Tiger Woods Injury

Understanding Tiger Woods’ injury

On February 23, golfing superstar and icon Tiger Woods was involved in a rollover crash in California. This made world news but we wanted to give a description of his injury from an orthopedic surgeon’s perspective.

The exact details of Tiger Woods’ injuries are still unclear, but we do know that he sustained a “compound fracture” to his ankle and lower leg. We hear this term often but what does it really mean? A “compound fracture” describes an injury when the bone breaks and then protrudes out of the skin. This is the most severe type of fracture due to its inherent risk of infection, vessel injury, and possible compartment syndrome which can even result in amputation.

Urgent treatment of an open fracture is crucial to reduce the risk of infection. Treatment begins with taking the patient to the operating room and washing out the wound and then either placing hardware or placing an external fixator that temporarily holds the leg in a more anatomic position while the swelling is allowed to resolve and later internal plates or rods can be placed.

An open fracture of the lower leg can be a devastating injury. Complications can result in infection, blood clots, nerve damage, and even loss of limb. Tiger Woods has a long recovery ahead of him but he has beaten the odds before with ACL surgery, tibia fracture, and spine surgery. Let’s hope he can defy the odds again.

Provided by Dr. Scott Resig

shoulder replacement surgery, what are your options?

Considering shoulder replacement surgery? Options and what to expect

Shoulder replacement surgery is a procedure that is done to reduce pain and restore overall shoulder mobility. There are several types of shoulder replacement surgery, the most common include: reverse shoulder replacement, partial shoulder replacement and shoulder resurfacing.

As with many surgical procedures, shoulder replacement surgery is often highly successful, but typically pursued only after other non-surgical options have been exhausted. Before recommending surgery, your orthopedic surgeon will want to ensure you are a good candidate and determine which type of surgery is best for you. A few of the most common types of shoulder replacement surgery include:

Total shoulder replacement surgery

The traditional shoulder replacement procedure has been done in the United States for more than 70 years[1] and replaces a person’s natural “ball and socket” shoulder structure.

In this procedure, the damaged shoulder parts, commonly known as the “ball” and “socket” are replaced with prostheses (artificial parts). The socket, where the shoulder blade connects to the top of the arm bone, known as the humorous, receives a prosthetic cup and then is reconnected to a metal ball that has replaced the end of the humorous.

This procedure relies on a healthy rotator cuff muscle to stabilize and move the shoulder upon recovery.

Reverse shoulder replacement (also known as reverse total shoulder arthroplasty)
A reverse shoulder replacement is often recommended when there has been a major rotator cuff tear or deterioration (often due to arthritis), causing those muscles not to work properly anymore. In this procedure, the ball and socket arrangement are reversed, which allows for the deltoid muscle to control movement of the shoulder post-surgery instead of the rotator cuff. In this set-up, instead of being attached to the humorous, the metal ball is affixed to the damaged socket, while a socket-shaped cup replaces the ball at the top of the arm bone.

Partial shoulder replacement  

There are a couple of types of partial shoulder replacement. The first, known informally as a “ream and run,” keeps the natural socket intact and only replaces the head of the humorous (the “ball”) with a prosthetic ball.  If needed, the surgeon will also reshape or smooth the socket tissue to ensure the best possible shoulder joint movement for the new ball.

The second common type of partial shoulder replacement is known as shoulder resurfacing. In this procedure, rather than removing the damaged head of the humorous, it is topped with a round cap to improve joint movement.  The natural socket also remains in place.

When should I consider shoulder replacement surgery?

No matter which type of shoulder replacement is best for your condition, shoulder replacement surgery is often considered when there has been severe trauma, such as a shoulder fracture, or for those whose arthritis has progressed considerably. In these cases, other treatments, such as physical therapy, ice, rest, NSAIDs (non-steroidal anti-inflammatory drugs, like Advil) or cortisone shots are no longer effective at maintaining range of motion and minimizing pain. Patients often have severe stiffness, limited range of motion and even a grinding sensation when they move their arm.

While shoulder replacement surgery is highly successful for most patients, there are some circumstances when the procedure should not be pursued. These include but are not limited to people who have who have more severe impairment of both the rotator cuff and deltoid muscles, those recovering from an active infection, and people who have a progressive nervous system disease such as Parkinson’s.

Qualified orthopedic surgeons work closely with each patient, using physical examination, review of symptoms and overall health, and imaging resources such as an Xray, CT scan or MRI to make case-by-case recommendations. If nerve damage is suspected, an EMG test may also be conducted.

Preparing for surgery

How you prepare for shoulder replacement surgery can impact your recovery experience and timeline. Your level of fitness, weight and other factors all play a part in improving your outcome and minimizing your recovery time.

