How To Keep Balanced With Pilates After ACL Surgery

Therapydia Pilates ACL Tear Treament

If you’ve had surgery or suffered a major injury to your ACL, you’ve likely felt immobile as you worked through the recovery process. Your ACL works as a rotational stabilizer for the knee. When you make quick turns or sharp movements, it keeps your knee as stable as possible. Objectives during ACL rehabilitation are to make sure you can fully move your knee through every range of motion. Pilates comes into play as a solution that furthers your ACL recovery. One major component of ACL treatment is to rebuild strength in the muscles that surround your hips and thighs such as your quadriceps, hamstrings, and glutes. Pilates doesn’t put too much stress directly on your injured knee but gives you all the tools to increase strength and flexibility.

Reforming The Knee

Therapydia ACL Injury Treatment

Pilates has different exercise options available depending on how much weight you can put on you knee. Working on a reformer, as opposed to a mat or chair, can help you begin doing Pilates moves much earlier. A reformer is a piece of equipment used in Pilates which looks like a bed with springs, a sliding carriage, and resistance bands. If you’ve had ACL surgery, it allows you to stay horizontal and have lighter resistance on your injured knee as equipment guides you to strengthen the muscles around your knee joint. Common movements on the reformer involve footwork and side-lying movements for your injured knee. You’ll begin correcting any muscles that aren’t aligned in your lower body, which will help your knee recover by keeping it stable as you start walking.

Stabilize Your Knee Joint

Once you start being able to bear more weight on your knee, you have the option of doing some Pilates mat work. Since you’re able to move around a bit easier, you’ll work on continuing to increase the range of motion of your knee that may have started on the reformer. Better alignment throughout your spine and pelvis is key. Instead of just focusing on strengthening your injured knee, you’ll be increasing flexibility around your back, core, and hips as well. Without alignment in those areas, you’ll be putting too much force on your injured knee. All pilates exercises are designed to have built-in postural awareness to improve spinal alignment. You might be able to do an exercise like The Saw to not only stretch the hamstrings but also your abdominals and the muscles of your back. These all work together to promote a more stable knee joint.

Therapydia ACL Injury Treatment

• Sit up straight on your bottom
• Extend your legs in front of you, keeping your feet shoulder-width apart
• Stretch your arms out to the side, palms facing forward
• Inhale and twist to the right, keeping your abdominals and hips steady
• Reach the pinky finger of your front hand across the outside of the opposite foot
• Touch your little toe if you can, but move in that general direction if you can’t
• Once you’ve gone as far as you can, inhale and untwist back to sitting position
• Repeat the same movement on your other side

Retraining your injured knee to have the balance you need after an ACL injury is tricky. That’s why another point of focus is on your hips. A move like Swimming builds a lot of much needed strength in your core, glutes, and hamstrings. That way, you’ll be more balanced and put less pressure on your healing ACL.

• Lay on your stomach with your legs together in parallel
• Keep your arms stretched straight overhead and the tip of the nose to the mat
• Pull in your abdominals so you lift your belly away from the floor
• At the same time, keep your tailbone moving down towards the mat
• Reach out and extend your arms and legs in opposite directions
• Focus on getting length in your spine so your head moves up off the mat
• Continue to reach your arms and legs out as you alternate sides
• Pump them up and down in small pulses

Staying Balanced

After ACL surgery, what you need from your body is better strength and balance. Using Pilates to develop strength in your back, core, and hips will give your body the alignment it needs. That way, you’ll develop your body’s sense of balance which was thrown off after your ACL injury. You’ll be able to use Pilates to focus on specific weaknesses and retrain imbalanced muscles that may have contributed to your injury. Having musculoskeletal issues in your body will delay recovery and continue to strain your knee. Pilates allows you to maintain control, balance, and coordination in your healing knee. Talk to your physical therapist to see if Pilates is an activity you can do to complement your ACL rehabilitation.

Run Assessment: Find The Right Form

Therapydia Run Assessment Analysis

Running isn’t just about speed and distance. It’s also about considering your body’s movements so you can run as efficiently as possible without pain. Most runners have to deal with mild aches and injuries every now and then. What may begin as a slight misalignment in form can develop into a serious injury. It’s important to remember that as you’re running and your feet are striking the ground, the ground is also punching back on you. For most people, it’s hard to visualize exactly what body mechanics put you at risk for injury. Recognizing what’s misaligned with your running form will allow your body to move as efficiently as possible. One of the best ways to analyze how to improve your running form is to participate in a comprehensive running assessment.

Better Form Equals Less Injury

Runners are mostly at risk for repetitive use injuries. Some statistics estimate that 90% of runners miss training time every year due to injury. A combination of running too far, too quickly, or too often can aggravate areas in your lower body. Common injuries affect your kneecap (Runner’s Knee), the tendons around your shin (Shin Splints), the tendons around your heel (Achilles Tendinitis), and the tissue around your foot (Plantar Fasciitis). Small aches here and there have the potential of developing into these conditions over time. You want to put the least possible amount of force on your joints and muscles when you go for a run. Keeping good form is one way of being a more efficient runner and can help prevent overuse injuries.

