Well, no trauma or event that I would expect to lead to greater injury, that’s good. It’s an area that can also get cysts due to repetitive activity. You might want to practice benign neglect as long as you have full ROM and no real pain.
Pete
Pete Dickinson MS,PT
Forum Replies Created
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ParticipantPete Dickinson MS,PT on March 30, 2020 at 7:45 pm · in reply to: Metacarpal-trapezoid joint issue? #40006Participant
I wouldn’t think in terms of specific hip abduction exercise, but posterior hip fascial mobility, and hip extension strength through hip hinge, step up etc.
PeteParticipantScott beat me too it. Strengthening the hips goes a long way to improving control and managing the aberrant force vectors around the patella. This can be done with ‘two legged’ exercises such as the deadlift, but then should progress to single leg exercises. Fascial mobility to the hip and inside quad is also helpful. Knees are allowed to creak, and as such, do not give a very good indication of dysfunction.
Cheers,
PeteParticipantPete Dickinson MS,PT on March 26, 2020 at 9:24 am · in reply to: Quad tendon rupture recovery #39856You’re more than welcome. Just email me at pete@worldcup.physio and we can arrange something.
PeteParticipantPete Dickinson MS,PT on March 25, 2020 at 2:40 pm · in reply to: Quad tendon rupture recovery #39831Rob,
So sorry to hear about your quad tendon reinjury and surgery predicament. While surgery is no guarantee, there might be a greater upside than treating it conservatively. On a significant proceedure like this, multiple surgeon opinions can be helpful in educating you about the pros and cons. 6 weeks immobilized is really nothing in the big picture if it allows for uphill/downhill activities again. There is a lot of suffering now in those who have to delay surgery to treat really painful conditions in their daily lives. Good reasons for that, but still a difficult time.
PeteParticipantPete Dickinson MS,PT on March 20, 2020 at 6:52 pm · in reply to: Maintaining aerobic base during rehab for high hamstring tendinopathy #39713Repeat episodes of hamstring pain in an older athlete can be many things. As we age, our nerve openings exiting the spine become more narrow giving the opportunity for nerve compression sending pain to our hamstrings, ischial tuberoties, etc. When this happen you often have little back pain, and are hard to convince it’s anything else but the area that hurts!! It this is the case, then spine mobility and core strength become more important as a rehab direction. Of course other things can cause leg pain such as facet cysts, disc herniations, muscle fascial restrictions, and training errors.
Cheers,
PeteParticipantPete Dickinson MS,PT on March 20, 2020 at 6:39 pm · in reply to: one month after Knee Replacement….what next?? #39712I can echo Scott’s experience with the roller skis. In dealing with a back injury I would shuttle a car up a long hill, ride the bike down, pick up my roller ski gear and ski back up to the car. It works and minimizes some of the downsides with fall risk. Bit of a time suck to do all that however.
As far as you recovery goes…Bike is your friend at this stage, you can get more activity in, without flaring up your knee by other impact activities (walking). The name of the game right now is to regain full extension. If you try and load it too much with the exercises you are accustomed to (lots of walk/hike/heavy exercise), the knee will tighten up. Now is the time to make a run at your range of motion. Restrictions in motion tend to ‘cement’ in if you get too far down the road.
One option is to walk/bike at Z1. Do 10min walk/10min bike….repeat x3 to start. Gradually increase time based on your knee response. Work your extension ROM prior, and after.
Cheers,
PeteParticipantPete Dickinson MS,PT on March 17, 2020 at 11:08 pm · in reply to: Maintaining aerobic base during rehab for high hamstring tendinopathy #39666I usually take a fairly aggressive approach to tendon rehab with a return to walk/run ASAP depending on level of pain and functional loss. Starting at 1min walk/2min run is usually available unless any jogging is painful. Performing your rehab activities prior to this will help. Tendons do not do well with rest after an initial acute phase, it just further degrades their function. Pool running can help supplement volume. If you are over 40, other regions can generate upper hamstring pain. If this is the case you can be missing the boat on your rehab focus.
PeteParticipantPete Dickinson MS,PT on March 11, 2020 at 3:20 pm · in reply to: Neuroma and lower body strength training suggestions #39450I’ve called it a ‘balance squat’, your back foot is elevated onto a bench or chair, basically a lunge position with the back leg elevated. Pistol squat can work, but may place greater challenge in minimizing load through the forefoot.
PeteParticipantThere are no specific studies on concussion and altitude, however the concussion treatment literature is quite robust. This is essentially a ‘training adaptation’ issue, however there is a lot of devil in the details with this. There are a lot of brain regions that can be impacted that give symptoms. We look at different clinical presentations in Ocular/Vestibular/Congnitive-Fatigue/Anxiety areas. By progressively training the affected areas, we can slowly improve the symptoms. Exercise is neuro protective, but more specific rehab is needed for difficult cases.
PeteParticipantPete Dickinson MS,PT on March 10, 2020 at 5:39 pm · in reply to: Illness after expeditions/ big big days #39433Tom,
Scott is dead on, you need volume to tolerate the activities you are participating in. You also need to NOT do your volume at the incorrect intensity. A coach is essential at this stage in your development.
Best,
PeteParticipantPete Dickinson MS,PT on March 10, 2020 at 5:34 pm · in reply to: Neuroma and lower body strength training suggestions #39431You can still participate in weight bearing exercise that pressures through the heel, instead of forefoot. Deadlifts are the premiere hip strengthening tool. Single leg ‘bench squat’ with the back leg up on a chair also allows for some single leg work but with the ability to pressure through the heel.
PeteParticipantPete Dickinson MS,PT on February 21, 2020 at 4:55 pm · in reply to: Shin Tenderness – Stop Completely or Reduce Load? #38617I might recommend switching the method you use for your aerobic training, to something not involving the gait cycle for a short period of time. Bike, stair climber etc. will lessen the load on the posterior tibialis and associated structures that are involved in decelerating your foot impact during running. Footwear can also be a factor with the compressive materials no longer absorbing impact, or a mismatch in shoe to foot structure.
PeteParticipantPete Dickinson MS,PT on February 17, 2020 at 8:47 am · in reply to: Recurring MTSS/stress fracture/"shin splints" #38317Yes, that’s basically the exercise, you can do it single leg and no need to use a step. Another strategy is to get aggressive with your hip strength, as that also controls the loads in your lower leg.
PeteParticipantPete Dickinson MS,PT on February 15, 2020 at 7:17 pm · in reply to: Recurring MTSS/stress fracture/"shin splints" #38259Is it on one side, or both? Interesting problem, especially when altering shoe choice and orthotic intervention hasn’t helped. I usually don’t initially recommend a running gait change unless all other avenues are exhausted, but after 5 years this might be a direction needed to create change. Maybe Alison can pipe in with some recommendations. Strength training to stress the attachments of the posterior tibialis on the tibia would also be appropriate. Doing heel raise holds for 45 sec x5 is a good place to start. Then progress to greater load, then jump landings in a heel raise position.
Pete