Returning to Play after ACL Surgery

Claire Martin, an 18-year-old from Orland Park, has been playing volleyball for manyClaire Martin years and recently joined the Vikings women’s volleyball team at Augustana College in Rock Island, IL. Volleyball has always been her passion and is the only sport she has ever played competitively.

However, when Claire was a sophomore at Mother McAuley High School in Chicago, IL, she endured a triple threat which endangered her dream to play at the college level: a torn anterior cruciate ligament (ACL), injured medial collateral ligament (MCL) and damaged meniscus – all in the same knee. ACL tears are one of the most common knee injuries, with more than 200,000 ACL tears occurring in the U.S. annually. The ACL is crucial when playing sports because it stabilizes the knee when turning or planting.

The injury happened during a game when Claire jumped and landed on another player’s foot. After hearing a ‘pop’ and feeling what she describes as, “the worst pain I have ever experienced,” she knew that there was a major problem.

Immediately after she sustained the injury, Claire sought help from Dr. Charles Bush-Joseph at Midwest Orthopedics at Rush. Shortly after the diagnosis, Claire underwent surgery to repair the three damaged components of her knee. The surgery was a success and Dr. Bush-Joseph guided Claire toward her recovery.

During rehabilitation, it was difficult for her to not be playing the sport that she loves, but she supported her team by attending every game and cheering them on from the sideline.

Once fully healed, Claire was eager to return to the court but was a little more tentative and fearful of hurting her knee again. She is now more aware of the importance of ACL injury prevention and is enjoying playing volleyball at the collegiate level. She says that her knee is back to 100 percent and it, “feels better and stronger now than before the injury.”

Visit MOR OrthoCare Now to learn more or call 844 BONES DR (844.266.3737) to schedule an appointment.

Want More Strength? Slow It Down

A super-slow weight-training program can dramatically improve strength, users say, and the workout is intense.

Hand holding stopwatch.The SuperSlow program began when its developer, Ken Hutchins of Orlando, Fla., led a program investigating the effects of resistance training on older women with osteoporosis. “These women were so weak we were afraid for their safety,” Hutchins recalls.

Even before then, Hutchins had toyed with the idea of slow exercise before, only to lose interest. But low weight combined with slow movements seemed like the perfect program for these women: Following it, the women made dramatic gains in strength.

Wayne L. Westcott, PhD, fitness research director at the South Shore YMCA in Quincy, Mass., heard of the program and staged two informal studies in 1993 and 1999. In each, about 75 people trained with the SuperSlow program — for 8 and 10 weeks, respectively.Those doing SuperSlow in both groups experienced a greater than 50% gain in strength. In fact, the results were so difficult to believe that Westcott had them verified at Virginia Tech.

According to Hutchins, the key to SuperSlow is to never let the muscle rest — to remove the element of momentum from each exercise, making the muscles do the work instead of capitalizing on the tendency of a weight in motion to stay in motion. Muscles are worked beyond the shaky phase to the point of failure, when the person is physically unable to perform one more repetition.

Killer Workout

The people in Westcott’s study did 12-13 exercises. The comparison group did 10 repetitions of each exercise, pulling the weight up and lowering it over a period of the usual 2 seconds in each direction. The other half did five repetitions, but lifted slowly, 10 seconds on the upstroke and 4 seconds on the way back down. (Hutchins and others recommend 10 seconds each way.) That’s 20 seconds of muscle contraction for each repetition instead of 4 seconds. Multiply that by five repetitions and 12 exercises, and you have a killer workout, Westcott says. Despite the fact that the technique started with elderly ladies, it is intensive and tough, Westcott says. (It also requires machinery in good working condition to minimize friction, which “unloads” the muscle.)

Not one person in Westcott’s groups had an injury. “SuperSlow is a neat trick,” says M. Doug McGuff, MD, an emergency-room physician in Seneca, S.C., and SuperSlow studio owner. “With other exercises, to make them more challenging, you usually have to increase the force required — the weight level, whatever — which brings on aches and pains. This makes them more dangerous. With SuperSlow, you can make exercise much more challenging without increasing force.”

