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Physicians Provide Practical Advice on Everyday Ortho Injuries and What You Can Do About Them

Panorama's world-class team of physicians discusses how you can prevent common injuries, equip you for your favorite activities, and the best way to find treatment when life throws you a curveball.

Top 5 Sport Medicine Injuries & How to Avoid Them

An interview with Sports Medicine Specialist Dr. Mitch Robinson on common injuries from everyday life and what you can do to prevent them.

It only takes seconds to get injured, but it can take more than six months to recover, depending on your injury. Whether your high schooler is preparing for soccer season, or it’s time to clean up the yard, how can you prevent injuries in everyday life?

Dr. Mitch Robinson, a board-certified orthopedic surgeon specializing in sports medicine at Panorama Orthopedics & Spine, shares his insight on the top five injuries he commonly sees, and how to avoid them.

1. ACL Tear

“ACL tears occur in sports that plant, twist, cut, and pivot,” explains Dr. Robinson. Sports that involve a sharp movement, with opponents running towards you often correlate to higher rates of injury. Soccer and lacrosse, which are played on both artificial turf and grass, also have a higher percentage of ACL tears. While these injuries may seem inevitable, the good news is you can reduce your chances of an ACL tear with proper pre-season training. Specifically, an ACL prevention program.

“During COVID, we saw an uptick in ACL injuries from skiing, because people weren’t working out as often,” says Dr. Robinson. “It can be a home program, or a more structured program, but it’s important to prepare your quads and hamstrings for ski season.” Group training classes or personal training programs are great preparation for the season and are usually found at your local gym.

If your child is actively involved in a sport, ACL prevention programs often come in the form of pre-season workouts. Pre-season workouts are especially important for young female athletes who are more likely than male athletes to tear their ACL. “Female athletes are more quad dominant. The imbalance with their hamstrings puts them at a higher risk,” Dr. Robinson explains.

2. Rotator Cuff Tear

Where ACL tears are more common during high activity, rotator cuff tears are more common in everyday life. “If you slip on ice and reach out to grab something, or if you’re cleaning up the yard, and reach too high for a tool, it can lead to a rotator cuff tear,” says Dr. Robinson.

“When it comes to rotator cuff tears, it’s all about technique,” he emphasizes. The best thing you can do to protect your shoulder is to learn the proper technique when it comes to lifting heavy objects.

3. Meniscus Tear

“Meniscus tears occur because of hyperflexion,” says Dr. Robinson. Hyperflexion is when you flex a joint beyond its safe range of motion. “Essentially, when people move in ways they’re not accustomed to,” he explains. It’s commonly seen in yoga, or other activities with deep flexion.

Don’t let this hold you back from trying a new activity! You can prevent injury by taking time to stay safe in the first place. “It comes back to learning good technique,” Dr. Robinson says.

4. Achilles Tendon

“As pickleball has become more popular, we’ve seen an increase in this type of injury because people aren’t prepared,” says Dr. Robinson. You can tear your Achilles in a variety of ways, but the top things you can do to prevent it are regular activity and warming up beforehand.

“Warming up is different for everyone. Some people have a routine, some people just need to get loose, so find what works best for you,” says Dr. Robinson. If a warm-up isn’t already a part of your regular workout, experiment with a five to ten-minute warm-up to add to your routine and help keep your body safe. The CDC recommends at least 150 minutes of activity for adults each week.

5. Overuse

Another common injury that people don’t often consider is overuse. “People who run every single day and don’t change up their routine can get stress fractures. People who rock climb often get shoulder injuries. It’s important to have moderation,” Dr. Robinson emphasizes. “Cross-training can be really good for that.”
Injuries from overuse can come from any repetitive activity, which can create muscle imbalances. Improper equipment can also contribute to injury because the same movement is repeated.

“If you’re a runner, try running one day, then yoga the next. You can also mix in biking or rowing,” Dr. Robinson suggests.

The Bottom Line

You can’t prevent all injuries, but you can educate yourself on the proper technique and arm yourself with the knowledge to compete safely, which sets you up for success to avoid injuries.


It’s not your ski boots’ fault.

Why foot pain or numbing may not be related to your ski boots at all… a conversation with foot and ankle surgeon, Dr. Katherine Dederer

Ski season is just around the corner, and the secret to a comfortable day on the slopes may surprise you. (Hint: it’s not a fancier pair of boots.) Dr. Katherine Dederer, an orthopedic foot and ankle surgeon at Panorama Orthopedics & Spine Center, is here to share best practices for preparing your feet for the season, staying healthy, and signs to watch out for if you need further care.

As a collegiate skier in her undergrad years, Dr. Dederer speaks from a personal perspective, in addition to her professional recommendations. She earned her medical degree from Virginia Tech Carilion School of Medicine and she completed her foot and ankle fellowship at Mercy Medical Center in Baltimore, Maryland, where she trained with nationally recognized experts in advanced surgical techniques including minimally invasive bunion surgery and total ankle replacement, among others.

As it turns out, you likely haven’t even heard of the most common reasons people experience foot discomfort while skiing and snowboarding. “That numbness in your foot while skiing can be an indication of foot arthritis,” explains Dr. Dederer. “A lot of people don’t know that you can get arthritis in your foot, or that bone spurs are often a result of foot arthritis.”