In addition, plan to have friends or family members available to take you and bring you home and give you support in the first few days or weeks post-operation. Expect to have limited strength and range of motion at first while you begin to heal. Don’t forget to plan support for everyday essentials immediately after the procedure, such as bathing, dressing, laundry, driving etc.

Shoulder replacement surgery is typically completed in a hospital or surgical center and most procedures take a couple of hours or less. After surgery, some patients are able to head home the same day, while others remain in the hospital for a few days.

Naturally, patients feel some pain after surgery, most can be managed with mild pain relievers (NSAIDs) or local anesthetics. Surgeons recommend minimizing the use of opioid pain relievers, which are highly addictive.

Recovery after shoulder replacement surgery

Your surgeon will provide specific instructions, such as what to wear post-surgery (hint: a button up shirt is often easiest to put on after the procedure) and send you home in a sling, which will protect your shoulder for the first 2-4 weeks as it heals. You will also need to take care of the incision site, keeping it clean and dry as it heals.

Depending on the type and nature of the surgery, it can take three to six months to fully heal.  During that time, physical and/or occupational therapy is extremely valuable to help regain strength and ensure full mobility. Many patients are referred to therapy almost immediately after surgery. Your surgeon will likely provide a home exercise plan for the first few weeks and then may recommend working with a professional therapist as you progress.

Many patients enjoy a noticeable reduction in pain after surgery but take care not to overdo it during recovery. Avoid lifting anything heavy or using your arm to push yourself up to a sitting or standing position. Doing so puts too much pressure on the incision point. Patients should avoid many household tasks and driving for up to a month, so asking for help is essential.

Shoulder replacement surgery can significantly improve quality of life for people who’ve suffered from pain and limited range of motion. If you’re considering your options, see one of our board-certified orthopedic surgeons for a recommendation:

Best Shoulder Replacement Surgeons

James Ferrari, MD

Dr. James Ferrari


H. Andrew Motz, MD

Dr. H. Andrew Motz


John Papilion, MD

Dr. John Papilion


[1] Source: https://orthoinfo.aaos.org/en/treatment/shoulder-joint-replacement/

texter's thumb

In the year of online everything, texter’s thumb is poised to increase

Forget shop till you drop, this year it might be shop until your hands hurt. Mobile shopping is expected to have its biggest season ever, and experts forecast that US Android users alone will spend more than 1 billion hours on their devices in the fourth quarter. That’s a whopping 50% more than the same time last year!

While all this mobile device use can make your holiday to-do list disappear, it can also wreak havoc on your fingers, thumbs and hands with a condition known as texter’s thumb.

If you’ve been wearing out every shopping app on your phone these last few weeks, you may be experiencing pain or tenderness at the base of your thumb or on the side of your wrist. Video gamers are also prone to the same condition, and in that case, it’s referred to as “gamer’s thumb.” The medical name for these conditions is DeQuervain’s tendinosis.

No matter what you call it, it’s the repetitive motion and overuse in the fingers, hand, and wrist that can cause tenderness, pain, swelling, and inflammation. It may also hurt to grip things or turn your wrist. Some people experience a clicking or “catching” feeling when they move their thumb.

Texter’s thumb is different than carpal tunnel syndrome, the symptoms of which include tingling and numbness, as well as weakness and pain in the thumb, index, and middle fingers rather than at the base of the thumb. The two may be confused in self-diagnosis, and it’s important to see a professional because the treatments are different as well.

What to do if you think you have texter’s thumb or gamer’s thumb

The first thing you can do is to take a break from the phone, game console, or whatever repetitive activity might be causing your discomfort. Rest, followed by icing the inflamed area and taking NSAIDS (such as ibuprofen) can help reduce swelling and pain. These steps and a little time may be all you need to get back to normal.

But if the pain is severe, your symptoms advance or your pain expands up your forearm or further into your thumb, it’s time to see a hand and wrist doctor for an evaluation and possible treatment. Scheduling an appointment with an orthopedic hand and wrist specialist is a good idea, to ensure they can evaluate all possible causes and provide a proper diagnosis.

Your hand specialist will complete a physical evaluation which may include the Finkelstein test, in which you make a fist with your fingers wrapped around your thumb and then attempt to bend your wrist toward your pinky finger. Patients with texter’s thumb tend to have considerable pain on the opposite (thumb) side of the wrist when attempting this movement.

Treatment of texter’s thumb

If you are diagnosed with texter’s thumb (DeQuervain’s tendinosis), your doctor may recommend splinting or bracing your thumb and hand to rest the inflamed area. They may also recommend anti-inflammatory medication (NSAIDs), or an injection of corticosteroids to help reduce swelling and pain. These are in addition to lifestyle changes – namely reducing the repetitive motion or making modifications to your movements.

If your case is severe, or non-surgical treatments do not improve your symptoms, surgery may be recommended. Surgery involves an incision in the tissue near the base of your thumb, which will release pressure on the inflamed tendons.

