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Free Webinar – Treating Our Youth From Head To Toe

By Jim Monaghan
Baseball Health Network

Jim Monaghan

Youth sports specialization is on the rise. As a result, the prevalence of pediatric ACL injuries is also increasing. Join Columbia University Sports Medicine on November 13th for Pediatric Sports Injuries: Treating our youth from head to toe to learn about the latest techniques for prevention and treatment of these injuries in our young athletes.

Children are playing sports in record numbers across the United States, and with this increase in participation there has been an alarming rise in the number of sports injuries. Taking optimal care of these injured kids requires extensive knowledge and comfort in techniques that have previously been thought of as only pediatric, or only adult. This webinar reviews and discusses treatment strategies to maximize outcomes and get these developing athletes off the sidelines and back onto the field. Understanding the etiology, diagnosis, surgical, and non-surgical modalities are the key elements of a successful treatment plan. This course will be of interest to Team Physicians, Certified Athletic Trainers, Physical Therapists, Primary Care Sports Medicine Physicians and coaches of all youth levels.

At the conclusion of this activity, participants will be better able to:

  • Interpret and differentiate the physiology of pediatric sports injuries to formulate a treatment plan
  • Classify and identify different graft options to reconstruct a pediatric ACL injury in order to generate an appropriate recovery plan
  • Analyze and recognize the role of Orthobiologics such as PRP in the Developing Athlete
  • Understand and implement treatment options for patellar instability in the growing athlete
  • Produce a workup and plan for the developing athlete with lower back pain

FACULTY/AGENDA –
Charles A. Popkin, MD
Pediatric ACL Reconstruction: What you need to know in 2018
Elan L. Goldwaser, DO
Concussion in the Developing Mind: Pearls for concussion management in kids under 12
Lauren H. Redler, MD
Patellar Instability in the Developing Athlete
Benjamin D. Roye, MD, MPH
Back Pain in the Developing Athlete: When should you be concerned?
Christopher S. Ahmad, MD
The Tommy John Epidemic in Youth Throwers: How can we stop it?

This course is free to all participants.

Tagged With: Baseball Health Network, Columbia Orthopedics, Dr. Christopher Ahmad, high school baseball, Little League Baseball, Tommy John Surgery, Youth Baseball

Free Live Webinar – Advances in Shoulder Arthroplasty

By Jim Monaghan
Baseball Health Network

Jim MonaghanThis is a great chance for you to get the latest advances in shoulder arthroplasty.

Baseball Health Network founding member Dr. Christopher Ahmad and the team at Columbia Orthopedics invite you to a free live webinar event – Advances in Shoulder Arthroplasty: An Evidence Based Update for 2018 – on May 22 at 8 PM EDT.
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The management and treatment options for early, middle, and late stage shoulder arthritis has been under much debate in recent years. As implant technology improves, so do the treatment options available to surgeons.

Sound judgment and understanding the anatomic difference can improve treatment outcomes. This course will discuss both empirical research and clinical findings related to: stem design and length, new evidence surrounding next generation glenoid implants, and debates on what materials are best for a reverse total shoulder with glenoid deficiencies.

At the conclusion of this activity, participants will be better able to:

  • Understand the different clinical indications for different stem designs in Total Shoulder Replacements
  • Gain better understanding of the techniques used in anatomic Total Shoulder Replacement
  • Arthroscopic indications and treatment options for treating patients with Total Shoulder Replacement
  • Guide a patient through post-surgical planning, rehabilitation, and return to activities of daily living

FACULTY & AGENDA
William Levine, MD
Stemless, Short-stem, Long-stem: Does it Matter?
Posterior Glenoid Bone Loss in Cuff Intact Arthritis: What Should We Do?

Christopher Ahmad, MD
Short Stem Anatomic Replacement Surgical Technique
Arthroscopic Indications and Techniques to Treat the Painful TSA

Charles Jobin, MD
What’s the Evidence on New Generation Glenoid Implants?
The Reality of Converting an Anatomic Replacement to Reverse

David Kovacevic, MD
Reverse Arthroplasty with Massively Deficient Glenoid: Autograft, Allograft, or Metal?

Rommel Dolar, DPT
Sports Participation After Shoulder Replacement

This course will be of interest to Orthopedic Surgeons, Primary Care Sports Medicine Physicians, Physical Therapists, Certified Athletic Trainers, Residents, and Fellows.