At his studio, with people who are completely untrained and have never worked out, McGuff says he can bring about a 30% increase in strength in six to eight weeks and almost guarantee a 100% increase in eight months to a year.

Sure, you’re thinking, these fanatics go to the gym six times a week. No! This is the best part. You only do SuperSlow once, and at most twice, a week, to get results. In fact, the developers don’t want you to do it more often. When pushed to the point of failure, muscles need time to recover. “A workout is like filling a hole,” McGuff says. “It needs time to fill up. If you start digging again before it’s full, the hole will never fill. You need to get out of your own way.”

 Substitute for Aerobics?

Some experts do not agree with the notion that one day of slow resistance exercise is enough. Charles J. Ruotolo, MD, director of sports medicine at Nassau University Medical Center in East Meadow, N.Y., says he has heard of holding resistance exercises longer but does not think a one-day workout each week suffices. “It depends on your goals,” he says. “For cardiovascular health, you need three to four workouts a week. For muscle strengthening, I advocate exercising each muscles group about every fifth day. So, say you do chest and arms (even super slowly), the next day you would do your back, then the next, shoulders, then maybe a rest day, then start over.

“Exercising more than one day a week,” notes Ruotolo, “is more realistic and helps you get into a routine. Three or four days are a routine, not one.

“McGuff and Westcott both say it’s OK to do other forms of exercise during the week. “I make a distinction between exercise and recreation,” McGuff says. “Distilled, pure exercise like SuperSlow does not provide much stress relief and socialization.”

Hutchins, however, is pretty down on so-called “aerobics” and has written several books on the subject, including Aerobics Is Dead. (He also disdains the term “cardio.”) He relies on biochemistry to explain the cardiovascular benefits of SuperSlow. “People who push so-called aerobics,” he scoffs, “think you can cut the heart out and put it on a treadmill. The heart is an involuntary muscle: It will pump harder when there is more blood to pump, and some informal studies have shown that SuperSlow returns more blood to the heart.”

Another benefit, according to Hutchins, involves cholesterol. “When you stop to think about it — what tissue has the most cells, blood, nerves, and chemistry? Skeletal muscles.” When you stress the muscle to the point of failure, it brings on a growth mechanism to build more muscle, he says. But that isn’t all. He claims that a doctor in Texas is finding that the metabolics of muscle failure are raising HDL, the “good” cholesterol, and may lower the bad stuff, LDL, somewhat. Another researcher, Hutchins says, finds that SuperSlow increases bone density 1% a month: No other exercise is known to come close to this result.

“None of this is really tested,” concedes Hutchins. Many people find SuperSlow too challenging. Others say it’s not only difficult, but boring. “It’s boring? It’s boring?” exclaims Hutchins. “That’s like saying you don’t want to brush and floss because it’s not fun.”

“It’s intense, but not horrible,” McGuff says. “Some eat it up. Others I think could go further, but they shut down.” In Westcott’s trials, only one of his 150 participants stuck with it. He himself quit, saying he was not motivated. “I talked to some Army drill sergeants about it last week,” Westcott says. “Maybe they would be able to take it. You need to be pretty tough.”

Train, Recover, Overcome With Playmaker II FourcePoint

Playmaker II FourcePoint

Knee injuries can stop you. Preventing injury or re-injury can keep you moving. Playmaker II FourcePoint, engineered by DonJoy, increases flexion angles and reduces the risk of ACL injury.

So go ahead and say it; I can recover. I can train. I can play.

Why Playmaker II FourcePoint?