• Focus on striking the ground with the middle of your foot, not the heel
• Keep your head and chest upright
• Keep your gaze ahead as you run and try to keep yourself from bouncing up and down
• Have a slight forward lean to propel your body forward
• Move forward, don’t cross your arms over the middle of your body
• Keep your shoulders relaxed
• Keep your hands loose
• Relax your jaw and neck

Analyze How You Run

Running form is always something you should be looking out for, but it can get more specific than that. The way you move and what injuries you’re at risk for really come down to how your muscles work together when you run. A comprehensive run assessment specifically analyzes your body’s mechanics as you run. An assessment can be done for runners of all levels—from someone just starting out who’s unsure of the right way to move to elite athletes who are trying to avoid re-injury. Using a video analysis will give your physical therapist real-time insight into your range of motion, gait, and posture. They’ll focus on observing how hard your feet strike, how much you bend your knees, and your footwork as you push off. They’ll also be able to see if you’re stronger on one side of your body compared to the other. Any asymmetries in the muscles of your legs might be affecting your stride. If you overstride or lean too far forward when you run, your physical therapist will be able to adjust your form.

Locate Those Weak Points

After a video analysis is complete, your physical therapist can focus on problem areas that were observed in your run form. They’ll do a thorough musculoskeletal exam to see where you need to increase range of motion and develop more strength and flexibility. If you’ve had a previous injury, the analysis also takes this into account by determining how at risk you are for reinjury. For example, if you’ve sprained your ankle in the past, any ankle instability you still have might be affecting how well you’re able to control your balance while landing on the unstable ankle. Your body can often compensate further up the chain in your knees, hips, back, or upper body.

To counteract the impact of running, it’s not only about having strong muscles surrounding your knees. You also need strength and mobility in your hips, spine, and core. Based on how you move, your physical therapist will be able to tell if you have weakness in your glutes or if you’re too tight in your hips. Without adequate strength and flexibility, you could be compensating by putting too much pressure on your knees as your run. It’ll also help keep you light on your feet by balancing the amount of force your body absorbs.

Prevent While You Train

With a sport like running, it’s all about keeping your body’s movements synchronized and efficient. Otherwise, your feet, knees, and hips will be dealing with the majority of the impact. Even small twinges of pain in your knees or shins are warning signs that point to your form being off. Based on the findings of your run analysis, your physical therapist will do a more in-depth musculoskeletal assessment and likely begin treatment during that session. This might include manual therapy on any injured joints or muscles, instruction for at-home exercises to help correct problems seen on the video running analysis, or provide a running plan to help you achieve your distance or race goals. A run assessment is the first component of treatment. Baseline measurements about your range of motion, strength, and flexibility are collected during your analysis. That data is used to drive your custom treatment plan specific to how you move. Make sure you focus on injury prevention as much as you focus on hard training. Don’t try and run off those aches.

How Pilates Can Relieve Lower Back Pain

If you have lower back pain, you know that many different types of treatment approaches exist. These include stretching, functional training, postural exercises, hot and cold therapy, and general exercise. How does Pilates fit into the spectrum of lower back treatment options? By combining some of the most important aspects of what it takes to relieve lower back pain. General lower back pain is difficult to diagnose—many different musculoskeletal imbalances could be contributing to your pain. In general, Pilates routines are an effective way to obtain strength, balance, and flexibility throughout your body. They work to specifically relieve lower back pain by targeting the core muscle groups that support the spine.

Better Alignment For A Healthy Back

The structure of the back is designed to act as a support for nearly every move the body makes. Keeping the back pain free involves focusing on the stabilizing muscles that surround your spine in the lower back. Not only that, it’s also key to strengthen the abdominals and obliques around your core. All of these muscles support the alignment of the spine’s natural curvature. Studies have shown that Pilates is more effective than minimal physical exercise interventions in reducing chronic lower back pain. Lower back pain is usually caused by abnormal pulling and tightness of muscles in the area. This happens when muscles in the back compensate for stabilizing muscles that are weak, which could be the ones in your core. By strengthening and mobilizing the muscles that keep your back aligned, you’ll correct the imbalances that may be causing your lower back pain. A simple move to engage your lower abdominals might include The Single-Leg Stretch:

Therapydia Pilates Lower Back Pain Treatment

• Begin on your back with your knees bent into your chest and shins parallel to the floor
• While exhaling, pull your abs in as you curl your head and shoulders up
• Continue until you reach the tips of your shoulder blades
• Extend 1 leg straight to a 45 degree angle
• As you do so, place both hands on the opposite shin
• Place the outside hand near the ankle, inside hand near the knee
• Focus on engaging your core as you switch your legs
• Extend your opposite leg straight and pull the opposite knee into your hands

Extend To Your Neck & Hips

Therapydia Pilates Lower Back Pain Treatment

Certain Pilates movements also focus on getting your hips and neck muscles aligned with the rest of your spine. Your pelvic and neck areas are extensions of your core. Without alignment and stabilization extending up and down into those parts of your body, you’re going to keep having issues in your back. Beneficial movements for your neck and shoulders might include what are called Scapular Isolations:

• Lie on your back with your knees bent
• Reach your hands with your palms facing in straight up towards the ceiling
• Keeping your head down, inhale and reach your shoulders off the mat
• As you do this, focus on stretching upwards

Exercises for the muscles in the neck and shoulders work to increase their range of motion while also strengthening the muscles in your upper and middle back. With lower back issues, increasing strength and flexibility in your hips and glutes also plays a big role in treating pain. Pilates movements such as The Bridge Roll-Up help to strengthen the glutes and core stabilizers while also improving hip extension:

Therapydia Pilates Lower Back Pain Treatment

• Start by lying on the floor with your knees bent and arms at your sides
• Widen across the chest and slowly raise your pelvis and lower back off of the floor
• As you do this, inhale and focus on pulling in towards your belly
• Pause for a bit as you maintain that bridge with your hips and lower back
• Slowly lower your bottom back towards the ground

By keeping your glutes and pelvic muscles activated, you’ll be taking that extra pressure off of your lower back.

Relieve Stress On Your Spine

Therapydia Lower Back Pain Treatment

Pain in your lower back isn’t usually caused by just issues in your back. Pilates strengthens those weaker muscles that stabilize your spine to relieve lower back pain. If you go into Pilates with lower back pain, you may be able to see a decrease in pain and symptoms within 4 to 5 sessions. If you have any conditions that affect the spine such as scoliosis, sciatica, or any nerve impingement consult with your doctor or physical therapist to see which specific Pilates movements would be the most beneficial for your rehabilitation. Almost everyone who goes into a Pilates program with lower back pain would be able to benefit. Athletes have begun to use Pilates as a way to maintain or improve core stability and control for better performance. Even if you sit at a desk all day and feel some tightness in your lower back, working on spinal alignment could offer you the relief you need.

ACL Recovery Timeline: Treatment Breakdown

A common athletic injury that you’ve probably heard about might have to do with tearing the ACL. The ACL, or anterior cruciate ligament, joins the upper leg bone (femur) with the lower leg bone (tibia) and functions as the primary rotational stabilizer for the knee. When you’re moving forward, such as when you’re running, the ACL isn’t really involved. It only comes into play when you’re cutting around or changing directions to stabilize the knee joint area. An ACL injury commonly happens when you rotate too quickly or with too much force in that joint area, which causes your ACL to overstretch and tear. Depending on how badly torn the ligament is, you may be a candidate for surgery to repair the damage. Post-surgery, you will likely feel immobile. You may wonder how you’ll ever get back on your feet again. Although the timeline for ACL recovery varies depending on your specific injury, you should expect 4-6 months of one-on-one treatment with your physical therapist.

Therapydia ACL Injury Treatment

0 Weeks, Treatment Before You Even Have Surgery

Pre-rehabilitation physical therapy, or “prehab”, is a form of physical therapy that begins before you have scheduled surgery. Prehab focuses on increasing strength and flexibility of the muscles in your surgery area. Although the surgery will fix the tear, it will also cause the muscles in the knee area to become weak and stiff. You’ll want to strengthen all the muscles that will aid in keeping you balanced post-surgery. Undergoing prehab before surgery has been proven to improve knee function faster after surgery. One study in 2013 found that patients participating in prehab returned to sports almost 2 months faster. Prehab treatment might involve building up quadricep and core strength pre-surgery so you’ll see greater knee stability and faster recovery post-surgery. It could also involve teaching you how to use assistive devices (i.e. crutches) and tackling tricky movement barriers, such as stairs, so you know how to move around after surgery.

Therapydia ACL Injury Treatment

0-4 Weeks, Baby Steps

Many of the same goals you would want to achieve in prehab also apply here in the initial phases of physical therapy treatment. Some of these processes may vary depending on your doctor’s protocols. Main priorities will be to reduce inflammation, regain range of motion of the knee (i.e. bending and straightening the knee), and begin to slowly withstand bearing weight on your injured knee so you can start to walk. Making sure you have the proper flexibility includes immediate manual therapy, or hands-on techniques, that your physical therapist will perform on the surface of the knee joint and the muscles surrounding it. A common complication post-surgery is stiffness and loss of range of motion because of excess scar tissue formation. Your physical therapist will manually breakdown any scar tissue restrictions that may be developing in your knee. Manual therapy can also help decrease swelling around your knee. You’ll slowly wean off of your dependence on crutches as your knee tolerates. Important exercises in this phase of rehab (i.e. straight leg raises, half squats, partial lunges, etc.) will be targeted toward quadricep strength. By strengthening the muscles at the front of your thigh, walking will become that much easier and the knee will feel more stable.

Therapydia ACL Injury Treatment

4-10 Weeks, Getting Back To Walking

At this point, the goal is to start getting your natural walking pattern back. You want to be able to control your walking movements again, which means you may have to begin some balance training. Both the fact that your knee is injured and that you haven’t been using your injured knee very much will have thrown your body’s sense of balance off. Guiding you back into proper walking form involves a combination of continued manual therapy and personal exercise-based treatment. It’s key to start building up balance on your weaker leg by doing some one-legged activities. There will also be a focus on building up strength and full flexibility in the muscles around your hips as well as the muscles around your knee. With improved strength in your hips and quads, you’ll be putting less pressure on your healing ACL. You’ll be working your way from exercises such as single-leg squats to step-up and step-down techniques (using a step) as well as resistance training with a band.

