which an environmental toxin specialist, Karen Wilkin dot com, is the website. Up next, our ask the doctor segment. Stay with us at Sports Medicine Weekly only under 6 72. Score back on Sports Medicine Weekly and net proceeds of our show Sports Medicine Weekly Go to support Orthopedic research at Rush through the live active now dot org's fund. I'm Steve Cashel and filling in this week my co host, Dr Charles Busch. Joseph. He is one of the team physicians for the Chicago White Sox and Chicago Bulls sports medicine specialist Midwest Orthopedics. It rush orthopedic surgeon and filling in this week for my usual co host, Dr Brian Cole and Dr Chuck, Um, again, Thanks for joining us. Uh, you guys are the head team. Physicians for the Deep All Blue Demons, aren't you? For Midwest weather, Ways to rush. We have been doing that for many years. It's a lot of fun, you know, we take care of a lot of professional athletes. Dr Cole myself, we've been taking care of the Bulls and the White Sox in Chicago fire for many years, but taking care of college athletes especially, you know, in a school like the Paul is beyond those air. The funnest athletes I enjoy taking. Why is that? You know, none of them are going pro afterwards. You know their their kids who were excited. They're playing a sport for the most part because they enjoy it and they love it or because it provided them with an opportunity to get a college education where maybe they didn't have that opportunity. But, you know, the majority of time, this is the This is the final competitive years. So they want to enjoy to the best they can. Yeah, so they have, Let's say, a full month of the season left all of February and then tournament time, whether they go and get into the N. C a a tournament or the N I T or the other tournaments that are out there, they seem like there's a new one every year just trying to get teams involved. But, you know, what's it like for a college athlete? And, uh, probably the most games these guys some of these has ever played, right? Yeah. You know, especially when you got a young team like the Paul Dave later has done a great job of developing the polls had a lot of lean years, but certainly we feel a lot better this year as a team, you know, they're playing well in the Big East. They've got do have a great opportunity to get into one of the postseason tournaments after the Big East tournament. But those guys, like are pros air wearing down their younger kids. They're you know, they're 1920 at most in many instances, and they they're not used to that over use. You know where their their knees air sore, but they want to keep playing, especially when you're having a good year. So we're seeing a lot of symptoms of tendinitis and the knee Achilles tendonitis I t band syndrome. Uh, in most instances, they wanna play through, especially when they're having a good year. So our job is to keep them ready enough that they can still practice, you know, and do all the team development issues and still be effective enough during game game day situations. You bring up interesting word there, tendonitis at what age might tendonitis set in? I mean, I'm not thinking 1920 years old, but what's the youngest you've ever seen tendonitis. I'm always thinking for the older guys. Remember Scotty and Michael, you know, always, uh, when they were playing for the Bulls, you know, they always wrapped their knees and ice on the bench. Once, Phil called him off the floor and said, We got this one in hand and they had tendonitis, but I always thought they were in their thirties. Then I mean, tell me, Tell us about that. Well, there's two kinds of tendonitis. I think we see it in young kids, even even our little leaguers age 14, 12, 13, 14. And in that situation you got a normal tendon that the young player is just using too much. They don't have the muscle strength to support or throw the baseball that much. Or throw a softball that many times, and the attendant just starts to fatigue. Unfortunately, in the older players, they actually have some intrinsic tendon damage where some of those fibers of college and are starting to fail. And so certainly by the time the players get thio, you're in my age. I'm a little bit older than you. We've got a lot of fiber, fiber tendon damage, so we're gonna break down even quicker. Uh, but so usually the young kids that for them, it's just a matter of rest for the middle or the later career athlete. For them, it's a matter of maintaining their body flexibility and balance. And for old guys like you and me, it just being careful. We don't rupture something because you and I are the ones they're gonna tear attendant. Whereas our pro athletes, it's actually quite rare for them to go on to a catastrophic tendon rupture when they've got tendonitis. Don't confuse tendonitis with arthritis. Arthritis for the older people, right? Arthritis for the older people. But patients who have arthritis like our arthritic knees, you know, it's amazing. Like a player like Dwyane Wade. Wayne has some Dwayne has some wear and tear on his knees and, surprisingly, did not have arthritic pain but would get secondary tendonitis pain but nonetheless. Well, I mean, his tendons were inflamed because they were trying to support and absorb the load instead of that shot going through the joint. Eso You know, Duane was superbly conditioned despite having you know, quoted arthritic knee. But every once in a while, he needed day is ofttimes off because his patella tendon or his hamstring tendons just couldn't take that repetitive overload. Great stuff Time Now for our Ask the Doctor segment, it's a staple. The show. We do it every week here on Sports Medicine Weekly on 6 70. The score. It's Very Easy Goto Our Home page on our website Sports Medicine weekly dot com. On the right side, you'll