After surgery, most patients experience some swelling and soreness for a few days. Stitches are typically removed a few weeks after surgery, and many patients wear a splint for up to a month to immobilize the area and encourage healing. Full recovery from surgery can take 6 weeks or more, but most patients see very positive outcomes and the ability to restore their range of motion.

If you’re experiencing pain and have been spending considerable time on your phone – whether tackling your holiday shopping list or keeping track of the rest of your life – visit one of our hand and wrist specialists.

Best Hand & Wrist Surgeons

A. Todd Alijani, MD

Dr. A. Todd Alijani


Davis Hurley, MD

Dr. Davis Hurley


Dr. Micah Worrell

Dr. Micah Worrell


When should you see a spine surgeon?

Spine surgeons know that your spine is one of the most critical parts of your body, because it protects the spinal cord – that essential collection of nerves that carry messages from your brain to the rest of the body. It also plays an important role in supporting your posture, especially your head and neck.

If you have severe or chronic back or spine pain, it’s likely that you’ve seen some kind of doctor to try to reduce pain, increase mobility or both. But when should you see a spine surgeon?

Spine surgery is typically only pursued when pain or mobility have a significant impact on a patient’s day-to-day life and after many other non-surgical solutions have been exhausted. But that doesn’t mean you need to wait until you feel like you’re out of options to see a spine surgeon.

Our team of neck and spine surgeons and physiatrists specialize in the evaluation, diagnosis and treatment of neck and spine disorders including – but not limited to – surgery. Their expertise extends to non-surgical spine care using conservative methods such as physical therapy, interventional spine care, and injections.

Seeing a spine surgeon who takes this approach will give you the most options for your care. They will use important diagnostic techniques to make the most informed recommendations and work closely with each patient to gain a deep understanding of symptoms, overall health and lifestyle, as well as short and long-term goals.

The Importance of a Comprehensive Diagnosis Before Recommending Spine Surgery

A spine surgeon and their team will use a physical exam, various imaging and other diagnostic techniques to pinpoint the source of pain and identify any clear anatomical abnormality that may be pinching a nerve or causing instability. Common conditions that may prompt a recommendation for surgery include:

Spinal Stenosis: which puts pressure on the spinal cord due to a narrowing of the spinal column

Disks Abnormalities such as degeneration, herniation or rupture of the disks, which act as the cushions between the bones of the spine.

Fractures: including microfractures caused by osteoporosis, or more significant fractures that often come from a trauma, such as a car accident.

Spondylolisthesis: where a bone or bones slips forward onto the bone below it.

But sometimes there is no visible anatomic problem. In these instances, an orthopedic spine surgeon generally will not recommend surgery, because there is simply not a clear problem that could benefit from surgical correction. There are, of course, always exceptions, which is one of the many reasons why it’s so important to see an orthopedic spine surgeon who has a wide array of expertise.

The most holistic spine surgeons look at the whole patient and make it a priority to provide non-surgical options before they recommend surgery, ensuring that spine surgery is not used as a ‘fishing expedition’ for the source of pain.

A thorough examination will reveal the proper course of treatment is right for you.

Non-surgical solutions include:

        • • Changes in activity levels that incorporate periodic stretches, massages and rest periods
        • • Heat and ice treatments
        • • Aspirin or NSAIDS
        • • Oral or steroid injections can reduce the underlying inflammation causing the discomfort.
        • • Physical therapy to help your body’s structural support system reduce back strain

There are also minimally-invasive surgical procedures to consider. Minimally invasive procedures typically focus on backbone surgeries that target herniated discs, fractured vertebrae, spinal infections, deformities or instability.

Given the smaller incisions of these procedures, their smaller impact to adjoining muscles and soft tissue tends to lead to less pain and a quicker post-surgery recovery.

Minimally invasive procedures include:

      • • Lumbar decompression: Removing portions of bone or a herniated disk to relieve pressure on spinal nerves
      • • Spinal fusion: Fusing together damaged vertebrae to create a single stable bone
      • • Discectomy: Removal of a back or neck disk
      • • Laminectomy: Removal of the back part of a vertebrae to create space for spinal nerve

If you’re considering seeing a spine surgeon, look for a fellowship-trained, board-certified expert that does more than surgery. Dr. Michael Shen uses the most recent conservative methods and surgically the most up to date technology and techniques to treat all disorders of the neck, mid-back and lower back.

Best Spine Surgeon

Michael Shen, MD

Dr. Michael Shen


ankle repair

Denver ankle repair doctors diagnose and treat ankle pain

There are numerous causes of ankle pain from arthritis to trauma, and ankle repair procedures vary widely according to the type of injury or illness. Learn when a sprain, strain or other injury is severe enough to require treatment or surgical solution. In Denver, ankle repair doctors treat the entire spectrum of injuries and illnesses that cause ankle pain.

