Posts

ACL Tears vs PCL Tears

Our knee is important, as it provides us with a foundation to stand on. The knee provides stability and mobility, and is vital to all types of movement, especially for athletes. If you ever had any sort of injury, especially a knee injury, you probably appreciate how your knees power you through various activities. To avoid knee injuries, it helps to understand how your knees work and what you can do to protect them.

The ACL (anterior cruciate ligament) and the PCL (posterior cruciate ligament) are the two major ligaments in the knee that work together to provide stability in the knee. They cross each other and form an ‘X’ which allows the knee to flex and extend without side to side movement. ACL and PCL tears are two of the most common and most serious knee injuries that happen to athletes. When you get an injury to the anterior cruciate ligaments or the posterior cruciate ligament, there are slightly different symptoms. 

What is an ACL Tear?

The ACL is one of the four main ligaments within the knee that connect the femur to the tibia. The knee is essentially a hinged joint that is held together by the medial collateral (MCL), lateral collateral (LCL), anterior cruciate (ACL) and posterior cruciate (PCL) ligaments.

The anterior cruciate ligament (ACL) is a tough band of tissue joining the thigh bone to the shin bone at the knee joint, providing much needed stability. It runs diagonally through the inside of the knee, and when there is too much stress on the ligaments, it can result in a sprain or worse, the ligaments can be stretched too far or snap, causing the ACL to tear. 

ACL Tear Symptoms:

  • Pain in the knee
  • Swelling, which builds up over twenty-four hours
  • Loss of complete range of motion of the knee
  • Tenderness to palpation of the joint line
  • Pain and inability to walk on the affected leg
  • Unstable knee

The most common treatment for a torn ACL is arthroscopic surgery and ACL reconstruction.

 What is a PCL Tear?

The posterior cruciate ligament (PCL) is located in the middle of the knee, next to the anterior cruciate ligament. While the ACL helps prevent your thigh bone (femur) from moving too far forward, the PCL helps prevent your shin bone (tibia) from moving too far backward. 

The PCL is lesser known because it is not injured as frequently as the ACL. However, injuries to the PCL should be taken seriously, as this ligament significantly affects the stability of the knee. Injuries to the PCL typically occur when the tibia is hit by an outside force while the leg is bent. One big difference between PCL and ACL tears is that most PCL tears are only partial tears, whereas the ACL usually completely tears.

PCL Tear Symptoms:

  • Pain in the knee
  • Immediate swelling of the knee
  • Difficulty or impossibility of walking on the affected leg
  • The knee feels like it is going to “give out”

To diagnose and treat tears to the ACL and PCL, your doctor will evaluate your injury by checking the severity of your knee instability. An MRI will most likely be done to get a closer look at the knee joint. If the diagnosis is an ACL or PCL tear, arthroscopic surgery can be done to repair the torn ligaments. Recovery can be lengthy for this injury, and will most likely require extensive rehabilitation, such as physical therapy.

The doctors at Colorado Center of Orthopaedic Excellence will do their best to get you back to optimal function as quickly as possible. To learn more about ACL and PCL tears, and how we can help, call our office at (719) 623-1050 to request an appointment. You can also schedule an appointment online.

The Overlap Between an Orthopedic Specialist and a Rheumatologist

If you are one of the 100 million Americans in the United States suffering from joint pain, and the unpleasant effects associated with it, you know how difficult carrying out or completing everyday tasks can be. Getting healthcare is a privilege and a right, however, not everyone is fortunate enough to receive good healthcare. Good healthcare depends largely on the specialist you see, and for joint pain it can get tricky. Doing research, and talking to others can help you choose the right doctor.

In getting an accurate diagnosis, a visit to your primary care doctor is usually the first step. They can give you a basic diagnosis, and refer you to a specialist such as an orthopedist or rheumatologist for a closer look and second opinion. Both a rheumatologist and orthopedist treat joint pain as part of their specialty, whether the pain is chronic or acute.

The main difference and overlap between an orthopedist and a rheumatologist is that an orthopedist is a surgical specialist and a rheumatologist is a medical specialist. Usually, first, a rheumatologist will give you a diagnosis, and monitor your condition/progression following the use of medications and other non-surgical treatments. If symptoms continue to persist, the rheumatologist will often refer you to an orthopedic surgeon to see if you are a candidate for surgery, usually as a last resort, if no other treatments could alleviate the problem. 

