I feel sadly that as of late all of my blog posts have been dealing with injuries. So the question is how do you deal with your injuries?
Well here is how I do it:
First and foremost I try to figure out what is causing the injury.
Is it overuse?
Is a pull or a strain? If so can I pinpoint when it happened (during a movement or exercise)
What bothers the injury?
How can I effectively treat and recover from the injury?
When can I get back to training at 100% without fear of further injury/re-injury?
So lets use the issue I am having with my feet. I have been suffering from neuromas (see link for definition (http://www.apma.org/Learn/FootHealth.cfm?ItemNumber=987) in both of my feet for almost three years and have come to the end of my road and will have surgery November the 18th to have them removed.
Here is how I answered my five questions:
Overuse is potentially part of my situation, I have high mileage on these feet – martial arts, running, thousands of calf-raises, mountain biking and road cycling (the cleats put pressure on that area of the foot), and I am also on my feet most of the day with clients.
Can I pinpoint what caused the injury – not really but overuse, genetics (my Mother had the same issue), and age (I am now 45) are contributing factors.
What bothers the injury – at this point I feel it all day everyday. The more I move the more it hurts. So basically any continuous movement really feel uncomfortable. I can last about an hour doing marital arts and thats it.
Recovering from the injury – I have tried alcohol injections, taking trace minerals, epsom salt baths and modifying my activities and activity levels (none of which have worked). So hence the need for surgery (which is always the last option!!)
How will I recover from the surgery and get back to full speed? I will probably be back up to speed within 3 months. Hopefully I won’t need physical therapy and will just need to keep off my feet for a few weeks, then ease back into work on light duty. Unfortunately I will have to repeat the process as soon as I am able. I have two neuromas in each foot and it is recommended to only take out one at a time. So in total I may be out for six months, kind of a bummer but I will work around it find ways to maintain my physical fitness.
I’ll keep you posted…
Today I finally got my Synvisc One injections!! I love my new Othopedic surgeon, Dr. James Gilbert (http://mostsportsmedicine.com/therapist/dr-james-gilbert/). I went to see Dr. Gilbert a few months back to get my aging knees checked out and found out thankfully that I had no new meniscus tears and no arthritis (I have had meniscus repairs on both knees). All good news, but my mileage is high and there is no sign of me slowing down anytime soon.
So it was time to take a preemptive strike…enter Synvisc One (http://www.synviscone.com/what-is-synvisc-one.aspx) . Synvisc One is like adding some lubrication to your knees to help lessen the wear and tear. Especially fitting considering my aggro lifestyle.
After wrangling with my insurance company for two months, I finally had my Synvisc One delivered to Dr. Gilbert’s office (they really went the extra mile to help me in dealing with the ineptitudes of my insurance company) and today I got the injections (one in each knee).
I need to lay low for 48 hours and then can resume normal activity and could notice “relief” within a month. My knees don’t hurt daily, but when I really push hard they ache. I hope this extends my martial arts career, skiing, lifting etc.
I’ll check back with you in a month…
So here we are a few weeks later with new reports on my ailing knees…
Thankfully all the news is good!! No arthritis and no new tears to the meniscus in the right knee.
Furthermore my new doctor has recommended a preventative treatment for both of my knees (they have both have meniscus repairs). Its called Synvisc-One (http://www.synviscone.com/what-is-synvisc-one.aspx) and its kind of like putting a coat of wax onto your hardwood floors but for your knees; it basically helps to lubricate and cushion the joint(s).
Since I don’t plan on slowing down anytime soon, I am thrilled at the prospect of taking a preventative measure.
I should get the injection in two or three weeks…I’ll keep you posted!!
So a few Wednesdays ago, I got a cortisone shot and my pain went away but my popliteal cyst was still large enough that is was causing pain in my knee.
I couldn’t get in to see my regular Doc at the Washington Hospital Center so I called in a favor. I have an old High school friend that is an orthopedic surgeon in Woodbridge (that was a fun drive from Bethesda!!). Anyway the practice is amazing and they drained the cyst…I literally didn’t even feel the needle go in and had immediate relief. A big thank you to NOVA Othopedic and Spine Care!! http://www.novaorthospine.com
I took it easy for a few more days after having the cyst drained and contacted another buddy of mine that introduced me to another Doctor whose office is only five minutes from my condo. I love the guys at the Washington Hospital Center but that isn’t the funnest drive either. Considering my aggro lifestyle why not establish a relationship with a Doctor thats right around the corner.
That being said yesterday I wend to see Dr. James Gilbert based upon the recommendation. Lovely office, very modern (all my paperwork was done online) and I was seen promptly. Dr. Gilbert has a great bedside manner and is all to familiar with the “aging athlete” with a hard head scenario. I have scheduled an MRI and will see him again at the end of July to review the images.
Check out Dr. Gilbert’s practice…hopefully you don’t need it but so far I like what I see!
James E. Gilbert, MD
So if any of you follow my ramblings you will know that I have had a meniscus repair on each of my knees. The left knee was insidious onset about 8 years ago and I still don’t know what caused the damage to the meniscus. My right knee I hurt while sparring about 5 years ago, and in both cases I had a popliteal cyst form. This is caused by extra synovial fluid that is produced in the knee due the “irritation” that the injury is causing and eventually a coating comes off of the tendons as the synovial fluid is being pushed to the back of knee and it is encapsulated and voila you have yourself a genuine popliteal cyst.
When my doctor operated on my left knee he removed the cyst, but chose not to with the right knee. The popliteal area of the knee is very vascular and full of nerves so if the cyst isn’t in a “safe” spot the Docs will leave it alone. That being said the cyst can fill again if there is more “irritation”. Again if you follow my blog, you know of my aggro lifestyle…I push the limit with my knees. For the past few weeks I have noticed that the cyst behind the right knee is nice and full along with some pain in the area of the medial meniscus (3-4 out 10). So I made an appointment with my pal Dr. David Johnson.
He gave me a cortisone shot and told me take it easy for five days. The cortisone is supposed to calm the irritation and allow for the production of synovial fluid to slow enough that the cyst will drain/shrink. We are at day five and the cyst is winning the battle, it doesn’t cause pain but can make my knee feel tight.
I have also been taking Aleve and just started experimenting with Blu Emu Cream (http://bit.ly/29edaac). The combination of the two has helped the pain greatly and I have been able to exercise regularly, while hitting some personal best with my back squat and front squat (315lb. and 255lb. respectively).
Tomorrow I will train legs and call back Dr. Johnson to get his thoughts and Wednesday I’ll be back at the Kung Fu school.
I’ll keep you posted…
I have been personal training for nearly twenty years, and it has be a pleasure to watch the field evolve. The training methodologies that are currently available for trainers and exercise enthusiasts are amazing.
The way I trained “then” and “now” are radically different. I won’t bore you with all the comparisons, but will outline what I think currently is the best approach.
There are three levels that need to be addressed:
- Structure – You need to make sure that you actual structure is in good order. I currently like the Chiropractic Biophysics approach to address this issue. Check out http://www.gotyourbacktotalhealth.com
- Function – Once you get your structure where it should be, you need to make sure that you are functional and have no asymmetries. I recommend an FMS Screen (http://www.functionalmovement.com) – we provide that www.jettllc.biz
- Training – Find a trainer that espouses the the first two “levels of need” and that focuses on training in a way that provides real strength gains that have real world applications. There should be a good blend of FMS corrective movements, functional movements, and work on flexibility and balance.
Now once you find all this, yes it’s a tall order but doable, it comes down to one thing – compliance. The ball is now in your court…
Be happy be healthy