The injury tally continues to rise in Sochi, especially on some of the more dangerous, extreme-style downhill events. The grimmest and most terrifying moment of these Olympics came on Saturday, when a freestyle cross skier, Maria Komissarova, broke a vertebra and dislocated her back, leading to an emergency airlift to Germany for multiple orthopedic surgeries.

She is hardly alone. Numerous reports have noted the high numbers for these games, including concussions, knee injuries and plenty of falls:

Norway’s Helene Olafsen had to drop out after she suffered what has been initially reported as a knee injury. Worse still, American Jackie Hernandez will also be withdrawing after taking a fierce blow to the head. During her qualifying run, Hernandez was knocked completely unconscious after a violent impact with the snow. She regained consciousness a few minutes later, and was attempting to speak with the medics who had rushed to her aid. She was taken down the mountain on her own power, but was very unstable on her feet.

As the former Chief of Sports Medicine at the University of California, San Diego, I have spent much of my career tending to athletes and the injuries they incur from pushing the limits. But here in San Diego, orthopedic surgery is just as likely to be indicated for everyday shoulder injuries, knee injuries, and wrist and elbow injuries. The process is the same in either case: careful diagnosis, expert orthopedic surgery when indicated, followed by vigorous and supportive rehabilitation that takes the entire patient’s needs into account.

Such tools are readily available at San Diego Orthopedic Surgery center. Ms. Komissarova is receiving such care in Germany.


Here’s what’s tricky about knee surgery. It’s really important that a surgeon pay attention to the complaints a patient has and to corroborate those complaints with physical examination and MRI findings.  When there is the synergy of all three, surgery is warranted and works well.  We know this, and medical literature supports it.

Unfortunately, often times patients have undergone surgery for the wrong indications.  Indications are what surgeons learn in residency and fellowship and can be cured by performing surgery.

Even when surgery is performed for the right indications, the postoperative recovery can take unexpected twists and turns.  Prone to periods of accelerated improvement punctuated by stretches of apparent stasis. For example, there is no calendar for how we recover from ACL knee surgery. Although most often patients ‘recover’ over four to eight months after surgery, our bodies follow their own timeline despite medical efforts.

So when an athlete offers a date for when she expects to be fully recovered from knee surgery, that day isn’t written in stone. Even someone clearly on track to regain full mobility and flexibility can reinjure their knee, setting or even resetting that recovery process back to zero.

All of which brings me to Lindsey Vonn, the world-class athlete whose triumphant return to the slopes at Sochi has been scuttled by reinjury:

Vonn tore her anterior cruciate and medial collateral knee ligaments in a tumbling crash 11 months ago at the world championships, but had appeared to be ahead of schedule in her recovery for the Sochi Olympics until a training crash Nov. 19 in Colorado. At that time, she said that she had partly torn her rebuilt anterior cruciate ligament and would still be able to participate in the Olympics. . .

On Dec. 21, Vonn entered a more demanding World Cup downhill in Val d’Isère, France — with Woods at the bottom of the hill, watching. About halfway through the course, her right knee buckled as she tried to make a high-speed turn, and she skidded off the course. After the race, for the first time, Vonn acknowledged her A.C.L. injury was more severe.

She said the ligament had been ruptured.

She has not been on skis since.

It is a teachable moment and a cautionary tale when an athlete pushes harder than most orthopedic surgeons might recommend in the interest of meeting a deadline. In Vonn’s case, that deadline was the Olympics: who could blame her? We have tons and tons of young elite level female soccer players in San Diego who feel the same drive of getting back out there…push push push.  I’m onboard, as long as the body can keep pace with our type ‘A’ drive. Often times that type ‘A’ drive gets us to the finish line with respect to our strength training and back out on the field to score.  Sometimes athletes get out on the field for contact or agility sports to early and are vulnerable to reinjury.  Know anyone who underwent revision ACL reconstruction?  For those of us non-Olympians with knee injuries recovering from ACL reconstruction here in San Diego, there is nothing quite as effective as rest, patience, rehabilitation….lots and lots of self-directed core-strengthening and agility training!

It all starts with an expert orthopedic surgeon.  One that you can trust will guide you to conservative care when appropriate and to surgery when appropriate.  Seek a consultation with a doctor that will take the time to listen to you, examine you, and properly treat you. To schedule your own San Diego knee surgery, please contact the experts here today.

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