  • Women are 2 to 10x more likely to injure their ACL
  • A person who has torn their ACL has 15x greater risk of a second ACL injury during initial 12-months after ACL reconstruction
  • 50 percent of ACL injuries occur in 15-25-year olds
  • 60-80 percent of ACL injuries are non-contact related
  • Risk of ACL injury to the opposing knee (opposite knee) is two times that of the reconstructed knee
  • Psychological factors, primarily fear of re-injury, influence the ability to return to play

Playmaker  II FourcePoint - Megan Rapinoe“I have had two major injuries during my career—both ACL tears. There is a lot of pressure inside and outside of schools and organizations to recover quickly, which I appreciate, but it’s up to young athletes, parents and coaches to take steps to recover safely and guard against injury and re-injury. This will only allow for a stronger, better return to sport in the long run.”
Megan Rapinoe
U.S. Soccer Player
Olympic Gold Medalist

Train your Knees | Prevent Injury | Minimize your Risk

‘Together in Motion‘ — see it in action

Pros turn to ‘posture shirt’ to help improve performance

NBA star Dwight Howard has worn one, so has Peyton Manning. Major league pitchers have worn them. NBA player Eric Gordon of the New Orleans Pelicans was wearing one last Monday when he returned from a 21-game layoff with a torn labrum. It’s a “Posture Shirt,” made by a company called Alignmed, and its job is to help keep the wearer’s shoulders properly positioned, a key to reducing fatigue.

This Shirt is the best kept secret in sports. An athletic shirt that helps the pros can make a difference for you, too. Watch the Video.


2015-01-20-alignmed-posture-shirtPosture shirts do basically the same work as kinesio tape — the black strips seen pulling Olympians’ shoulders and backs into place on the volleyball court. Unlike the tape, there’s no precise spots or application — just put the shirt on. Variable stretch sections in the back of the shirt — the company calls them “neurobands” — work on the postural muscles in the upper body, including stimulating the muscles to hold your shoulder blades pressed against your rib cage. When the shoulder blade begins to pull away from the rib cage due to fatigue, the socket in which the shoulder rotates isn’t set up right — the arm angle changes, which reduces the accuracy and power of throws while also increasing risk for injury. With the shirt on, the stretch bands encourage the shoulders to return to the correct position.

While use of the shirts by professional athletes is on the rise, people who sit at a desk all day and use a computer are actually the ideal customer, says Craig Morgan, an orthopedic surgeon in Wilmington, Del., and a doctor for the Kansas City Royals. “That’s probably 30% of America.” The garment “takes the place of Mom yelling at you about your posture,” says Tom House, a former major league pitcher and a coach at USC who works with NFL quarterbacks and professional baseball players.

Morgan says Royals pitcher Greg Holland “wears it every game.” Holland saved 46 games in 2014, posting a 1.44 ERA. One year at spring training, Morgan dropped off Alignmed garments for Royals players to try. “It’s my understanding that he put one on, and he’s never taken it off.” Morgan says he uses the shirt to rehab pitchers in the Royals organization who have strength issues associated with control of their shoulder blade – an issue that, when fatigued, can cause changes in a pitcher’s arm angle that lead to a drop in velocity and accuracy. He said he partially credits its use with the team’s low injury numbers among pitchers. In 2014, only one Royals pitcher, Tim Collins, spent time on the disabled list with an elbow- or shoulder-related injury. And he’s been able to use the shirt to maintain velocity and control where, in the past, surgery might have been needed.

“Noel Arguelles was a Cuban defector who was signed three years ago by the Royals for $7 million,” Morgan says. “He shows up at (Wilmington, N.C., the Royals’ high-A affiliate), and his first two starts were spectacular. His third start … in the third inning, all of a sudden, this guy can’t throw a strike, and he’s lost 10 mph on his fastball.” In previous experiences, Arguelles’ problem – weakness of muscles around the shoulder blade – would take Morgan about three months to rehab. By using the posture shirt, Arguelles recovered faster and pitched a complete game shutout just two weeks later.


Professional athletes tend to talk up any product they feel helps them play better, even if it invites skepticism — energy necklaces, pressure point bracelets, copper-infused elbow sleeves. And it’s not as if Alignmed garments aren’t readily available — they sell for $80 and up from the company’s website. So why aren’t the shirts better known among the general public?

