“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

Return to Reality ~ Remember Who You Are

f65f1cc99b863ca37484061c3c05283bIts September 1st and here is my update . . . . 

Well, actually it is September 12th because  ~ Life Gets In The Way 😛  but . . . Here’s my update 🙂

The Life that got in the way included:

  1. My son had his wisdom teeth removed!
  2. We tented the house which required bagging things, moving out and then cleaning up.
  3. The start of school while we were moved out! I earned my “master schedule juggler” award that week!
  4. I continued to see patients at various locations (because my clinic is in my home ~ which was tented).
  5. My volunteer commitments resumed ~ I coordinate the Snack Shack for my son’s high school and we had opening days for AYSO and FRAM soccer!

My Successes included:

  1. I resumed cooking delicious and healthy dinners for my family (once we were back home and the kitchen cleaned).
  2. I relaxed over this weekend after the chaos of the last few weeks. Relaxation is so important to allow us recharge our physical and emotional energy banks.
  3. I reconnected with people I had missed over the summer!
  4. I began a health journal which I will continue sharing as the weeks go by!
  5. I played fetch with the dog and did some yoga flow today 🙂

My Stagnations included:

  1. Forgetting who I am

It all comes down to this! For me when I let life gets in the way it is because I have forgotten who I am and therefore I no longer make the choices that I want to make but allow my circumstances dictate how I spend my time. I lose myself in my circumstances.

Have you ever looked in the mirror and thought or said:

  • “What the . . . ?”
  • “Who is that?”
  • “That’s not me!”
  • “When did I get ____________ (old/fat/crows feet/dark circles/bags/jowels/chin hair)?” 😀

I am shocked when I look in the mirror because what I see reflected back is not how I actually see myself! In my minds eye, I see a timeless beauty; an intelligent, vivacious, woman; someone who loves yoga, hiking, taking care of her mind, body and soul. What is reflected in the mirror is not that person. So how did I get off track? Life got in the way 🙂

More importantly how do I get back on track?

I have been asking this question for years and have never found an answer until . . . a recent conversation I had with someone with whom I am working on my branding. She asked me a series of questions about the future ~ goals, desires, plans. But she asked it in a way that made me see who I am 6 months from now. AND THEN . . . she told me to act the way that person acts.

Eureka! See what you are 6 months, a year, 5 years from now. Act the way your future self acts. It’s so simple. If I see myself as an athletic, intelligent, compassionate wonder woman then all I have to do is consistently act like an athletic, intelligent, compassionate wonder woman and that is what I will see in the mirror!

So . . . now I finally have a cairn to mark my path, a guide to show me the trail, a way tostay on track and stop life from getting in the way!

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~ My Cairn ~

Join me on this journey as I post more personal and professional stories. And stay tuned for continued PT education!

Follow me on facebook, twitter and this blog!

Blessed to share the journey~  Roxi

Life Gets in the Way!

If I had a dime for every time I made this excuse . . .

images
I’d be rollin’ in dough!

A perfect example is vacation right?

We have a routine that keeps us doing t
he things
that keep us healthy ~ eating right, exercising, taking our vitamins, etc. Then we go on vacation! We relax, indulge, pamper, overdo (or under-do), and return home feeling like we need a vacation from our vacation before we return to work. Because we are tired and have lots of laundry or yard work to catch up on we skip returning to our regular routine until we realize we have been back for a month and still haven’t gotten to the gym or studio . . .

This can happen with the holidays, projects at work, illness, renovations or any number of other things that make it easy for the majority of us to set aside our commitments to our heath and wellbeing and focus on outside things.

Do you find yourself in these examples?

(I hope I am not alone~heeheehee)

I think of this because our family is currently on a college touring road trip. And I have 8 hours in the car . . . We have toured 5 campuses in 5 days, from Iowa to Pennsylvania! Driven 1,288 miles (not including the 1700+ it to get to the first campus ~ #roadtrip) and walked 21.8 miles!

It was good exercise but not complete exercise. We were all missing the flexibility component of our routine, as evidenced by our taking every opportunity to stretch ~ in line at the gas station, during the standing portions of the tours, and while in bed!  We are now done with the college tours and starting the family vacation portion of our road trip . . . so what did we do when we got to Mackinac Island?? Walked around a lot the first afternoon and rested from our college touring ~ its actually quite tiring! Yesterday we slept in and then rented bikes! We were so excited to not be walking that we road the entire island and then some! The circumference of the island is 8.2 miles, but we also wanted to see the interior and only had yesterday left (as I write we are traveling to Two Harbors, Minnesota to spend five days with family).  So . . . we biked around the island sightseeing, returned to the hotel to get our swim suits, biked to a place to swim in Lake Huron and back to the hotel again ~ A total of 20 miles (gasp). Needless to say the legs were jello, the joints were achy, the spirit was blessed and the mind was clear!

IMG_8417I know the rest of the week holds hiking and water activities, shopping and more. Of course there is the long drive home as well (sigh). So what will happen when I get home?

Back to the same routine of 3 day a week strength training, 3 days a week walking the dog, 10-15 minute of yoga and foam rolling, cooking healthy meals, taking my vitamins?

