FAQ (in general)

When do you know that other methods of managing an injury are not working and surgery is required?
When weeks to months pass while seriously working on non-operative management and minimal or no progress is enjoyed. Even then, surgical solutions can only be considered when they carry an overwhelming chance of improving the situation.

What sometimes causes numbing in my hands after a long bike ride, or in one of my feet after a walk or run? Is this nerve-related, or circulation. What type of conditioning can be done to prevent it?
I have the same problem whenever I do a 100-mile ride. It is from compression of the ulna nerve at the base of the hand. Wear good gloves. Change the position of your hands frequently. Consider triathlon bars. For the feet, make sure you have the best running shoes, and make sure they are not too tight. And stay away from the doctor for all these problems.

Is there any one sport more likely than another to injure knee or shoulder joints and muscles?
The ACL is at risk more in Football, basketball, volleyball, and soccer. The shoulder is more at risk in throwing athletes. I wouldn't choose my sport, though, based on injury avoidance. Sports are for fun.

Why is it that a shoulder dislocation in a young person is almost always likely to result in future dislocations, as I have read?
Children and young adults do not regularly develop much joint stiffness after an injury. But stiffness and loss of motion limits the instability associated with dislocations. Since young people don't get it, their "loose" shoulders stay loose - contributing to future instability.

Older people get stiff, which limits instability. Still in all, I'm 47 and would prefer - despite this - to be young and a bit "too loose" over old and stiff!

What is an MRI? When should I have an MRI?
An MRI is a fancy imaging study that can demonstrate lesions both in bone and soft tissue, using the magnetic resonance of hydrogen ions. Over the past 15 years, it has gained popular acceptance by coaching staffs, insurers, lawyers, and misinformed athletes - as the "be-all" and end-all of imaging studies. Unfortunately, its use has supplanted not only the patient's history and physical exam, but also common sense! Many professional football players have an MRI after every knee sprain during the season. These examinations will nearly always lead to unnecessary surgery.

It is expensive. An MRI costs at least $1000 per body part. It should only be used when a patient's history and physical exam does not clearly indicate a provisional diagnosis, or a reasonable course of treatment.

At the Sanders Clinic, an MRI is not a substitute for a patient evaluation. For example, the cost of a KT-1000 exam for ACL and PCL integrity is about $150. If the side-to-side difference is greater than three mm, then the ACL is torn. This examination is more accurate than an MRI, because it is an actual stress test of the ligament's integrity, rather than a static photograph. This test can be done in the Training Room or Clinic and takes 10 minutes. When the travel and waiting time is factored in, an MRI proves far more time-consuming yet no more accurate.