My Blog

5 years post ACL rec.

Fri, 26 Oct 2012 04:21:00 GMT

Hi William

The only way to be sure if they graft has stretched is to visit your surgeon again for a consult - as they know how tight it was after surgery and can compare to the other knee.

You can still regain your ROM and strength in the knee - you just need to get back on the strengthening wagon and into the stability and conditioning exercises more, as well as muscled building.

You should see a Physio to see where your knee is at and what you're missing then restart your rehab program and the appropriate level. He is a link for the reconstruction protocol to give you a idea of what exercises you may have neglected and what to start with.

http://physiofitness.com.au/Admin/Literature_Details.aspx?LiteratureID=129172

Any Q's keep sending them through.

Regards

Tim

Tim Keeley Principal Physiotherapist Bondi Junction

Kinesio Tape

Fri, 26 Oct 2012 04:15:00 GMT

It depends what part of the wrist is weak - if it's a tendon weakness then yes, kinesio-taping to increase the activation and support the tendon may help. If it's a joint instability / ligament laxity issue, rigid sports taping would be a better option for you.

Tim Keeley

Principal Physiotherapist Bondi Junction

Neck & Shoulder pain ongoing

Fri, 26 Oct 2012 04:13:00 GMT

Hi Mark

It does sounds like the wear and tear in your neck is giving you some inflammatory pain at night, AS WELL as the bursitis may still be aggravating your shoulder and giving you pain. Most times people who have bursitis also have rotator cuff tendinopathy - which requires a specific, slow and progress strengthening program. Have you tried a course of anti-inflammatories at all?

Tim Keeley

Principal Physiotherapist Bondi Junction

Neck & Shoulder pain ongoing

Mon, 15 Oct 2012 07:57:00 GMT

Hi, Id appreciate advice I keep getting neck pain r/side down into shoulder and muscle. Doc said bursitis and I had injection which calmed shoulder (told it was not rotator cuff), but also told i have little degeneration in neck. My neck and back shoulder muscles keep hurting esp worse if I use my right arm to do housework etc, and also in bed at night, when I turn over my neck 'cracks' like a twig snapping, and then I feel all my RSide muscles in back, down to my hip, spasming up.

I just cant get any answers, xrays etc show just bit of degeneration, and $$$ spend on chiros and physios only give me temp relief. Im considering if my atlast is out and needs adjusting, other than that Im stumped and would appreciate any advice or pointers on what it could be... Thanks so much

m cave

Exercise with bulging disc

Mon, 17 Sep 2012 07:49:00 GMT

Hi there

If you have a bulging disc your symptoms will most likely be back pain with prolonged sitting and bending, and pain with lifting. You will also restricted with extension (bending backwards). Does this sound like you? You really should get it fully assessed by the Physio as well as an MRI to see the extent of the bulge.

Weightlifting exercise to avoid would be:

Deadlifts
Heavy lifting of all kinds
Ab Crunches
Bent over rows
Heavy Squats and heavy Leg Press

For sport, as long as you are not bending forward whilst twisting, you may find it is ok. However, you need to be doing a lot of McKenzie extension stretches to make sure and for long term back health.

Have a read of my articles on Disc Injuries and Back stretches:

http://physiofitness.com.au/_literature_57151/Lumbar_Spine_Disc_Injuries_-_First_Aid_and_Prevention_(May_2010)

http://physiofitness.com.au/LiteratureRetrieve.aspx?ID=79903

Regards

Tim

Buttock pain after exercise/soccer

Wed, 12 Sep 2012 23:26:00 GMT

Hi there

This sounds like it maybe a hamstring tendon tear near the insertion (origin) on the bone of your pelvis. Best to rest from the aggravating exercise, and see a Physio for assessment and treatment as soon as you can to get a correct diagnosis, then they will be able to help you with treatment options.

Tim Keeley

Principal Physiotherapist - Bondi Junction

www.physiofitness.com.au/Therapists_Tim.htm

Exercise with bulging disc

Tue, 11 Sep 2012 21:37:00 GMT

I believe I have a bulging disc in the L5 region of my lower back, but I am a very active person at age 20. I don't know what I can or can't do without further hurting my back. I really like working out, biking, racquetball, and frisbee golf. Which of these activities can I continue doing because racquetball and frisbee golf require a lot of twisting motion and I'm not sure if that would be bad. I have read mixed opinions online. Thank you very much for your help.

Buttock pain after exercise/soccer

Sun, 26 Aug 2012 09:26:00 GMT

Hi there

I am quite an active person and play a lot of sports.

A few months ago I took up crossfit where I started to do a good bit of weights.

Not sure if it was the crossfit or just from playing soccer but after a soccer match one day I had what felt like severe muscle pain in my behind. It was okay after a couple of days but most sporting activity since then has triggered the injury again which affects me during and after the sport.

I took a break the last 6 weeks from all strenuous sport but played a soccer game today and it's back!

I'm going to get it checked out but was more wondering do you think seeing a physio is the best approach or should I go to someone else first (e.g. a GP).

The pain is way up the centre of my behind and not sure how a physio would treat it!

The harder/faster I attempt to run the worse it is and after the game I'm generally fairly stiff for a day or 2.

Any ideas?

Thanks folks.

Kinesio Tape

Sun, 19 Aug 2012 01:12:00 GMT

I have weak wrists. Would Kinesio Tape assist in doing planks in yoga classes? If so, what is the process?