Therapydia ACL Injury Treatment

12-16 Weeks, Starting Some Light Running

By about 3 months, any swelling you had will likely be gone. You also should have full range of motion in your knee, which means being able to extend and bend without restriction (135-145 degrees for bend, 0 degrees for extend). If you still have muscle stiffness, your physical therapist will apply more manual therapy to any specific muscles that are restricting your ability to extend or bend your knee. Depending on your unique recovery progress, your knee joint may still need to be manually mobilized in a certain way. Any basic aspects of leg movement should be back under control, such as naturally walking or being able to move around casually. Your personal ACL treatment program will continue building strength in your core and lower body muscles. You might be doing some endurance training on a stationary bike, elliptical, or treadmill. At this point, you will want to do some more advanced balance training on balance boards or bosu balls to ensure that your healing leg is stabilizing well. Your physical therapist will want to customize your treatment to make sure that you’re treating any balance issues that were caused by your ACL injury. At some point in this phase, you might begin lightly running, jumping, or getting back into any physical activities you used to do.

Therapydia ACL Injury Treatment

4 Months+, Getting Back In The Game

There’s a range of what patients with a healing ACL injury might begin to do around 4 months. Everyone has different preferred physical activities and you’ll begin to get back into your favorite activities at this point. If you played basketball, you might begin some shooting drills. If you’re a runner, you might begin getting back into some longer jogging. It all depends on what your activity takes to get back into. You don’t want to halt any progress you made by overly exerting your knee, but certain sports-based drills will be okay to practice. Your treatment program post-injury should focus on not only reducing pain, but building up your body’s strength and flexibility in a way that prevents a future ACL tear. Beyond that, you’ll be given the tools you need to have better endurance, balance, and coordination with your healing knee. You may feel totally thrown off balance and mobility-wise after your ACL injury, but one-on-one treatment is meant to steadily get you back to 100%.

Top 5 Game Changing NBA Playoff Injuries in Last 5 Years

top nba injuries

During the NBA Playoffs every fan has a love-hate relationship with any injuries that happen—depending on the team you want to win. Losing star players to injury during the post-season might greatly affect a team’s chance at winning a championship title. Currently, the 2016 season has been no exception to its fair share of injuries. Ankles issues were prominent from Steph Curry in the Western Conference to Nicolas Batum and Isaiah Thomas in the Eastern Conference. Sudden injuries were also mixed in, with Chris Paul’s hand fracture being one of the worst. Here’s a look at some of the most devastating injuries that have shaken up the Playoffs in the last 5 years.

2016: Western Conference First Round, Clippers vs. Trail Blazers

Looking at the 2016 post-season, the Clippers take the award for the worst (double) injury so far during the Playoffs. Core players Blake Griffin and Chris Paul were both taken out of the Western Conference during Game 4 of their 1st round playoff series. The Clippers were deprived of their 2 All-Stars at the worst possible time. Paul ended up with a fractured bone in his third metacarpal in his right hand while Griffin agitated his left quadricep injury (i.e. muscles around the thigh)—he had partially torn a tendon in his thigh earlier in the season. Both Paul and Griffin were unable to continue through the rest of the Playoffs. With a depleted roster, it was a serious setback for the Clippers as it considerably derailed their advancement through the Playoffs. The Clippers continue to be plagued with bad luck as they head into the 3rd straight post-season without advancing past the second round after losing against the Trail Blazers during Games 5 and 6.

2015: NBA Finals, Cavaliers vs. Warriors

The Cavs moved onto the Second Round and eventually made it to the Final Round against the Golden State Warriors, sound familiar? The Cavs ended the first game of The Finals with Kyrie Irving suffering a terrible accident during overtime. Kevin Love, another part of Cleveland’s Big 3 (including LeBron James), was taken out of the post-season during the First Round after suffering a shoulder dislocation. Irving had already missed two earlier games during the Eastern Conference because of knee tendinitis and had recently returned to play in The Finals. Irving was driving down the court during Game 1 and while attempting to stop, felt his knee give out. Irving limped off of the court and was eventually diagnosed with a fracture of the kneecap. It was the longest he’d actively played on the court in a month, which may have contributed to the stress behind his fracture. Irving was out for the rest of the Playoffs, which was an unfortunate end to his dynamic overall season (averaged 22 points). The Cavs were down 2 All-Stars with Irving and Love no longer able to play. LeBron James pushed forward through the series for the remaining games. The Warriors accomplished what the the Cavaliers could not—staying injury-free. The Warriors eventually defeated the Cavs during Game 6. There’s no way to tell what impact Kyrie and Love would have had on these games, but they are tremendous players and their impact would certainly have been positive. Here’s to another year of seeing the Warriors vs. Cavaliers in The Finals.