Or will I let life get in the way?

Stay tuned . . . I’ll give an update September 1st!

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!

“If I Tell You it Hurts . . .

. . . You Won’t Let Me Play!”

Its a complicated subject really . . . PAIN

There are may different kinds of pain and each structure in our body hurts differently depending on why it is hurting!

I have heard these words many, many times and my biggest concern is twofold:

  1. Kids not telling their parents they are in pain because they really fear that their parent won’t let them play and they want to keep playing! OR WORSE
  2. Mom/Dad/Coach saying “suck it up” and play through it while turning to the parent next to them to say kids are “too soft” these days.

Ever experience either of those scenarios? I have seen it first hand on the fields!

How do we find a middle ground?

Well first we need to look at the type of injury ~ how did you wind up with pain?

If you have an acute injury:

  • You probably have lots of pain, some swelling and are not in the mood to play ~ follow those instincts!
  • If you are feeling better in a few minutes try playing again ~ you’ll know if you need to stop.

If you have a chronic injury:

  • You probably have intermittent pain and of varying intensity.
  • This is the most confusing pain to deal with because there is no simple answer . . .
  • You may be able to play through the pain BUT that doesn’t mean you should . . . you could be doing more damage to the injured tissues.

If you don’t have an injury at all:

  • Your pain could be the start of an overuse injury that develops slowly or you happen to “just notice” one day – see acute and chronic injuries above . . .
  • Your pain could be just from regular muscle use and totally normal ~ when you play through it you will feel better and better.

Next we need to consider the tissues involved in your injury ~ Muscles, Tendons, Ligaments, Bone. All of these tissues send different pain signals and heal at different rates.

Muscles can be sore from normal exercising, when you are sick in bed or just from growing! These types of pain feel sore or achy and you can play through them if it feels good to do so.the healing time of muscles can range from a few days to several weeks depending on the type of injury.

Tendons are sore when you are growing or when you have overused the muscle that is attached to that tendon. This kind of pain is more sharp, like a pinch or a stab and also intense achy. You can play through this pain ONLY IF it feels better when you play 🙂 If it hurts to play then DON’T 😦 Tendons healing phase is about 10-12 weeks.

Ligaments and bones are sore when you are growing or when you have injured them (see acute and chronic injuries above). These kinds of pain are typically deep achy or very sharp and intense. You should not play through these types of pain because you can be doing more harm than good. Bones take about 2-3 months to heal and ligaments continue to heal for up to a year.

Another thing to consider . . . “Growing Pains”.  Remember above that I mentioned pain can be related to growth . . . layer on top of that the repetitive actions of some sports or the frequency with which your child participates in that sport and/or an acute injury and you have the makings of a perfect storm. How do you tease out what the pain is from in order to decide if it is okay to play through or not?

Like I said, Its a complicated subject really . . . PAIN.

Bottom line: IF it hurts to play DON’T and see your Physical Therapist for guidance.

What kind of injury or pain does your child have? Reply to this post and tell me about your situation!

Have questions? Comment and ask away! I love to answer questions ~ yes I’m a nerd!

Look forward to hearing your story . . .

The Active Play A.T.H.L.E.T.E.

The forth and final in the series: The Athlete and the Injury . . .

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Active Play Athlete

Here are some guidelines for the Active Play Athlete:

Accommodate your body

You are already doing this by participating in a variety of activities! This is what our bodies crave and what limits our injury risk

Continue this habit!

Take time to  . . . do what you dislike 🙂

There is something you don’t like to do ~ admit it! And then do it anyway!

Even though your performance is already a mixture of sports and activities you still need to strengthen, stretch and get in some cardio work to decrease your risk of injury.

Have goals

Is there a fitness goal you are working toward? If not make one. This will keep you motivated and engaged in your physical health.

Lift Weights

So many people forget to do strength training – you don’t need dumbbells or machinery, you can simply use your body weight.

Girls between the ages of 12-25 can lose bone mass and set themselves up for osteoporosis later in life if they are not getting stronger in their teens!

Environment will enhance your athleticism

If you prefer one type of activity over another then vary the environment in which you perform it! If you like  to hike or bike then do it in the mountains, the beach, trails and asphalt. The varying terrains will force your muscles to work differently reducing your overall risk of injury.

Take a class

Classes can offer flexibility, strengthening, cardio, agility all in one hour or less!

Sometimes it is easier to be motivated when you are with your friends!

Also, since variety is your spice of life you can take a different class each day and stay a well rounded athlete!

Exercise your judgement

If your body is telling you something isn’t right, listen to it. Sometimes the “No Pain No Gain” adage is not correct! (sometimes it is!)

Take rest/recovery days

Eat right to fuel your body for the activity you do

If you have an injury, or are not sure how to round out your routine . . . see a PT, the human movement specialist, who can provide you will information to make educated decisions.

So there you have it . . .  tips for all types of athletes . . .Have you decided who you are? How about your child?

Leave a comment and tell me how you are going to prevent injury now that you know?

No matter the type of athlete you are, risk of injury is part of living. Use the tips above to mitigate your risk and see your PT for more help!

Be Well, Roxi

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!