Visit an orthopedist if you have experienced:

  • Joint or musculoskeletal pain following an injury
  • Hip or knee pain that gradually increases when bearing weight
  • Severe joint pain interfering with typical functioning
  • Moderate or advanced arthritis in the hips or knees
  • Previous unsuccessful treatment of joint pain
  • Need surgery – Joint Replacement

See a rheumatologist if you have experienced:

  • Pain involving multiple joints
  • New joint pain not associated with an injury
  • Joint or musculoskeletal pain associated with fever, fatigue, rash, morning stiffness or chest pain
  • Joint pain coinciding with back pain
  • Joint pain with psoriasis
  • Muscular pain with or without any other symptoms
  • Recurring headaches or muscle aches
  • Back pain with or without leg pain
  • Ongoing symptoms, such as unexplained fever, sweating or weight loss

At Colorado Center of Orthopaedic Excellence, we understand how chronic pain, or pain in general can disrupt your life. At our practice, you will find a multi-disciplinary team of specialists that will diagnose and treat your joint pain. Whether your pain is caused by disease or an injury, our orthopaedic surgeons, podiatric surgeon, and physical therapists will provide the relief you need to get you back to doing the things you love. If further care is needed, we will refer you to the right specialist, to receive the best care possible.

To request an appointment with one of our orthopedic surgeons, call Colorado Center of Orthopaedic Excellence at (719) 623-1050. You can also request an appointment online today.

How Weight Loss Can Help Joint Replacement Surgery

As we age, our joints begin to break down. Without adequate blood volume, so that nutrients can move through your blood and into your joints, our joint health is compromised.  Just like our bodies need to be hydrated by drinking water, and nourished with food, our joints need to be exercised and taken care of, in order to function properly.

According to The American Academy of Orthopaedic Surgeons (AAOS), obesity is one of the most common diseases and epidemics affecting bone and joint health. It is also one of the most common reasons that orthopedic surgeons deny or postpone their patients the right to have joint replacement surgery.

Obesity is an epidemic, as it affects more than 35 percent of people in the United States. If someone has a BMI of 30 or greater, they are considered to be obese. Studies have shown that individuals who struggle with obesity are 20 times more likely to need some kind of joint replacement surgery, compared to those who are not overweight. Maintaining a healthy weight can be difficult, but it is important.

A joint is where two or more bones come together, like the knee, hip, elbow, or shoulder. Joints can be damaged by many types of injuries or diseases. Your joints are strong, but also fragile if not given proper care. If someone is overweight, they are putting extra weight and stress on their joints that could already be in a degenerated condition, due to wear and tear, and conditions such as arthritis, osteoporosis, and bursitis, among others.

Your surgeon will use your BMI (body mass index) when determining if you are ready to undergo surgery. Many surgeons require a patient’s BMI to be under 35. If it is over 30, and you are considered to be in the obese category, but healthy, the surgeon may go forward.

If other risk factors such as diabetes are involved, it may be determined that getting joint replacement surgery is too risky at the time. This wakeup call means that losing weight is necessary to move forward. In other words, patients with obesity are more likely to have conditions or complications such as infection, blood clots, risk of dislocations, and difficulty breathing, putting them at too high of a risk for surgery. Since joint replacement surgery is an elective surgery, your surgeon can postpone surgery, and perform the procedure when they feel and see that your risk is lower.

Since our joints affect other systems and organs throughout the body, losing weight is imperative, as it can significantly improve your recovery time and outcome, and reduce your risk of developing complications. Therefore, losing weight before and after your joint replacement surgery has its benefits including: 

1.    Fewer complications after surgery: Losing weight will lessen the risk for health complications before and after surgery, allowing the body to function better.

2.    The surgery is easier to perform: Obese patients have more difficult surgeries, due to low visibility, meaning more complications. This includes: veins are harder to find making it harder to administer necessary medications; anesthesia is harder to administer; breathing is more greatly affected; there tends to be more blood loss; and surgery times are longer. Losing weight beforehand, means an easier surgery, with a more seamless recovery and rehabilitation.

3.     Less pressure on new joints: Losing weight takes unnecessary pressure off the new joints you will receive during surgery. Most importantly, weight loss can help alleviate pain overall.

