Knee injury:  Warm weather brings many of us outdoors; here in San Diego, that can mean year-round soccer, lacrosse, football, gardening, golf, tennis and more. Sadly these same activities are often closely associated with osteoarthritis knee pain, a debilitating symptom which can hit the brakes on an otherwise active lifestyle.

My practice offers a number of remedies for chronic knee pain in San Diego, including some Tips of the latest revolutionary treatments such as Platelet Rich Plasma injections (PRP). Our goal is quite simply to Tips you as a whole person, and to help you avoid knee surgery through gentler, noninvasive techniques.

As one article recently advised:

Don’t wait too long to see a specialist. A doctor who specializes in knee pain can be very helpful in guiding you through all the treatment options, even in the early stages of knee osteoarthritis. The most common specialists for knee osteoarthritis are orthopedic surgeons, pain management, physical medicine and rehabilitation, and rheumatologists.

If you’re suffering from knee pain and want to relieve yourself of this daily struggle, I urge you to contact the knee pain specialists at my San Diego orthopedic surgery offices today.


Much has been said about whether running has net beneficial or detrimental effects on an athlete.  The cardiovascular upside on overall health is clear cut.  But what about all that trauma that a runner’s knees must endure with each step slamming into the pavement?

Protecting your knees and back while running is a battle that must be fought on several simultaneous fronts.  Simple strategies such as proper shoe maintenance and alternating exercise regimens are simple ways to avoid foot and ankle injuries that are commonly seen in runners.  When it comes to the knees and low back, a well-conceived functional strengthening program can help avoid injury.  The concept is very similar to what any recreational athlete feels at the end of a long day skiing.  Most injuries in skiing tend to occur at the end of the day when our muscles are fatigued and less apt to allow us to recover from some perturbation/fall.  Basically, tired muscles have difficulty protecting us from injury when compared to muscles that are better conditioned.  The core muscles are at the ‘core’ of injury prevention with respect to the knee and low back.  The core muscles help to shock-absorb and avoid injuries to the adjacent joints.

This list offers a nice starting point for strengthening.  It features some simple exercises to keep your core, back, hips and shoulders in reasonably loose and powerful form.

Still suffering from knee pain, hip pain, back pain or shoulder pain? Visit my San Diego orthopedic surgery practice to learn more about how you can achieve lasting health without losing a step.


There is a growing momentum in sports medicine to encourage athletes and their coaches to warm up in more effective ways. Born partly out of the Santa Monica Sports Medicine Foundation’s PEP program, and spurred on by success stories such as this one, these new exercises are widely touted as simple and powerful, reducing knee surgery numbers by a substantial percentage:

These programs, formally known as neuromuscular training, use a series of exercises to teach athletes how to land, cut, shift directions, plant their legs, and otherwise move during play so that they are less likely to injure themselves. Studies have found that the programs can reduce the number of A.C.L. tears per season by 50 percent or more, particularly among girls, who tear their A.C.L.s at a higher rate than boys do (although, numerically, far more boys are affected).

The good news: these are easy-to-perform and familiar exercises which resemble the calisthenics we all learned growing up. Educating yourself or your local sports team is as simple as watching a few online videos. Yet the savings in medical care costs can be staggering, especially as you diminish the likelihood of ACL tears and their attendant recovery measures.

While a warm up run to get the juices flowing and proper stretching prior to the main work out helps to prevent muscle strains, neuromuscular training is an entirely different concept.  Neuromuscular training is really nothing more than a functional core workout.  Yup, that’s it!  What you do in martial arts, or yoga, or pilates….these strengthening activities helps the young female soccer athlete avoid that infamous ACL tear.  The muscles in the torso, abdominal wall, pelvis, and proximal thigh help the athlete to properly position the knee, which minimizes risk of ACL tear.  It has been proven!!!

For some mature athletes, in addition to neuromuscular training, further measures to maximize knee longevity and function include oral supplements (glucosamine, chondroitin, MSM), platelet rich plasma (PRP) or stem cell injections, and hyluronic acid (HA) injections.

I specialize in knee surgery and orthopedic surgery in San Diego, and encourage all my patients to take every precaution they can to stay active and nimble. Please call my offices today to learn more about how you can prevent knee surgery.

© 2023 Dr. Robert Afra – San Diego Orthopedic Surgery Shoulder – Knee – Elbow