The Suite Sojourn: Dr. Rothenberg, can you briefly share your background and what drew you specifically to sports medicine and orthopedic surgery? How does your experience shape your approach to treating active travelers who are sports enthusiasts?

Dr. Rothenberg: I grew up playing sports—hockey, basketball, baseball, and football—and went on to play football in college. After college, I stayed active through CrossFit and distance running, including completing the New York City and Chicago marathons. That lifelong connection to athletics is what drew me to sports medicine and continues to shape how I treat my patients.

As a former athlete myself, I understand how central sport and fitness can be to someone’s identity and quality of life. My treatment philosophy is built around helping people stay active, not telling them to stop. Sometimes that means addressing injuries directly, and other times it’s about mitigating symptoms so someone can continue playing even if there’s mild pain. My goal is always to preserve participation—whether that’s skiing in Japan, playing pickleball on vacation, or simply running at home. I focus on solutions that allow people to keep moving safely.

The Suite Sojourn: With the growing trend of travelers visiting popular skiing destinations like Japan and Courchevel — and more hotels adding pickleball courts, what types of injuries are you concerned about among these active travelers?

Dr. Rothenberg:  Skiing injuries are extremely common, and some of the most established sports medicine institutes in the world are built right at the base of ski resorts because of the sheer volume of injuries that occur. These mountains can sustain multiple high-volume orthopedic practices. For travelers, it can be especially frightening to get injured in an unfamiliar environment far from home. The most common serious skiing injury is an ACL tear, but we also see more severe cases such as tibial plateau fractures, upper-extremity fractures, and rotator cuff tears.
Pickleball, on the other hand, tends to involve lower-energy mechanisms compared to flying downhill on skis at high speeds. The most frequent pickleball issues are ankle sprains and tendonitis, but I’ve also seen ACL tears and rotator cuff injuries from the sport, particularly as it grows in popularity and attracts older athletes.

The Suite Sojourn: For those new to these sports, can you explain what the ACL and meniscus is and why it’s especially vulnerable during activities like skiing and pickleball?

Dr. Rothenberg: The ACL, or anterior cruciate ligament, is one of the main stabilizers of the knee. It prevents the shin bone from sliding forward and keeps the knee stable during cutting, pivoting, or sudden stops. It’s particularly vulnerable in skiing because of the twisting falls that happen when a ski catches an edge, and in pickleball because of the quick side-to-side movements and sudden changes in direction.

The meniscus is the C-shaped cartilage in the knee that acts like a cushion between the thigh bone and shin bone. It helps absorb shock and also provides stability. When you combine bending, twisting, and loading the knee—like turning down a slope on skis or lunging for a pickleball shot—the meniscus is put under stress and can tear. These are classic mechanisms for both ACL and meniscus injuries, which is why we see them so often in these sports.

The Suite Sojourn: What are the top three prevention strategies you recommend for travelers to reduce their risk of ACL and meniscus injuries before they hit the slopes or the pickleball court? Are there specific warm-up or training routines you suggest?

Dr. Rothenberg: The best way to prevent ACL and meniscus injuries is to prepare before you play. I focus on three things: strength, balance, and a proper warm-up. Building strength in the quads, hamstrings, and glutes helps protect the knee from twisting forces. Balance and neuromuscular drills—like single-leg hops or controlled jump landings—train your body to react and stay stable. And a short dynamic warm-up, like the FIFA 11+ routine, can significantly cut injury risk. Whether you’re skiing or playing pickleball, spending ten minutes to activate your muscles and move with control can make a huge difference.

The Suite Sojourn: Many of our clients are “weekend warriors” — they may not play year-round but engage in intense bursts of activity while traveling. What advice do you have for them to safely prepare for seasonal sports and minimize injury risk?

Dr. Rothenberg: For the weekend warriors out there — the folks who may not train year-round but go all-in when they travel — the biggest thing is preparation. Even a few weeks of focused conditioning before your trip can make a huge difference. Build up your core and leg strength, work on balance, and include some light cardio to get your body ready for the demands of your sport.