Losing weight can help with stress on joints, mobility, pain, but most importantly, benefit your overall health. Eating a healthy and nutritious diet is the key, along with staying hydrated and exercising. Your surgeon, physical therapist, and nutritionist, can help develop a regimen that you can follow at home. Changing your life to a healthy one is a challenge and commitment, but one you will not regret in the long run. It will not only reduce your risk for complications, so you can be cleared to finally undergo joint replacement surgery, but also change your entire quality of life for the better.

 To learn more about how weight loss can help your joint health, call Colorado Center of Orthopaedic Excellence today, at (719) 623-1050, to request an appointment, or request an appointment online.

How an Orthopedist Can Enhance Sports Performance

Orthopedic and sports medicine specialists are dedicated to focusing on the rehabilitation and the performance needs of athletes, and the prevention of sports-related injuries. Most people think that when an athlete is hurt, they see a physical therapist (PT) for rehab and training. This is often the case, but if they are looking to run faster, jump higher, or get stronger, an orthopedist (who specializes in the musculoskeletal system) is devoted to the diagnosis, treatment, and prevention of musculoskeletal injuries. While a physical therapist can help recover from and prevent future injury, an orthopedist specialized in sports medicine can help a healthy athlete improve their performance, too.

If you are an athlete seeking to increase endurance and strength while improving your speed, reaction times, and agility, rehabilitation combined with sports performance training will help push you sharpen your edge on athletic ability, to help you achieve your goals and break through your previous limitations.

In our unique approach at Colorado Center of Orthopaedic Excellence, our orthopedists, along with our physical therapists, have advanced training and knowledge of the musculoskeletal system and are passionate about helping you achieve optimum results. We often work alongside sports performance trainers to develop individual treatment plans that rehabilitate, while also enhancing your sports performance.

 Our customized sports performance training programs are designed for strength and conditioning based specifically on your unique objectives, fitness level, and sport. We provide a thorough evaluation of your current abilities to determine any areas of instability or weakness that need to be addressed during your training.

We combine corrective and rehabilitation exercises, conditioning, cardiovascular training, and strength training with exercise techniques specific to your sport. You will be closely monitored by one of our performance team members to ensure accuracy and development. This combination of physical therapy, sports medicine, and sports performance training, will benefit everyone from the elite athlete to the post-op patient working to resume their normal lifestyle.

If you are interested in sports performance training or any other orthopedic concerns, contact Colorado Center of Orthopaedic Excellence today, at (719) 623-1050, or schedule an appointment online right now.

What to Do If You’ve Dislocated Your Hip?

Your hip is a ball and socket joint making it one of our most flexible joints, hence allowing greater range of motion than almost every other joint in the body, sans the shoulder. A smooth tissue, the articular cartilage, covers the surface of the ball and the socket. It creates a low friction surface that helps the bones glide easily across each other. The acetabulum is surrounded by strong fibrocartilage called the labrum. The labrum forms a lining around the socket, creating a tight seal, helping to provide stability to the hip joint

When they are healthy, it takes great force to hurt them. However, playing sports, running, overuse or falling, can all sometimes lead to hip injuries. These include strains, bursitis, dislocations, and fractures.

Certain diseases also lead to hip injuries or problems. Osteoarthritis can cause pain and limited motion. Osteoporosis of the hip causes weak bones that break easily, both of which are more common in older people.

What is A Hip Dislocation?

A traumatic hip dislocation occurs when the head of the thigh bone (femur) is forced out of its socket in the hip bone (pelvis). When there is a hip dislocation, the femoral head is pushed either backward out of the socket, or forward. It typically takes a major force, like a fall, to dislocate the hip. Car collisions and falls from significant heights are common causes and, as a result, other injuries like broken bones often occur with the dislocation. A hip dislocation is a serious medical emergency, where immediate treatment is necessary.

Symptoms of A Hip Dislocation:

  •  Severe chronic and persistent hip pain
  • Numbness in the foot, leg, or ankle
  • Limited mobility

If you have suffered an injury to your hip or think you may have dislocated it, request an appointment with the Colorado Center for Orthopaedic Excellence at (719) 623-1050 for immediate treatment. 

