While running is a popular sporting activity that presents a number of important health benefits, it’s not without its risks. Many runners experience an injury at some point or another, due to overuse, improper technique, or another similar factor. So what are some of the most common running injuries?
Top 5 Running Injuries:
Runner’s knee. Chondromalacia patellae, known colloquially as runner’s knee, is a general term describing any damage or irritation to the cartilage under your kneecap. While the exact cause is currently unknown, it’s thought to be related to repetitive stress on the knee joint, or any trauma to the kneecaps. It’s typically associated with a dull pain in the knee, that can be aggravated when your leg is bent.
Achilles tendinitis. A common overuse injury, Achilles tendinitis is essentially an inflammation of the Achilles tendon – what connects your calf muscles to your heel bone. It can cause pain in the back of your leg, and is commonly brought on by a sudden increase in the intensity of your physical activities.
Plantar fasciitis. Affecting over 2 million patients each year, plantar fasciitis is the most common cause of heel pain. It occurs when there is too much pressure placed on the heel, damaging the plantar fascia – the ligament that connects the front of your foot to your heel.
Shin splints. A term used to describe medial tibial stress syndrome, shin splints can cause runners to feel pain on the inner side of the shin, both during rest and exercise. It’s caused by excessive stress to the shins, and results in small tears in the muscles around the shin bone.
Stress fractures. Defined as tiny cracks in a bone, stress fractures occur due to repetitive force and are commonly seen in long-distance runners. Symptoms generally include swelling, pain, and tenderness in any affected areas.
Tips for Preventing Running Injuries
For runners who want to reduce their risk for injury, here a few easy tips you can follow.
Wear the right shoes. The right pair of running shoes can play a huge part in injury prevention. Make sure to select a pair with the contour of your feet in mind – and buy for comfort, not just looks.
Listen to your body. Many of the most common running injuries are caused by overuse. Don’t push through the pain – if your body is telling you to stop, continuing on will typically only worsen your condition.
Stretch. Warming up and stretching before a run is a crucial component in preventing injury, as it can loosen up the muscles that are most susceptible to damage.
Orthopedic Surgeon in Westwood and Hackensack
To learn more about common running injuries as well as their prevention and treatment, contact us today to schedule your consultation. You can reach our Westwood office at (201) 358-0707 or our Hackensack office at (201) 343-2277. We look forward to serving you.
Cortisol, the stress hormone, is the only hormone in the body that increases with age. High cortisol levels are associated with high blood pressure, high blood sugar, and high cholesterol. Stress reduction is key; and for those who need more help, an intergrative medicine physician can measure cortisol levels and help with management. – Dr. Lynn Corrigan
For more information please visit www.theactivecenter.com or call (201)487-4600 for a consultation.
If you’re a sports fan, you’ve probably heard the term “rotator cuff injury” before. A group of muscles and tendons that connect the shoulder blade to the upper arm, the rotator cuff is responsible for stabilizing the arm and giving it its full range of motion. Particularly important to swimmers, pitchers and tennis players, the rotator cuff is also susceptible to injury.
What Causes a Rotator Cuff Injury?
Rotator cuff injuries tend to fall into two categories: acute injuries and repetitive use injuries. Acute injuries can result from situations such as a hard fall or lifting something too heavy. Any repetitive movements – such as overhead throwing – can also put a strain on your shoulder and potentially lead to a rotator cuff injury. In older patients, a rotator cuff injury can be a result of normal wear and tear.
When it comes to warning signs of a rotator cuff tear, the first and most obvious symptom will be shoulder pain. This can range from a dull ache to severe pain, depending on the severity of the injury. Many patients also complain of shoulder weakness and a limited range of motion. While a shoulder injury can certainly be a discouraging experience – especially for athletes – it’s important to remember that rotator cuff tears are often treatable.
How Are Rotator Cuff Injuries Treated?
In some cases, a rotator cuff injury will heal on its own. If your doctor suspects this to be the case, he or she may simply recommend icing the injury, getting plenty of rest and taking over-the-counter medications. Physical therapy may also be recommended.
