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Meet Dr. Robert Afra

Dr. Robert Afra has been leading the charge toward more modern and effective orthopedic surgical procedures for more than 15 years.

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Meet Dr. Javaherian

Leader and educator in acupuncture and herbal medicine

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Meet Dr. Kart

Doctor of Chiropractic

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Meet Dr. Catherine Gillespie

Physical Therapist

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Meet Dr. Amanda Martin

Physical Therapist

Shoulder Rotator Cuff Repair Research

Rotator Cuff is a  group of tendons in the shoulder joint that provides support & enables a wider range of motion.


Shoulder Labral Repair Surgery Research

Labral repair surgery is a procedure used to reverse damage to the labrum, or cartilage, in the shoulder.

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Knee Replacement Surgery Research

Knee replacement, or knee arthroplasty, is a surgical procedure to resurface a knee damaged by arthritis.


Knee ACL Reconstruction Research

Select the doctor you prefer and book a visit with him or her in a matter of minutes.


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Hand and wrist problems can paralyze your productivity. Click here to get […]

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Knee injuries and ailments can make walking an agony. Click here to find lasting […]

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Shoulder pain and impaired movement can be debilitating symptoms. Click here to […]

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Elbow Surgery, Hand Surgery, and Wrist Surgery procedures. Click here to get […]

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Knee surgery options at Orthopedic Surgery San Diego. Click here to find more […]

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Shoulder pain and impaired movement can be debilitating symptoms. Click here to […]

Dr. Afra


Dr. Robert Afra has been leading the charge toward more modern and effective orthopedic surgical procedures for more than 15 years. Click Here to learn more about the credentials and experience of Dr. Afra

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Doctor of Chiropractic

Jason Kart

Dr. Jason Kart, is a seasoned chiropractor with three decades of private practice experience, and former esteemed position of Dean of Education at California College, San Diego.

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Doctor of Acupuncture & Herbal Medicine

Mo Javaherian

Dr. Mo Javaherian, an accomplished practitioner of Chinese medicine, brings a rich tapestry of international experience to his work.

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Physical Therapist

Catherine Gillespie, MPT

Cathie Gillespie, a distinguished physical therapist, brings over two decades of extensive outpatient orthopedic experience to our clinic.

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Functional Strength and Conditioning Coach

Bill McDonald

With an impressive melding of military medical expertise and a seasoned fitness background, Bill McDonald stands as a distinguished authority in the realm of functional strength and conditioning.


It’s always the word of mouth that’s the best advice. Here are some of our…



Dr. Afra treated me for ankle and shin fractures. The ease and timeliness of getting an appointment with a specialist like Dr. Afra was huge! I appreciated his prompt care and continued follow-up and monitoring of my injuries. And I appreciated the way he took time to listen, answer, and explain. Also, his staff is excellent and attentive. I highly recommend Dr. Afra.



I was referred to Dr. Afra for a sprained wrist through workers comp. Dr. Afra was very personable and warm. He was very knowledgable and took the time to explain diagnosis. He was always willing to listen to my concerns and preferences rather than other doctors who tell you what you are going to do. I highly recommend Dr. Robert Afra to future patients.


What do our athlete patient say?


The document under review is titled “Exercise for mental health: An effective intervention for depression and anxiety” by Harvey et al., published in the British Journal of Sports Medicine in 2018. The paper discusses the impact of exercise on mental health, specifically focusing on depression and anxiety. It provides a comprehensive review of the existing literature and presents a case for the inclusion of exercise as a part of mental health treatment plans.

Exercise and Mental Health

The paper highlights the growing body of evidence supporting the positive effects of exercise on mental health. Regular physical activity has been shown to reduce symptoms of depression and anxiety, improve mood, and enhance overall mental well-being. The authors argue that exercise can be considered an effective intervention for mental health conditions, alongside traditional treatments such as psychotherapy and medication.

Randomized Controlled Trials and Meta-Analyses

Several randomized controlled trials (RCTs) and meta-analyses have been conducted to investigate the effects of exercise on mental health. For instance, a meta-analysis by Morres et al. (2018) found that aerobic exercise had a significant antidepressant effect in adult patients with clinical depression. The study included only trials with depressed patients recruited via mental health services, making the findings representative of routine practice and of additional value.

Another study by Ensari et al. (2015) found that exercise had a substantial effect on reducing anxiety symptoms. The study employed the PEDro scale, a tool for evaluating the risk of bias in physical therapy interventions, and reported that a significant number of trials had a lower risk of bias.

Key Findings

The paper by Harvey et al. (2018) concludes that exercise can be an effective intervention for mental health conditions. The authors suggest that exercise should be considered as a part of treatment plans for individuals with depression and anxiety. They also highlight the need for further research to understand the mechanisms through which exercise impacts mental health and to determine the most effective types and amounts of exercise for different individuals and conditions.

Implications for Practice

The findings from this paper and the referenced studies have significant implications for mental health practice. Exercise could be incorporated into treatment plans for individuals with mental health conditions. Mental health professionals could work with individuals to develop personalized exercise plans, taking into account their preferences, abilities, and existing physical health conditions.


In conclusion, the paper by Harvey et al. (2018) provides a strong case for the inclusion of exercise in mental health treatment plans. The evidence from randomized controlled trials and meta-analyses supports the positive effects of exercise on mental health, particularly for individuals with depression and anxiety. Further research is needed to optimize the use of exercise as a mental health intervention.


  1. Harvey, S. B., Overland, S., Hatch, S. L., Wessely, S., Mykletun, A., & Hotopf, M. (2018). Exercise for mental health: An effective intervention for depression and anxiety. British Journal of Sports Medicine.
  2. Morres, I. D., Hatzigeorgiadis, A., Stathi, A., Comoutos, N., Arpin-Cribbie, C., Krommidas, C., & Theodorakis, Y. (2018). Aerobic exercise for adult patients with major depressive disorder in mental health services: A systematic review and meta-analysis. Depression and Anxiety.
  3. Ensari, I., Greenlee, T. A., Motl, R. W., & Petruzzello, S. J. (2015). Meta-analysis of acute exercise effects on state anxiety: An update of randomized controlled trials over the past 25 years. Depression and Anxiety.


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