An ACL (anterior cruciate ligament) tear is one of the most common and disruptive knee injuries, particularly among athletes who participate in cutting, pivoting, and jumping sports. Recovery from ACL reconstruction is a multi-month process that requires patience, consistency, and a well-structured rehabilitation program. This guide walks you through what to expect at each stage so you can approach the process with confidence and realistic expectations.

Understanding the ACL and Why Reconstruction Is Needed

The anterior cruciate ligament is one of four major ligaments stabilizing the knee joint. It prevents the tibia from sliding forward relative to the femur and controls rotational stability. When the ACL is completely torn, the knee becomes functionally unstable for most athletic activities. Because the ACL has a poor blood supply and does not heal on its own, surgical reconstruction using a graft is typically recommended for active patients.

Days 1–7: Immediate Post-Op

The primary goals in the first week are pain and swelling control, protection of the graft, and beginning gentle range-of-motion work. Ice, elevation, and compression are essential during this phase. Most patients begin working with a physical therapist within the first few days to initiate quad-setting exercises and ankle pumps. Crutches are typically used during this period to offload the knee.

Weeks 2–6: Early Rehabilitation

During weeks two through six, the focus shifts to restoring full knee extension and achieving at least 90 to 120 degrees of flexion. The physical therapy program expands to include straight-leg raises, mini squats, heel raises, and stationary cycling with low resistance. Crutches are gradually phased out as the patient regains sufficient quadriceps control.

Swelling and stiffness continue to decrease during this phase, though full resolution takes months. Attending every physical therapy session and completing home exercises is critical, graft maturation depends on progressive mechanical loading.

Weeks 6–12: Strengthening Phase

As the graft begins to mature (a process called ligamentization), rehabilitation shifts toward building strength in the quadriceps, hamstrings, and hip musculature. Closed-chain exercises, squats, leg presses, step-ups, and lunges, are progressively introduced. Swimming and water-based therapy are excellent options for cardiovascular conditioning while minimizing joint load.

Months 3–6: Functional Training

Jogging, lateral movements, and basic sport-specific agility drills are gradually introduced during this phase, provided the patient meets strength and neuromuscular benchmarks. Return to non-contact practice or light team training may be approved during this window depending on the sport and the patient’s progress.

Months 6–9+: Return to Sport

Return-to-sport clearance is not based solely on time, it requires passing a battery of functional strength and movement tests. Most current evidence recommends waiting at least nine to twelve months before returning to full competitive play, as earlier return significantly increases the risk of re-rupture. Psychological readiness is also assessed before clearance is granted.

Factors That Affect Your Recovery Timeline

• Age and overall physical fitness level
• Type of graft used (patellar tendon, hamstring, quadriceps, allograft)
• Concurrent injuries such as meniscus tears or cartilage damage
• Consistency and quality of physical therapy participation
• Post-operative swelling and compliance with activity restrictions

Preventing Re-Injury After Return to Sport

ACL re-tear rates following return to sport are significant, particularly in young female athletes. Continuing neuromuscular training, maintaining quad and hamstring strength balance, and paying attention to landing mechanics are all important protective factors. Your rehabilitation team will work with you on these skills before and after clearance.

Our orthopedics and sports medicine team provides ACL evaluation, reconstruction, and rehabilitation to patients throughout the area. Contact our office to schedule an appointment.

Contact Surgeons Dr. Thomas and Dr. Pennington at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

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Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Platelet-rich plasma (PRP) therapy has become an increasingly popular regenerative treatment option for athletes and active adults seeking to accelerate healing and avoid, or delay, surgery. By harnessing the body’s own healing biology, PRP offers a targeted, minimally invasive approach to treating a range of musculoskeletal conditions. Our sports medicine team offers PRP as part of a comprehensive, individualized approach to injury care.

What Is Platelet-Rich Plasma?

Blood is composed of red blood cells, white blood cells, plasma, and platelets. Platelets are small cell fragments best known for their role in clotting, but they also contain a rich concentration of growth factors, proteins that signal tissue repair and regeneration. Platelet-rich plasma is a concentration of these platelets isolated from the patient’s own blood.