For more serious rotator cuff injuries, a patient may require surgery. Very often, rotator cuff surgery can be performed arthroscopically. A minimally-invasive surgical procedure, shoulder arthroscopy is performed through a series of small incisions. Using a fiber-optic device known as an arthroscope and tiny surgical instruments, a surgeon can reattach the tendon to the bone and remove any loose fragments from the shoulder. Compared with an open procedure, this approach tends to result in a speedier recovery, less scarring and less post-surgical pain. Adhering to a structured physical therapy regimen, many patients make a complete recovery.
Rotator Cuff Repair in Westwood and Hackensack
Think you may be suffering from a rotator cuff injury? Contact our orthopedic offices today. You can reach our Westwood location at (201) 358-0707 or our Hackensack location at (201) 343-2277. We look forward to serving you.
The knee is the most complicated joint in the human body, so it’s not surprising that it’s quite susceptible to injury. This is of particular concern to athletes, especially those who participate in contact sports. Let’s take a brief look at one of the most common knee injuries: meniscal tears.
Top 5 Patient Questions about Meniscal Tears
What is a meniscus? The meniscus is a crescent-shaped disk made of cartilage that cushions your knee. Each knee has two of them, one for the outer and the inner edge, and they also work to keep the knees steady.
How can they tear? Meniscal tears frequently occur during forceful twists of the knee, a common occurrence in sports. They’re often seen in older people as well, as the cartilage thins and wears over time, leaving them more prone to injury.
What are the symptoms? The symptoms are typically dependent on the severity of the tear. Those with a minor tear might experience some slight swelling or pain, which can go down on its own. The symptoms of a moderate tear might be stiffness in the knee, pain in the side or center of the knee, and swelling. If you’ve experienced a severe meniscal tear, you may have difficulty straightening your knee due to torn pieces of the meniscus moving into your joints. Your knee will likely feel wobbly, and can swell for a number of days.
What are the treatment options? Many doctors begin to treat meniscal tears by simply advising rest, ice, and occasionally over-the-counter medications. If the tear is large or too severe to heal on its own, your doctor may offer surgery as a solution.
What does the surgery involve? In partial meniscectomy and arthroscopic knee repair procedures, the torn section of the meniscus will be removed. In rare cases, your surgeon will be able to suture the edges of the meniscus, allowing them to heal without being removed. Other patients require a full meniscectomy, a procedure in which the entire meniscus is removed. If the need for surgery arises, your doctor will lay out your options and help you decide which treatment is best for you.
Meniscus Surgery in Westwood and Hackensack
If you think you might be suffering from a meniscal tear or just want more information, contact us today to schedule your appointment. You can reach our Westwood office at (201) 358-0707 or our Hackensack office at (201) 343-2277. We look forward to hearing from you.
Partial knee replacements are proving a popular alternative to conventional total knee replacements.
Osteoarthritis, or OA, the most common form of arthritis, is a wear and tear condition that destroys joint cartilage. Cartilage is the cushion that sits between the bones of a joint, and it typically begins to break down after years of constant motion and pressure in the joints. A normal knee glides smoothly because cartilage covers the ends of the bones like Teflon. As the cartilage layer continues to break down and wear away, bone begins to rub against bone becoming more like sandpaper rubbing against sandpaper, causing the irritation, swelling, stiffness and discomfort commonly associated with arthritis. Many athletes have knee injuries that accelerate or exacerbate the arthritic process in their joints.
Full or Partial?
When knee pain becomes severe and begins to affect quality of life, the most common surgical intervention is total knee replacement, a procedure that removes the natural knee joint and replaces it with artificial total joint implants. An orthopedic surgeon may recommend knee replacement surgery when a patient has more advanced osteoarthritis and has tried and failed all the nonsurgical treatment options. Surgery should only be considered if the knee is significantly affecting the patient’s quality of life and interfering with normal activities.
In many athletes, as well as other patients, a procedure known as partial knee replacement, or unicondylar knee replacement, has become a popular alternative to the more invasive, conventional total knee replacement. A partial knee implant is designed to repair only a single side of the knee, (usually the medial side), making it much smaller than a total knee implant. The normal knee contains three compartments. When a partial knee replacement is performed, only the damaged areas are replaced with an implant. When arthritis is confined to only one of the three compartments, a partial knee replacement is an attractive surgical option.
Although partial knee replacements have grown popular lately, the first ones were actually done in the 1950s. In order to be a candidate for this procedure, the patient must have arthritis limited to one compartment of the knee. Patients with inflammatory arthritis, significant knee stiffness or ligament damage may not be ideal candidates. With proper patient selection, modern unicompartmental knee replacements have demonstrated excellent medium- and long-term results in both younger and older patients.
