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The Physical Therapy / Rehab Thread

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Monique

Monique

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:facepalm:
...IDK, perhaps I'm projecting but I can't phantom how doing 5x205 deadlifts (sounds heavy), benefits someone with ongoing (arthritic related?) knee and shoulder problems. Then again WTF do I know...

My PT said that my shoulder problems should actually be fine, possibly even be improved, with deadlifts as long as I maintain proper shoulder position, so maybe you don't know? *shrug*

Deadlifts do involve knees - but based on pain levels, I'd say that skiing is a lot harder on my knees than deadlifts. I guess I should quit skiing and stick to deadlifts?
 

neonorchid

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My PT said that my shoulder problems should actually be fine, possibly even be improved, with deadlifts as long as I maintain proper shoulder position, so maybe you don't know? *shrug*

Deadlifts do involve knees - but based on pain levels, I'd say that skiing is a lot harder on my knees than deadlifts. I guess I should quit skiing and stick to deadlifts?
I'd want to save my knees for skiing. Deadlifts seems like unnecessary wear and tear stress on the knees, IDK, I never did them, has zero appeal to me. Still, assuming you spend 30 minutes to an hour max doing deadlifts vs., skiing six hours give or take a few either way, can that make an apples to apples comparison pain wise for someone with an arthritic condition?

BTW, one of the doctors who's been putting me back together for over a decade said running is the worst thing I could be doing for my knees and I'm still running on a weekly basis.
A nurse from the hiking group said she'd tell me how to keep my osteoarthritic knees from getting worse but I wouldn't want to hear the answer - "don't run!" I pretty much stopped hiking, been going for shorter runs instead.
Like I said what do I know? I'm just hoping and trying to stay healthy and fit for the upcoming ski season ...one ski season at a time;)
 
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Monique

Monique

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I'd want to save my knees for skiing. Deadlifts seems like unnecessary wear and tear stress on the knees, IDK, I never did them, has zero appeal to me. Still, assuming you spend 30 minutes to an hour max doing deadlifts vs., skiing six hours give or take a few either way, can that make an apples to apples comparison pain wise for someone with an arthritic condition?

BTW, one of the doctors who's been putting me back together for over a decade said running is the worst thing I could be doing for my knees and I'm still running on a weekly basis.
A nurse from the hiking group said she'd tell me how to keep my osteoarthritic knees from getting worse but I wouldn't want to hear the answer - "don't run!" I pretty much stopped hiking, been going for shorter runs instead.
Like I said what do I know? I'm just hoping and trying to stay healthy and fit for the upcoming ski season ...one ski season at a time;)

Couldn't pay me to run. My knees are now a good excuse ;-)

Yeah, can make an apples to apples comparison because I deadlift twice a week ... Also, if you think you're actually skiing six hours when you're on the mountain six hours, I want to ride the lifts you're on!

But, like you said, you don't see the appeal of dead lifts. I don't see the appeal of running. My bet is that our body types are *very* different. Risk is only meaningful in terms of perceived reward. And honestly, I'm not convinced that deadlifts are bad for my knees. Not at 205 for sure. For context, until recently, that was my body weight.
 

karlo

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I discovered a new therapy for my left hip today. So, while I hold my stretch, I'll document it. As said before, my injury affected left hip rotation and flex/extension. In skiing, this manifests itself as difficulty with left footers in moguls, and with steeps that have irregularities, which can be a mogul under powder or can be a rut. I also have lost some fast-twitch abilities to maintain balance. That's what this new therapy or exercise works on. Here it is.

Hold my dog back standing on one leg, my left leg, when he sees a squirrel. Keep upper body upright, core tight. Face 90-degree from where he wants to go, so there are rotational forces on the hip. Hold steady as he tugs, tugs, and tugs, again and again

Edit: He is available for a small fee. Squirrels are extra
 

François Pugh

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I think I dislocated my shoulder last night; it felt like the arm was out of place,but went back in when I moved it around immediately post injury. So I have a few Questions.
How long until it stops hurting? I had heard having it pop back in relieves the pain.
How long before it's fit for exercise? I imagine it would be similar exercise as when I broke the humerus at the ball last spring, or when I separated the shoulder a few years ago.
 

LuliTheYounger

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I think I dislocated my shoulder last night; it felt like the arm was out of place,but went back in when I moved it around immediately post injury. So I have a few Questions.
How long until it stops hurting? I had heard having it pop back in relieves the pain.
How long before it's fit for exercise? I imagine it would be similar exercise as when I broke the humerus at the ball last spring, or when I separated the shoulder a few years ago.