Questions to Ask Your Podiatrist

A podiatrist is a licensed health care professional who specializes in the care of feet, ankles and legs. A podiatrist is also a fully trained foot surgeon with a medical designation of DPM (doctor of podiatric medicine) instead of an MD (medical doctor). A licensed podiatrist can diagnose and treat medical conditions of the foot, ankle and related structures of the leg. Some PDM’s focus on one area of care, such as diabetic complications that affect the foot. If you visit a podiatrist, here are some questions you might want to ask.

Questions to Ask a Podiatrist

During your visit, the doctor is probably going to examine your feet as well as take a full medical history. This makes sense because the health of your feet is part of your overall health and wellbeing. This is especially true when you have other related medical conditions such as diabetes, poor circulation, nerve damage, kidney issues or previous injuries of the foot, ankle, or leg. Your podiatrist may also take X-rays, an MRI, and observe the way that you stand, run, or walk.

During the exam, you may have questions about topics such as foot pain, numbness, bunions, or other foot-related topics. Just as you would with any other health professional, it is always okay to ask questions when you do not understand something. You can ask what kind of tests the doctor is going to run to determine the underlying cause of your condition. You may also want to ask about the doctor’s experience treating your specific kind of issue. 

Ask if there is a medication that can help or if there are any advantages or disadvantages to the treatment they are recommending. You can always ask general questions too, such as what kinds of socks and shoes are right for you.

You can, for example, ask if bracing and rehabilitation can be used instead of (or alongside) surgery. You may also want to ask how to support your healing with exercise and diet, or ways that you can reduce your risk for re-injury in the future. Ask if the condition is chronic (ongoing) or acute (sudden), and if it’s possibly due to a medical condition or an injury. The kinds of questions you may want to ask the podiatrist will, of course, vary according to the specific issue that you are having treated.

Be sure to inform the podiatrist of any signs and symptoms that you are aware of. For example, if you hear clicks when you rotate the outside of your ankle, or if you are having numbness, tingling, or any other symptoms related to the care of your feet and legs.

If you, or a loved one is looking for exceptional care of the foot, ankle and leg, we are here to help. Please call the Colorado Center of Orthopaedic Excellence at (719) 623-1050 or request an appointment online. Don’t let foot pain get in the way of your busy life. Call today for a better tomorrow.

Proper Sports Techniques to Prevent Hip Pain

The hip joint is one the large joints of the body that helps the thigh move forward and backward. The hip joint also rotates when sitting and with changes of direction when walking. The hip joint is where the ball of the thigh bone (femur) joins the pelvis at a socket called the acetabulum. There is cartilage covering both the bone of the femur and the acetabulum of the pelvis in the hip joint. A joint lining tissue, called synovium, surrounds the hip joint. The synovium tissue produces fluid that lubricates the joint and provides nutrients to the cartilage of the joint. 

The singer Shakira had it right when she says “Hips Don’t Lie” in her hit song. It seems that until our hips are in pain, we don’t give them much thought. We use our hips every day, when we walk, stand, sit and workout. In fact, there are few times when we are not using our hips, especially when playing sports or exercising.

If your hips are not working properly, other movements and muscles will suffer. Your hips are able to withstand a great amount of stress, but if they are used improperly, an uneven amount of stress can be transferred elsewhere in the body where it is not meant to go. Over time, the muscle that is compensating for the weakened hip muscles will begin to feel tight, decreasing agility and speed, as well as taking longer to recover. Reducing participation in painful activities is the most important step a patient can take. Here are some other tips to help reduce pain:

Modifying activity: Athletes who must perform repetitive movements will need to avoid painful activities and modify their training during the rehabilitation process.

Icing: Applying ice after exercise may diminish the pain and other symptoms, such as swelling.

Medication: Physicians frequently prescribe ibuprofen or acetaminophen to help reduce inflammation and pain. Physicians also may prescribe injections of steroids or anesthetic to both diagnose the source and treat the pain.

Rehabilitation: Physical therapy is often needed to reduce pain and improve function. Therapy will include heat and/or ice to decrease inflammation and stretching/strengthening exercises for specific hip muscles. The therapy will progress to more functional activities, simulating sport-specific motions. As the symptoms improve, a specific training program will allow proper, incremental return to full activity.

To learn more about hip pain and how to treat it, call the Colorado Center of Orthopaedic Excellence at (719) 623-1050 to request an appointment, or request one online.

Can Your Orthopedic Doctor Treat Fibromyalgia

You may have heard about fibromyalgia on television advertisements, or from someone you know. However, without a visit to an orthopedic surgeon, most people may not know what this condition exactly is, or the symptoms that come with it.