Benefits of Partial Replacement
Since a partial knee replacement involves only one of the knee’s three compartments, the option has several advantages:
Quicker recovery
Less pain after surgery
Less blood loss
Lower incidence of medical complications
Additionally, a partial knee replacement does not remove ligaments and results in much less bone and cartilage loss than is the case with a total knee replacement. This minimal invasion enables a more rapid recovery, and provides a better and more natural range motion when compared to a total knee replacement. Patients undergoing a partial knee replacement also seem to have a more favorable result in regard to certain daily activities such as stair climbing or kneeling.
Patient satisfaction is greater with partial knee replacements; most patients report that it feels more “natural” than a total knee replacement. Since a partial knee replacement is done through a smaller, less invasive incision, hospitalization time is shorter, and rehabilitation and return to normal activities are faster.
After partial knee surgery, patients usually are hospitalized for up to two to three days. However, in some patients, partial knee replacement can be performed as an outpatient. Recovery time varies, but many people are able to drive after two weeks, garden after three to four weeks, and golf after six to eight weeks. Each patient is different, and it is up to the surgeon and the rest of the team to determine when and what activities patients can return to safely, and what activities to avoid.
Disadvantages are Few
The main disadvantage of partial replacement is the potential need for additional surgery in the future. If the disease progresses to the other compartments, a total knee replacement surgery may be necessary.
Although surgery may be a frightening idea, arthritis and knee pain usually progresses with time. Many patients who have undergone a partial knee replacement wish they had done it sooner. A partial knee replacement may delay, and, in some cases, prevent a more extensive total knee replacement.
Dr. Michael Gross, the founder and director of Active Orthopedics and Sports Medicine P.A., www.activeorthopedics.com, is the section chief for sports medicine and the orthopedic director for the center for sports medicine at Hackensack University Medical Center.
Don’t let the cold weather put a freeze on your workouts.
The days are growing shorter and the mercury is dropping, and that can only mean one thing: winter is on its way. Unless you’re ready to move your workouts indoors, you better start thinking about exercising in the cold weather and how to do it safely. Injuries due to overexposure in cold temperature have risen in recent years due to increased participation in outdoor winter activities such as ice skating, skiing, snowboarding, and in all-season walking, jogging and cycling. Short of investing in a treadmill, or taking up mall walking, knowledge of potential hazards and prevention during cold weather are the key to keeping us safe during our outdoor fitness activities.
Unfortunately, the cold weather also robs many people of their motivation to exercise. And, when you’re not motivated, it’s easy to just stop exercising and hibernate like a big black bear. You don’t have to let cold weather spell the end of your exercise. With these tips for exercising during cold weather, you can stay fit, motivated and warm when the temperature turns chilly.
The American Council on Exercise offers these suggestions for exercising safely in the cold:
Wear layers of clothing that you can peel away as you warm up.
Keep your head, hands and feet warm with a hat, gloves and socks.
Always check the weather before heading out. Don’t exercise outdoors in dangerous conditions.
Dress in Layers
Heat conservation is the major goal when exercising in cold weather. Prevent heat loss by wearing appropriate clothing. The key to protection is to wear clothing that is layered, lightweight and waterproof or water-resistant.
The air trapped between clothing fibers and the skin, which becomes warm and serves as a barrier to heat loss, provides insulation. The more layers between the skin and the air, the more insulation. Keep in mind that several layers of lighter layers provide better protection than a single bulky layer.
For the innermost layer against the skin, choose a lightweight synthetic such as polypropylene. This wicks moisture away from the body’s surface and dries quickly. Cotton or natural fibers tend to become saturated and stay wet. Clothing that becomes wet through sweating or external moisture loses almost 90% of its insulating properties. Since water conducts heat 25 times faster than air, wearing wet clothing will quickly facilitate heat loss. Lighter sweaters and long-sleeve shirts made with natural materials work best as inner layers, providing insulation without restricting movement.
Cover these layers with a zipped or easy-to-open jacket. Choose one that is both waterproof and lightweight, since it will be your protection from snow, rain and wind, and will be the layer you shed if you heat up too quickly.
