The Physical Therapy / Rehab Thread

Discussion in 'Physical Fitness, Rehabilitation, and Infirmary' started by Monique, Oct 2, 2018.

  1. Monique

    Monique bounceswoosh Skier

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    I could have sworn something like this existed, but I can't find it. If a mod knows where it went, please feel free to move this there ...

    Anyway, I figure we should have a thread for general PT/rehab encouragement and updates.

    My story: I tore my ACL and had it reconstructed in 2016. It's not back to 100%, but I'm still seeing (glacial) improvement. I also have had shoulder issues on and off in the last year, most recently because I took a nasty digger downhill mountain biking. Generally speaking, I seem to be injury prone, so I've had experience with PT for lots of different things.

    My shoulders are getting better (once again). My ortho surgeon commented that he expects to see me again - he says that some people (like me) just don't have as much space in their shoulders, so all the pieces tend to rub against each other. I'm taking that as a personal challenge, so I've been doing lots of shoulder stretches. My favorite is a passive stretch - lie lengthwise on a foam roller and let the arms hang in "cactus" shape for a couple of minutes. I also like holding a narrow PVC pipe behind my back in both hands - below the upper body - and stretching both arms back from there. And I'm constantly checking in with my posture, and finding it's off.

    As for my knee, it's been a process. For a while now, I've been concerned that my right quad would never fully develop again. Part of the problem was that my knee hurt when flexing it much. One leg squats were too much. But I have a wonderful trainer who got me doing some modified lunge/squat exercises, and it really seems to be helping. That, and doing barbell squats. Front squat was great for my legs and balance, but it irritated my shoulder (typical impingement symptoms), so now I'm doing "regular" (back) squats. Very little weight - focused on form.

    I'm getting back into deadlifts, and I would like to see how much weight I can lift if I really focus and train for it. This is a long term project. Deadlift has a way of shaking out any form/alignment issues. I'm working with a trainer, and as the weight goes up, alignment issues crop up. Same with squats. Then he does some analysis, gives me some MAT exercises (similar to PT exercises, but with a different focus), I go down in weight, and we start again. It's frustrating, but I see progress. As I go through this process, I am finding that I consider the alignment discoveries a feature, not a bug. It's more important to me to get my body right than to lift a lot of weight, but I think the two will go hand in hand.

    Early this year, I couldn't do deadlifts because my right leg wouldn't participate fully. I'd end up putting more weight on my left side, and that inevitably led to back pain. Fortunately, a chiro session would instantly fix it, but obviously that's not a good scenario. The modified lunges and barbell squats (which require balance) helped me there. Now, I actually see that "bulge" on the outside of the quad on both legs, not just the left one! I slowly worked up the deadlift weight. It was a little frustrating. A few years ago, I could do 5x205. Starting over at 85 pounds, not because I wasn't strong enough but because of bad proprioception, was tough. But I got my legs equalized.

    Then, the next iteration. One of my shoulders was lower than the other. The bar would hit the floor on one side before it hit on the other. Again, no good. My back hurt again. My trainer fixed this with some MAT work. I don't remember the details, but my shoulders went back to being more or less straight.

    He's had me doing sets of 10 reps. I got up to multiple sets of 185. Then another thing cropped up, in both squats (which are still at 55 lb max - again, form limitation, not strength) and deadlifts. My feet aren't moving, but everything from there up is turning slightly sideways. You guessed it - back pain. So we're doing some more MAT - I have three exercises to work with - and I'm back to 85 pounds.

    I guess some people would say to stop doing deadlifts. I'm finding them to be an excellent diagnostic tool. I hope that by doing this, I'll be fixing issues that would have plagued me as I age. Oh, and - get me to bigger lifts more safely :)
     
  2. karlo

    karlo Out on the slopes Skier

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    Me, it's been a year and a half. Injury to soft tissue of left hip from a very hard landing of a new taboggan ramp. Balance and fast reflex affected; rotary and flex/extension. Finally went to a pelvic PT specialist. She took me off my training and strengthening routine, to rebuild from ground up. Seems to be working.

    Went on a ski tour last month, carrying 20 or 40 lbs, depending on whether or not it was a traverse day. Ms. PT said it could either hurt or help. I think it helped. Skinning, you pretty much have to keep to form. No strange pelvic drops or rotations. I felt weak out-of-use left muscles being used and fatigued.

    Skiing is good for certain rehab
     
  3. Thread Starter
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    Monique

    Monique bounceswoosh Skier

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    Interesting. Skinning always seems to affect one of my hip flexors. I think it's because one side of the hip/pelvis is usually higher than the other. Fingers crossed for you. Pelvic PT specialist is usually not a fun time.
     
  4. neonorchid

    neonorchid Out on the slopes Skier

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    @Monique, do you cross-country ski? Asking because IMO, I think "Classic" cross-country skiing would help with that as well as the upper body issues. And it's low impact so easy on the knees. ogsmile
     
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  5. cantunamunch

    cantunamunch Meh Skier

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    She can always try the old school drag-wine-boxes-on-carpet-with-toes drill.
     


  6. Thread Starter
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    Monique

    Monique bounceswoosh Skier

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    I've thought about cross country skiing, but I doubt it will happen this year. Lots of factors.