It's probably worth getting it checked out with a doctor to see if there's any tendon damage. I get subluxations all the time and I feel like the comeback varies a ton depending on the severity; the minor ones are usually good to go after a week or so as long as I play nice, but the more complete ones can cause issues for months on end. I also feel like the tendon stretching in a subluxation can really mess with my separated shoulder. Even if it was just minor, it's probably worth doing a fair amount of rehab to see if you can lower the risk of future instability.
 
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Monique

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@François Pugh - I don't know much about this sort of thing, but I have heard that once you dislocate the joint, it becomes easier and easier to dislocate it (and re-locate it) again.

I *suspect* (but don't really know) that a PT could give you exercises to improve your shoulder's ability to keep the bone in place using muscles. I have different shoulder issues, but my PT actually encouraged me to do bench press and overhead press - before, I'd been avoiding them due to shoulder pain. She said the muscle would actually help. (Again, DIFFERENT shoulder issue.) And my trainer has me doing hangs (just literally hanging from something on the ceiling) to improve my upper back flexibility and says it's a good rotary cuff exercise to help keep shoulders where they should be. But again - those are just things that seem to be working for my particular body. There might be other exercises that would help, and I'm guessing hangs aren't in your near future ;-)
 

Living Proof

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I think I dislocated my shoulder last night; it felt like the arm was out of place,but went back in when I moved it around immediately post injury. So I have a few Questions.
How long until it stops hurting? I had heard having it pop back in relieves the pain.
How long before it's fit for exercise? I imagine it would be similar exercise as when I broke the humerus at the ball last spring, or when I separated the shoulder a few years ago.

Several years ago, I dislocated my shoulder during a fall on a Jackson Hole bump run. "Popping" the shoulder in is known as "reducing" the dislocation, and, the emergency physician at the JH clinic put my shoulder right. Wore a sling for a few weeks, and, got checked out by an Orthopedic shoulder specialist who did X-rays and said there was no major damage to the joint or the lining of the socket. It was 6 weeks before I could ski, and, putting on a jacket easily took longer. It took months before it was retuned to normal. Never had a repeat, but, it happened in my 60's which is a positive because late stage injuries tend not to reoccur.

How did your injury occur? If a major blow, like mine, it may not reoccur. My son is subject to dislocations, and, they happen with very little force, but, go back easily. My advice is get checked out by a specialist, it's the only way to resolve your specific concerns.

Best wishes for a speedy recovery
 

Living Proof

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:facepalm:
...IDK, perhaps I'm projecting but I can't phantom how doing 5x205 deadlifts (sounds heavy), benefits someone with ongoing (arthritic related?) knee and shoulder problems. Then again WTF do I know...

Hey, I'm no expert, but, my PT recommends Dead Lifts for those with knee issues, ie me. The logic is to strengthen the muscles around the knee, and, there is very little knee movement compared to squat type exercises. Now, I am nowhere near lifting 200 lbs, but, my knees are not stressed by this exercise. Also, get some good coaching on proper technique, like many lifting exercises technique matters.
 

neonorchid

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Hey, I'm no expert, but, my PT recommends Dead Lifts for those with knee issues, ie me. The logic is to strengthen the muscles around the knee, and, there is very little knee movement compared to squat type exercises. Now, I am nowhere near lifting 200 lbs, but, my knees are not stressed by this exercise. Also, get some good coaching on proper technique, like many lifting exercises technique matters.
Interesting, I hope it helps you. I erroneously thought dead lifts involved lifting weights over the head! Still there is no way I'm doing that to my back, hips and knees! As it is my knees can't handle doing leg presses, and this on the machine with a sliding sled to lay on / feet pushing against a stationary pannel. They also can't take bicycling. Yet I ran 4.25 miles in the Wissahickon yesterday and am ok today - more then one of my doctors have been telling me running is the worst thing I could be doing for my knees!

Re: technique, etc., I found the following video, I'm still not about to sign on but have a better understanding of the excercise then when I previously posted -

Edit: I should add that the stationary bike and the leg press machine exercises were presented to me by tseveral PT's at different times as something to be doing while at PT for other injuries unrelated to the knees. Nither excercise worked and both were dropped from the PT routines.
 
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Thread Starter
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Monique

Monique

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Hey, I'm no expert, but, my PT recommends Dead Lifts for those with knee issues, ie me. The logic is to strengthen the muscles around the knee, and, there is very little knee movement compared to squat type exercises. Now, I am nowhere near lifting 200 lbs, but, my knees are not stressed by this exercise. Also, get some good coaching on proper technique, like many lifting exercises technique matters.