Ankle sprains or tears

When the ligaments connecting your ankle bone to the rest of your foot and leg are stretched too far, the result is an ankle sprain. For most sprains, time, along with a regimen of rest, ice, compression and elevation (RICE) is enough to repair the damage. Some people also benefit from a wrap or brace to stabilize or immobilize the joint while the ligaments heal. Giving your ankle enough time to fully heal is essential. Repeat sprains can occur if the injury goes untreated or doesn’t heal properly, and more complex ankle repair may be needed.

If the ligaments are strained to the point of tearing, ankle repair may include longer immobilization or even surgery, as well as physical therapy. Surgery can be used to repair or replace the torn ligaments, depending on the severity of the tear.

Ankle fractures

A broken ankle can impact one or more of the three bones that make up the ankle, and ankle fractures often occur with ligament damage, especially when more than one of the ankle bones is broken. As with most fractured bones, the more severe the break, the more involved and time intensive the ankle repair.

Ankle fractures can occur from over rotating (“rolling”) or twisting the ankle, or from other trauma caused by sports collisions, falls, car accidents, etc. In addition to a physical exam, doctors use various imaging methods such as x-rays, MRIs and CT scans to determine the type and severity of an ankle fracture. If surgery is required to repair the ankle, a surgeon will reposition any bone fragments to realign your ankle bones. These pieces may then be held together with plates and/or screws so they can correctly heal.

Achilles tears or tendonitis

The Achilles is the largest of our tendons and connects the calf muscles to the heel bone. People who have repeatedly experienced tendonitis in the Achilles, which presents with inflammation and pain, can be more prone to tearing their Achilles tendon. Tendonitis can be treated with rest, ice, immobilization, physical therapy and non-steroidal anti-inflammatory drugs (NSAIDs), like Advil.

An Achilles tear is typically accompanied by a “pop,” and the pain can range from severe to none at all. Some people experience a sudden pain in the calf, others, pain in the heel. Most feel very unstable when attempting to walk after the Achilles ruptures.

Ankle repair for an Achilles tear involves surgery to reattach the tendon to the bone or tendon to tendon. Your Denver ankle repair specialist may want to order an MRI in addition to a physical exam to confirm a tear or the severity of any tendonitis.

Arthritis

Both rheumatoid arthritis and osteoarthritis can cause ankle pain due to inflammation and eventual destruction of the tissue (cartilage) between the ankle bones. Although the nature of the damage is different in each type of arthritis, in both cases, some patients respond well to non-surgical ankle treatments like rest, ice, steroid injections and NSAIDs. However, end-stage arthritis of the ankle may require surgery to resolve chronic pain issues.

Chronic Ankle Instability

People who have had multiple ankle sprains can develop chronic ankle instability, where the ankle frequently gives way on the outside of the foot. This can happen to anyone regardless of age and occurs in athletes and non-athletes alike. Symptoms include frequent swelling and pain, and overall lack of stability that often results in a turned ankle while standing, walking, running or competing.

Many treatments for this type of ankle repair are non-surgical and include patients wearing an ankle brace for support and protection during day-to-day activities; and physical therapy to build balance, strength and stability. Surgical ankle repair is typically considered if more conservative treatments are not effective, and the instability is significantly impacting a patient’s lifestyle.

Whether chronic ankle pain is disrupting your life, or a traumatic event causes damage to your ankle, ensure you take time for proper healing and ankle repair. Our experienced foot and ankle doctors, and our comprehensive team of physicians’ assistants, physical and occupational therapists and more are here to help you get moving again!

Best Ankle Surgeons

Keith Jacobson, DPM

Dr. Keith Jacobson


Alan Ng, DPM

Dr. Alan Ng


Scott Resig, MD

Dr. Scott Resig


hand pain

Parker Hand Doctor Can Diagnose and Treat Your Pain

Your hands are critical to everyday life, so when you have hand pain or limited function, it’s important to see a hand doctor to get the right diagnosis and treatment.

Located in Parker, hand doctors at Advanced Orthopedic & Sports Medicine Specialists have extensive expertise diagnosing and treating a wide variety of injuries and disorders, including these common conditions:

Carpal Tunnel Syndrome

If you have symptoms such as tingling, numbness, weakness or pain in the hand or thumb, your hand doctor may evaluate you for a pinched median nerve known as carpal tunnel syndrome. This condition is often caused by repetitive motion in your hand and wrist.

The most common treatments for carpal tunnel syndrome involve changing or eliminating motions that are putting pressure on the nerve and wearing a brace or splint that maintains a straight wrist position (during key activities such as typing or sleeping). Steroid injections or surgery may be recommended if conditions do not improve.

Cubital Tunnel Syndrome

Compression of the ulnar nerve, which runs from the outside of your hand all the way up your arm, also causes tingling and numbness in hands and fingers – but typically in the pinkie and ring fingers.