2014: Western Conference Semifinals, Thunder vs. Clippers

The Oklahoma City Thunder didn’t begin their Final Round during the Western Conference at fighting strength. Serge Ibaka, a power forward, had to be subbed out of the game after suffering an injury to his leg in the 3rd quarter. He left the series clinching semifinals against The Clippers with a left calf injury. After attempting to block Chris Paul’s shot, he tangled legs with him and both fell to the ground. Up to that point, Ibaka had been a strong asset for the Thunder, shooting no worse than 40 percent from the field in any game. Many considered Ibaka to be a part of the Thunder’s “Big 3” at the time, alongside Russell Westbrook and Kevin Durant. A fully healthy OKC would have been a favorite in the series, especially if Ibaka had been able to return in full capacity. He did return from his injury in a limited role (29 minutes of play time) after the Thunder fell behind 0-2 against the Spurs during Game 3, a game which they ended up winning. In the end, the Spurs ended up winning the semifinals in Game 6 and advancing forward.

2013: Western Conference First Round, Thunder vs. Rockets

The Thunder’s bad luck also plagued them the previous post-season as well. All-Star Russell Westbrook was injured midway through the 2nd quarter of Game 2 against the Rockets. After a collision with Rocket’s player Patrick Beverley, Westbrook fell to the floor after banging legs with Beverley. He limped off the court in visible pain and was eventually diagnosed with a torn lateral meniscus (i.e. cartilage around the knee). It was the first time Westbrook had missed an NBA game in his career. On the other hand, it also meant that the Thunder’s lineup had never played without Westbrook. In general, the Thunder had avoided major injuries to their core players as they built themselves up to being Playoff contenders. Westbrook eventually ended up missing the remainder of the 2013 Playoffs after undergoing surgery to repair the tear. The Thunder had been the Western Conference’s number 1 seed (i.e. ranking) leading the series 2-0. A series that looked like a sweep became shaky with Westbrook gone for the rest of the season. Although the Thunder ended up advancing to the Western Conference semifinals, the Grizzlies ended up winning and advancing to the final round against the Spurs.

2012: Eastern Conference First Round, Bulls vs. 76ers

In a postgame report, TNT’s Cheryl Miller said that the packed arena went silent when reigning MVP Derrick Rose went down with an injury in Game 1. He suffered a torn ACL (i.e. anterior cruciate ligament) in his knee with 1 minute left in the game after coming down hard on his left leg after going for a layup. Rose seemed to have been back to himself after dealing with a variety of injuries (a sprained toe, sprained ankle, strained groin, and back issues) for 27 games during the 2nd half of the season. The Bulls finished the 2011-12 lockout season with an NBA best of 50 wins and 16 losses. They had captured the top overall seed in the Playoffs for the 2nd year in a row. Rose was unable to play for the rest of the post-season after undergoing knee surgery. Uncertainty formed over the Bulls’ chances of a championship title since Rose led all scorers—the Bulls were 18-9 without him that season. The Bulls had managed relatively fine when Rose was out during the season, but playing against the NBA’s top teams during the Playoffs was another challenge altogether. As a Playoff series extends into 6 or 7 games, that’s when a player like Rose could make a huge difference. The Bulls eventually ended up losing closely to the 76ers during Game 6.

NBA Playoffs: How To Come Back From An Ankle Injury

Ankle Injury Steph Curry Warriors

If you keep up with the NBA Playoffs, it’s clear that these seasoned athletes perform with incredible agility and endurance. Unfortunately, during the heat of the Playoffs, these athletes also have to deal with recurring injuries flaring back up. Steph Curry’s sprained ankle gave Warrior’s fans cause for concern earlier in the Western Conference Playoffs. What is the best way to treat an ankle injury? It comes down to two concepts: strength and balance.

Breaking Down Steph Curry’s Right Ankle

Stephen Curry sat out 2 games during the Western Conference Playoffs when the Warriors were matched up with the Rockets. Although Curry returned from his ankle “tweak”, Curry has had a 5 year history of issues with his right ankle. In basketball, ankles are one of the most commonly injured body parts . With sprain after sprain, his season in 2011 ended with surgery to repair a tendon in his damaged right ankle. This season, he played 80 games compared to just 26 games in 2011. It’s clear Curry has put his nagging ankle pain behind him. Yet, as seen by his sprain earlier this season, ankle injuries do have the potential to happen again.

Ending The Cycle Of Spraining

The chances of re-spraining your ankle are at least 30% and sometimes as high as 80% if the ligaments of your ankle are severely stretched and unstable. Basketball players are especially prone to ankle injuries because of the movements they engage in. Unexpected changes in direction and potential contact with other players leads to a risky environment for the ankles. There’s a lot of side-to-side movement with players cutting around other players at quick speeds. Player’s take an opening when they have the chance, which means a lot of high impact jumping and landing can occur in awkward positions. Landing on another player’s foot is also another common way to sprain the ankle.

Physical rehabilitation for any ankle injury involves manual therapy to improve the ankle’s range of motion, prevent scar tissue buildup, and reduce any swelling in the joint. Combatting future sprains involves taking a full-body approach to treating your ankle. What makes rehabilitation unique to basketball players is teaching them how to control their bodies during unnatural movements when they jump or land. Players work on extending their range of motion within their body so they won’t be injured if they jump at weird angles.