    I ... what?
     
  7. cantunamunch

    cantunamunch Meh Skier

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    One foot in one box, the other in the other. Put some weight in in behind the heels. Shuffle them across the floor. Use as long a stride as you can manage without pain.

    It's pretty simple and can be adapted to most any circumstance. Got two lasagna pans and some sandy beach? No probs.
     
  8. Thread Starter
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    Monique

    Monique bounceswoosh Skier

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    Hmm. Interesting. Given all the other things I'm working on, and lack of wine boxes and lasagna pans, I'll pass for now.
     
    neonorchid likes this.
  9. scott43

    scott43 Making fresh tracks Skier

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    Anybody know how to fix peroneal tendon pain?
     
  10. karlo

    karlo Out on the slopes Skier

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    Searching for what this is, I found this,



    Amazingly, there is huge assymetry in my hip rotation and in hamstring or IT band tightness. Will have to discuss with my PT. Thanks @cantunamunch for stimulating the avenue of exploration.

    Me? Nothing more than can be found in a Google search, like

    https://www.medicalnewstoday.com/articles/318349.php
     
    Last edited: Oct 12, 2018
  11. neonorchid

    neonorchid Out on the slopes Skier

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    I had a nasty case of peroneal tendonosis about four years ago. Took ~ 10 weeks of PT followed by another 6 months of backing off when it flaired up. It came back last year as a tag along with a new one for me, Achilles insertion tendonitis, 11 weeks of PT for that one.
    PT administered deep tissue massage is instrumental to the healing process. Breaks up scarring and along with the various exercises "reforms" the tendon (the healing process).
    My advice, without repeating everything you've already read on web md, mayo clinic dot com and the like, don't go it alone, you do not want the tendon to continue to thicken up and become a more serious problem which could require surgery. Have your primary care physician or the nurse practitioner write a Rx for PT, or however it's done in Canada. PT works. Begin ASAP and you should be good to go for the upcoming 2019 ski season this January.
     
    Last edited: Oct 12, 2018
    scott43 likes this.
  12. neonorchid

    neonorchid Out on the slopes Skier

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    :thumb:Thinking about it ... that's a startogsmile Interferring factors:(
     
  13. neonorchid

    neonorchid Out on the slopes Skier

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    :eek:

    I'm trying to get her out of the gym and away from those inquisition torture devices, her weight lifting is scaring me! I'm thinking of an outdoor sport that'll benifit her overall fitness ... not training her for the American Birkebeiner:nono:
     
    Last edited: Oct 12, 2018
  14. Jenny

    Jenny Out on the slopes Skier

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    Having spent the summer recovering from peroneal tendon surgery (among other things they fixed), I second this statement, whole-heartedly!

    My PT report - I can walk normally again! The doctor is quite pleased with his work (he gave me a little bit of credit, too, lol). ROM is good, balance is good although still not all the way back, strength still needs work, too, but everything is coming along well. I've been released to all activities. He said full healing would be 12-18 months.
     
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  15. UGASkiDawg

    UGASkiDawg AKA David Pugski Ski Tester

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    You haven't had peroneal tendon pain till you've dislocated both of them skiing moguls. Fortunately it's a short lived pain till surgery to try and repair....
     
  16. coskigirl

    coskigirl Making fresh tracks Skier

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    This is an ongoing issue for me. In running it crops up if I run with too much camber and/or if I start with uphill without any warm up. If it flares during a run I'm pretty debilitated. In skiing it it crops up in long traverses or catwalks and can put me nearly in tears although I'd bet money that those I ski with don't know that. My fear of heights and this combination make long traverses a nightmare for me. Literally. Hey @Ron remember following me at Alta last season? Yeah, that combo.

    I wish you luck in dealing with it.
     
  17. scott43

    scott43 Making fresh tracks Skier

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    Thanks for the input everyone. I get it in hockey for about 10 mins and it eventually works itself out, but it's aggravating and I think, like you guys do apparently, I should probably address it before it gets worse. Thanks.
     
  18. coskigirl

    coskigirl Making fresh tracks Skier

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    If you decide to give it a try I highly recommend the lesson program at Eldora. They were great when I gave it a go a couple years ago. I wish I had more time to do it.
     
    Monique likes this.
  19. Thread Starter
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    Monique

    Monique bounceswoosh Skier

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    But .. I LIKE lifting.
     
  20. neonorchid

    neonorchid Out on the slopes Skier

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    Not surprised. The doctors and I initially had thought my acute injury was a stress fracture of the fibula.
    I hung up the low cut inline speed skates after my bout with peroneal tendonitis. Although it happened running, I'm convinced the speed skates were a major contributor to the acute p. tendonitis condition. The top of the skates hit exactly where the MRI showed the tendon damage.
    Hair brained idea but I'm wondering if a different AT boot, perhaps something light and more up-hill specific, which goes thru it's range of motion without putting pressure on the peroneal would help?
    Btw, I too am terrified of high heights. Not so much skiing but I haven't spent a fraction of the time in the mountains as you so who knows. Nevertheless, the balcony of my mothers city digs scares the :poo: out of me:eek: Every time I watch taped footage of Alex Hannold (or any other climber) in action the palms of my hands sweat profusely, even if I've seen the video before!
     

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