When I first got back to practicing deadlifts with my trainer quite a while ago (over a year? Time flies), my knee was still cranky enough that it griped even when I did modified deadlifts where the bumper plates were elevated so that the bar wasn't so low. He had me do all sorts of intermediate steps and learn all sorts of exercises and self-massage techniques. These days, when I do deadlifts, my knee isn't even a consideration.

Squats have been a challenge, but again, my trainer found all sorts of "squat adjacent" exercises that got the muscles engaged without pissing off the knee too badly. These days, after many months working with lunges and Bulgarian squats, I'm back to working on squats again. My knee is pretty good. I'm slowwwwwwly getting a more even stance and better proprioception. It's a struggle getting both legs to contribute evenly, but I do see both quads bulking up, not just the left one, so I think it's working. I'm not instinctively shifting to the side as I stand up from the hole.

TL;DR - The right guide makes all the difference. I wish I had advice on how to choose one; I lucked into my guy maybe a decade ago, and have worked with him on and off ever since. My post-surgery PTs (YMMV) and the trainer at the rehab facility had a certain set of go-to exercises - but when those exercises caused me a lot of pain, they got stuck. My trainer always listened very carefully and came up with ways to use the muscle without causing the pain.

Deadlifts are THE "technique matters" exercise. They're great for your back if you do them right. If not ... well, there's a reason so many people think that deadlifts are bad for your back - and that reason is that they used poor technique.


I erroneously thought dead lifts involved lifting weights over the head!

Hah! The terms for everything are so confusing. I only recently finally sat down and educated myself on what constitutes Olympic vs Powerlifting moves. I still can't seem to keep the Oly terms straight, which is funny because there are only two of them. You may be thinking of one of those two, because they start similarly to a deadlift.

I recently saw a chiro who also seemed to have trouble - he used deadlifts as an example of Olympic lifting. Then talked to an ortho about deadlifting after a wrist sprain, and he kept doing some weird arm motion as an example which involved lifting his forearms and bending his wrists downward, sort of like a dog "sitting pretty" with its paws relaxed. I ... don't think that's a thing, even if you're doing curls.

FWIW, deadlifts might get your knees strong enough that you could have more success with leg press. I think that deadlifts were a step on my way to being able to do squats (my gym is tiny and doesn't have a leg press machine). But I sure as hell would find a strongly recommended trainer with a proven track record, and have them critique the hell out of you, and keep doing it as you go up in weight. Just going and doing them - no. I know plenty of people do it, but I wouldn't. And of course, you didn't ask :)
 

François Pugh

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Thanks for the replies.
My injury happened while barely moving, having stopped, I stopped paying attention and began talking to a fellow patroller. Only I hadn't completely stopped; I was still going sideways a bit. When the skis hit a pile of snow they stopped completely; I didn't. I fell on my outstretched arm. Upon moving my arm around, I noticed it kalunking like a broken piston rod until it worked its way into place. It hurt a lot when I fell on it, less once it got back into place, but still very painful (I'm even tempted to take a few hydromorphone that I passed on when my arm was broke last spring (same shoulder) because I had access to percocets.

Went to the clinic today. Saw a doc. Got x-rays. They'll call if I need any work done. I can move it and use it; it just hurts like hell when I do.

Could be worse, it could be lower body, then I couldn't ski very well.
 
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Monique

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Thanks for the replies.
My injury happened while barely moving, having stopped, I stopped paying attention and began talking to a fellow patroller. Only I hadn't completely stopped; I was still going sideways a bit. When the skis hit a pile of snow they stopped completely; I didn't. I fell on my outstretched arm. Upon moving my arm around, I noticed it kalunking like a broken piston rod until it worked its way into place. It hurt a lot when I fell on it, less once it got back into place, but still very painful (I'm even tempted to take a few hydromorphone that I passed on when my arm was broke last spring (same shoulder) because I had access to percocets.

Went to the clinic today. Saw a doc. Got x-rays. They'll call if I need any work done. I can move it and use it; it just hurts like hell when I do.

Could be worse, it could be lower body, then I couldn't ski very well.

Ouch!

Pain killers are a personal decision - I always keep a few around from my last injury (there's always some relatively recent injury) because I can't take NSAIDs. Sometimes Tylenol just doesn't cut it. But I also don't have a history of addiction, YMMV, etc etc. For me PERSONALLY and my level of comfort with these things - if I can't sleep, my body isn't resting and can't recover properly, and I think a prescription pill (that's been prescribed to me and is just sitting around waiting for the next medicine recycling day) is reasonable.