see a picture of Dr Colin myself to click on that link, and you can ask the doctor a question. Got a couple of great questions here for you, Doc? First one is how can I determine if my daughter or female athlete is at risk for a serious knee injury? You know, Steve, this is actually a very important question, and I think one that unfortunately we have with great frequency. We know that young girl especially, uh, late junior high in high school, girls will tear the racy Els at a rate anywhere from 4 to 6, even sometimes eight times that of boys the same age. So there are some physical characteristics, and many of them are growth and development issues, and they could be spotted typically by a professional, certainly a trainer or coaches have been properly schooled on this to recognize certain patterns and young women that place him at greater risk. Number one If there knock kneed. If a girl's got a little bit of wider hips and narrower knees and they're what we call knock kneed on, they don't have good hip strength. That's a high risk characteristic. Now if you've got real concerns, this is something where physical therapists and trainers now are very well experienced. That where they look at these, a C L prevention programs where they can identify these physical characteristics. Sometimes you can't see them visually. Theon Vesely ones like I said, like the narrow you know, wide hips, narrow knees, Um, or sometimes they're balanced, single legged stance and balance on one leg, those air obvious ones. But there are other ones that we can find out with a little bit more sophisticated testing, where a ah functional sports analysis and many therapy companies and trainer trainer providers will do this. And they do a visual analysis either by video tape and tape specific measures, and tell you what girls where their deficits are and who is indeed at greater risk now the good thing about that. When you identify these risk, you can mitigate them. And so certainly, coupled with these risks analysis can you can get a these prevention programs that specifically focus the muscle deficit, whether it be their hip abductor, muscle or groin muscle that can help lower that risk. Important question for parents to ask if they've got if they're nervous about their young daughter. Okay, and uh, maybe one that relates to that next question from one of our listeners. What are the failure rates for the A. C. L after surgery? Well, the failure rates kind of go along with the risks of tearing your A cell in the first place. So, you know, the older the patient, the lower the retail rate, the higher lower the retail for the retail rates. So yeah, somebody in their late thirties early forties, their retail rates should be really that 2 to 4% whereas the very young patients and certainly the young young adolescent females, as we talked about earlier, they have potentially the highest retire rate anywhere from 10 to 15% in some rare studies as high as 20%. And so usually the same factors occur. So if I'm at high risk for tearing my a c L. I'm doing high risk sports, and I've got muscle imbalances. I better have a really good rehab. And if my rehabs not good, I'm at much higher risk for for re tear. Whereas an older, older players usually they could get away with it where they're functioning. Onley about, say, 65 70 or 75 75% of their muscle strength and in their thigh and their hamstring and hip muscle groups, where, as a young adolescent female, we wanted them well over 80 85% of muscle function or, we think there and indeed higher risk for retail Doc. What's a bigger percentage? You're going to retire the surgically repaired knee or the other knee that is perfectly healthy. You know, Steve, that there's a timeframe on that. Certainly, within the first year, the risk of retail is higher on the operative knee. Once you get past that first year out, I've got a successful A C l reconstruction. I've returned to my sports and in my competitive situation, then really it about two or three or five years out. It's almost 50 50 between reinjuring the surgical knee or reinjuring the other day. And I was one of those people. I was a basketball, a C L tear playing in my church league out in the western suburbs four years later to the day same league retour my other knee Tory right toward the A C. L on my other knee. So it ended up with, unfortunately, a second surgery. So I I'm in that 10 to 12. I'm sorry that 10 to 15% of patients who are in the bilateral A. C L Club and you know, for those who get it a second time, it's very depressing because you go Oh, not again. But at least the second patients who undergo the second surgery on the other leg get through the surgery a lot easier because they're unfortunately very experienced on how to get through the rehab. That's what's Jabari Parker said. He said, You know, after I had the second re tear, the the re tear, we started again. That's what Jabari Parker said, right, because he's had a double a c l tear. And he said after the first one, the second one was easy because I went through it once. Yeah. You know that fear of of what you're going through, Eyes gone because you've got that experience. I mean, you know, we all like experience and and certainly when you experience medical care, even invasive medical care, like a surgical procedure, you find it. Really? It's not as scary as what it is, and you understand the science behind it. And that helps you with your rehab and dealing with your therapist and trainers. Good stuff. Appreciate. We're out of time, Doc. Really appreciate you filling in for Dr Brian. Colin joining us this week. I enjoyed all the time. Thank you. Many thanks to our producer, Shane Reardon are coordinating Producer is Treece and Seager. We also want to thank David Cole for managing our website.