A hand doctor will determine if pressure or stretching is impacting the nerve and suggest therapy or changes in activities that cause symptoms. Surgery may be recommended in circumstances where pressure on the nerve needs to be released.

Broken Bones

Fractured bones in the hand or wrist are common and your hand doctor will likely have you get an X-ray if she or he suspects a broken bone. The most common symptom is pain, but many patients also experience swelling. Bones may be stabilized or set with a brace or cast for healing. In severe breaks, surgery may be needed.

Tendonitis

Tendons are the essential tissue that connects muscle to bones. Tendonitis occurs when the tendons become irritated and swollen, typically caused by overuse or injury. Related injuries can occur to the tissue around the tendons, which is called tenosynovitis. In the hand and wrist, there are two types of tendonitis that hand doctors see commonly:

  • DeQuervain’s tenosynovitis is the most common and causes pain and swelling in the thumb, typically a result of repetitive motion.
  • Trigger finger or trigger thumb occurs when one finger is bent and will not straighten without assistance. This happens when the tissue around the tendon is swollen, which makes it difficult or impossible to bend the finger or thumb. The finger or thumb may lock or “trigger” suddenly. There are several therapeutic and non-surgical treatment options that a hand doctor may recommend first. In addition to minimizing or eliminating repetitive motion activities that cause these issues, your hand doctor may also recommend steroid injections, or in some cases, surgery

Dupuytren’s Contracture

While the end result may appear to be similar to trigger finger, a qualified hand doctor can quickly diagnose this disease. Dupuytren’s limits the ability to straighten the fingers – usually the ring finger or smaller fingers – due to a thickening of tissues in the palm. Depending on the progression of the disease, treatments can vary widely, and some patients focus on protecting their hands with simple accommodations to everyday activities if progression is slow. Faster progression may be treated with needling, injections and in some cases, surgery. 

Jammed Fingers 

Most people think of jammed fingers occurring in basketball or other sports, but hand doctors see cases from everyday activities as well. It happens when a finger is “jammed” inward toward the hand, usually with significant force.

Symptoms may include swelling, pain or tenderness, and limited range of motion. It’s important to see a doctor if these symptoms persist, to treat a jammed finger or address a more serious injury, such as a fracture or dislocated joint.  

Damaged Nerves

There are numerous causes of nerve damage in the hand or wrist. Common causes include excess pressure on the nerve (such as carpal tunnel syndrome, noted above) or a serious cut. If you’ve had a near miss while cutting a melon or an avocado, you know how easily it can happen.

It’s important to see a hand doctor quickly if you’ve cut your hand or wrist and you’ve lost feeling in the area, or if the cut is big or deep enough that you cannot close the gap by pressing it together. Absolutely consider it urgent and get immediate medical attention if you cannot stop the bleeding. A hand doctor is uniquely qualified to diagnose and treat nerve damage to prevent permanent damage.

Whether you relate to any of these symptoms or have others that need diagnosis, don’t ignore your hand or wrist problems and don’t self-diagnose. See a hand doctor who can give you a complete exam.

For diagnosis and treatment of hand and wrist pain, see an Advanced Orthopedics’ Parker hand doctors. Or, visit us at another location.

Our Denver hand doctors are located in Stapleton at 8101 E. Lowry Blvd. Suite 230 Denver, CO 80230

Our Aurora hand doctors are in Southlands 6235 S. Main Street. Suite C-101 Aurora, CO 80016

Call (303) 344-9090 for a hand doctor appointment at any office.

Best Hand Surgeons

A. Todd Alijani, MD

Dr. A. Todd Alijani


Davis Hurley, MD

Dr. Davis Hurley


Dr. Micah Worrell

Dr. Micah Worrell


Knee Replacement Surgery

What to expect from knee replacement surgery

When people consider knee replacement surgery, it’s typically because they’ve exhausted other non-surgical treatments, but are still living with pain or mobility issues that are impacting day-to-day life. If this sounds like you, there are a number of key questions to ask before having knee replacement surgery.

There are several types of knee replacement surgery – which one is right for me?

Your orthopedic specialist will help you determine which, if any, of the four main types of knee replacement surgery are right for your situation. It depends on the type and extent of the damage to your knee, and other personal factors. Your surgeon will also evaluate your existing range of motion, stability and your overall strength.

• The most common and comprehensive is total knee replacement, also known as total knee arthroplasty. In this procedure, your surgeon removes the damaged femur and tibia bone and cartilage surfaces and replaces them with artificial material. This procedure may be recommended for patients who have extensive damage or disease throughout the knee joint and are limited in their day-to-day activities by pain and lack of mobility.