Protect Hands, Feet & Ears
At least 30% and up to 50% of body heat dissipates through our heads, so top off your ensemble with a hat or helmet, depending on your sport. Make sure to cover your ears as well. Since hands and fingers are highly susceptible to frostbite, wear mittens or gloves.
When it’s cold, blood flow is concentrated on your body’s core, leaving your hands and feet vulnerable to frostbite. Try wearing a thin pair of gloves under a pair of heavier gloves or mittens lined with wool or fleece. Don the mittens or gloves before your hands become cold and then remove them if your hands begin to sweat.
Consider buying exercise shoes a half-size or one size larger than usual to allow for thick thermal socks or an extra pair of regular socks. And don’t forget a hat or headband to protect your ears, which also are vulnerable to frostbite.
Check the Weather
Never fail to check the air temperature and wind chill factor before exercising in the cold. Used by the National Weather Service since 1973 as a public health tool to reduce cold injuries, the wind-chill index represents the cooling effect of the wind on bare skin for different temperatures and wind velocities. Higher winds increase the cooling effect of cold temperatures, further emphasizing the need to cover skin in cold weather.
Data from the National Safety Council suggests little danger to properly clothed individuals whose skin is exposed at 20 degrees Fahrenheit, even with a 30 mph wind. A danger does exist for individuals with exposed skin when the wind chill factor (combined effect of temperature and wind) falls below minus 20 degrees Fahrenheit.
Exercising when it’s cold and raining can make you more vulnerable to the cold. If you get soaked, you may not be able to keep your core body temperature high enough, and layering won’t help if your clothes are wet. If it’s extremely cold, you may need to take your exercise indoors or skip it for a day or two.
Wind chill extremes can make exercising outdoors unsafe even if you dress warmly. The wind can penetrate through your clothes and remove the insulating layer of warm air that surrounds your body, and any exposed skin is vulnerable to frostbite.
Hydrate Properly
Just because its cold, it doesn’t meant you can forget all you know about proper hydration. You need to stay well hydrated when exercising in cold weather just as you do when exercising in warm weather. Drink water or sports drinks before, during and after your workout, even if you’re not thirsty. You can become just as dehydrated in the cold as in the heat from sweating, breathing and increased urine production, but it may be harder to notice during cold weather.
Significant body fluid can be lost and since sweat may evaporate more quickly in a cold environment than in a hot one, you may not have a clear indication of how much fluid you are actually losing. Always begin your workout properly hydrated and continue drinking 15 to 20 ounces of water per hour.
Dehydration affects your body’s ability to regulate body heat and increases the risk of frostbite. Avoid consuming alcohol or beverages containing caffeine, because these items are dehydrating.
Special Conditions
Exercising in cold weather may not be ideal if you have certain health conditions. Check with your doctor before starting to exercise in cold weather, especially if you suffer from any of the following:
Asthma
Exercise-induced bronchitis
Heart condition
Raynaud’s disease (a condition that limits blood circulation to certain areas of your body, causing them to numb in response to cold temperatures or stress. This may make it difficult to determine whether or not you’re getting hypothermic; the reduced blood flow may also increase your risk)
These tips can help you safely—and enjoyably—exercise when the weather turns chilly. Remember that as you exercise in cold weather, you must always monitor how your body feels. It may be necessary to shorten your outdoor workout or even cancel it altogether during extreme weather. Always know when to head home and warm up. Finally, be sure to let someone know your exercise route and your expected return time, in case something does go wrong.
Dr. Michael Gross, the founder and director of Active Orthopedics and Sports Medicine P.A., www.activeorthopedics.com, is the section chief for sports medicine and the orthopedic director for the Center for Sports Medicine at Hackensack University Medical Center.
Exercise for Life: Preventing Disease and Increasing Longevity
We all know the positive effects that exercise can have on our external body, but did you know about the internal benefits? Regular exercise has been proven to help the body fight disease and improve your chances of living a longer and healthier life.
Cardiovascular disease, or heart disease, is the leading cause of death in the United States. One of the biggest benefits of regular exercise is minimizing the risks of cardiovascular disease. The heart is a muscle and just like any other muscle in our body, it needs to be worked out and strengthened in order to keep up with your lifestyle and continue to function properly. When you exercise, your heart will automatically beat faster in order to pump more blood throughout the body to supply integral oxygen to tissues. Many people don’t realize that you can actually strengthen your heart muscle. With regular exercise, the heart muscle becomes stronger, ultimately improving your circulation, which, in turn, helps to promote cell growth and organ function.
