Dr. Ben Mayo is an orthopedic surgeon specializing in sports medicine, currently practicing at Synergy Orthopedics with clinic locations in Livonia, Sterling Heights, and Troy, Michigan. We sat down with him to discuss current trends in sports medicine and the management of common sports injuries as a Surgeon/Physical Therapist team.
Dr. Mayo grew up as a competitive athlete playing AAA hockey and lacrosse. That athletic background drew him toward exercise science in college at St. Olaf College in Minnesota — where he originally considered becoming a strength and conditioning coach and even earned his CSCS (Certified Strength and Conditioning Specialist) credential. Instead, he pursued medicine:
“Sports medicine is kind of a misnomer. It’s not just people who play sports. It’s the active population, whether they’re 12 or 30 or 60 or 80.”
— Dr. Ben Mayo
Listen to the podcast on Spotify or scroll down to read the summary.
Sports medicine orthopedics covers the full spectrum of injuries and conditions affecting the musculoskeletal system in active people. Dr. Mayo’s most common procedures include:
– ACL reconstruction (anterior cruciate ligament)
– Patella instability surgery (MPFL reconstruction, osteotomies)
– Meniscus surgery
– Rotator cuff repair
– Shoulder replacement (anatomic and reverse)
– Shoulder instability surgery
– Achilles rupture repair
– Ankle sprains
– Tommy John surgery (UCL reconstruction of the elbow)
Importantly, surgery is far less common than most patients assume. Dr. Mayo estimates that only about 5% of the patients he sees end up having surgery. The rest are managed with physical therapy, injections, activity modification, or time.
One of the most common questions patients have after an ACL tear is: *which graft should I get? Dr. Mayo explains that there is no single best answer. The right choice depends on the individual patient, their age, goals, activity level, and anatomy.
Patellar Tendon Graft (BTB)
The gold standard for high-level athletes. Every NFL player essentially gets this graft.
Pros: Strong, well-studied, excellent long-term outcomes
Cons: Larger scar on the front of the knee, potential for kneeling discomfort, higher risk of anterior knee pain
Quadriceps Tendon Graft
Increasingly popular among recently trained surgeons and patients who want to avoid patellar tendon risks.
Pros: Strong graft, avoids BTB harvest site
Cons: Patients can struggle more with quad strength recovery in the early months of rehab
Hamstring Graft
Still a reasonable option in the right patient.
Pros: Smaller incision
Cons: Less popular in Dr. Mayo’s patient population; slightly different biomechanical profile
Allograft (Donor Tissue)
Best suited for patients 35 years and older or lower-demand individuals.
Pros: Easier recovery, no harvest site pain
Cons: Slightly higher re-tear risk in young, high-demand athletes
ACL Repair with Biologic Augmentation (BEAR Implant)
An exciting newer option that stitches and reattaches the *patient’s own* ACL rather than replacing it, with biologic materials added to encourage healing.
Best for: The right patient: typically not recommended for high-risk athletes like a 18-year-old competing at a D1 level
Pros: Easier recovery, preserves native tissue
Cons: Higher re-tear risk in high-demand populations; still an evolving technique
“There’s a time and a place for all of them. They all have their strengths and weaknesses and it all depends on the specific patient.”
— Dr. Ben Mayo
Beyond just waiting long enough, Dr. Mayo highlights several key factors that contribute to re-tear risk:
1. Returning to Sport Too Early
It cannot be overstated: you should not return to sport prior to 9 months. This is the single most controllable risk factor.
2. Inadequate Strength and Functional Testing
Strength symmetry testing (limb symmetry index), hop testing, and movement quality assessments are essential before return to sport, not just a calendar date. This is an essential component of ACL rehab at Souva PT and Performance
3. Psychological Readiness
Fear of re-injury and lack of confidence in the knee can cause compensatory movement patterns that increase risk. Passing a strength test isn’t enough if the athlete doesn’t TRUST their knee.
4. Anatomical Risk Factors
Some individuals have naturally increased valgus (knock-knee) alignment or shallow trochlear grooves that put them at higher risk. These are generally not addressed surgically for a first-time ACL unless the deformity is severe.
5. Unrealistic Expectations Based on Professional Athletes
Pro athletes have unlimited resources, elite coaching, and their full-time job is recovery. The average patient has work, school, and family obligations. Comparing recovery timelines to the NFL is not realistic.
6. Nutrition
Pre-operative and post-operative nutrition significantly impacts outcomes. Optimizing protein and micronutrient intake has been shown to decrease muscle atrophy and enhance wound healing after orthopedic surgery.
Dr. Mayo sees patients at multiple locations across metro Detroit: Livonia, Sterling Heights, and Troy through Synergy Orthopedics. He prioritizes getting athletes with acute injuries in quickly so recovery (or surgery, if needed) can begin without delay.
Visit his website: [www.benmayomd.com]
Appointments: Available via ZocDoc, the Synergy Orthopedics call center, or online appointment requests through his website
The Rebuild+ Podcast is hosted by Jake Souva, DPT, doctor of physical therapy and owner of Souva PT and Performance in the Detroit metro area. Each episode features conversations with medical professionals, athletes, and performance experts focused on injury recovery, performance, and living an active life at every age.
Follow along for future episodes covering physical therapy, orthopedic surgery, sports performance, and evidence-based recovery.