That being said, pain killers make me itch (Benadryl actually addresses this) and make my head spin, so it's really just when I can't sleep due to pain. (Benadryl also helps with the sleeping.)
 

neonorchid

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-
Deadlifts are THE "technique matters" exercise.
They're great for your back if you do them right. If not ... well, there's a reason so many people think that deadlifts are bad for your back - and that reason is that they used poor technique.
-
I sure as hell would find a strongly recommended trainer with a proven track record, and have them critique the hell out of you, and keep doing it as you go up in weight. Just going and doing them - no. I know plenty of people do it, but I wouldn't. And of course, you didn't ask :)
Good advice!

Outside Mag "10 Most Overratted Exercises"
#9, Barbell Deadlift
"This is another great movement and it can be very effective, but it's too advanced for most people," says Holland, referring to the act of bending at the knees to lift a (usually very heavy) barbell from the ground to about waist height. "Most trainers don't even teach it correctly. It's vey high-risk, and it's much easier to get hurt than it is to do it right." (Two common mistakes, according to the American Council on Exercise: Arching the back too much during lifting and lowering, and not raising and lowering your hips and shoulders together.)
 
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Good advice!

Outside Mag "10 Most Overratted Exercises"
#9, Barbell Deadlift
"This is another great movement and it can be very effective, but it's too advanced for most people," says Holland, referring to the act of bending at the knees to lift a (usually very heavy) barbell from the ground to about waist height. "Most trainers don't even teach it correctly. It's vey high-risk, and it's much easier to get hurt than it is to do it right." (Two common mistakes, according to the American Council on Exercise: Arching the back too much during lifting and lowering, and not raising and lowering your hips and shoulders together.)

Ugh. I hate this quote. If he's going to say that deadlifts are too advanced for most people, he's also saying "picking a moving box up off the floor is too advanced for most people." And that's probably true, but it doesn't mean we should all avoid picking items up off the floor for the rest of our lives. Everyone performs deadlifts all the time - it's just that most people don't think of it that way, and it's why so many people F up their backs doing something stupid, like picking up a box of books.

Imagine someone saying "Skiing is a great activity, and it can get you some exercise, but it's too advanced for most people. Most skiers don't even bother with instruction, and a lot of instructors aren't very experienced, anyway. It's very high risk, and it's very easy to get hurt." Now, instead of skiing, take an activity that everyone WILL perform thousands of times in their lives.

Sigh.
 

Coach13

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You’ll be fine if you use solid technique and don’t over do things weight wise.
 

neonorchid

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Ugh. I hate this quote. If he's going to say that deadlifts are too advanced for most people, he's also saying "picking a moving box up off the floor is too advanced for most people." And that's probably true, but it doesn't mean we should all avoid picking items up off the floor for the rest of our lives. Everyone performs deadlifts all the time - it's just that most people don't think of it that way, and it's why so many people F up their backs doing something stupid, like picking up a box of books.

Imagine someone saying "Skiing is a great activity, and it can get you some exercise, but it's too advanced for most people. Most skiers don't even bother with instruction, and a lot of instructors aren't very experienced, anyway. It's very high risk, and it's very easy to get hurt." Now, instead of skiing, take an activity that everyone WILL perform thousands of times in their lives.

Sigh.
I imagine DL's are safer then picking up a box off of the floor. Seems to me the bar places one in a better location and position to lift the weight.

Love the skiing analogy!

P.S., have a look at what they say about the leg extension machine and the Mayo Clinic study.
 
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Monique

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S., have a look at what they say about the leg extension machine and the Mayo Clinic study.

Funny. I remember being told that they're a bad idea even back in my college days. I guess capitalism works ... where there's a demand, there will be supply.
 
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I imagine DL's are safer then picking up a box off of the floor. Seems to me the bar places one in a better location and position to lift the weight.

For years, "Lift with your legs, not with your back" was baffling to me. I couldn't figure out what it meant. It's only after studying deadlifts that the penny dropped.

I've been moving a lot of stuff lately. Boxes of books, awkward items, etc. It's satisfying to approach a box and realize that you can use the same technique I use to deadlift. (Also satisfying, to bring it back to the subject of the thread, that I can squat really low to grab something from beneath, and my knee doesn't hurt!)

That being said - it's not the most convenient movement. It's easier to just reach down and pick something up. This is why even people who have excellent form when standing on a deadlift platform will throw their backs out while picking up something relatively light around the house.
 
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