How NBA Players Train Their Glutes

Preventing an ankle injury involves strengthening the whole body so players aren’t as dependant on their ankles when they move. Emphasis is placed on strengthening the hips, gluteal, and abdominal muscles to give a player more control when they move. Basketball players have to focus on controlling their bodies during unnatural movements when they jump or land so they don’t injure their knees or ankles. For that, it’s not only the ankle that needs stability—the knee, hips, and core need strengthening as well. Your glutes provide stability throughout the lower half of your body. The Warriors prefer exercises such as the trapbar deadlift to build up strength. It involves stepping into a diamond shaped bar and lifting the weight straight up around your body. One of the primary muscles groups that this exercise strengthens are the glutes.

Sacramento Kings shooting guard Seth Curry also practices the single-leg deadlift to continue to improve his strength and balance. You start off by standing up straight and keeping your arms by your side while holding a single weight in one of your hands. Then, you lower your torso as far as you can go while balancing on the opposite leg as the hand that’s holding the weight. As you do this, you lower the dumbbell slowly down while keeping your arm straight.

If you practice this exercise while balancing on the sprained ankle, you balance train and strengthen the glutes at the same time. With weak glutes, your hips can drop out, and your knees can turn inward as you move. Once that happens, there’s more pressure put on your ankle to compensate for the imbalance—which increases the chances of a resprain.

Keeping Balanced On The Court

Balance retraining is another key component to treatment to help your ankle stay stable as you move around. For basketball players, they need to have exceptional balance control for the lower half of their bodies. They battle against the forces of gravity while on the court by constantly jumping and landing. An ankle injury disrupts your body’s sense of balance and puts you at risk for re-spraining it. Your ankle has small muscles surrounding it that help keep it in place. Those small muscles are constantly activating and sending signals to your brain to help keep you balanced.

One of the primary goals of physical therapy is to re-educate your ankle’s sense of balance that was damaged during the injury. Special receptors in your ankles send information to your brain about how your ankle is positioned when you’re walking or moving. After an injury, communication between these receptors in your ankle and your brain is disrupted. Since the receptors are damaged, they can’t tell your body how your ankle is positioned. Your ankle may lose its sense of where it’s positioned relative to your movements (i.e. proprioception). This may leave your already injured ankle prone to instability since your body can’t balance it correctly. Ankle stability training involves dynamic activities such as balancing while throwing a ball or moving on a balance board.

Kevin Durant incorporated this type of balance training into a lunging exercise. Watch it here. He would lunge forward and place his foot onto a wobbly balance board in order to improve the stability of his ankle on an unstable surface. By doing this, he prepared himself for the unstable footing he might have to deal with on the court. As you get better at balancing, you’ll lose the feeling of instability or wobbliness in your injured ankle. Your body will get better at controlling the positioning of your ankle without having to consciously think about it.

Staying In The Game

Without properly treating your initial ankle injury in the first place, future ankle instability may lead to future sprains. It doesn’t come down to simply strengthening the ankle muscles. Steph Curry began rehabilitating his ankle by not only strengthening his ankles, but his hips and glutes as well. Your sense of balance and ankle stability go hand-in-hand. Retraining the way your balance system communicates with your brain is a key part of the physical rehabilitation process.

Shadowing A Physical Therapist

therapydia denver physical therapy clinic

At Therapydia Denver, we enjoy having PT students shadow us to see what life is like in an outpatient physical therapy clinic. Last month, Taylor, a prospective PTA student, was at our clinic to shadow both Casey and Josh and here’s what her experience was like:

“I’ve always wanted to have a job in the healthcare field. My senior year of high I decided that my career path came down to two options, nursing or physical therapy assisting. After volunteering at a nursing home I realized that I could not do bodily fluids on a regular basis and decided to pursue a career in physical therapy. Over my spring break I shadowed Casey and Josh at Therapydia Denver. While they both had slightly different approaches to physical therapy, what amazed me the most was their knowledge of the human body. They knew exactly what was wrong when a patient described their pain and how to help. It was astounding. Out of the three shadowing opportunities I have done this was the most interactive by far. Both Casey and Josh explained what the patient was coming in for, their techniques for treatment and how this treatment will help the patient. This deepened my knowledge of the human body and also the world of physical therapy. I am definitely grateful for Casey and Josh taking the time to teach me and give me the most hands on experience. I will be applying for the PTA program at ACC this spring for the fall program, with an even greater desire to work in this field. I want to get my life started and have a real job for a while and maybe later on go back to school to further my career in this field.”

If you’re a medical student or medical professional who is interested is seeing what physical therapy is like at Therapydia Denver, contact us at hello@therapydiadenver.com.

What’s In a Sit-Up? Follow Wade’s Journey To Doing His First Sit-Up

Wade’s newest fitness goal comes down to doing 1 sit-up. In his words, do a sit-up, unassisted, no cheating—for the first time. Wade’s “The Sit-Up Movie” wittily chronicles his fitness journey towards his #NoMoreNevers goals as well as his battle with dermatomyositis. Throughout his short video he challenges the viewer to consider what goals they thought they could never achieve.