• Partial knee replacement – also called “unicompartmental” knee replacement is an option for patients whose injury or damage is affecting only part of the knee joint, and the remaining joint areas are not significantly affected. Our experienced knee replacement surgeons use state-of-the-art technologies including computer-assisted surgeries that allow the procedure to be less invasive and more precise. MAKOplasty, which was first performed in Colorado by Harold Hunt, is one such procedure, which allows the surgeon to resurface only the diseased portion of your knee and ensure that your implants are optimally positioned.

• Revision knee replacement is a special type of total knee replacement that is performed when a previous knee replacement has worn out, is not thriving or performing as hoped, or has loosened in the bone. It’s a more complex procedure because there is less bone to attach new total knee. Although more complex to perform, many patients have good results with this procedure.

• Kneecap replacement (aka patellofemoral replacement) is another partial knee replacement. in this case the undersurface of the kneecap and the groove in the femur are replaced. It typically involves a smaller incision, less disruption to other nearby tissue and thus tends to have the fastest recovery time.

How do I prepare for knee replacement?

Preparation for knee replacement involves physical, mental and organizational aspects of your life.  Physically, it always helps to be in the best shape and health that you can be. Your doctor will want to know if you have any serious health conditions like diabetes or heart disease and will encourage exercise and a healthy diet. The good news is you can impact your physical health in a relatively short amount of time and may need to improve your diet and work on leg strength – particularly your quadriceps – before having surgery.

Mental preparation includes a personal commitment to pre and post-surgical care from pre-op exercise to post-op physical therapy. By committing to do the work every day, being patient and realistic with your recovery timeframe and outcomes, you will be better positioned for a positive experience.

Lastly, being prepared means having plans and equipment for post-operative care and rehabilitation. This includes help from family and friends, ice packs, perhaps a walker and help getting around in the first few weeks after knee replacement. Patients should prepare their home to be as accommodating as possible. Depending on your home set up, this may include moving your sleeping area to the main floor, removing any obstacles or clutter that could make it difficult to navigate your space and setting aside an area that is safe and comfortable to spend time in while you recover. 

What is the recovery time for total knee replacement surgery? For partial?

Even for a full knee replacement, your doctor will likely have you up and moving as soon as possible after surgery, within a few hours of the procedure. It’s essential to get the joint moving and begin the rehabilitation process to minimize scar tissue and maximize long-term range of motion.

Within a few weeks – as soon as 2 weeks for partial, and three-six weeks for total knee replacement – most people are able to return to many daily activities including driving, as long as you are not taking pain killers, and have the range of motion and muscle control to safely operate a vehicle. At this point many low-impact activities are in play too, but it typically takes more time to be active in sports like running, skiing and tennis. Your orthopedic team will work closely with you to map out a recovery plan that includes therapy and exercise.

What does a “full recovery” look like? Will I be able to return to the activities I love?

Regardless of the type of surgery, knee replacement is intended to improve mobility and reduce pain, ultimately allowing for more independence and better quality of life. It’s important to remember that outcomes are unique to each individual. A successful outcome can mean many different things depending on the amount, type and source of damage pre-surgery; your physical fitness level, overall health and age, and your personal goals among other things.

It’s important to understand the range of likely outcomes for your personal situation before you say yes to surgery of any kind, so that you can ensure that the time and effort will result in your best outcome.

The bottom line

Talk with your doctor to ensure you understand the potential risks and rewards of knee replacement surgery, and if there are any non-surgical treatments that might provide relief. Do your homework on your surgeon, the type of surgery that’s been recommended and your role in a successful outcome. Have questions about knee replacement? Talk to one of our specialists.

Best Knee Replacement Surgeons

dr harold hunt denver co

Dr. Harold Hunt


Jared Michalson, MD

Dr. Jared Michalson


John Papilion, MD

Dr. John Papilion


Scott Resig, MD

Dr. Scott Resig


R. Presley Swann, MD

Dr. R. Presley Swann


Rotator Cuff PT Exercises Video

Rotator Cuff PT Exercises

For patients recovering from an injury of the rotator cuff PT exercise are key. PT – or physical therapy – supports the healing of rotator cuff injuries – whether post-surgery, or for someone working to stabilize and strengthen their rotator cuff.

Your doctor or orthopedic surgeon may prescribe rotator cuff PT exercises that you do in a clinic with a specialist, and they may also recommend exercises you can do at home. Physical therapist Carole Reda helps rotator cuff patients on the road to recovery every day. She walked us through three common rotator cuff PT exercises that can be done at home with just a few simple and affordable resistance bands and light weights. Both can be found at most sporting goods stores, or online.

