Rehab: Exercise's evil second cousin, once removed.

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Fossa
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Rehab: Exercise's evil second cousin, once removed.

Postby Fossa » Thu Jan 13, 2011 12:17 am UTC

So about 3 months ago I took a small, unplanned journey of sorts.

It was a short trip, only about 20 feet actually. Unfortunately it was straight down and the final destination was not a place I wish to visit again. It was unpleasant the first time around and the addition of some of my blood did little to make the area more appealing. Also? The service was atrocious.

In all seriousness, I severely sprained several ligaments and strained plenty of tendons in my left knee. Thankfully I did not fully rupture anything. No meniscus damage either, so that was awesome. Less awesome was my HMO's coverage which didn't cover much beyond the initial screening, MRI, and a couple of sessions with a physical therapist.

So now 3 months later I'm trying to follow the rehab "road map" I've been given after exhausting all of my covered PT sessions. It's deeply frustrating, and I can't help but wonder if anyone else here has gone through rehab and has stories, anecdotes, or advice to share.

Mostly I'm just frustrated with how long it's taking. I still have plenty of pain when going down stairs and the occasional unexpected jolt, and running has become both a distant memory and a painful dream. It's been 3 months, and I'm apparently still walking with a limp (though I only realize this when other people point it out).

The effect this has had on my body is painfully obvious as well. My left leg used to be my strong leg. I'm a traceur and an acrobat and my left leg was always my preferred takeoff and landing leg. Now my left thigh is well over an inch skinner than my right in terms of circumference, even with the rehab.

Also, I feel a bit lost. Some of the exercises I'm doing feel perfectly fine some days, but painful other days. I wish I could talk to a PT without clearing out my savings account, but instead I'm just left wondering if I'm being productive or doing more harm than good as I struggle to get better, struggle to cope, and mostly just struggle to not get discouraged.

Parkour used to be a way of life for me. 3 months without it and, well, I'm losing more than just muscle tone...

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Jacque
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Re: Rehab: Exercise's evil second cousin, once removed.

Postby Jacque » Thu Jan 13, 2011 1:07 am UTC

Tried swimming?

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Nath
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Re: Rehab: Exercise's evil second cousin, once removed.

Postby Nath » Thu Jan 13, 2011 3:39 am UTC

That sucks. I haven't had a similar knee injury, but I had a fairly unpleasant ankle injury on my dominant leg a few months ago, and my movement has been kind of asymmetric since then.

What's your PT road map like? Strength and mobility work? Mostly unilateral or bilateral exercises?

The one lesson I've learned from my various injuries was not to over-rest the damaged body part. Movement keeps the range of motion good, and blood flow is supposed to help recovery. One of the doctors I spoke to gave me the surprisingly sensible advice to stay as active as possible, and let pain be my guide -- if something hurts (and it's the bad kind of pain), it's probably not helping my recovery.

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Re: Rehab: Exercise's evil second cousin, once removed.

Postby Fossa » Thu Jan 13, 2011 5:44 pm UTC

I've been doing lots of mobility and flexibility work while progressively adding more simple, bilateral strengthening exercises. It's compound, unilateral movements that tend to cause me pain.

How do you tell good pain from bad pain during rehab exercises? Back when I was just doing mobility work trying to improve my range of motion it wasn't a question, but now...

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Re: Rehab: Exercise's evil second cousin, once removed.

Postby Nath » Fri Jan 14, 2011 12:42 am UTC

Unfortunately, I don't know how to concisely describe good vs bad pain. I can usually tell instinctively, probably from trial and error. As an example, compare the pain of massaging sore muscles with the pain of a pulled muscle. If you've done a martial art, compare a correctly applied joint lock to a sprained ankle.

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Re: Rehab: Exercise's evil second cousin, once removed.

Postby studyinserendipity » Thu Feb 17, 2011 4:49 am UTC

Fossa, so sorry to hear about your injury :( I went through some similar things when I broke my foot almost 2 years ago. Rehab for me was lots of stretching, massaging, and manually moving joints (like actually pulling at my toes and moving them via my hands) to increase the range of motion. Using my hands to move joints allowed me to pinpoint exactly what was moving and in which direction more accurately than trying to make the joints move themselves. I believe those exercises helped a great deal, and I still do them sometimes to increase my strength and range.
This is purely anecdotal, but I feel that the most difficult part of the recovery is retraining your body to not act as if you're still hurt. Even once my bones were all healed, I was walking with a limp, and my PT person told me flat out that I'd have one for the rest of my life if I didn't start noticing how I was walking and pushing through the motion completely to make a full, even stride. It was uncomfortable at first; it felt like I really really needed to 'pop' a joint in my foot, like it was cramped up. The 'mindful walking' helped a great deal, and I use similar strategies now that I'm relearning how to kick and pivot. I'll do stuff on my left foot (my new strong foot!) and try to replicate the motion and feeling using my right.