Fibromyalgia is a disorder that causes aches and pain all over the body. People with fibromyalgia also have “tender points” throughout their bodies. Tender points are specific places on the neck, shoulders, back, hips, arms, and legs that hurt when pressure is put on them.

Fibromyalgia affects as many as five million Americans aged 18 and older. Most people with fibromyalgia are women (about 80 – 90 percent), however, men and children also can have the disorder. Most people are diagnosed during middle age. Fibromyalgia can occur by itself, but people with certain other diseases such as lupus, rheumatoid arthritis, and other types of arthritis, may be more likely to have it. Individuals who have a close relative with fibromyalgia are also more likely to develop it themselves.

How is fibromyalgia diagnosed?

People with fibromyalgia often see many doctors before being diagnosed. One reason for this may be that pain and fatigue, the main symptoms of fibromyalgia, also are symptoms of many other conditions. Therefore, doctors must often rule out other possible causes of these symptoms before diagnosing fibromyalgia.  Your orthopedic surgeon can treat your fibromyalgia based on these criteria:

1.       A history of widespread pain lasting more than 3 months: Pain must be present in both the right and left sides of the body as well as above and below the waist.

2.       Presence of tender points: The body has 18 sites that are possible tender points. For a fibromyalgia diagnosis, a person must have 11 or more tender points. For a point to be “tender,” the patient must feel pain when pressure is put on the site. People who have fibromyalgia may feel pain at other sites, too, but those 18 sites on the body are used for diagnosis.

How is Fibromyalgia Treated?

Fibromyalgia can be difficult to treat, as much so as it can be to diagnose. It’s important to find a doctor who has treated others with fibromyalgia. Treatment often requires a team approach. The team may include your orthopedic doctor, a physical therapist, and possibly other health care providers.

To learn more about fibromyalgia, call Colorado Center of Orthopaedic Excellence at (719) 623-1050 to request an appointment.

Causes of Shoulder Pain

Your shoulder is a ball-and-socket joint. The ball portion of the joint consists of the rounded head of the upper arm bone (humerus), and the socket portion is made up of a depression (glenoid) in the shoulder blade. The humeral head (ball) fits into the glenoid (socket), creating the joint that allows you to move your shoulder. The joint is surrounded and lined by cartilage, muscles, and tendons that provide support and stability and make it easy for you to move. It’s your shoulder joint that lets you rotate your arm in all directions. Your range of motion depends on the proper articulation of the humeral head upon the glenoid.

In a healthy shoulder joint, the surfaces of these bones where the ball and socket rub together are very smooth, and covered with a tough protective tissue called cartilage. Arthritis causes damage to the bone surfaces and cartilage. These damaged surfaces eventually become painful as they rub together. With that said, there are many different reasons why you could be feeling shoulder pain, including injury, infection, and arthritis.

Shoulder pain can be either acute or chronic, depending on when a diagnosis was made and how long the pain or disability has been felt for. An acute shoulder injury occurs suddenly either through direct impact, by overstretching a muscle, tendon or ligament, overusing a muscle or tendon, or twisting of the shoulder joint. However, if pain becomes chronic, it is important that you see an orthopedic doctor. While chronic pain is considered pain that lasts longer than six months, if the pain doesn’t seem right you should seek help as soon as possible.

Many shoulder problems are caused by the breakdown of soft tissues in the shoulder region. Using the shoulder too much can cause the soft tissue to break down faster as people get older. Doing manual labor and playing sports can also cause shoulder problems, whether from overuse or by sudden injury. The most common shoulder pain problems are:

  •       Dislocation
  •       Separation
  •       Rotator cuff disease
  •       Rotator cuff tear
  •       Frozen shoulder
  •       Fracture
  •       Arthritis

Whatever the reason, continuing to suffer with shoulder pain shouldn’t have to be your only option. To learn more about the shoulder and the most common causes of shoulder pain, call Colorado Center of Orthopaedic Excellence at (719) 623-1050 to request an appointment, or request one online.

Hip Pain, Shoulder Pain and Fibromyalgia

Fibromyalgia is a disorder that causes aches and pain all over the body. People with fibromyalgia also have “tender points” throughout their bodies. Tender points are specific places on the neck, shoulders, back, hips, arms, and legs that hurt when pressure is put on them.