When Wade was 5, he was diagnosed with a rare form of arthritis called dermatomyositis. Dermatomyositis is a neuromuscular condition that causes inflammation and weakness of the muscles and skin. Growing up, Wade experienced major flexibility losses as his muscles atrophied, tightened, and shortened. Wade has been highly committed to his fitness journey over the past few years. He started exercising his upper body and core which he hadn’t really ever done before. He joined his first gym, Vital Strength and Fitness, began training for a marathon, and began preparing to do 37 burpees on his 37th birthday. Wade’s goal is to improve his functional strength and eventually begin to try out new sports for the first time.

The Ultimate Triple Threat

After a snowboarding accident, Wade began to see his physical therapist, Casey, at Therapydia Denver. His rheumatologist, Jason, his Vital personal trainer, Todd, and Casey, came together to assess what some of Wade’s barriers to his goals might be to create a holistic wellness plan. Wade needed to strengthen his core—and one way to do that would be to do a sit-up. In Wade’s case, it’s more than just increasing his muscle size in his core area (i.e. hypertrophy). It’s having all of his muscles in his core area to coordinate one major movement without any joint restrictions (i.e limited lumbar flexion). It also has a day-to-day significance—sitting up, getting out of bed, or reaching over to get some favorite snacks.

#NoMoreNevers

To get this goal, Wade and his team developed a weekly fitness program. It included going to personal training three times a week, physical therapy once a week, an intensive cardio regimen, and daily stretches. Unfortunately, no major effort comes with its setbacks. Wade’s dermatomyositis came out of remission for the time in 20 years. With doubled recovery times and buckets of daily medication, Wade hardly lets it slow him down from completing his prodigal sit-up. According to Wade, it’s not about some sappy monologue, he’s going to do a sit-up.

What’s your #NoMoreNevers?

Thank you Wade for sharing your dynamic fitness journey with us!

FEEL BETTER FASTER: QUICK LINKS TO COMMONLY SUGGESTED ITEMS

 

At Therapydia Denver we strive to help our patients feel better as quickly as possible.  In some cases, regular treatment sessions and a solid home exercise program are not all that is necessary for a speedy recovery.

Here is a list of items the Therapydia PTs often suggest for patients to purchase for home use:

KT Tape

KTtape

KT tape is a specific brand of tape that is used to promote healing, manage swelling and enhance your body’s control of muscles and joints while not limiting range of motion.  It can be worn for 3-4 days at a time and rarely causes skin issues.  With instruction from a Therapydia PT, most people are able to apply the tape in a safe and effective manner.

We like KT Tape specifically because the strips are pre-cut and rounded, ready for application right out of the box.

KT Tape is most commonly suggested for patients with: shoulder pain, golfers elbow, tennis elbow, knee pain, plantar fasciitis

Lumbar Support

lumbarsupport

Many low back, neck and even shoulder issues can be exacerbated by poor Lumbar Support during prolonged sitting.  If the curve in your low back is allowed to flatten out, it essentially starts a chain reaction which can adversely affect structures above and below your spine.

We like this particular lumbar support because it is affordable, portable and durable.

Lumbar Support is most commonly suggested for patients with: low back pain, sciatica, shoulder pain, neck pain, headaches

Stabilizer

stabilizer

Numerous studies show that low back pain is accompanied by absent, poor or incorrect activation of important core muscles.  The Stabilizer  gives the patient immediate and accurate feedback, letting them know if they are doing their prescribed exercises properly.  It essentially increases the quality of core exercises at home.

A standard blood pressure cuff can be used for the same purpose, but they are often too sensitive to give useful feedback.  We like this particular stabilizer because it is durable and just sensitive enough to give the patient only the information they need.

A Stabilizer is most commonly suggested for patients with: low back pain, sciatica, sacroiliac joint (SI joint) pain, hip pain

Foam Roller

foamroller

The Foam Roller has been suggested by healthcare professionals for years and for good reason.  They are extremely helpful for loosening up tight muscles and fascia between sessions with your Therapydia PT.  After careful instruction, they are also effective at loosening up tight spinal joints that make achieving proper posture difficult.

We prefer the 36 inch round roller as it can be used for the widest variety of exercises and activities.  This particular roller is affordable, extremely durable and more dense than others on the market.

A Foam Roller is most commonly suggested for patients with: knee pain, hip pain, upper back pain, shoulder pain, neck pain

Roller Stick

rollerstick

The Roller Stick is essentially used for the same purpose as a foam roller.  The main difference is that this hand-held tool allows the patient to control the amount of pressure, whereas a foam roller usually incorporates body weight.

We like this roller stick because it is much more portable than a foam roller and allows the patient to reach some areas that may be tough to address with a foam roller.

The Roller Stick is most commonly suggested for patients that travel frequently and suffer from: knee pain, hip pain, calf pain, achilles tendon pain, plantar fasciitis

Metatarsal Pad

metpad

A number of aches and pains in the foot may arise from a fallen transverse (or forefoot) arch. A Metatarsal Pad is used to brace this portion of the foot, thus restoring the natural shape of the forefoot and dissipating compressive forces.