Tagged With: Baseball Health Network, Columbia Orthopedics, Dr. Christopher Ahmad

Growth Plate Injuries In Baseball

By Dr. Christopher Ahmad
Frank Alexander
Baseball Health Network

Dr. Christopher AhmadFrank AlexanderMost players and parents are aware of the term “Little Leaguer’s Elbow,” but may not fully understand what it truly is. Little Leaguer’s Elbow was first coined in 1960 to describe an injury caused by the repetitive throwing motions in children. Technically, it’s an inflammation of the growth plate in the part of the bone called the medial epicondyle. The medial epicondyle is the palpable bump or knob on the inside of our elbow. Little Leaguer’s Shoulder is an inflammation of the growth plate of the shoulder called the proximal humeral physis which is in the bone called the humerus. Inflammation causes a widening of the growth plate which causes the pain players feel while throwing. In most cases, only an x-ray is needed to diagnosis Little Leaguer’s Elbow or Shoulder.

Little Leaguer's Shoulder & Elbow
X-rays of the shoulder (left) and elbow (right) demonstrating Little Leaguer’s syndrome of that joint (arrows)
While commonly seen in pitchers, Little Leaguer’s Elbow and Shoulder can occur in any young baseball player. Typically, the players who suffer from these injuries are between 12-16 years old and are still growing. The inflammation is caused by the repetitive stress of overhead throwing. Improper throwing mechanics, muscle imbalances, and fatigue also play a role in the development of growth plate injuries.

Little Leaguer's Elbow
X-rays demonstrating screw fixation of a medial epicondyle fracture due to excessive throwing and progressive Little Leaguer’s Elbow
In the elbow, the pitching motion creates a pulling stress to the inside part of the elbow and is primarily resisted by the ulnar collateral ligament (UCL). The UCL is like a rope or shoelace that is firmly attached to bone and in a growing child, the exact attachment location includes a growth plate called the medial apophysis. This is also the location where the forearm muscles attach, which can add additional stress to the growth plate. In children, the growth plate and UCL are weaker than in an adult. The growth plate is the weak link in the chain in kids and can be injured with inflammation or can sustain a fracture. In some instances of Little Leaguer’s Elbow where players continue to play through the pain, the growth plate can become so damaged that the athlete may need surgery. Surgery entails a screw being inserted into the elbow to correct the injury. For players who are no longer growing, the more common injury is to the UCL, an injury that often requires Tommy John Surgery in order for the athlete to resume high-level competitive throwing.

Our recommended treatment for Little Leaguer’s Elbow or Shoulder is complete rest from baseball activities – including hitting – for a minimum of 6 weeks. We also prescribe physical therapy for the player to work on leg and core exercises in addition to their upper body regimen to enhance their kinetic chain that is developed while throwing. After the 6 weeks of rest, we repeat a clinical examination. If the player is pain free, we implement a gradual throwing program. The throwing program is designed to make sure the player builds back up their throwing strength before returning to full, unrestricted competition. Players typically return to full competition in around 3 months.

Regardless if a player is suffering from Little Leaguer’s Elbow or Little Leaguer’s Shoulder, they can still run and play other sports that do not involve overhead throwing while they’re shut down from baseball activities. Should a player not adhere to the prescribed rest, this injury can be cumulative – meaning if the player rushes back too soon then they’ll have to sit out for 12 weeks the second time they become injured, 24 weeks the third time and so on.

Players can avoid these injuries by making sure they get enough rest. When we say rest, we mean taking time off between pitching outings, and for position players, enough rest between games. These types of injuries are overuse in nature so making sure a player gets adequate rest is important. We also suggest players rest during the off-season as well. Studies have shown that players who do not rest for 3 months have a 3600% chance of injuring their throwing shoulder or elbow where surgery is recommended. Another good tip for injury prevention is to not play on multiple teams in a single season. Playing on multiple teams can lead to overuse, and lack of communication between coaches may put a player in a position where they may feel obligated to play through pain. Keeping a log or journal of how many innings and pitches the player has thrown is a good way to keep track of how a player is being used.

Dr. Christopher Ahmad is a founding member of the Baseball Health Network and is the head team physician for the New York Yankees.