When you arrive, don’t skip the warm-up — take 5 to 10 minutes for dynamic stretches like lunges, leg swings, and light jogging to activate the muscles you’ll be using. And just as important, listen to your body. If you start to feel fatigue or soreness, that’s your signal to back off and recover. A little preparation and smart pacing go a long way toward preventing ACL, meniscus, and other overuse injuries that can ruin a trip.

The Suite Sojourn: Since prevention is better than cure, do you recommend any specific types of gear, braces, or footwear that can help reduce injury risk while skiing or playing pickleball?

Dr. Rothenberg: Gear definitely plays a role, especially when it comes to support and fit. For skiing, proper boot fitting and correctly set bindings are your first line of defense against knee and leg injuries. If you’ve had a prior ACL or meniscus injury, a functional knee brace can add stability and confidence on the slopes.

For pickleball or tennis, footwear is everything. Always use a sport-specific shoe — whether it’s made for pickleball or tennis — or at the very least a good pair of cross-trainers. Running shoes aren’t built for lateral movement and can actually increase your risk of ankle and knee injuries. If you’ve had previous ankle sprains, a light brace or supportive sleeve can help as well. Gear should enhance your preparation, not replace it.

The Suite Sojourn: If a traveler suspects an ACL or other serious knee injury while away from home, what immediate steps should they take? Are there any symptoms that one should watch out for? What should they look for in local medical care or clinics abroad? At the bare minimum, are there any imaging studies they should get to understand the severity of the situation?

Dr. Rothenberg: If you feel a sudden pop, have immediate swelling, or can’t put weight on your leg after a knee injury, that’s a red flag for something significant like an ACL or meniscus tear. The first step is to stop the activity, ice the knee, and keep it elevated — don’t try to ‘walk it off.’ A compression sleeve or wrap and crutches, if available, can help protect the joint until you’re evaluated.

Some ski injuries can be high-energy and quite serious. If you’re unable to bear weight, it’s completely reasonable to be evaluated in an emergency room — and ski patrols often take injured skiers straight to an urgent care or ER at the mountain. That said, aside from fractures, most orthopedic injuries are not true emergencies. Even some fractures can safely be managed once you’re home, so you shouldn’t feel pressured to have ACL or meniscus surgery abroad if you can return home in a reasonable timeframe.

At a minimum, getting an X-ray helps rule out a fracture. If you have persistent swelling, instability, or locking of the knee, an MRI is the best way to assess ligament or cartilage injury. Whenever possible, arrange a telemedicine consultation with your orthopedic surgeon back in the U.S. — they can review your imaging and help guide next steps. If you can make it home, it’s almost always better to have surgery in a more comfortable environment, with a surgeon you know or someone your trusted contacts can recommend.

The Suite Sojourn: In your expert opinion, is there a role for rehabilitation in treating knee injuries, or—much like a heart attack—are these injuries something that typically require immediate surgical intervention?

Dr. Rothenberg: Absolutely — there’s a huge role for rehabilitation in treating knee injuries. Unlike a heart attack, most orthopedic injuries aren’t true emergencies. In fact, the majority of orthopedic surgeries are elective. The decision to have surgery is a shared discussion between you and your surgeon, taking into account your goals, activity level, age, expectations, and support system.

Many ligament, meniscus, and cartilage injuries can initially be managed with structured physical therapy to restore motion, strength, and stability. Some people do very well with rehab alone, while others ultimately choose surgery once they understand the risks, benefits, and recovery timelines. The key is having a thoughtful conversation — not rushing into surgery, especially while you’re away from home.

The Suite Sojourn: From your experience, what’s one common misconception about ACL injuries or recovery that you’d like our travelers to be aware of — especially those planning active vacations?

Dr. Rothenberg: Two big misconceptions come up all the time. The first is that every ACL tear needs surgery — that’s not true. While surgery is often recommended for active individuals who want to return to cutting or pivoting sports, some people can do very well with rehabilitation alone, especially if they’re not playing high-impact sports.

The second misconception is that an ACL injury is an emergency that has to be fixed right away. In reality, most ACL surgeries are elective. Once the knee is calm, swelling is down, and you’ve regained your range of motion, you can safely plan surgery on your own timeline — ideally with your trusted surgeon back home. That recovery planning and preparation make a big difference in long-term outcomes.