We like these particular metatarsal pads because they are affordable, durable and self adhesive.  When applied between the insole and the shoe they tend to stay in position during most activities.

Metatarsal Pads are most commonly suggested for patients with: metatarsalgia, morton’s neuroma, forefoot callus

Heel Lift

heellift

A Heel Lift can be used to treat a leg length discrepancy as well as a variety of achilles tendon issues.  When properly applied, a heel lift can essentially level out a patient’s pelvis which can provide rapid alleviation of hip, knee and lumbar spine pain.  A heel lift can also alter the amount of tension on the achilles tendon to allow for proper healing after an injury.  

We like this particular heel lift because it is affordable and adjustable.  This allows for proper fit and progressive increases in tension to the achilles tendon as healing continues.

A Heel Lift is most commonly suggested for patients with: leg length discrepancy, hip pain, sacroiliac joint (SI joint) pain, achilles tendonitis, achilles tendon rupture

 

Peyton Manning’s Plantar Fascia Tear…Is this the End?

Fantasy Football Injury of the Week:  Peyton Manning and his Plantar Fascia

Yesterday we learned that Peyton Manning has a tear in his plantar fascia and will miss at least this week’s game against Chicago.  The fantasy implications of Manning missing time might be minimal (Manning is ranked 30th in my leagues this year for QBs), but as a Denver resident and Broncos fan, this is some serious news.

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This week I want to focus on what exactly is a tear of the plantar fascia, what can be done to treat it, and will Manning play again this season or ever again?

What is the plantar fascia and why is a tear career threatening?

The plantar fascia is a thick band of connective tissue that supports the arch of the foot. In the physical therapy clinic, we most commonly see an acute inflammation or micro-tearing of the fascia near the heel bone, known as plantar fasciitis.  We also see very chronic cases in which there is a buildup of scar tissue at the same location from repetitive micro-tearing followed by healing.  Plantar fascia injuries are one of the more common diagnoses that we see in PT but also one of the hardest to treat, especially the chronic cases.  Even though this band is thick and tough, it’s job is to maintain your arch while supporting all of your body weight.  When the plantar fascia becomes irritated, inflamed or weakened by chronic injury, every step can be painfully perpetuating the injury.

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Manning’s situation is much more severe than the common plantar fasciitis diagnosis we see at Therapydia.  In his case, he has sustained a partial rupture or larger tearing of the plantar fascia.  For any of you who have experienced the pain of plantar fasciitis yourself, that pain is magnified significantly with a partial rupture.  Imagine having a cut on the knuckle of your finger.  Every time you use or bend that finger, the cut painfully reopens and the healing has to start over.  The finger is easy to keep from moving, just buddy tape it or use a splint from the drugstore to keep it from bending.  The foot on the other hand is very difficult to immobilize so the time it takes to heal can be painfully long…..and therein lies the major problem with Peyton Manning’s foot issue.  Will there be enough time for him to return and be effective this year or will this be the end of Manning’s illustrious career?

When will Manning be back and is there anything that can be done to speed up his return?  

Unfortunately, I am not privy to all the details about Manning’s injury.  I can only speculate on what I’ve read or seen on Sportscenter.  The typical time frame for a non-operative recovery of a partial tear of most soft tissue injuries is 12 weeks or more.  This is when we often consider the injured tissue to be back to or near full strength.  However, at 4-6 weeks, the injury could be 80% healed which may be sufficient enough to allow an athlete to return to their sport.  Returning too early though can increase the likelihood of reinjury or lead to another serious problem.  See Arian Foster.

Manning has a few options that may get him back on the field quickly.  Platelet rich plasma (PRP) injections are being used more often these days to speed up the healing process.  Injecting the injured tissue with PRP provides an instant proliferation of growth factors that can quickly stimulate healing. Tenex is a minimally invasive procedure that removes the damaged or injured tissue, allowing the healthy tissue to regenerate and thrive.  Finally, Manning and his doctors may decide to do a plantar fascia release or surgical cutting of the the partially torn fascia.  By fully releasing the partially torn section of the plantar fascia, tension is released and inflamed nerve endings are no longer sending painful signals to the brain.  However, the long term risk factors of this procedure are much greater than other options including nerve damage, instability in the joint of the feet, loss of normal biomechanics of foot and ankle.  The expected recovery from these procedures is 3-6 weeks versus the 8-12 weeks or more of conservative treatment.

Again, I have very limited information on the severity of Manning’s plantar fascia injury.  He is also dealing with injuries to his throwing shoulder and ribs.  As the Denver Post points out, there are also a number of scenarios that could occur in the next several weeks that impact Manning’s return.  Nonetheless, we are here to predict when or if Manning returns from his plantar fascia tear, so here it is….

Prediction: Peyton Manning misses 4 games.  The tear is either mild enough to return in four weeks or he undergoes a minimally invasive treatment that allows him to return for an important Week 15 matchup against the Pittsburgh Steelers.