undergo arthroscopic surgery to address a partially torn rotator cuff and a fraying labrum in his right shoulder.

Uncertainty was the theme of the press conference, as Halladay shared that doctors are optimistic he can return to pitching later this season. Later, however, he admitted that doctors could find more extensive damage once they are able to see the shoulder during surgery.

Sports Doc went in search of some hints as to the most likely outcome for Halladay in 2013—and beyond. The key may be the bone spur in Halladay’s shoulder that is causing the fraying of the labrum.

Last night, former Phillies pitcher J.A. Happ was struck in the head by a line drive while pitching for the Toronto Blue Jays.

This morning, Happ is in stable condition and undergoing tests at Bayfront Medical Center in St. Petersburg, Fla.

Perhaps most troubling, however, were this morning’s reports and headlines that referred to Happ as the latest pitcher to sustain such an injury. He is the fourth MLB pitcher to be struck in the head since September. What can the league do to prevent or lessen the likelihood of further instances?

The Phillies expect to have some information about the particulars and the severity of Roy Halladay’s shoulder injury sometime today. The ace right-hander admitted to feeling discomfort in his shoulder after Sunday’s start against the Miami Marlins, and spent yesterday visiting with Dr. Lewis Yocum in California.

Phillies team physician and Sports Doc panelist Michael Ciccotti, M.D., says he doesn’t take it personally when a player asks to get a second opinion on an injury. In fact, he encourages the practice, and does everything in his power to ensure the player receives the best possible opinion.

“After an injury, the physician thoroughly evaluates the player—as with any patient,” says Dr. Ciccotti. “We ask how the injury happened, where they feel pain, when does it hurt. You gather a history, and do a full examination.”