How the PRP Process Works

The PRP preparation process begins with a standard blood draw of approximately 30 to 60 milliliters. The blood is placed in a centrifuge and spun at high speed, which separates the components by density. The platelet-rich layer is extracted and, in some protocols, further concentrated before being prepared for injection. The entire preparation process takes approximately 15 to 20 minutes.

How PRP Promotes Healing

When injected into an area of injury or degeneration, the concentrated growth factors in PRP promote healing through several mechanisms: they stimulate collagen production, encourage the proliferation of tendon and ligament cells, reduce chronic inflammation, and attract additional healing cells to the injury site. In essence, PRP amplifies what the body would do naturally, but at a concentration that can overcome the limited regenerative capacity of tissues with poor blood supply, such as tendons and ligaments.

Conditions Commonly Treated With PRP

• Tennis elbow (lateral epicondylitis) ,  one of the most well-studied indications
• Plantar fasciitis ,  chronic heel pain that has not responded to conservative care
• Rotator cuff tendinitis ,  shoulder tendon degeneration
• Knee osteoarthritis ,  early to moderate joint degeneration
• Patellar tendinopathy (jumper’s knee)
• Achilles tendinopathy ,  chronic Achilles pain or partial tears
• Partial ligament tears ,  particularly the UCL (elbow) and collateral ligaments (knee)

What to Expect During a PRP Injection

PRP injections are performed in our office and are guided by ultrasound imaging to ensure precise placement at the target tissue. The procedure takes 45 to 90 minutes from blood draw to injection. Ultrasound guidance dramatically improves accuracy compared to landmark-based injection and is associated with better outcomes. Mild soreness and swelling at the injection site are normal for three to five days.

How Many Treatments Are Needed?

Many patients experience significant improvement after a single PRP injection, but some conditions, particularly chronic tendinopathy and knee osteoarthritis, respond better to a series of two to three injections spaced four to six weeks apart. Your physician will discuss the recommended treatment protocol for your specific condition and severity.

PRP vs. Cortisone Injections

Cortisone injections reduce inflammation quickly and provide faster symptomatic relief, but they do not promote tissue healing and may actually weaken collagen over repeated use. PRP takes longer to produce results but works by promoting actual tissue repair. For patients with chronic conditions that have not responded to cortisone, PRP is often a superior long-term option.

Is PRP Covered by Insurance?

PRP is currently considered an elective or experimental treatment by most insurance carriers and is typically not covered. Your care team can provide transparent pricing information and discuss whether PRP is a worthwhile investment for your specific injury.

Our sports medicine team provides PRP therapy and comprehensive injury care to active patients in the area. Reach out to our office to schedule an evaluation and find out if PRP is the right treatment for your injury.Contact Surgeons Dr. Thomas and Dr. Pennington at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments,contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Pain in the lower body can sometimes be difficult to pinpoint. Many patients assume their knee is the source of discomfort when the issue actually originates in the hip—or vice versa.

Understanding the differences can help ensure accurate diagnosis and effective treatment. At the practice of Steven C. Thomas, MD and Donald W Pennington, DO, our board-certified  surgeons specialize in orthopedic procedures in the Las Vegas area.

Why Pain Location Can Be Misleading

The hip and knee are closely connected through muscles, nerves, and joints. Pain can radiate from one area to another, making it difficult to identify the true source.

Signs Your Pain May Be Coming From the Knee

• Pain directly around the kneecap

• Swelling or stiffness in the knee

• Clicking, popping, or locking sensations

• Pain worsens with bending or stairs

Common causes include:

• Meniscus tears

• Arthritis

• Ligament injuries

Signs Your Pain May Be Coming From the Hip

• Pain in the groin or upper thigh

• Discomfort that radiates down to the knee

• Stiffness when walking or standing

• Reduced range of motion in the hip

Common causes include:

• Hip arthritis

• Labral tears

• Muscle strain

Key Differences in Symptoms

• Knee pain is often localized

• Hip pain may feel deeper and radiate

Why Proper Diagnosis Matters

Treating the wrong area can delay recovery and worsen symptoms. A thorough evaluation, including imaging if needed, helps identify the true source of pain.

Treatment Options

Treatment depends on the underlying cause and may include:

• Physical therapy

• Medications

• Injections

• Surgical intervention when necessary
  

If you are unsure whether your pain is coming from your hip or knee, a professional evaluation can provide clarity and relief. Contact our office to schedule an appointment and get an accurate diagnosis.