Heart of the Matter
Regular physical activity helps control your weight and makes the heart stronger, which decreases the strain that may be put on your heart and significantly reduces the risk for heart attack or stroke. Regular exercise has also been shown to lower blood pressure and can actually increase the occurrence of “good” cholesterol (high-density lipoproteins, or HDL) and lower “bad” cholesterol (low-density lipoproteins, or LDL), which can significantly lower your risk of heart disease.
Being active boosts high-density lipoprotein (HDL), or “good” cholesterol, and decreases unhealthy triglycerides. This combination keeps your blood flowing smoothly, which decreases your risk of cardiovascular diseases. In fact, regular physical activity can help you prevent or manage a wide range of health problems and concerns, including stroke, metabolic syndrome, type 2 diabetes, depression, certain types of cancer, arthritis and falls.
Aid in Diabetes
Individuals who are overweight and have excess body fat are also at high risk for developing type 2 diabetes. This disease is increasing at alarming rates—by 62% since 1990—and 17 million Americans now have it. Physical activity can enhance weight loss and help prevent and/or control this condition. Losing weight can increase insulin sensitivity, improve blood sugar and cholesterol levels, and reduce blood pressure—all of which are very important to the health of people with diabetes.
So, exercising, combined with a healthy diet, can improve blood sugar and cholesterol levels, which may help control diabetes without the use of medicine. Insulin levels respond to exercise, and by maintaining a more even insulin level in your bloodstream, appetite is controlled and your metabolism is kept at a healthy fat-burning state.
Apart from reducing your risk of developing type 2 diabetes, regular physical activity can also help reduce metabolic syndrome. Metabolic syndrome is a condition in which you have some combination of too much fat around the waist, high blood pressure, low HDL cholesterol, high triglycerides or high blood sugar. Research indicates that lower rates of these conditions are seen in people who exercise with at least moderate-intensity aerobic activity every week. And the more physical activity you engage in, the lower your risk will be. Many researchers believe that it is the amount of exercise—not the intensity—that is important. In other words, it’s not how hard you exercise, but how much. And, any exercise is better than no exercise at all.
Cancer Connection
Being physically active lowers your risk of developing many types of cancer, most notably colon and breast cancers. Physically active people have a lower risk of colon cancer than do people who are not active. Physically active women have a lower risk of breast cancer than do people who are not active.
Colorectal cancer has been one of the most extensively studied cancers in relation to physical activity, with more than 50 studies examining this association. Numerous studies in the United States and around the world have consistently found that adults who increase their physical activity—either in intensity, duration or frequency—can reduce their risk of developing colon cancer by 30 to 40 percent relative to those who are sedentary regardless of their body mass index (BMI). The greatest risk reduction has been seen among those who are most active.
It is estimated that 30 to 60 minutes of moderate to vigorous physical activity per day is needed to protect against colon cancer. Physical activity may protect against colon cancer development by its effect on energy balance, hormone metabolism, insulin regulation, and by decreasing the time the colon is exposed to potential carcinogens. Physical activity has also been found to alter a number of inflammatory and immune factors, some of which may influence colon cancer risk.
The relationship between physical activity and breast cancer incidence has also been extensively studied, with more than 60 studies published in North America, Europe, Asia and Australia. Almost all the research indicates that physically active women have a lower risk of developing breast cancer than inactive women. Although most evidence suggests that physical activity reduces breast cancer risk in both premenopausal and postmenopausal women, starting regular exercise during adolescence may be especially protective. Although a lifetime of regular, vigorous activity is thought to be of greatest benefit, women who increase their physical activity after menopause may also experience a reduced risk compared with inactive women.
Whether it involves helping with heart conditions, chronic conditions such as diabetes or preventing cancer, one thing is clear—physical exercise does a body good.
Michael L. Gross, MD, is the founder and director of Active Orthopedics and Sports Medicine P.A., the section chief for sports medicine and the orthopedic director for the Center for Sports Medicine at Hackensack University Medical Center, as well as co-founder and medical director of the Active Center for Health and Wellness. Visit www.activecenterforhealthandwellness.com.