Good luck on your recovery!
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Fossa
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Re: Rehab: Exercise's evil second cousin, once removed.

Postby Fossa » Thu Mar 10, 2011 9:35 pm UTC

I'm getting better slowly but surely, but there have been some bumps along the way. This should give you some idea of how bad things got...

About three weeks ago I took a trip up to Seattle with my girlfriend. On our way back I was randomly selected to go through the back-scatter X-Ray machine so that they could get a "naked" picture of me and what not. Immediately after the picture the operator frantically signals to the guy standing next to me who moves me to a secluded area with foot prints stenciled on the ground. I was told to stand perfectly still.

A supervisor then talks to the person who was watching the back-scatter, comes over, and informs me that he has to pat me down.

He pats down my healthy leg from my calf to my butt, looks confused, pats it all again, looks up at me, looks very confused, and lets me go.

Apparently my injured leg had atrophied so much that my healthy leg looked suspicious by comparison. They thought I had something molded around my leg!

Full extensions are still quite painful (particularly when jumping), and my medial patellar ligament acts up every other day or so, but I'm seeing definite progress. I also caved and bought a home ultrasound therapy kit to promote healing and what not. The science is about 50/50 on the thing working wonderfully or being total hokum, but at $200 I was willing to risk it.

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Re: Rehab: Exercise's evil second cousin, once removed.

Postby Fossa » Mon Mar 21, 2011 9:44 pm UTC

Therapeutic ultrasound + tiger balm + rigorous stretching = happier knee.

I still get occasional twangs which terrify me ("Oh god, did I damage my meniscus afterall?") but I'm getting much better much faster.

Did some wilderness training on Saturday rock hopping and bouldering at Chatsworth Park. Nothing too ridiculous (though admittedly, probably more than I should be doing at this stage of my recovery) but it felt amazing. My friends literally welcomed me back at one point even though I've been attending sessions for a month or so.

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Re: Rehab: Exercise's evil second cousin, once removed.

Postby illCoder » Wed Mar 23, 2011 6:11 am UTC

I'm very sorry to hear about your injury, it sucks beyond comprehension of the term.

A bit about myself;
My legs don't work very well. I had one arthroscopy and three fasciotomies (chronic compartement syndrome) performed all in the past year .
Through 2009 I was treated by a physiotherapist with ultrasound and electro-something (I can't recall the name of that machine of pain), which did absolutely
nothing to help me. Mind you, this was only for my knee injury, not the compartement. I spent many an hour lying on a bench recieving "treatment" which in the end didn't
make a difference, since I wass still in pain.
Finally, I went to another hospital who performed the arthroscopy. It worked.

The morale is: don't rely on physiotherapy to do anything. This doesn't mean you have to have invasive surgery immediately, though!
My new physiotherapist is more like a personal trainer, showing me how to build muscle around the knee and ancle. I found this to be very effective.

Finally, try to think "atleast I can still do <exercise>". I had to give up my BMX, tennis and badminton, but I now enjoy strength training.

Best of luck!


Regards,

illCoder

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Re: Rehab: Exercise's evil second cousin, once removed.

Postby TheNorm05 » Thu Mar 24, 2011 9:11 am UTC

I feel you man. I was in a car accident that totally wrecked my lower back a few years ago. It's taken the last couple years to build up the courage to even start training again as I've been dealing with the unpredictable, debilitating pain of pinched nerves. I've been biking pretty heavily since last fall, and I've started strengthening my lower back from it's extremely atrophic state. It still hurts sometimes, especially if I catch myself sitting down for more than say 20 minutes(as my college classes regularly require), or if I try to carry too much weight. The "bad" pain in my experience has been the sharp pain that you can't readily ignore. I'm starting to get flexibility back, and if I keep it up it might sort itself out without surgery(at least I'm hopeful). Take care of yourself, and keep moving. Hope you get better.


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