Each exercise is described below and is often done in two “sets” of 10 each, but check with your doctor for your specific needs, and be sure to watch Carole’s demonstration in the video to follow the correct form:

Rotator Cuff PT Exercise #1: The Row
This exercise is excellent for shoulder stability.
1. First, loop the band through a sturdy item like a handrail or door handle and center the band so there are equal amounts of band on each side. [Important safety tip: always avoid looping the band through furniture or any other item that could tip and fall when pulled.]
2. Stand away from the anchor point so that the band is loose in your hands when your upper arms are straight at your side and your elbows are at a 90-degree angle.
3. Then, keeping your shoulders down, slowly pull the band toward you, extending your elbows back and squeezing your shoulder blades together.
4. Keep your motions slow and controlled.

Rotator Cuff PT Exercise #2: Shoulder External Rotation
1. Stand sideways so that the anchor point of your band is on one side of your body. Position the shoulder you want to exercise furthest from the anchor point.
2. Hold the band in your hand, keeping your elbow tight against your body and position your forearm in front of your stomach.
3. Rotate your forearm out and away from your stomach, keeping your upper arm and elbow against your body.

Rotator Cuff PT Exercise #3: “Is, Ys and Ts”
1. I’s: Stand with small weights (or no weight as recommended by your doctor) in each hand. Keep your arms straight and start with your hands by your sides. Raise your arms in front of you until they are even with your shoulder.
2. Y’s: Start in the same position with the weights, but this time raise your arms out at a 45-degree angle from your body, to create a “Y” shape with your arms.
3. T’s: Again, start with your arms at your sides. Raise both arms straight out from each side to shoulder height to make a “T” shape with your body, and then lower them back to your sides.

So, now you know three new rotator cuff PT exercises that can help support your treatment plan. As You can find all of these and more info about physical therapy on our website.

Denver Back Pain

Denver Back Specialist

As our Denver back specialists will tell you, the majority of adults will suffer from back pain at some point in their lives. Pain in the lower back is a common concern, affecting up to 80% of Americans at some point in their lifetime.

So, if you’re like many of us who are trying to navigate our way back into a workout routine, or simply get out of the house to get moving again, be thoughtful in your approach to avoid injury, including back pain.

Whether you’re ramping up your formal exercise program after several months of down time (Netflix anyone?), or you’ve taken on new independent sports as a way to stay fit and be physically distant, there are several tips our Denver back specialists offer to protect your back and keep you moving.

1) Just get going again. We’ve all had to adapt our lifestyles in recent months. First and foremost, we must still do our best to keep our families safe and manage our changing, and often challenging, work situations and demands at home. On top of all that, we have had less access to fitness and recreational facilities. All of this might have you feeling stiff and fitness may feel impossible. Or maybe you’re not quite sure how to get back in a rhythm again. “Most back pain comes from the strains and stresses of everyday life, but movement can be extremely therapeutic,” says Dr. Michael Shen, Denver back specialist and orthopedic spine specialist. “Start by getting out for a 10-15 min walk, taking an online yoga class or simply stretching.”

2) Start cross training and HIIT workouts slowly. As gyms and fitness studios begin to reopen, it’s understandable if you want to jump back into your pre-COVID routine (while complying with all local requirements, of course). Cross training and HIIT (High Intensity Interval Training) workouts are popular, and can be great for fitness, but remember to start slowly to minimize the chance of an injury, especially if you haven’t been moving at the same level of intensity for a while. Although it will be hard to take it easy and built back the level of intensity, it is important do so to avoid injury.

3) Good habits and good form go hand in hand. From golf, to running, cycling and standup paddle boarding – even that new gardening habit you’ve picked up – poor form or ergonomics is a recipe for pain. Our Denver back specialists have talked to many people who have taken up running, biking, golf or stand up paddle boarding for the first time.These independent activities can be a great socially distanced alternative to a crowded gym or other group fitness activity. But learning proper form is key. Here are a few tips for each of these independent activities:

Running: Always wear supportive running shoes and be sure to replace them once they begin to wear out. Try to run on trails and softer surfaces, avoiding concrete when you can.

Be sure to warm up before hitting your peak pace and always stretch when you’re done – especially your hamstrings. When running, keep your shoulders relaxed – down and back and keep your hands loose.

SUP: if your new to SUP – stand up paddle boarding that is – there’s lots to learn. REI has a great guide for beginners. If you’ve been getting out on the water regularly, you may be feeling the strain from all those hours of paddling. But poor form could also be the culprit. Proper paddling form relies on using your legs and core (abdominals), not your back. Keep your knees softly bent and rotate your core and hips with each gentle motion. If you’re feeling fatigued, keep each session to an hour or less.

Cycling: whether you’re on a spin bike at home, or on a road or mountain bike outside, ensuring proper fit and good posture will minimize strain on your back. Try to avoid rounding your back or bunching your shoulders together. A bike seat should be adjusted to allow you to maintain a 90-degree angle at your knee when the peddle comes to the top of each rotation. This helps ease the strain on your lower back and your hips. As always, stretching after each ride is key.