5 years post ACL rec.

Sun, 10 Jun 2012 15:42:00 GMT

Dear Mr. Tim Keeley, your presentation at http://www.youtube.com/watch?v=Yp4eYFald-g&feature=related is what got me to get in touch with you. I had an ACL reconstruction (patellar) in July of 2007. I followed physio and PT up to 4 months post surgery and afterwards continued alone due to high costs. Although those 4 months were intensive non-stop because i was off work, however since after that i haven't brought my affected knee (left) to full strength. I have no pain and i can fully bend the knee. However i can feel the instability in the knee and know deffinitely that i cannot get back to soccer yet. I have two questions. 1) Will the delay in restoring the knee (5 years) cost me, are there any

consequences? 2) I heard you talking about stretching the new graft? Is there a way i can confirm that that hasn't happened to me? (i tried once to play soccer for 10 minutes and heart my knee during a run).

Thank you very much for your attention,

William

ACL recon anxieties 18 months post op

Mon, 14 May 2012 23:42:00 GMT

Hi Andy

Yes the cadaver option is similar to the hamstring graft. They don’t do that much here in Australia anymore, hence why it wasn’t covered in the seminar/.

Sometimes they will do that option if a person’s hamstrings are not thick enough for a graft, or it’s their 3RD (yes 3^rd!) reconstruction.

However I have seen people that have gone for a LARS without a stump due to the fact that allografts are too expensive, and done well.

Regarding your jumping episode, the only way to may sure is to get the ACL reassessed with testing from the Physio, they can do various tests to see the integrity.

However, if you can do all the exercises on it and it improves and feels stable – don’t worry about it. It would have been more a patella-femoral joint pain problem due to dancing on a knee without enough VMO strength and flexibility in the joint, - and it has a little moan. It’s letting you know you can’t dance at 10 weeks!

My knee still gets tight if I don’t train it and feels weak. If I train, - it’s 100%. Think of a slow leaking tyre – you have to keep pumping it up to ride the bike!

Once you get the muscles strong enough you need to get into the jogging to deal with impact and really get it strong.

Make it a goal and work on it ALL YEAR!

Good luck

Tim

ACL recon anxieties 18 months post op

Wed, 09 May 2012 18:18:00 GMT

I had acl allograft (cadaver achilles) surgery September 2010. Already a while ago. I was progressing well through the rehab and my flexion and range of motion returned in a couple of months. About 10 weeks post op, I felt strong and went out dancing. I danced on it (some jumping) for 15 minutes or so. I never felt a giving/popping just soreness after for a few days. I regretted doing it and now seeing your video about how at 9 weeks the thing is most vulnerable, I am worried. How do you know if it lost elasticity and needs retreatment? Would it slip or give out? Mine has never done that, it just feels weaker than I'd like it to.

I am now over 18 months post op and my knee does not feel back to where I want it. I have been biking and working it out but just don't feel I have returned proper strength. It doesn't slip or give out it just gets sore and pops quite a bit.. I feel my normal gait is not quite there yet either. The quad is half the size of the other normal knee.

You don't mention the caver allograft option in your 80 min seminar that I watched (wish that I had watched right after acl surgery). I don't think my graft is the problem, but just needing more physio, but I am nervous for the thing. Are there tell tale signs that the graft is the issue or just needing more muscle strength and retraining?

Doing bench press and squats with old injuries - what should I avoid?

Fri, 13 Apr 2012 03:24:00 GMT

Dear Mark,

See the latest Q&A article I have written on common gym exercises – what are the best practices is of particular relevance to you. Hope this helps! If you have any further questions feel free to get in contact with one of our therapists at your convenience.

Cheers,

Jeff

Doing bench press and squats with old injuries - what should I avoid?

Fri, 13 Apr 2012 03:19:00 GMT

Dear Physio,

I’m recently new to weight training however I have sustained a number of injuries over the years. I injured my shoulder and hurt a disc in my lower back labouring a couple of years ago.

Is there anything I should stay away from or avoid with common weight lifting exercises such as bench press or bar squats? Any tips would be great.

Thanks,

Mark

A/C Joint Injury - "Separated Shoulder"

Tue, 13 Mar 2012 00:55:00 GMT

Hi Joe,

As a physio who works has done a fair bit of work with contact sports teams, I often using taping as a treatment for the AC joint. Taping has been documented to relieve pain and allow an improved range of motion. In the protective (early- week 1-2) stage of the injury I would likely use taping to approximate the joint, add stability, decrease pain, muscle guarding and spasm. I would then use it again in the later stages of the injury as a preventative/protective device during the return to sport. Taping is only an adjunct to the treatment and some therapists may choose not to utilise it, favouring slings or instructed rest over the use of the tape.

However once you are pain free and have full range of motion, the focus turns to increasing your stabilising control and strength of the joint.

Is your range of motion pain free? Are you able to perform your rehab exercises without pain?

If not, then taping may still be beneficial to you. If the taping can help to decrease you pain and muscle spasm you will be able to increase your strength and range at a faster rate. From a cosmetic perspective you may also want to get onto some taping to try and reduce the step deformity and try to prevent it from scaring in that position and becoming a permanent lump!

3 weeks post a grade II AC joint dislocation you should have full Range of Motion and be starting to increase your strength retraining with the aim of returning to previous activities by 4-6weeks.

Regards,

Claire

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