Frank J. Alexander, Jr., M.S., ATC, is a Physician Extender to Dr. Christopher Ahmad, Department of Orthopaedic Surgery at Columbia University Medical Center.

Tagged With: Dr. Christopher Ahmad, Frank Alexander, Little League Elbow, Little League Shoulder, Tommy John Surgery, UCL, ulnar collateral ligament

Understanding Tommy John Surgery – And How To Avoid It

By Dr. Christopher Ahmad
Baseball Health Network

Dr. Christopher AhmadIn baseball, we have reached epidemic levels of players needing Tommy John Surgery. At the Major League level, one in four pitchers has had Tommy John as a result of tearing their ulnar collateral ligament, or UCL. Unfortunately, these numbers translate to many younger players needing the surgery as well. To help combat the issues facing America’s pastime, I, along with Frank Alexander and Charlie Ahmad put our heads together and wrote Understanding Tommy John Surgery and How To Avoid It: A Guide for Young Baseball Players.

Understanding Tommy John SurgeryTo reverse these epidemic trends our goal is to start changing the culture at the youth levels before bad habits develop, similar to how we educate children on the dangers of smoking. In our office, we’re seeing younger and younger players walk through the door at an alarming rate. We hope that by educating younger athletes, they won’t wind up in our office when they’re older.

Adds Frank, “I remember playing and even when I worked at the college level, guys walked around the clubhouse or dugout with their scar from Tommy John as a badge of honor. They viewed it as a rite of passage. No player should ever want to have surgery and it’s time that we change that line of thinking.”

Understanding Tommy John dives into the anatomy of the elbow, what the process is like when a player gets injured, and offers tips and tricks for youth baseball players to stay healthy. By taking action earlier, players can make better decisions and avoid injury by understanding how the elbow works and what mistakes can be avoided before they land in our office!

Tagged With: Baseball Health Network, Dr. Christopher Ahmad, Major League Baseball, Tommy John Surgery, UCL, Youth Baseball

Advancements In ACL Surgery

By Frank Alexander
Baseball Health Network

Frank AlexanderPreviously, we’ve discussed anterior cruciate ligament (ACL) reconstruction surgery and the importance of prehab after sustaining an injury to your ACL. No athlete wants to injure their ACL but there is good news for athletes who may have injured their ligament. There have been advancements in ACL surgery that Dr. Ahmad and Team Ahmad are at the forefront of that can help get athletes back to playing sooner!

Knee jointIt was first reported in 1903 by Mayo Robson that the ACL could be surgically repaired and patients could remain hopeful that they’d have a good outcome. Over a century later, surgeons are able to perform 3 different types of surgery to help a patient with an injured ACL: primary repair, repair with augmentation, and reconstruction. Typically, after a reconstruction, athletes return to sport-specific activity around 6 months post-operatively with full participation on the horizon. Complete, unrestricted return to play may take up to a year. After a repair, return-to-play is nearly half that of a reconstruction!

The ACL is the main stabilizing ligament of the knee. When it tears, the knee may feel unstable or loose. The athlete or patient may not be able to fully bear weight on the injured knee. If they try to participate in athletic events, further injury may occur such as cartilage damage or meniscus tearing. The way the ACL tears plays a role in surgical intervention. Think of the ACL as a rope attached to two bones. If the rope tears through the middle completely, it creates two free ends that are like the ends of a mop. This type of tear will not lend itself to a repair and requires a reconstruction for the ACL to work again. Should the rope tear off the bone rather than in the middle, a repair is possible.

ACL Repair

If the ACL is able to be repaired, physical therapy is able to progress much quicker when compared to a traditional reconstruction. Patients that have a repair could return to sport specific activity potentially as early as 4 months after surgery! ACL repairs are an innovative surgery and can only be used in certain situations as previously described. Our Team is working on new research to help healthcare professionals have a better understanding of ACL repairs and returning athletes to play!

Tagged With: ACL, Dr. Christopher Ahmad, Team Ahmad

BHN’s Steve Hayward To Be Featured Speaker At Columbia Sports Medicine Live Webinar

By Jim Monaghan
Baseball Health Network

Jim Monaghan

 

 

 

 

JUST ANNOUNCED!

Baseball Health Network founder Steve Hayward will be a featured guest speaker at a live webinar on Wednesday July 12 presented by Columbia Sports Medicine.