4) Take rest days. Maybe you haven’t taken on a new sport but instead have significantly increased the frequency of your favorite activity. Doing so can strain your muscles or injur yourself from overuse. A common example of this is golfers who used to play 3-4 times per month and are now playing 3-4 times per week. All that extra time on the golf course is causing lower back pains and strains – when your body doesn’t have time to rest or is suffering from overuse. Good form applies here too. Talk to a teaching pro about your swing and try to keep your motion steady and relaxed.

Denver back pain specialists understand how complex and individual back pain can be. That’s why proper diagnosis and treatment requires a skilled specialist.

Some types of acute back pain may improve with time and rest. A back specialist may suggest hot or cold packs or over-the-counter medicines such as acetaminophen or ibuprofen to help with discomfort, and then monitor your progress over time. They may also recommend physical therapy or home exercises to strengthen your core.

It’s a great time to get moving, and individual exercise is the first choice for many people. If you’re already enjoying Colorado’s great outdoors, be safe, get rest and watch your form! If you’re just getting started, go easy, have fun and build intensity and frequency.

If you need to see on of Denver’s back pain specialists, we’re here for you! We have convenient locations in Denver, Parker and Southlands:

Lowry Medical Center
8101 E. Lowry Blvd
Suite 230
Denver, CO 80230

Tel: (303) 344-9090


Directions to Lowry Location


Lincoln Medical Center
11960 E. Lioness Way
Suite 260
Parker, CO 80134

Tel: (303) 344-9090




Southlands Office
6235 S. Main Street
Suite 101
Aurora, CO 80016

Tel: (303) 344-9090


Southlands


Denver orthopedic surgeons

Choosing a Denver orthopedic surgeon? Four considerations for finding the right fit.

If you’re trying to choose a Denver orthopedic surgeon, there are several important things to consider so that you can find the right fit for your needs. Here are four to get you started.

A good Denver orthopedic surgeon wants it to be all about you

First, it’s important to think through your personal situation and preferences so you can find the right fit. Every person is different, and your lifestyle, goals and nature of your injury will all impact your needs.

For example, competitive and recreational athletes often want to see an orthopedist who specializes in sports injuries and recovery plans. These sports medicine specialists use the latest technological advancements, working closely with athletes to minimize recovery time while being careful to prevent re-injury. They use a team of experts – often all under one roof – to give athletes the best treatment protocol available. This starts with imaging and other advanced diagnostic tools, and also includes an expert treatment team, from physicians’ assistants to physical therapists.

Many patients also prefer to try non-surgical solutions first before making the decision to have surgery. If this sounds like you, look for a specialist who is experienced in non-surgical solutions, such as a physiatrist, physical therapy, or a surgeon who has a focus on minimally invasive techniques that get you back to your routine without major surgery. If non-surgical options are a viable alternative, they’ll help you look at all the options and determine the best treatment plan.

Whatever your preferences or circumstances, the best Denver orthopedic surgeons want to know you as a whole person so they can provide recommendations that meet your needs.

Look for Denver orthopedic surgeons that are experts in their specialty

Orthopedic surgeons that specialize in specific areas and techniques can become experts in their field. Some of these areas of expertise include:

Denver is also home to some of the top orthopedic surgeons that specialize in areas such as MAKOplasty, the anterior approach to hip surgery, non-invasive treatments like injections or strength and conditioning treatments.

As active leaders in their area of specialization, many top orthopedic surgeons are board certified, and are active leading industry organizations, participating in research and advocating for development of new and innovative treatments. They also volunteer their time and services to communities in need.

This level of commitment and specialization gives surgeons the depth of expertise to diagnose and treat even the most complicated orthopedic conditions.

When orthopedic specialists take a team approach, you win

Many of the top Denver orthopedic surgeons are part of a group of doctors, physician assistants, medical assistants, x-ray technicians, and others, who work as an integrated team. And within each practice, there is a wide variety of physicians who have each received specialized training in orthopedic surgery and in specific subspecialty areas, so you’re sure to get access to the right types of expertise all in one place.

When orthopedic surgeons use a multidisciplinary approach, it can also provide patients with a better, more streamlined experience. In this set up, your care team works together to treat you, sharing your goals, progress and treatment plan in a way that improves your diagnosis, surgical and recovery experiences.

Consider referrals, reviews and awards

When a patient receives great care, it shows. That’s why many of the top Denver orthopedic surgeons are routinely nominated for prestigious positions or awards, or sit on national boards for their specialty. Likewise, patients from all walks of life share inspiring success stories regarding their injury, treatment and recovery, so that patients with similar situations can get a feel for the type of orthopedic surgeon that can be a good fit.

There are many great choices in Denver. Orthopedic surgeons who are experts in their specialty, committed to their patients’ success, and dedicated to continuously advancing their field are available across the front range.

The team at Advanced Orthopedics and Sports Medicine is just a call or click away to help you find the specialist that best fits your needs.