Owen,
You certainly have all the tools available to shift methods during your period of modified weight bearing. My general recommendations would be to use upper body strength training as a stimulus for the endocrine system to aide in tissue healing and recovery. If you can use a tegaderm waterproof dressing or leg ‘condom’ to protect the surgery site, deep water running is an excellent tool. My skiers that have had this surgery return to presurgery fitness without much difficulty. The devil is in the details of not loading up on the foot too quickly causing inflammation and losing training time.
Cheers,
Pete
Pete Dickinson MS,PT
Forum Replies Created
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ParticipantParticipantPete Dickinson MS,PT on September 19, 2020 at 5:46 pm · in reply to: Hiking/mountaineering recovery for partial ACL tear #45203
Your chondral fissure is not a ‘meniscus tear’ which ‘should’ not add to instability. The location on the patella does lead to greater awareness of patellar loading during quad dominant activities. Posterior chain strengthening is appropriate for both the patellar chondral injury and the grade 1 ACL tear. I would recommend giving conservative care (non surgical) a shot, with your athletic background you have the best chance possible adapting to this injury.
Cheers,
PeteParticipantPete Dickinson MS,PT on September 18, 2020 at 3:01 pm · in reply to: Hiking/mountaineering recovery for partial ACL tear #45163You can definitely return to a high level of sport activity with an ACL injury. Some partial tears can still give a stable knee depending on your inherent joint stiffness. The issue is whether you have instability, episodes of giving way, with your chosen activities. These symptoms can cause tearing of the meniscus which you want to avoid. You also don’t want to have an ‘episode’ in the backcountry where you pivot, and lock your meniscus leading to an evacuation situation.
As always, listen to how YOU are responding to the injury.
Cheers,
PeteParticipantPete Dickinson MS,PT on September 10, 2020 at 9:05 pm · in reply to: Tips for meniscus repair recovery? #44948While meniscus surgery is considered a quick rehab, it’s not uncommon for a lot of inflammation to develop on the trimmed rim as you return to loading. You can only progress as quick as it lets you, so not to bang this drum all the time, you gotta listen to the pain and not overdo it. The 10% rule for volume and intensity is a great rule of thumb. From your description of other injuries, I would prescribe a core and general strength program to help with the back and tendon injuries that are common in the Uphill Athlete.
Cheers,
PeteParticipantPete Dickinson MS,PT on September 10, 2020 at 8:59 pm · in reply to: Pete Dickinson ,Thanks for the help #44947Barry,
AltG is a great tool for getting some greater activity in during modified loading of the lower extremity. Big focus now is to do some bilateral stance loading in squat and hip hinge with even weight bearing distribution. You then do some loading into the affected leg back and forth, you know the drill. You can make it ski specific by doing weight shifts onto a ‘flat’ ski, gotta get that weight shift alllll the way over. Ski season around the corner!!!!
Cheers,
PeteParticipantListen to your bodies true response, don’t have a story in your head about what SHOULD happen. Work the progressions, but adapt to how you respond.
Cheers,
PeteParticipantPete Dickinson MS,PT on September 10, 2020 at 8:50 pm · in reply to: Calf strain, bad right side, avoiding future injuries #44945Well, you’re not doomed:) Some thoughts to help a tendon injury is….wait for it….Strength. This helps you gain more fatigue resistance, and resistance to tendon injury. A focused calf strength program with progression to tolerance of 6rm loads will help the tendon. The other elephant in the room is the effect of nerve irritation has on tightening up the posterior chain. It can either directly be the cause of pain, or the effect of activation/irritation of the nerves to the hamstring/hip/calf. Food for thought.
Cheers,
PeteParticipantDarn, pic didn’t load. Keep mobilizing the area, you made need to use the palm of your hand as other firmer tools can be too much. You just want to friction the tissue, then use it. You should check in with your provider for an xray to make sure you don’t have some of your soft tissue ossifying, just to rule out the bad stuff.
Cheers,
PeteParticipantI would just ski erg normal, I don’t think you need to kneel unless there is a fracture or you are in a boot for the tib/calc sprain…..Give deep water running another chance, trust me, it can be hard!
Cheers,
PeteParticipantPete Dickinson MS,PT on September 4, 2020 at 7:25 pm · in reply to: Scott’s killer core with disk surgery #44757Jim hit the nail on the head with the idea of slow progression, patience, and listening to your pain. As Uphill Athletes, you are used to a lot of discomfort. This can take the form of toughening it out, cowboy up, when faced with pain during movement in association with an injury. This usually just digs the hole deeper and you lose training time. Disc injuries take a lot of time to resolve, but they do!
Cheers,
PeteParticipantMAD,
A typical cause of bakers cycst is a meniscus tear, easily treatable with an arthroscopy, and worth the gains in training tolerance. Usually an MRI is needed to qualify for surgery as there are other causes…. Sometimes a surgery is worth it to get you to the point where you can tolerate training loads, other times the better course is the gradual rehab approach to save you the trauma of the surgery. Bakers cyst is one of those conditions where it is worth it to look at some more invasive options.
Cheers,
PeteParticipantLee,
Methods for training with less impact but keeping up hours of activity would include biking, and deep water running when possible. Substituting a long bike ride instead of hours of pounding on the legs goes a long way to keeping running viable. Patellar tendon injuries tend not to do well with high load cycling, but level 1 should be doable. After a brief rest, you want to return to progressive loading of the leg extensor complex, or you dig yourself a very deep hole to climb out of. During injury periods I recommend picking an upper body or core fitness goal to pursue, keeps you less crazy.
Just general comments as requested, hope it goes well.
Cheers,
PeteParticipantPete Dickinson MS,PT on August 22, 2020 at 8:38 am · in reply to: functional hallux limitus advice #44450There are carbon plates that are stiff along the entire length, but the spring plates flex at the metatarsals and might be easier on them.
PeteParticipantPete Dickinson MS,PT on August 21, 2020 at 5:06 pm · in reply to: functional hallux limitus advice #44439Tom,
For stiffness you might want to try a carbon fiber foot plate. They come full stiffness, as well one with a little flexibility for a forefoot rocker (spring plate).
Cheers,
PeteParticipantPete Dickinson MS,PT on August 18, 2020 at 8:04 pm · in reply to: Lack of ankle mobility, squats and step downs #44391Ian,
Feel free to use the plate riser for squats, the goal is strength for that movement! Substitute movements that keep your heel flat…….and then have some ankle mobility movements that you are doing PRIOR to strength. I like to do a combination of soft tissue mobility with rolling etc. Follow the soft tissue work with ankle dorsiflexion movements. Knee to wall, goblet squat with hold in the hole,
Keep at it, things can still change.
Cheers,
Pete