“Help!” Continues . . . So you’ve had ACL Reconstruction, Now What??

Hi! We are continuing our discussion on ACL tears and last post we talked about what to do if you think you have torn your ACL. Today we will discuss Rehabilitation and all the questions you should ask your Physical Therapist and Orthopaedic Surgeon and the answers they may give you . . .

If you missed the first part you can read it here Help! My daughter tore her ACL . . . We think??

So you’ve had surgery . . . 20150625__701135-s500-phHopefully you are feeling like you made a great choice ~ I don’t suspect you are necessarily happy with needing surgery and the coming rehabilitation but now that your joint is stable again proper healing can begin ~ its uphill from here baby!

I suspect you have the lots of questions tho . . .

  • How long do I have toimages-8
    • take meds
    • use the crutches
    • wear a brace
    • keep icing
  • When will it stop
    • hurting
    • being so swollen 
  • When can I get back to
    • sports
    • school/work
    • walking normally
  • Is this normal???

First lets talk about some common things you may be surprised by or concerned about that your  surgeon may not have mentioned . . .

  1. You may have a LOT of pain and swellingtherapeutic-drugs-monitoring-19-638
    1. STAY ON YOUR MEDS AS LONG AS YOU NEED TO!
      The pain and anti-inflammatory medication is needed to manage the pain and swelling along with frequent icing for the first days after surgery. If you do not take your medications regularly they will not build up in your system enough to control the pain and swelling.
    2. It is okay to use the ice machine that was sent home with you as much as you need. It doesn’t really freeze your knee just keeps it cool and comfortable.
    3. elevate your leg as much as you can during the day.
  2. You may bruise ~ tearing your ACL and Surgery are both internal injuries that can cause bruising.
  3. You may have trouble sleeping ~ Because of the pain and swelling, you may not be able to find a comfortable position.
  4. You may feel nauseous
    1. This should only last a day or two 
    2. if it lasts longer the pain medication may not be sitting well in your stomach. Speak to your physician about a different medication.
  5. You may feel more tired ~ everything you do may require more effort.
    1. Getting in/out of the car
    2. Walking with brace and crutches
    3. You may have trouble lifting your leg
      1. It will be heavy and your muscles may not be working well.

Lastly, you will (sometime in the rehabilitation process)images-6

be frustrated at the speed of recovery,

be concerned about your progress,

be anxious to get back playing your sport,

be sad that this is taking sooooo long,

be angry that this happened!

Allow yourself to have these feelings, sit with them, embrace them, accept them and move through them ~ it’s a part of the healing process.

A typical rehabilitation protocol looks like this:

Phase 1

  • Control pain and swelling with ice, medications and exercise to create optimal healing conditions.
  • Keep muscles working with exercise to avoid atrophy.
  • Introduce joint range of motion with exercise to prevent stiffening of tissues.
  • Continue wearing brace until you have adequate quad muscle control to protect ACL ~ usually 2-6 weeks depending on surgeon.
  • Use of crutches as needed when walking ~ usually only 1-2 weeks.

Phase 2 ~ continue with above and . . .

  • Introduce coordination exercises if haven’t already.
  • 6 weeks is a key healing time requiring protection of graft ~ at this point many people are feeling better and assume they can doing things that could put the graft at risk for tearing.
  • Toward the middle and end of this phase introduce balance, agility and coordination.

Phase 3 ~ continue with the above and . . .

  • Increasing speed with balance, agility and coordination
  • Remediate movement pattern dysfunction to prevent future injury.

Phase 4 ~ Return to Sport

  • Typically return to practice with a specialized knee brace at 8-9 months and playing in games at 9-12 months.
  • All making sure that you are using normal movement patterns and are cross training the opposite movements as well to reduce your risk of future injury

So there you have it  . . . The Nutshell Version of ALC rehabilitation!

Have I answered your questions? Created more? Post below and let me know . . .

Speak with you soon! Roxi

Olympics 2016 ~ #TeamUSA!

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Have you been watching the Olympics this year? 

We are college touring (my son is a senior) and vacationing for the entire two weeks so I have only been catching the sports I love at the end of the day or via Sirius XM!

What are your favorite events?

Mine are gymnastics, beach volleyball and soccer. This year I did get into the swimming a bit too! Wow, we have some phenomenal athletes! #TeamUSA.

Another sport I have been following is mixed doubles Badminton!?! I know kinda random but . . . a former PT Aide that I worked with is an Olympian in this sport! I am so proud of her just being an Olympian and Athlete. She posted a picture of herself on Instagram using gradient compression pumps on her legs for recovery 🙂

In addition, Kerri Walsh Jennings and April Ross are sporting their kinesiotape and Michael Phelps has had cupping. What’s that you ask?? Stay tuned below for a link to my colleague’s blog post!

All of this had me thinking . . . I kinesiotape a few of my athletes for competition and many people come to ask me on the sideline “Does that stuff really work? What does it do??”

So here’s the scoop . . .

What is kinesiotaping?

Kinesiotaping is a technique used by Physical Therapist, Athletic Trainers, and Athletes to improve muscle performance or decrease pain during sport. It can also be used to decrease swelling in certain circumstances. It is a light elastic tape that is applied to the body to facilitate or inhibit muscles or move swelling. It is not rigid and therefore allows the body to move through its full range of motion during sport.

Does it really work?

Most medical research says there is no significant difference between use of tape and other treatments BUT . . . Athletes say YES it totally works!  Ultimately, you need to decide for yourself. Ask your Physical Therapist if kinesiotaping is appropriate for your problem and if so have him/her tape that area to see if it helps ~ reduce pain, swelling, make moving easier.