Contact Surgeons Dr. Thomas and Dr. Pennington at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments,contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

The meniscus is a piece of cartilage that cushions and stabilizes the knee joint. Tears are common and can occur due to injury or gradual wear.

Not all meniscus tears require surgery, and understanding the difference can help guide treatment decisions. At the practice of Steven C. Thomas, MD and Donald W Pennington, DO, our board-certified  surgeons specialize in orthopedic procedures in the Las Vegas area.

What Is a Meniscus Tear?

The meniscus acts as a shock absorber in the knee. A tear can occur from:

• Sudden twisting movements

• Sports injuries

• Degenerative changes over time

Symptoms of a Meniscus Tear

• Knee pain

• Swelling

• Clicking or locking

• Difficulty bending or straightening the knee

When a Meniscus Tear Can Heal on Its Own

Some tears may heal without surgery, especially if they:

• Occur in areas with good blood supply

• Are small or stable

• Cause minimal symptoms

Non-Surgical Treatment Options

• Rest and activity modification

• Physical therapy

• Anti-inflammatory medications

When Surgery Is Needed

Surgery may be recommended if:

• The tear causes locking or instability

• Symptoms persist despite conservative care

• The tear is large or in a poorly vascularized area

Types of Surgical Treatment

• Meniscus repair

• Partial meniscectomy (removal of damaged tissue)

Recovery Timeline

• Non-surgical recovery may take weeks

• Surgical recovery varies depending on the procedure

• Physical therapy is key to restoring function

If you are experiencing knee pain or suspect a meniscus tear, a proper evaluation can determine the best course of treatment. Contact our office to schedule an appointment.

Contact Surgeons Dr. Thomas and Dr. Pennington at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments,contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Rotator cuff tears are a common cause of shoulder pain, particularly in active individuals and aging patients. These injuries can range from mild inflammation to complete tendon tears.

Understanding when physical therapy is sufficient and when surgery may be necessary is key to choosing the right treatment. At the practice of Steven C. Thomas, MD and Donald W Pennington, DO, our board-certified  surgeons specialize in orthopedic procedures in the Las Vegas area.

What Is the Rotator Cuff?

The rotator cuff is a group of muscles and tendons that stabilize the shoulder and allow for movement. A tear occurs when one or more of these tendons become damaged.

Symptoms of a Rotator Cuff Tear

• Shoulder pain, especially when lifting the arm

• Weakness in the shoulder

• Limited range of motion

• Pain at night or when lying on the affected side

When Physical Therapy Is Recommended

Many rotator cuff tears can be treated without surgery, especially if they are:

• Partial tears

• Degenerative (age-related) tears

• Associated with mild to moderate symptoms

Benefits of Physical Therapy

• Strengthens surrounding muscles

• Improves flexibility

• Reduces pain

• Restores function

When Surgery May Be Necessary

Surgery may be recommended if:

• The tear is complete or severe

• Symptoms do not improve with conservative treatment

• There is significant weakness or loss of function

• The patient is highly active or an athlete

Types of Surgical Treatment

• Arthroscopic repair

• Tendon reattachment

• Debridement of damaged tissue

Recovery Expectations

• Physical therapy is essential after surgery

• Recovery may take several months

• Gradual return to normal activities
  

If you are experiencing persistent shoulder pain or weakness, early evaluation can help determine the best treatment approach. Contact our office to schedule a consultation and develop a personalized plan.

Contact Surgeons Dr. Thomas and Dr. Pennington at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments,contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Knee pain is one of the most common orthopedic complaints, especially when walking, climbing stairs, or standing from a seated position. While occasional discomfort may not be serious, persistent or worsening pain can signal an underlying condition that requires evaluation.

Understanding the common causes of knee pain can help you determine when to seek care and what treatment options are available. At the practice of Steven C. Thomas, MD and Donald W Pennington, DO, our board-certified  surgeons specialize in orthopedic procedures in the Las Vegas area.

Why Knee Pain Happens During Movement

The knee joint is significant weight and stress during everyday activities. Walking and stairs increase pressure on the joint, which can aggravate existing issues involving cartilage, ligaments, or surrounding tissues.

