JPEDDER,
Yes and Yes for bike and the rower for optional work taking some load off the Achilles. I’d say you are 1.25-1.5 for the bike, 1-1 for the row or even less as its both upper and lower extremity and you will be less efficient at it. Get going on 3-5 sets of 30-45 sec. heel raise isometrics with both legs, progressing to single leg.
Cheers,
Pete
Pete Dickinson MS,PT
Forum Replies Created
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ParticipantPete Dickinson MS,PT on August 10, 2019 at 10:59 pm · in reply to: Achilles injury – What to replace running? #26621ParticipantPete Dickinson MS,PT on August 7, 2019 at 8:00 pm · in reply to: Maintain Fitness during Treatment #26429
Exercise has a significant positive role in pre/post surgery and cancer treatment. Gentle aerobic activity within your tolerance creates a host of positive events for circulation, blood flow, and endocrinolgic stimulus. You need not to adversely stress healing regions, and be gradual in your progressions. Start modestly and progress gradually.
PeteParticipantPete Dickinson MS,PT on August 7, 2019 at 7:55 pm · in reply to: Peroneal Nerve Issue, full knee flexion/extension #26428One thought is that it might be a more ‘central’ nerve issue coming out of the lumbar spine, and not just a peripheral issue at the peroneal nerve locally. Treating the lumbar spine with mobility might yield some more positive results. Of course there are fascial issues across the region that also interplay with the nervous system. Finally, I recommend single leg strengthening along the lines of single leg step downs to build better support and control of the knee before venturing into explosive efforts. Also, meniscus does not resolve with rest. Hope this gives some food for thought!
Cheers,
PeteParticipantInteresting discussion here. I think the initial line of treatment would be to investigate your electrolyte ingestion prior and during the event. Failing to see improvement would lead me to look at your training and preparation for the specific type of activity. Can you reproduce the loads, duration, heat load during training without seeing symptoms? Often we really don’t recreate what we are aiming for causing a type of ‘training error’, or failure to properly prepare the demands you are facing.
PeteParticipantPete Dickinson MS,PT on August 6, 2019 at 9:35 am · in reply to: Hip flexor / Musculus sartorius pain #26298Another cause of hard to resolve muscle tightness in the anterior thigh is femoral nerve irritation, especially with impact activities. Some questions would be if your back is tight as well, do you have a history of a back condition. Its unusual for tight muscles to bother you for months on end without some additional causes. Early treatment for back mobility can be helpful, in addition to rolling of the hip and quad to relieve peripheral neural restrictions. Just some additional food for thought in addition to Alison’s excellent comments.
Cheers,
PeteParticipantPete Dickinson MS,PT on July 22, 2019 at 10:21 am · in reply to: Anterior Ankle Tendonitis/Impingement #25320Briguy,
It is a common cause for the tight laces to cause this type of pain, and for it to last for a while. I recommend ice massage to the area, and removal of any compression at the top of the foot. If return to uphill treadmill walking is painful, try the elliptical as that requires less active dorsiflexion.
PeteParticipantThe fascial region is more medial quad than VMO, I would also address the posterior hip in the same way as that is surprisingly an important area for the knee as well. I also use Ktape until I am painfree with my strength movements.
PeteParticipantIt depends…. The severity and causes of the tendonitis all have impact on treatment. Fascial guidance of the region through Ktaping, and manual therapy/ball rolling to resolve tissue restrictions are necessary precursors to strengthening of the tendon which ultimately is what leads to pain reduction. The elbow region needs a strong shoulder first and foremost. Localized strength needs to be consistent starting at a level that is ‘tolerated’ and gradually increased. Movement patterns that contribute to overuse need to be identified and changed. Whew!! You’ve got work to do!!
Cheers,
PeteParticipantBriguy,
The fascial spot to work is in the ‘region’ below the VMO, just superior to the medial condyle. You know its the right spot when mobilizing it is quite painful with light pressure.Step ups with 20lbs. is not really a complete picture of your lower extremity strength. I would not say that you have ‘played out’ your strength gains as it relates to patellofemoral pain.
Cheers,
PeteParticipantPete Dickinson MS,PT on June 30, 2019 at 2:30 pm · in reply to: Suspected achilles' tendonitis: recovery tips? #24259Kendra,
Excellent plan, just modify based on response. Each step may even take weeks and not days, thats the nature of tendonitis. Training shoes are fine, may even help to compensate for some foot issues. Load is load with a calf raise, whatever means is convenient.
Cheers,
PeteParticipantPete Dickinson MS,PT on June 29, 2019 at 2:33 pm · in reply to: Suspected achilles' tendonitis: recovery tips? #24225I would begin isometrics immediately and daily, and trial biking for aerobic fitness initially. If bike goes ok, try elliptical. Once isometrics are tolerated, then isotonics can be added with progression to true strength loads. You should see improvement in function throughout this process. As always, the devil is in the details.
Cheers,
PeteParticipantPete Dickinson MS,PT on June 28, 2019 at 2:07 pm · in reply to: Suspected achilles' tendonitis: recovery tips? #24159Kocanez,
Calf lowering exercises are a few steps up the ladder from where you want to start your strengthening. I would begin 5x45sec calf raise holds, basically an isometric. Current thinking has moved on from just eccentrics, but strength is the key as you try to make the healthier part of the tendon strong enough to support the loads you place on the calf structure. You have to be very consistent with daily strengthening of this area, progressing from double leg load, to single leg loading, and progressing to 8rm strength loads. Keep up with deadlifts as you work on your achilles.
Cheers,
PeteParticipantbriguy,
You’re right in that there can be multiple issues contributing to anterior knee pain. This region is very susceptible to subtle tissue tightness affecting the ‘tracking’ on the patella. As a starting point I would roll out the hip and medial quad, then begin strength with deadlifts initially avoiding single leg work until double leg work is pain free. Then its off to the races back to step ups and lunges etc. This can be resolved, but it also takes a strong dose of patience and discipline.
PeteParticipantPete Dickinson MS,PT on June 11, 2019 at 2:04 pm · in reply to: cervical spondylosis – getting fit #23368Great question! Shoulder impingement can be independent, or caused by your cervical spine spodylosis. Have you seen improvement with shoulder pain from your course of treatment? Your shoulder pain might be caused by inefficient sport movements or weakness of the shoulder separate from inhibition from the neck. Initial rotator cuff strengthening and cervical mobility treatments would be a good starting point. Failure to see improvement would encourage me to circle back around to other shoulder issues related to impingement. This often involves mobilizing some restrictive soft fascial tissue around the shoulder, gaining full mobility of movement, and returning effective sport strength to the shoulder.
Back to your original question about weightlifting, I like to return to normal strength movements as soon as possible. As it relates to the shoulder I would initially avoid chest press movements, do rows and pulls listening to your response. Start easy, use bands on pull-ups to start, rows with trx or straps. Overhead presses are important, but you have to have full end range mobility overhead, or you shouldn’t load with any significant resistance.
Hope this gets you started. Don’t hesitate to contact me for more assessment/specifics.
PeteParticipantRussell,
Try: pete@worldcup.physio
Pete