What does kinesiotaping do?

  • For use on muscles, the tape gives your body signals to either use a muscle more or less.
  • For reduction of swelling the tape lifts the skin and fascia to create movement of the fluid so it drains away from the swollen area.
  • For pain it lifts the skin and fascia to decrease the pressure on a muscle that is in spasm.

How do I know what kind of tape to buy?

Your Physical Therapist may be able to recommend the tape that is best for you. The major differences between the brands are patterns of wave forms, color options, and adhesive none of which affects the function of the tape but each person will have different preferences in brand of tape so use which every you like best!

Are they side effects?

  • You can have skin sensitivity reactions such as itching, redness, and the like.
  • If worn for many hours after sweating it can cause a rash from trapped sweat under the tape.
  • If you have latex allergies the tape may irritate your skin.
  • If the tape is close to the neck, head, armpit or back of the knee you can have dizziness, nausea and a general feeling of not being right ~ if this happens it will happen within 5 minutes of applying the tape, REMOVE THE TAPE IMMEDIATELY and the symptoms should be reduced greatly if not gone within 5 minutes. Kinesiotape should never be applied in the armpit or back of the knee.

Can I tape myself?

Yes . . . But, you will want to know what to tape and how to tape it. Speak to your Physical Therapist about your specific issue.  There are lots of YouTube videos available to teach you how to tape yourself but to avoid injury, and understand the purpose of taping, make sure they are done by reliable sources. Better yet check with your PT.

Do you have any Kinesiotaping stories to share? Comment below!

Did I answer all your questions? If not comment below or email me . . . drroxi@zptforinjury.com

Look forward to hearing from you! Be well, Roxi

P.S. here’s the cupping blog my colleague wrote!

The Sport Specialized A.T.H.L.E.T.E.

The third in the series: The Athlete and the Injury . . .

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Sport Specialized Athlete

Here are some guidelines for the Sport Specialized Athlete:

Allow for rest and recovery

You must build in recovery days to your training schedule to maximize the benefit of your training as well as reduce risk of injury.

Your training is designed to build specific skills but in doing this the muscles, tendons, and ligaments take stresses that the body is not designed to take. The body needs time to recover and heal from these stresses placed upon them in order to improve your athletic performance.

Take time to condition

Incorporate flexibility, strengthening, agility, and cardiovascular exercises into your training. If you are just playing your sport you will miss out on needed conditioning that will prevent injury and improve your skill!

Hydrate

As you sweat you will need to replenish with water. You should be taking in about one ounce of water per 2/3rds of your body weight, so if you weight 150 pound = 100 oz of water a day. This can change based on how active you are. If you are sweating for more than an hour a day drink more maybe add a sports drinks for the electrolytes you are losing.

Two hints

  1. If you are thirsty you are already dehydrated! 
  2. Chocolate milk is a great recovery drink for after competition or a intense workout!

Live your whole life

Remember that sports is one component of you life ~ school, family, friends, relaxation, and fun must all play a role!

Expect overuse problems

When you perform the same types of motions day in and day out those body structures can suffer fatigue and failure. Because you are training at such a high performing, highly skilled level you are prone to injuries that we used to only see in adults. And your growing body presents other challenges as well. Sometime in your athletic career you will have an injury, the important thing to know is how to manage it without creating permanent problems or losing your edge.

Talk to your PT

Your Physical Therapist is the human movement specialist. They will help you with injury prevention strategies, general and sport specific conditioning, and injury rehabilitation. If you do not have a physical therapist you consult and trust, FIND ONE!

Exercise in other ways

Like living your whole life, be active in ways that don’t involve your sport. Take a walk, hike, bike or swim. Play a different sport with friends. The physical demands of soccer are much different than the physical demands of basketball! Providing your body with multiple physical experiences helps to prevent injury and enhances your overall sport performance!

Stay tuned . . . Up Next, the Active Play Athlete!

The Athlete and the Injury . . .

Kids these days fall into one of three categories of activity participation:

  1. The Virtual Athlete who plays FIFA Soccer, Madden Football, MLB The Show and NBA 2K on a gaming system.

  2. The Active Play Athlete who plays many different sports or participates in a wide variety of activities – individual and team sports or exercise.
  3. The Sport Specialized Athlete who plays one sport year around and may be on a few different teams – school, club and community.

Injury can occur no matter what category your child is in but for different reasons!

  • The Virtual Athlete may get injured when beginning an activity or sport due to lack of strength, flexibility, agility or control for the activity they are performing.
    • Of Special Note: Kids who play active games on the Wii or Xbox Kinect systems can get injured as well! Especially if they play one game over and over – think overuse or repetative movements!
  • The Sport Specialized Athlete may get injured due to repetitive movements done during practice and games  that wears a body part down and prevents healing.
  • The Active Play Athlete may get injured for the same reasons a Virtual Athlete or Sport Specialize Athlete depending on the situation.

Think of spraining your ankle . . .

The Sport Specialized tennis player or basketball player is prone to these injuries by nature of the sport, the Active Play Athlete may be running and step in a hole twisting their ankle and a Virtual Athlete may slip off the Wii board twisting their ankle ~ it’s all still an ankle sprain!

So . . .

Who are you? Who is your child?

How do you prevent injury now that you know?

Hint: its different for each category!

See tomorrow’s post for advice particular to each type of athlete . . .