How working out can work wonders for your love life
A big part of being sexy is feeling sexy. People who exercise have an improved body image over people who do not exercise. Being more comfortable with your body generally leads to better and more relaxed sex, resulting in greater pleasure.
Sex by the Numbers
Research indicates that exercise may increase sexual drive, sexual activity and sexual satisfaction. Results of a recent study reported that women were more sexually responsive following 20 minutes of vigorous exercise. Among males, short intense exercise is linked with increased testosterone levels, which may stimulate sexual interest and behavior. Libido in men is dependent both on testosterone levels and on psychological factors. Another recent study showed that more physically fit men and women rated their own sexual desirability higher than less active men and women the same age. Eighty percent of men and 60 percent of women who exercised two to three times a week rated their own sexual desirability as above average. As the number of days of exercise per week increased, so did the ratings of sexual desirability.
Performance Confidence
Not only did men and women who were more physically fit rate themselves as more sexually desirable, but they also rated their own sexual performance as higher. Among people who exercised four to five days per week, 88 percent of the women and 69 percent of the men reported their own sexual performance as above average or much above average. The reason for this could simply be an increase in confidence due to an improved body image, a physiological reason (such as better circulation and blood flow), or a hormonal cause involving increased endorphins, decreased cortisol and higher circulating levels of sex hormones.
The More the Better
Another interesting, but undeniable, result of exercise is that people who exercise more, actually have more sex. The reason for this is complicated. Individuals who exercise more are generally healthier, younger and have more attractive bodies than individuals who are non-exercisers. Additionally, frequent exercisers may be more physically oriented people who seek out activities and sensations. Whatever the case, research does indicate that the more a person exercises, the more sex he or she tends to have.
Age & Sex
Sixty-year-olds who exercise frequently report having the same amount of sex and sexual pleasure as people who are decades younger. One study examined the sexual frequency and satisfaction ratings of swimmers aged 60 and found that the frequency of sex for the older swimmers was the same as those who were 20 years younger. The good news: If you exercise a lot, your “sexual age” likely will be years younger than your chronological age.
Heart of the Matter
There is a saying among doctors who treat erectile dysfunction that: “Penis health is heart health.” Erectile dysfunction frequently is caused by circulatory problems. In order to have an erection, the penis must swell with blood. Blocked arteries, high blood pressure and other cardiovascular issues can interfere with that process. Exercise keeps the heart and arteries healthy, reducing the risk of erectile dysfunction. Researchers looked at men over the age of 50 and found that those who were physically active reported better erections and a 30 percent lower risk of impotence than men who were inactive.
Exercise releases endorphins that give a feeling of pleasure. The classic “runner’s high” is an example. In a “runner’s high,” a seasoned runner may experience a feeling of bliss and contentment during exercise caused by a release of endorphins. Your sex drive and feelings of sexual pleasure also use an endorphin release system. Each time you exercise—or have sex—your body releases these “feel good” endorphins. The more frequent and intense the releases, the easier it is for sexual arousal and pleasure in the future. In fact, studies have shown that women who frequently exercise become aroused more quickly and are able to reach an orgasm faster and more intensely.
All of these are great reasons to become more active in and out of bed.
Orthopedic Surgeons Dr. Michael L. Gross, M.D., Dr. James C. Natalicchio, M.D., Dr. Oscar Vazquez, M.D., Dr. Steven Weinfeld, M.D., Dr. A. Ylenia Giuffrida, M.D.
and Dr. Richard D. Rhim, M.D., and Anti-Aging Specialist Robert Ortiz, serving Bergen County & Passaic County New Jersey, including Westwood, Hackensack, Ridgewood, Paramus, Fair Lawn, Oradell, Teaneck and the surrounding area.
While running is a popular sporting activity that presents a number of important health benefits, it’s not without its risks. Many runners experience an 
If you’re a sports fan, you’ve probably heard the term “rotator cuff injury” before. A group of muscles and tendons that connect the shoulder blade to the upper arm, the rotator cuff is responsible for stabilizing the arm and giving it its full range of motion. Particularly important to swimmers, pitchers and tennis players, the rotator cuff is also susceptible to injury.
The knee is the most complicated joint in the human body, so it’s not surprising that it’s quite susceptible to injury. This is of particular concern to athletes, especially those who participate in contact sports. Let’s take a brief look at one of the most common knee injuries: meniscal tears.