The Baseball Athlete: Myths & Truths that Every Physician, Athletic Trainer, Therapist, Strength and Pitching Coach Should Know in 2017 will be of interest to team physicians, certified athletic trainers, physical therapists and primary care sports medicine physicians.

Steve Hayward photo
BHN Founder Steve Hayward

Participation in recreational and organized sports is on the rise. With that comes increased pressure to get athletes back to their sport as quickly and safely as possible. This webinar will highlight important topics in sports medicine that are experienced at the highest levels on a daily basis.

The management of athletic injuries is under constant debate, often needing to decide between conservative and surgical intervention. Good judgment on the part of the sports provider is vital as management decisions are usually tailored to the individual athlete. Optimal management of these injuries is essential to an athlete’s career. Understanding the etiology, diagnosis, surgical, and non-surgical modalities are the key elements of a successful treatment plan.

DATE – Wednesday, July 12, 2017
TIME – 8:00 PM

FACULTY & TOPICS:
T. Sean Lynch, MD
The Hips Don’t Lie…The Hip-Elbow Connection in the Throwing Athlete
Charles M. Jobin, MD
Labral & Rotator Cuff Tears: Why throwers have them and never need surgery?
Christopher S. Ahmad, MD
Startling Breakthroughs in Tommy John Treatment
A.J. Yenchak, DPT
Unlocking Your Throwing Performance Safely: Strategies to Enhance Core Strengthening and Maximize Hip Explosion
Joseph Ciccone, PT, DPT, SCS, CIMT, CSCS, ART
Hot Trends from the Major League Training Room that College and High School Players Need: The Toys that Work
Thomas S. Bottiglieri, DO
Biologic Treatments that Keep Players on the Field & Out of the Operating Room
Steve Hayward, Co-founder of the Baseball Health Network
A Pitching Coach’s Approach to Reducing Elbow Injuries

CLICK HERE TO REGISTER

Tagged With: Baseball Health Network, Columbia Orthopedics, Dr. Christopher Ahmad, Steve Hayward

Dr. Ahmad To Host 2nd Annual Baseball Sports Medicine Seminar

By Jim Monaghan
Baseball Health Network

Jim MonaghanDr. Christopher Ahmad, Head Team Physician for the New York Yankees and founding member of the Baseball Health Network will lead an esteemed panel of physicians, trainers and baseball notables at the 2nd annual Baseball Sports Medicine: Game-Changing Concepts seminar on November 16-17 in New York.

This live activity is designed to identify areas of concern or controversy in the management of baseball athletes in a team sport setting through didactic presentations and case-based scenarios. Key issues, along with up-to-date and practice solutions, will be addressed. Time has been built into the agenda for questions and answers.

Joining Dr. Ahmad as course director is Chicago White Sox Team Physician Dr. Anthony Romeo.

GUEST SPEAKERS
Jeff Passan – New York Times bestselling author and MLB columnist for Yahoo! Sports
Joe Torre – MLB’s Chief Baseball Officer and former manager of the New York Mets and New York Yankees

INVITED FACULTY
Robert B. Anderson, MD OrthoCarolina Charlotte, NC
Michael Ciccotti, MD Head Team Physician Philadelphia Phillies Philadelphia, PA
Jeffrey R. Dugas, MD Andrews Sports Medicine Birmingham, AL
Neal ElAttrache, MD Head Team Physician Los Angeles Dodgers Los Angeles, CA
Lee Kaplan, MD Medical Director & Team Physician Miami Marlins Miami, FL
Sean T. Lynch, MD Assistant Professor of Orthopedic Surgery Columbia University Medical Center New York, NY
Ron Porterfield, Head Athletic Trainer Tampa Bay Rays Tampa, FL
Mark Schickendantz, MD Head Team Physician Cleveland Indians Cleveland, OH
Nikhil Verma, MD Team Physician Chicago White Sox Chicago, IL
Kevin Wilk, PT, DPT, FAPTA Associate Clinical Director Champion Sports Medicine Director, Rehabilitative Research Birmingham, AL

TARGET AUDIENCE
This conference is designed for any orthopaedic surgeon, physician, athletic trainer, physical therapist, strength and conditioning expert, or coach concerned with the management or prevention of injuries to the baseball athlete.