Common Causes of Knee Pain

1. Patellofemoral Pain Syndrome (Runner’s Knee)

This condition causes pain around the kneecap, especially when:

• Walking downhill

• Climbing or descending stairs

• Sitting for long periods

2. Osteoarthritis

Degeneration of cartilage leads to:

• Stiffness

• Swelling

• Pain that worsens with activity

It is more common with age but can also develop earlier.

3. Meniscus Tears

The meniscus cushions the knee joint. A tear can cause:

• Pain with twisting or bending

• Clicking or locking sensations

• Difficulty with stairs

4. Tendonitis

Inflammation of the tendons, often from overuse, can cause pain during movement.

5. Ligament Injuries

Injuries such as ACL or MCL tears may result from trauma and can lead to instability and pain.

When to See a Specialist

You should seek medical evaluation if you experience:

• Persistent pain lasting more than a few weeks

• Swelling or stiffness

• Instability or the knee “giving out”

• Difficulty bearing weight

Treatment Options

Non-Surgical Treatments

• Physical therapy to strengthen muscles

• Anti-inflammatory medications

• Activity modification

• Bracing or support

Surgical Options

If conservative treatments fail, surgery may be recommended, such as:

• Arthroscopic procedures

• Cartilage repair

• Joint replacement in advanced cases

Preventing Knee Pain

• Maintain a healthy weight

• Strengthen surrounding muscles

• Use proper footwear

• Avoid repetitive strain
  

If knee pain is affecting your daily activities, early evaluation can help prevent further damage and improve your quality of life. Contact our office to schedule an assessment and explore treatment options tailored to your needs.

Contact Surgeons Dr. Thomas and Dr. Pennington at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments,contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada≈

Frozen shoulder, also known as adhesive capsulitis, is a painful condition that limits shoulder movement and can significantly interfere with daily activities. It often develops gradually and may take months or even years to fully resolve. Understanding why frozen shoulder occurs and which treatments are effective helps patients navigate recovery with confidence. At the practice of Steven C. Thomas, MD and Donald W Pennington, DO, our board-certified  surgeons specialize in orthopedic procedures in the Las Vegas area.

What Is Frozen Shoulder

Frozen shoulder occurs when the connective tissue surrounding the shoulder joint becomes inflamed and stiff. As this tissue thickens and tightens, shoulder movement becomes restricted and painful.

The condition typically progresses through stages, starting with pain and worsening stiffness before gradually improving.

Why Frozen Shoulder Develops

Frozen shoulder often develops after injury, surgery, or prolonged immobilization of the shoulder. It is also more common in people with diabetes, thyroid disorders, or other metabolic conditions.

In many cases, the exact cause is unknown, but inflammation and reduced joint use play a major role.

Common Symptoms

Symptoms include shoulder pain that worsens with movement, progressive stiffness, limited range of motion, and difficulty with activities such as reaching overhead or behind the back.

Pain is often worse at night and can disrupt sleep.

Non-Surgical Treatment Options

Most cases of frozen shoulder improve with conservative treatment. Physical therapy is the cornerstone of treatment and focuses on gentle stretching and range-of-motion exercises.

Other treatments may include anti-inflammatory medications, corticosteroid injections, and activity modification to reduce pain while maintaining mobility.

When Surgery Is Considered

Surgery is rarely the first option. It may be considered if symptoms persist despite months of non-surgical treatment. Surgical options aim to release tight tissue and restore movement.

Early diagnosis and treatment improve outcomes and shorten recovery time.

Contact Surgeons Dr. Thomas and Dr. Pennington at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments,contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Arthroscopic knee surgery is a minimally invasive procedure used to diagnose and treat a variety of knee conditions. It allows orthopedic specialists to address joint problems through small incisions, resulting in less pain and faster recovery compared to open surgery. At the practice of Steven C. Thomas, MD and Donald W Pennington, DO, our board-certified  surgeons specialize in orthopedic procedures in the Las Vegas area.

What Is Arthroscopic Knee Surgery

Arthroscopy involves inserting a small camera into the knee joint to visualize internal structures. Specialized instruments are then used to repair or remove damaged tissue.

Common conditions treated include meniscus tears, cartilage damage, ligament injuries, and loose bone fragments.

