WOW! 3 months have virtually flown by…But I’m still taking my time
Uncategorized May 29th, 20105/29/10
Well folks, the hiatus of the ATR community may have been perhaps a blessing in disguise of sorts for me (this is my first entry since the reconfiguration) as I have been able to get to athletic therapy regularly (2 days a week) to now going in only when I get really sore. I have progressed out of the rubber band exercises and into more agility and conditioning training that has made me quite happy on my road back to routine of physical activity. What I can stress or perhaps CAN’T stress enough is… STRETCHING!!!
That is perhaps THE single most beneficial habit that you can perform as often as possible as many times a day, anywhere, in speeding up your return to whatever activities you had Pre-ATR. You can never stretch your heel enough from now on for the rest of your life, in my humble opinion.
My duration of time jogging has gradually increased and balance has been slowly developing again. It is SOO important not to be discouraged with any progression you are not happy with. If you couldn’t hit a particular range of motion, or perform a particular movement, don’t worry. Take it from me TIME DOES HEAL ALL WOUNDS though you obviously will never forget how you got them, but the same goes for progress of rehab (take your time). It goes without saying that million dollar athletes try and do bounce back from such injuries BUT THEY ARE PAID TO DO SO.
I think in our cases our recovery should be an even more vested interest because ;
1. We are NOT paid athletes though our livelihoods depend on our recovery that much more AND
2. The sense of accomplishment and achievement; I feel is a more motivating accomplishment that may or will hopefully transcend into improving other aspects of our lives.
Honestly, for those of you back on your feet (congratulations by the way) didn’t you at some point feel a sense of “Will I ever walk again??” Come on don’t lie… But really, now you don’t even think about it anymore. Right?
The worst thing you could do is hurry your rehab/therapy, if you don’t really have to. It’s true, coming to grips with your new reality is the first step to ensuring you truly do give yourself a “FAIR SHAKE” in your rehab process, but listen to your body!
In all, I am quite pleased with where my “heel cord” has come thus far and the more I am able to do GRADUALLY and having it balance with new movements and more reps and more weight feels great! Really, take it as it comes, stretch constantly and be patient…
May 29th, 2010 at 10:47 pm
I’m with you on everything except maybe the stretching. Short of re-rupturing, or having a post-op infection that keeps a surgical wound from closing properly, one of the most vexing problems that surfaces on this website is the AT that heals up too long. It’s hard — maybe impossible — to know how many of the post-op ones were caused by surgical errors, but at least some of them were probably caused by over-stretching the AT while it was still healing and vulnerable.
Of course, that “over-stretching” could have been during accidents or falls, rather than during intentional stretching. We just don’t know.
But as soon as it started looking as if my dorsiflex ROM was heading for a good spot (matching my other ankle), I backed off my serious ankle stretches. My PT was just as fond of them as you are, but I figured I had nothing to gain and something to lose. And my ROM is now a hair better on my “involved” ankle than on the “uninvolved” one, so I don’t think that decision cost me anything.
Even if I “should” or “could” have a few more degrees of dorsiflexion, I don’t think I’d notice any benefit. And if it came at the expense of plantarflexion or PF strength, it would be a net cost (because that’s the only area where I’ve still got a deficit at 5.5 months).
And as far as stretching in general goes, I think most of the latest studies have shown that it’s at best overrated and at worst deleterious — both for preventing injuries in an immediately following sports activity, and for improving performance in an immediately following sports activity. A 1- or 2-yr-old NYTimes article (and video) is one of the better summaries of the fairly recent evidence in general, and I think the study showing WORSE athletic performance after stretching is even more recent. There are also good radio shows on the subject (downloadable as Podcasts) from Australia’s (ABC’s) “The Health Report” and Canada’s (CBC’s) “Quirks and Quarks”. I think the latter is entitled something like “Everything you learned about exercise is wrong”!