OBJECTIVES
Upon completion of this course, participants should be able to:
•Analyze epidemiological trends in baseball injuries for professional, collegiate and youth baseball players
•Integrate prevention strategies with their health care team(s) to improve musculoskeletal and medical health for baseball players
•Assess and apply surgical and non-surgical treatment recommendations and rehabilitation protocols for the management of essential musculoskeletal and medical conditions in baseball

Last year was a huge success with MLB team physicians, trainers, and therapists presenting diagnosis, treatment and rehabilitation for baseball injuries.

For more details, click here for our full-color brochure.

CLICK HERE TO REGISTER.

Tagged With: Baseball Health Network, Dr. Christopher Ahmad, Major League Baseball

Returning To Exercise After Shoulder Or Elbow Surgery

By Frank Alexander
Baseball Health Network

Frank AlexanderWhen someone is injured and needs surgery, the hard part is not undergoing the surgery itself. The hard part is being patient and maintaining the drive to get through each physical therapy session. For our patients with active lifestyles, the desire to get back to the activities they love may feel far away. But there is light at the end of the tunnel. Many patients want to get back to playing their sport or even just get back into the weight room or gym. In some cases, getting on a stationary or recumbent bike is possible within days of surgery. However, that may not be enough. The type of surgery a patient has determines the length of time away from the gym and sports.

Once being cleared to return to working out, there are a number of exercises we would like our patients to steer clear from. Whether you are recovering from surgery or not, we strongly advise our overhead athletes to avoid these exercises.

free weightsExercises to avoid include: dips, chest flyes, lat pull-downs behind the neck, heavy-weight overhead shoulder presses and wide-grip bench presses. Patients should also avoid allowing the shoulders to be stretched to the extreme end range of motions. While these exercises are discouraged, there are variations and other exercises that can be substituted. Variations include: lat pull-downs with the hands in front of the body, using a medium grip for chest press and lat pull-downs, and using dumbbells for bench pressing. Substitutions include: the Thrower’s Ten exercises (internal/external rotation with TheraBands) and lying light dumbbell exercises such as Y’s, T’s, and A’s.

Upon being cleared to return to the gym or weight room, it is best for a gradual return to activities. For example: when returning to cardio, avoid using the moving arms on the elliptical for a number sessions or stick with the bike a little longer. As for weight training, it is suggested to start with light weights and gradually progress to heavier weights. If you are not sure if you should progress, feel free to ask in the office or check in with your physical therapist. Your physical therapist is a great resource for guidance when returning to unsupervised exercising.

Thrower's TenWhile some exercises should be avoided, many should be done regularly. The Throwers Ten Exercises are a staple of all throwing athletes’ shoulder programs and should be done throughout the off-season and regular season to help keep the shoulders healthy. Core and leg exercises are integral for any throwing athlete. When performing lower body exercises with a load, be sure to listen to your body. If soreness is present, modify the lift or avoid it if possible.

If you are ready to return to weightlifting, our office has a handout with guidelines that you should follow as well as the Thrower’s Ten. Following these guidelines and the advice of our team and your physical therapist will help ensure the ability to safely return to the gym and sports!

Frank J. Alexander, Jr., M.S., ATC, is a Physician Extender to Dr. Christopher Ahmad, Department of Orthopaedic Surgery at Columbia University Medical Center.

Tagged With: Baseball Health Network, Dr. Christopher Ahmad, Team Ahmad, Thrower's Ten, Tommy John Surgery

The Importance of Prehab

By Frank Alexander
Baseball Health Network

Frank AlexanderINJURY PATHOLOGY
A soccer player makes a great run, has one defender to beat – plants their foot, twists the knee, and feels a pop. The player immediately goes to the ground clutching their knee in pain. A lacrosse defenseman checks the ball out of an offensive players stick, goes for the ground ball – tries to avoid an opponent – plants their foot, twists, and feels a pop. Similarly to the soccer player, they immediately grab their knee wondering what happened.

The athletic training staff rushes to the player, assesses the injured knee, and the player doesn’t return to competition. In the doctor’s office, the knee has great laxity and a tear of the anterior cruciate ligament (ACL) is confirmed. Unfortunately, the only way the ACL will heal is with surgery. It will not heal on its own. There is significant swelling and a decrease in range of motion (ROM). Before a surgery day can be set, the swelling needs to be decreased, range of motion must be improved, and while strength will not be 100% pre-surgery – it needs to be improved as well. To achieve these goals, prehab is recommended. Prehab is pre-surgery rehab specifically designed by an athletic trainer or physical therapist targeting ROM, quadriceps strength, and swelling.