Fibromyalgia affects as many as five million Americans ages 18 and older. Most people with fibromyalgia are women (about 80 – 90 percent). However, men and children also can have the disorder. Most people are diagnosed during middle age. Fibromyalgia can occur by itself, but people with certain other diseases, such as rheumatoid arthritis, lupus, and other types of arthritis, may be more likely to have it. Individuals who have a close relative with fibromyalgia are also more likely to develop it themselves.

What Causes Fibromyalgia?

  • The causes of fibromyalgia are not yet known. Researchers think a number of factors might be involved. Fibromyalgia can occur on its own, but has also been linked to:
  • Having a family history of fibromyalgia
  • Being exposed to stressful or traumatic events, such as:
  • Car accidents
  • Injuries to the body caused by performing the same action over and over again (called “repetitive” injuries)
  • Infections or illnesses

How is fibromyalgia diagnosed?

People with fibromyalgia often see many doctors before being diagnosed. One reason for this may be that pain and fatigue, the main symptoms of fibromyalgia, also are symptoms of many other conditions. Therefore, doctors often must rule out other possible causes of these symptoms before diagnosing fibromyalgia. Fibromyalgia cannot be found by a lab test. A doctor who knows about fibromyalgia, however, can make a diagnosis based upon two criteria:

  1. A history of widespread pain lasting more than 3 months. Pain must be present in both the right and left sides of the body as well as above and below the waist.
  2. Presence of tender points. The body has 18 sites that are possible tender points. For fibromyalgia diagnosis, a person must have 11 or more tender points. For a point to be “tender,” the patient must feel pain when pressure is put on the site. People who have fibromyalgia may feel pain at other sites, too, but those 18 sites on the body are used for diagnosis.

How is Fibromyalgia Treated?

Fibromyalgia can be hard to treat. It’s important to find a doctor who has treated others with fibromyalgia. Many family doctors, general internists, or rheumatologists can treat fibromyalgia. Rheumatologists are doctors who treat arthritis and other conditions that affect the joints and soft tissues.

Treatment often requires a team approach. The team may include your doctor, a physical therapist, and possibly other health care providers. A pain or rheumatology clinic can be a good place to get treatment. Treatment for fibromyalgia may include the following:

Getting enough sleep: Getting enough sleep and the right kind of sleep can help ease the pain and fatigue of fibromyalgia. Most adults need seven to eight hours of “restorative” sleep per night. Restorative sleep leaves you feeling well-rested and ready for your day to start when you wake up. It is hard for people with fibromyalgia to get a good night’s sleep. It is important to discuss any sleep problems with your doctor, who can then recommend proper treatment.

Exercising: Although pain and fatigue may make exercise and daily activities difficult, it is crucial to be as physically active as possible. Research has repeatedly shown that regular exercise is one of the most effective treatments for fibromyalgia. People who have too much pain or fatigue to do hard exercise should just begin to move more and become more active in routine daily activities. They can begin with walking (or other gentle exercise) and build their endurance and intensity slowly.

Eating well: Although some people with fibromyalgia report feeling better when they eat or avoid certain foods, no specific diet has been proven to influence fibromyalgia. Of course, it is important to have a healthy, balanced diet. Not only will proper nutrition give you more energy and make you generally feel better, it will also help you avoid other health problems.

Pain management: Three medicines have been approved by the U.S. Food and Drug Administration (FDA) to treat fibromyalgia. These are pregabalin (Lyrica), duloxetine (Cymbalta), and milnacipran (Savella). Other medications are being developed and may also receive FDA approval in the future. Your doctor may also suggest non-narcotic pain relievers, low-dose antidepressants, or other classes of medications that might help improve certain symptoms.

Other treatments: Complementary therapies may help you. Talk to your physician before trying any alternative treatments. These include:

  • Physical therapy
  • Massage
  • Myofascial release therapy
  • Water therapy
  • Light aerobics
  • Acupressure
  • Applying heat or cold
  • Acupuncture
  • Yoga
  • Relaxation exercises
  • Breathing techniques
  • Aromatherapy
  • Cognitive therapy
  • Nutritional supplements

To learn more information about fibromyalgia, and if you may have it, call Colorado Center of Orthopaedic Excellence at (719) 623-1050, or request an appointment online.