May 29th, 2010 at 11:09 pm
I’m looking at the transcript of a 2009 show on ABC’s “The Health Report” about a follow-up study, and it found a very small (but stat-significant) benefit from stretching in terms of avoiding muscle, ligament, and tendon injuries. (But NOT, interestingly, in decreasing the TOTAL risk of injuries! That may be because there was an offsetting increase in risk elsewhere, or just because there was enough statistical “dilution” that the totals weren’t stat-significant.)
The authors suggest that the benefit is small enough, and the time to do the stretches they specified is large enough, that most people wouldn’t consider the benefit to be worth the time. In addition, they write:
“The secondary analysis suggested that in the youngest participants, people around the age of 20 years, there was a beneficial effect on reducing the risk of injury, whereas in older people the effects seemed to disappear and there was even a tendency for a harmful effect of stretching in the older participants.”
So for the average “weekend warrior” ATR patient, stretching may be neutral or even harmful in this study, too. This radio show is
called Stretching trial results - Health Report - 15-June-2009. Google knows about it, as does ABC.net’s search engine.
May 29th, 2010 at 11:17 pm
The Quirks and Quarks show is entitled “Exorcizing Exercise Myths” and dates from Feb. 4, 2006. CBC.ca still has it online, as a streaming audio file or a downloadable MP3 podcast. On stretching, it says this:
“First on the agenda is stretching. For decades stretching has been seen as an essential preliminary to a workout. But according to Dr. Ian Shrier of the faculty of Medicine at McGill University, and past president of the Canadian Academy of Sport Medicine, that’s old, and bad, advice. Research has shown that pre-workout stretching decreases performance and doesn’t protect
against injury.”
They have a link to “Dr. Shrier - Myths and Truths of Stretching”.
May 30th, 2010 at 9:24 pm
Alright!
This is great information in terms of my experience with “limbering up” for activities…Perhaps to push the (STRETCH AS MUCH AS POSSIBLE IDEALS) wasn’t the best way to communicate ensuring you are developing good rehab. As for myself, I have found that on days where I am on my feet for the duration of my workday, stretching throughout my day, doing circles with my toes etc, at least in my mind has alleviated some of the soreness I would feel after work when I got home. For me, being on my feet (at this point and time; post op) along with frequent gas pedaling, was actually making the end of the tendon (right above the heel, quite sore (which I failed to mention in my last post)
Yes, of course there are many studies out there throughout the years, that suggest the arbitrary effects of stretching one way or the other.
What I have learned from your responses is that I should disclaim my statements and stress “What’s working for me…” before I suggest to all ATR sufferers and “survivors” that they should do exactly what I’m doing. Also, the information given just eases my initial anxieties that I first felt when I got injured, which were “Should I have gone to the court that night!?!?” and “Didn’t I stretch enough?!?! How could this happen!?!??!” Nonetheless great feedback Norm,
Thanks
May 31st, 2010 at 1:05 am
I think a lot of what you’re calling “stretching” is what I call “movement”! I agree with you that standing still for a long time is the WORST (with the possible exception of SHOPPING, which takes it out of me and my leg like crazy!).
I’d much rather walk or run for an hour than stand for an hour, before and after my ATR! And driving is tough, too. If you can wiggle your foot around to break that up, you’ll feel better for sure. Me, I don’t equate that with the “lean against the wall and dorsiflex as hard as you can for the count of 30″ that I call “stretching”. It’s that latter kind of activity that coaches and trainers and gym teachers swear by, and that recent studies have found gives little or no (or even negative) benefit, when done right before a sports activity.
There are still indications, BTW, that doing stretching workouts that AREN’T just before you play a sport, can be beneficial. It’s just the “make sure you stretch before you play, or you may hurt yourself — and you’ll play better” that seems to be based on no evidence.
June 12th, 2010 at 2:50 pm
Hey! Im 14 weeks post op and I would feel that although stretching is important, massage and manipulation to the the scar tissue is really important as well. I dont know about you or any others but when I went to the PT 6 weeks post op my dorsiflexion was only a hair different than the “good” leg. She was more concerned about manipulation to the scar and tissue than stretching. is your achilles still thick? How long does that last? keep up with your healing!!! congrats!