COMPONENTS OF PREHAB
There are three main goals of prehab: decrease swelling, increase range of motion, and increase strength. After an injury, the body has a natural reaction to protect itself and a consequence is swelling. Swelling in the knee will restrict range Game Ready unitof motion and needs to be decreased. If swelling is not diminished before surgery, the outcome will not be favorable for the patient. By doing prehab exercises, icing, and taking anti-inflammatory medications, swelling can be decreased. Many athletes have heard of the GameReady unit. This unit combines both ice and compression through a sleeve that surrounds the knee. Another unit similar to the GameReady is the CryoCuff which operates in a similar manner. These units are highly recommended in both the prehab and rehab phases. They can be discussed with our staff in the office.

The knee is a joint that, when healthy, has 0 to 130 degrees of motion, or more. When the knee is fully extended, we say it is at 0 degrees. In a healthy knee, it can flex (bend) to 130 degrees or beyond. Not everyone is the same and range of motion varies from person to person. However, it is said that the knee can be functional at 125 degrees of flexion and that is the goal before surgery. Exercises such as wall-slides and assisted flexion are parts of a good home prehab exercise program. While flexion is important, extension should be emphasized. Extension should be emphasized because if it is lost, extension is difficult to get back. Physical therapists will be able to flex the knee post-operatively, but extension has to be a focus of the therapist and patient as well. Ways to prevent a loss of extension is by performing exercises such as quad sets and straight leg raises. Another good way to aid extension is, while watching TV, icing, or hanging out, prop a few pillows under the ankle and keep the toes towards the ceiling. This will allow gravity to gently pull the knee into extension.

In addition to decreasing swelling and regaining range of motion, quad strength is another key component of prehab. Quad strength will help avoid atrophy – which is a decrease in muscle mass. Exercises such as quad sets and straight leg raises will help with quad strength and control. These two exercises are not only a large part of prehab, but also of the immediate rehab phase.

READY FOR SURGERY
Dr. Ahmad surgeryOnce improvements are made, the patient is ready for surgery. The prehab process varies for each patient with the ideal time from injury to surgery being 2 weeks. Timelines are not set in stone so while some patients are in the average, some may be quicker and others may be longer. Another factor is severity of injury. Many ACL tears happen in addition to other injuries within the knee such as medial collateral ligament (MCL) tears and meniscus tears. These other injuries need to be taken into account for timing of surgery as well. The more effort put into prehab, the quicker surgery can be scheduled. For many athletes, timing is of the essence and getting ready for the upcoming season will take a lot of work. The hard work doesn’t stop on the day of surgery, athletes will need to keep their work ethic for the months following surgery to ensure staying healthy once they return to the athletic fields.

When an ACL tear is diagnosed, Dr. Ahmad’s office will provide each patient with home exercises that should be done in addition to any prehab. In some cases, prehab may not be necessary but this is not always the case. We suggest that each patient does not compare their injury to another’s. Everyone heals differently but if maximum effort is given throughout the process, a return to the field is well within sight.

Frank J. Alexander, Jr., M.S., ATC, is a Physician Extender to Dr. Christopher Ahmad, Department of Orthopaedic Surgery at Columbia University Medical Center.

Tagged With: ACL, Baseball Health Network, Dr. Christopher Ahmad

Dr. Ahmad Speaks With WFAN Host Kim Jones On ACL Injuries

By Jim Monaghan
Baseball Health Network

Jim MonaghanDr. Christopher Ahmad and doctors from Columbia Orthopedics recently sat down with WFAN host Kim Jones to discuss treating and preventing ACL injuries.

Dr. Christopher AhmadBaseball Health Network founding member Dr. Ahmad, Dr. Lauren Redler, and Dr. Charles Popkin discussed steps athletes can take to avoid injury, warning signs athletes should be aware of, identifying at-risk behaviors, treatment options and recovery expectations.

With proper training and education, the risk of ACL injuries can be reduced between 50 and 80%.

Tagged With: ACL, Baseball Health Network, Columbia Orthopedics, Dr. Christopher Ahmad, Kim Jones, WFAN

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