Morgan says athletes, noting that the shirts’ stretchy bands have a level of compression, may be reluctant to be too public about using them, lest they run afoul of Under Armour, Nike or other major sponsors who also manufacture compression garments. The makers of Alignmed say they don’t want to compete with the likes of Under Armour. Though both types of garments feature compression, CEO Bill Schultz says the Alignmed shirts are medical devices and have been classified as such by the American Medical Association. The highest-level and most sophisticated shirt in the Alignmed line can be obtained with a prescription, and as such, the shirts have been subjected to medical studies by sports scientists as well as physical therapists and medical schools.

In one study of college and high school pitchers, Morgan found that pitchers’ accuracy can be maintained for 20 percent longer when wearing an Alignmed shirt. In another study at USC, House found an increase in accuracy among pitchers who wore the posture shirt. Morgan and House are both medical advisers to the company. Eric Cressey, the owner of Cressey Performance in Jupiter, Florida, is a baseball training specialist who works with Major League pitchers including reigning AL Cy Young winner Corey Kluber. “(With pitchers,) you have to be careful about anything that’s ‘one-size-fits-all,’ ” Cressey says.

He acknowledges a posture shirt could be good for certain pitchers with certain shoulder problems, but he thinks it’s more useful for the regular office worker. “If you were going to generalize and say, ‘You need this,’ I’d say it’d be for them … they have a lot of utility in the general population who spend too much time sitting at a computer.” Studies back up Cressey’s opinion. In a four-week study of office workers conducted at the Utilities Center for the city of Colorado Springs, those wearing the Alignmed shirt decreased their overall fatigue by 21 to 29 percent, and increased productivity by as much as 20 percent.

“If you’re sitting at a desk, working at a computer, that’s going to create a compensation that creates postural dysfunction,” says Gary Vitti, athletic trainer for the Los Angeles Lakers. “If you’re an airline pilot, if you drive a truck, if you sit in a car a lot, whatever it is … a garment like this can help you.” It also can be tiring. Posture shirts not only squeeze the wearer, the stretch bands encourage use of muscles that a person may “cheat around” if poor posture is a habit.


The reason may be as simple as time. Posture exercises or workouts attempt to overcome eight hours of poor, desk-bound posture with 10 minutes of correction – a balance that, without fixing the posture problem, is virtually impossible to overcome. The shirt evens out the clock by stimulating the muscles to practice proper position throughout the day, as House says, “reminding” your body of the neutral position “to start any movement,” an optimal position that will increase power and reduce injury risk.

That means, Vitti says, that when worn while training – whether for the NBA or for a half-marathon or just to look better – the shirt can improve most of the exercises you do, because you’re training them in the position that’s ideal for those exercises. Vitti wears a posture shirt garment while running and lifting weights, when trainers and other coaches aren’t there to correct his position. So while it’s great for training the Lakers and other pros, Vitti says, if athletes can get such benefits “as easily as wearing the correct garment, why wouldn’t everyone want to do that?”

Greg Presto, USA TODAY Sports


Photo Courtesy of the Grand Forks HeraldFor Sydney Boike, a star high school basketball player, a devastating knee injury threatened her academic and athletic goals. Averaging 19 points and 11 rebounds per game, Boike hoped to play basketball in college while she worked towards medical school.

Her orthopedic surgeon implanted a cartilage allograft in her injured knee, hoping the OATS procedure would allow Boike to return to her favorite sport.

OATS is an abbreviation for osteochondral autograft/allograft transfer system. A chondral defect is like a “pothole” in your femur. When the chondral defect is small, an autograft transfer is usually done. Autograft refers to taking tissue from your own body to “fill in” the defect.




When the defect is large, an allograft is used. This involves taking tissue from a cadaver to replace the bone and cartilage loss. It is like putting a “plug in the pothole”. Not all patients are candidates for this surgery. Contraindications include advanced osteoarthritis, rheumatoid arthritis, total menisectomy, and ligament tears. Return to activities after OATS is generally 6-9 months.