Essentially, when bone spurs develop as a result of foot arthritis, the ski boot can put pressure on the spurs, which then results in numbness. In these cases, it may be worth a foot evaluation for arthritis or structural changes, as this condition could lead to nerve injury.

Another common structural factor in foot discomfort are bunions. A bunion is typically a bony bump that forms on the base of the big toe, which can cause pain and stiffness. Bunions are also worth an official evaluation, but for skiers, they don’t always mean surgery.

“Ski shops will often make custom boots that form around the shape of your bunion,” says Dr. Dederer. “If your foot is stiffer and you find it challenging to get into a ski boot, some people also will use rear entry ski boots.”

For people who are trying to time their surgery to recover in time for ski season, a good rule of thumb is to schedule their surgery 3 months prior to ski season. “Summertime is a good time for a diagnosis,” says Dr. Dederer. “If you come in now for an evaluation, you could schedule surgery and likely recover before it’s time to hit the slopes.”

When it comes to preventing foot injuries, don’t worry about the toe exercises you find on YouTube. “You probably could look up a few foot exercises, but you’re better off conditioning your whole body for ski season,” says Dr. Dederer. “Doing your cardio, lower body lifting, etc., can help prepare you better to prevent injuries.” Most injuries she sees from skiing and snowboarding are fractures. Skiers often see breaks in the tibia from ski boot stress, and snowboards commonly get ankle fractures from a day in the terrain park landing on ice.

In fact, the most preventable ski injuries are typically due to ill-fitting ski boots. “People with poor fitting ski boots can slide back and forth in their boots. This can cause injury to your toenails, which causes them to turn black and blue and fall off,” says Dr. Dederer. The solution is to make sure you have properly fitting boots, and to keep your toenails trimmed.

It’s also important to have good wool socks for insulation, and to double check that you can feel your feet at lunch time. For people with neuropathy, damage to one or more nerves that can cause loss of feeling, it’s important to avoid foot warmers. “People with neuropathy can’t feel if the foot warmer is actually burning their foot,” says Dr. Dederer.

Whether you have foot arthritis or break a bone out on the slopes, Dr. Dederer can help get you back on your feet. “One of my patients had a complex injury involving a bone fracture and a tendon injury from skiing last year. He let me know that he’s back skiing this season on the same trail a year later, facing his fears with even better form.”


Avoid the ER & Urgent Care: Why Choose Our Injury Express

Dr. Jon-Michael Caldwell explains there’s a better option for musculoskeletal care that will save you time, money, and a whole lot of frustration

You’re out hiking, and suddenly you take a fall. From how you’re feeling, you’re pretty sure that you broke something, so you should go to the emergency room… right?

Wrong.

Panorama’s Injury Express Walk-in Clinic provides specialized care for urgent situations at a fraction of the cost – no appointment necessary.

“Here’s what will typically happen when you visit an ER,” says Dr. Jon-Michael Caldwell, an orthopedic surgeon at Panorama who specializes in sports medicine. “After you’re injured, you’ll go to the ER and be triaged. Depending on how busy the ER is that day, after a few hours you’ll be evaluated and likely get an X-ray, but rarely an MRI or CT. If your injury isn’t life- or limb-threatening, you’ll likely be discharged with a cast or sling and referred to an orthopedic center for further follow-up. With Injury Express, you can skip all of this and get straight to the source of your definitive treatment.”

Instead of waiting for hours inside the ER just to be referred elsewhere, you could go to the Injury Express clinic and receive comprehensive care for your injury. If you need additional orthopedic care, you’ll already have the “inside track” to Panorama physicians.

“When you go to the ER, you’re seeing an emergency medicine provider whose primary concern is making sure your injury won’t kill you. Optimal treatment of many musculoskeletal injuries requires specialist care which you just can’t reasonably provide in the emergency room setting. If your car gets a flat tire, you don’t go to a muffler shop to fix it,” Dr. Caldwell explains. “When patients come to me from the Injury Express clinic, it comes as an internal referral. They’ve already been evaluated, with the proper scans, by a musculoskeletal specialist who knows what they’re doing.”

You’ll not only save time in the waiting room and multiple visits, but you’ll also save on cost of care. “There’s a common misconception that Injury Express is more expensive than the ER, but that’s just not the case,” Dr. Caldwell confirms.

When you visit the Injury Express clinic for bone and musculoskeletal injuries instead of an urgent care or ER, you’re only charged for a regular orthopedic office visit instead of emergency care, which is typically more costly. Panorama accepts most major insurance plans, and offers a discount for self-pay patients.

Another added benefit of seeing an orthopedic specialist is that a broken arm isn’t contagious. “At the ER, patients come in for a wide variety of reasons, some of which in this era of pandemics can be contagious. The Injury Express clinic is only for people with orthopedic-related issues, so there’s minimal chance of catching the monkeypox,” says Dr. Caldwell.

The Injury Express Walk-In clinic is best suited for patients with acute injuries. An acute injury typically happens suddenly from a specific instance (I.e., you fall while playing soccer and tear your ACL). By contrast, a chronic injury develops gradually over time in an area of the body (I.e., chronic back pain or arthritis).

The Injury Express Walk-in Clinics are open at Panorama’s Golden and Highlands Ranch locations, and are available to anyone age 12 and up. They are open:

  • 4:30 pm – 6:30 pm Monday through Thursday
  • 8 am to 11:00 am on Saturday