When Arthroscopic Surgery Is Recommended

Arthroscopic knee surgery is typically recommended when conservative treatments such as rest, physical therapy, and medication fail to relieve symptoms.

It is often appropriate for mechanical issues like catching, locking, or instability rather than generalized arthritis pain.

What to Expect During the Procedure

The procedure is usually performed on an outpatient basis. Most surgeries take one to two hours, and patients return home the same day.

Anesthesia type depends on the procedure and patient needs.

Recovery Expectations

Recovery time varies depending on the condition treated. Many patients begin physical therapy shortly after surgery to restore strength and range of motion.

Light activities are often resumed within a few weeks, while return to sports or high-impact activity may take longer.

Long-Term Outcomes

When appropriately recommended, arthroscopic knee surgery can significantly reduce pain and improve function. Following rehabilitation guidelines is essential for optimal results.

Contact Surgeons Dr. Thomas and Dr. Pennington at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments,contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Occasional joint pain is common, but chronic joint pain that persists or worsens over time should not be ignored. Early evaluation by an orthopedic specialist can prevent further damage and improve long-term outcomes. At the practice of Steven C. Thomas, MD and Donald W Pennington, DO, our board-certified  surgeons specialize in orthopedic procedures in the Las Vegas area.

What Qualifies as Chronic Joint Pain

Joint pain is considered chronic when it lasts longer than several weeks or recurs frequently. Pain may be constant or activity-related and often limits movement or daily function.

Commonly affected joints include the knees, shoulders, hips, ankles, and elbows.

Warning Signs That Need Medical Evaluation

You should see an orthopedic specialist if you experience persistent swelling, stiffness, weakness, joint instability, or pain that does not improve with rest or over-the-counter treatment.

Night pain or pain that interferes with sleep is also a concern.

Common Causes of Chronic Joint Pain

Chronic joint pain may result from arthritis, tendon injuries, cartilage damage, ligament instability, or previous injuries that did not heal properly.

Accurate diagnosis is essential for effective treatment.

How Orthopedic Specialists Diagnose Joint Pain

Diagnosis often includes a physical examination, imaging studies, and review of medical history. Identifying the underlying cause allows for targeted treatment.

Treatment Options

Treatment may include physical therapy, medication, injections, lifestyle modification, or surgical intervention depending on severity and diagnosis.

Why Early Care Matters

Early treatment helps reduce pain, preserve joint function, and prevent progression to more serious conditions. Addressing joint pain promptly leads to better outcomes and improved quality of life.

Contact Surgeons Dr. Thomas and Dr. Pennington at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments,contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Joint pain does not always require surgery. In many cases, physical therapy is the most effective first-line treatment. Knowing when physical therapy is the better option helps patients avoid unnecessary procedures and recover safely. At the practice of Steven C. Thomas, MD and Donald W Pennington, DO, our board-certified  surgeons specialize in orthopedic procedures in the Las Vegas area.

How Physical Therapy Treats Joint Pain

Physical therapy focuses on strengthening muscles, improving flexibility, and correcting movement patterns that place stress on joints. It addresses the root cause of pain rather than just the symptoms.

Therapy programs are customized to the patient’s condition, activity level, and goals.

Conditions That Often Respond Well to Physical Therapy

Many joint issues improve with physical therapy, including tendonitis, muscle strains, early arthritis, mild ligament injuries, and overuse conditions.

Physical therapy can also help patients recover from injuries while avoiding surgery altogether.

Benefits of Choosing Physical Therapy First

Physical therapy is non-invasive and carries minimal risk. It helps preserve joint function, improve mobility, and reduce pain without the downtime associated with surgery.

In some cases, physical therapy may also improve surgical outcomes if surgery becomes necessary later.

When Surgery May Still Be Needed

If joint pain is caused by severe structural damage, instability, or advanced degeneration, surgery may eventually be required. Physical therapy is often used first to determine whether symptoms improve without surgical intervention.

Working With an Orthopedic Specialist

An orthopedic evaluation helps determine whether physical therapy, surgery, or a combination of treatments is most appropriate. Personalized care ensures the safest and most effective approach.

Contact Surgeons Dr. Thomas and Dr. Pennington at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments,contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada