I love mountain sports. They energize, inspire, and motivate me—highly so. But sadly, I’ve become a regular patient at the orthopedic clinic. A renowned surgeon told me I need surgery on my right knee. As well as the left knee. And I trust the guy—yet, joint surgery is profoundly terrible. I know first-hand, I’ve been through it five times. Instead, I decided to see what I can do to stay active and put my back into knee cartilage regeneration through holistic and modern procedures and habits.

It’s worked very well. I’ve recently been doing 40-60 days of snowboarding a winter, learned new rotations, skinned up big mountains, entered amateur downhill bike races, and picked up biking down big mountain lines. I can trampoline again, and run as fast as ever. I’ve carried a friend’s 30lb backpack (put on top of my own 45lb backpack) for most of a 13-mile trek, two days after a 19-mile trek, in the Eastern Sierra.

Thrilled about where I’m at, I’d like to share what I’ve learned. I want to help you avoid the mistakes I made and take advantage of holistic and modern knowledge I’ve gained so you can sustain your athletic activity for years on years.

The Fall From Mountain Sports Bliss

Mountains and mountain sports have always been where I find my flow state and build my drive. In my teen years, I’d be gone biking for hours at a time, finding shortcuts in the woods around our Eastern Slovakia home. In the same green, forested, rolling hills, I learned snowboarding in knee deep powder. During college, I passed two snowboard instructor certificates, a CPR class, an avalanche safety class. I’ve lived in the mountain sports hubs of British Columbia, Scotland, Norway, French Alps, Colorado, and now California.

In terms of measurable achievements, I’ve had the honor to be a downhill bike instructor in Mammoth, one of the best bike parks in the US. That experience gave me the blissful opportunity to report back to my dad that people will pay me to do this. I’ve won a pull-up contest on my day five at Burning Man.

I also came second in a plank contest at the Pohoda Festival in Slovakia. I’m more flexible than most and very comfortable upside down. I’ve been in finals and on podiums in amateur snowboard and bike contests. I’ve guided people in the backcountry, trained corks on trampolines. I can comfortably walk on a slackline, backward. I am ambidextrous with both hands and feet.

Now I live in the breathtaking Mammoth Lakes, CA, and work on my marketing analytics company. The major part of the motivation to work online was to be able to have a great professional life in a mountain town where I can continue my pursuits.

Life is great when you get to a fair level in mountain sports. They fulfill you, provide hours in the meditative state of flow, give you lessons about fear and growth you get to apply in everyday life, bring you to unique friends and places. Yet, it’s not just high-five’s and Instagram likes every day. Almost everybody I know who does this long term has been through sports injuries and surgeries.

I was not always very coordinated, definitely not in my teens and early twenties. Neither did I always know enough to make my own educated decisions about health. As a result, I have a horizontal tear in the medial meniscus of my left knee. The big problem, though, is the right knee. It doesn’t have an ACL or the medial meniscus, it does have a hole in condyle cartilage.

In the fall of 2017, the surgeon told me I need surgery 1 to try and stitch together the meniscus in the left knee. They also want to do surgery 2 (ACL reconstruction, meniscus transplant from a cadaver, condyle cartilage transplant from a cadaver). Surgery 1 is mellow. Surgery 2 has of some 10 intensive months of recovery, then a risk of reinjury for up to 2 years. More than that, the procedure can’t be planned for a specific date and the process is fairly morbid.

Frozen menisci are held in stock and can wait for your day of transplant. For condyle cartilage, it’s harder than that. Typically, a teenager needs to pass in a car accident. So, once you put your name on the list, you may get a phone call in a few days. Or in several months.

When they finally call, they’ll ask you if you’re ready to go under next week. When you say yes, life changes drastically for a while. Knowing that a deep focus on rehabilitation routines is a major factor of successful recovery, this is not ideal. It is equally not ideal to introduce myself with “Hi, I’m Branko. And a little bit of Johny.”

Stacked Up Problems

The story of getting to this point is one of progressive degeneration and a series of poor decisions. It started during a night-skiing session in December 2009. Last-minute, I changed my mind and decided to dodge a rail. Launching to the side, I flew onto flat ice.

My landing posture was solid, but the impact was too much. It felt like the knee was going to come out, and as I later found out, I made myself a partial ACL tear. Getting drunk for New Year’s that night and carrying a buddy up and down stairs didn’t help.

A partial ACL tear is a minor injury, but I didn’t know enough at the time. Worse yet, the ER doctor misdiagnosed it as a knee sprain and said I should just give it a break for a month. Knee sprain, oh no. Beware that it is a vague diagnosis that doesn’t determine anything. The partial tear that I actually had requires doing mild exercise for strength, stability, and blood flow, as well as avoiding twisting under pressure.

You do not just want to give a partial ACL tear a rest. So when I resumed activity, I kept tearing the ACL further. It would snap during controlled moves such as pushing off the chairlift or dancing. I would collapse to the ground every time; it was like snapping a guitar string that’s keeping you upright.

One year after the first crash, December 2010, we went snowboarding on a powder day and I hit a pillow of fresh snow. It brought me to halt instantly. The weak, misdiagnosed, and mistreated knee gave out. The ACL finally tore completely and took the medial meniscus with it, too.

The ER doctor I saw once they drove me off the hill probably had a fake MD. He told me it was only a torn ACL. It should’ve been clear to her that when I can’t either bend or straighten my knee, something is very wrong with the meniscus. By the time I saw another doctor three days later, the meniscus had died off and couldn’t be stitched together anymore.

As they were going to operate on me for the first time in my life, they told me they wouldn’t do ACL reconstruction because the recovery time for that is too long. Overwhelmed and on pain killers, I thought to trust a surgeon is always a good idea, so I said OK. They removed the ACL as well as the meniscus. This was the last time I went to a doctor thinking that showing up at the clinic is all I need to do to get good care.

The missing parts in my right knee cause instability. That leads to higher than normal wear. For me, it’s resulted in a deficiency in condyle cartilage. Through compensation during strenuous activity, the left knee joined my laundry list of conditions and developed a horizontal meniscus tear.

Please don’t get me wrong. If I’m mad at anyone for the knee issues, it’s with myself and nobody else. I have high respect for orthopedic surgeons. I’m now very familiar with their work and it is indeed some of the hardest vocations one can choose.

Beyond that, their work sometimes solves problems that no other procedures can solve. The lesson is not to avoid surgery at all times. It is to make your own decisions about how to use surgery as one of the ways to solve or help a problem, instead of viewing it as a magic wand.

There’s also the fact that if I engaged in lower risk activities, I would not have to deal with sports injuries as much to start with. That’s valid. The point I’m making is rather that no matter what you do to yourself, you’ll have a more successful and faster recovery if you seek out a variety of diagnostics if you take ownership over your healthcare decisions.

1. Variety in Diagnostics

Healthcare professionals have great opinions—qualified opinions based on rigorous education and hands-on experience. But it’s still just that, opinions. No less, no more. Further, a diagnosis is just an estimate of what’s going on.

An experienced surgeon will tell you that they only know for sure what’s going on once they’re under the skin. I once had a rear and front labrum tear of the shoulder, but the MRI only helped discover the front one. My mom once had torn wrist tendons, but the imaging only helped discover the fracture.

Getting a variety of diagnoses is the best way to get the full picture. For a busted hand, I got opinions from a GP, a hand surgeon, an acupuncturist, two chiropractors, two occupational therapists, and one physical therapist. Two of them misdiagnosed me; each of them helped inform one of the stages of my healing process.

This leads to a lesson I’ve learned in my marketing analytics work—knowing the finding is less important than knowing how the finding was drawn. With that approach, even if you get a misdiagnosis, you dig into the factors that lead to it and end up learning a lot about the condition.

For my knees, I went overboard, and I’m happy I’ve done so. I got opinions from the same list as for my hand, plus two more surgeons, one stem cell doctor, and two pro athletes who’ve had similar injuries. All of the opinions were very useful. The result is not one 100% clear recommendation for how to take care of my knees. Better yet, the result is a list of things I can try and a comprehensive set of options with their respective probable outcomes.

2. Know Success Factors

Whatever procedure you’re recommended, become closely familiar with the success factors. Then compare those with what the doctors are telling you and consider how well you’re able to control them.

For a knee, for instance, you need stability. If I had an ACL reconstruction, but no meniscus and deficient cartilage, the ligament would likely tear again.

3. Research Autologous Stem Cell Therapy

Stem cells are what repairs our body. When you have a cut, stem cells are what comes to the rescue to repair the wound. But they have a hard time accessing joints. Modern medicine has figured out a way to do a 3-hour procedure where a doctor harvests stem cells from your own bone marrow and fat, adds growth factors from your blood, and injects the stem cell formula into your knee (or other joint).

You then need to take a month of a break from activity that involves impact or twisting, i.e. compression. Anesthesia is local and you can return to work the next day. You can keep up your non-impact exercises.

I’ve had this done at a stem cell clinic in Colorado that I’ve known about for years. I went in January 2018 and took 6 weeks off snowboarding. Then I went again in April 2018 and took three weeks off snowboarding. I continued with yoga, swimming, bike commuting, and weightlifting throughout the breaks. Contrary to surgery, I thus returned to snowboarding stronger and more confident. That’s an amazing process.

Patients have avoided knee replacements this way, so yes, you can expect a lot. But don’t expect miracles or another solve-all. I went in for a new MRI nine months after the first stem cell procedure, in October 2018. All the deficiencies still looked the same. But my symptoms, my pain and discomfort and decreased range of motion, diminished rapidly right after the procedures and remained that way until now.

4. Meditation and Visualization

Meditation has helped me slow down, focus better during both sports and work, be more present, and understand the body’s energy flow better. I now do quick sessions to wake up or to put myself to bed. I also do occasional long sessions—those were highly effective for me in pain relief during surgery recovery. Then, I try to focus on the flow and meditate by clearing my head completely during yoga and swimming. Audible and Calm have been very helpful in guided content.

Visualization, to me, is a form of meditation. I won’t be telling you that you’ll experience major improvements from this alone—instances of that may have been anecdotal and definitely require a high level of meditation skills. But, visualization via visual and healing imagery is very effective in making you believe in getting there. It also helps you learn to work with your energy flow and to send healing sensations into your injured body part.

I find it easiest to visualize healing when I’m actually doing something physical that’s healing, too. I visualize during acupuncture sessions and when applying ointments and creams. Of the latter, the most effective ones have been those with THC or comfrey, as well as the phenomenal pain relief cream by The Feel Good Lab.

5. Acupuncture

I swear by this one. Maybe it’s the blood flow it supports, maybe the depth of relaxation it fosters. Acupuncture can be very effective at helping your body heal itself. I do it every other week if I’m hurting and once a month if I just want to maintain a healthy status of a deficient joint.

6. Chiropractic and Massage

Body alignment is key. If you have knots, misplaced little bones, uneven gait, or misaligned spine, your knees and the tissue that surrounds them may heal in ways that promote harmful compensation or that make problems resurface later. It is important to remember that your body is one machine, and every part of it that’s off will throw off the rest, too.

I get a chiro adjustment or a long massage session once a month. My favorite chiropractor is a skilled climber and backcountry skier. My favorite massage therapists know a combination of massage techniques, along with cupping. They’re both great at evaluating my body and picking the right technique to establish balance.

7. Kinesiology Taping

The tape is magical. Its texture stimulates muscle fiber and blood flow, and its tension works like scaffolding that fosters stability without causing atrophy. I’ve used a complex pattern instead of my custom carbon knee brace and it was actually better than the brace. On a regular basis, I use simple taping patterns for taking pressure off the knees during impact.

8. Mindset Shift

First of all, I realized I used to jump through unreasonable hoops. Now, inspired by Mark Manson’s articles and book about what to (not) care about, I’m much pickier about the challenges I pursue. I want long seasons instead of intense seasons.

I want to be active year round instead of going through frequent downtime after or during winters that wear out my body. I am very conscious about what I want, I even write it down. In snowboarding, I clearly set my priorities on jumps and backcountry lines, so snowboarding where I rarely ever get beat up.

Second, I’ve understood Lincoln’s quote “folks are usually about as happy as they make up their minds to be” (unless it was said by another wise person). You tend to be as healthy and strong as you decide. I have friends who’ve had identical injuries, yet vastly different recovery results from each other. If you make it an important goal to be back to your favorite sport, you’ll most likely be there. This doesn’t imply it’ll be easy, but it’ll indeed be simple.

Third, a lesson from a rafting guide friend. Healing yourself can get intense. It grows into somewhat of a hobby and it’s rewarding when it goes well. Therefore, it’s important to set my mind on wanting to be done with the process.

For me that meant making a plan for when I’ll be done working on my knees. I now treat my knees well by default, but I also want to treat them as normal knees eventually. Not as deficient knees forever. I have a clear idea in my head for what is enough to call this project done, along with tentative dates based on experience.

9. Regenerative Sports

Lift-based snowboarding is super fun. So is lift-based downhill biking. The amount of lines and the progress one can make in a day is tremendous. You couldn’t learn this much downhill technique if you were to hike it all yourself. But the potential energy you build by taking lifts, the energy your body then has to absorb, is ludicrous. It’s far too much for you body to handle long term.

For every three to four days of snowboarding or downhill biking, I’ll do one swimming and one yoga session. Both provide the stretching and core strength you need for protecting your joints. Then, for every one day of lift-based snowboarding or downhill biking, I do one day of hiking or pedaling my own lines. This strengthens the same muscle groups and ligaments as those you need for the downhill part. It also creates balance and pumps synovial fluid through the knees like there’s no tomorrow.

Straight-up balance sports deserve their own shout-out. Put an Indo Board in your living room and you’ll have a blast when your friends come over. Put inflatable discs or an easy balance board in front of your standing desk at work. Stand on one foot when brushing your teeth. Take your date slacklining in the park or paddleboarding on a lake—besides a mad amount of points, you’ll gain strength, dexterity, and confidence.

10. Wholesome Supplements

For what you can take in pill form, I’ve read great things about MSM and chondroitin. But I prefer natural, whole alternatives. My rule of thumb is that our grandma knew it all already. Biohacking via Kion by Ben Greenfield’s Kion is a great resource, too. I make my morning mixes with ingredients such as molasses, ground flax seed, turmeric with pepper, collagen, ashwagandha, or fish oil. Pick your favorite(s), stick with it for a few months at a time, switch it up, keep going.

Much of the above, as well as the fasting and cold-hot routines described below, targets inflammation. On the contrary, sugar and alcohol support inflammation. Don’t do that to yourself. As hard as it may be to cut out the two completely, reducing them significantly is easy. Change your drinking from casual to purely occasional, it’s one of the worst drugs out there, anyway.

11. Fasting and Time Restricted Eating

Intermittent fasting has been great. My routine is to give my body 14 hours to fully process everything, four times a week. This is best done on work days when you’re less social and your schedule more predictable. In practice, I only eat 10 am to 8 pm Monday through Thursday. It’s super easy to get used to—you’ll love it very soon.

This has also been called the warrior diet. The benefits include reduced inflammation, building lean muscle mass, higher nutrient absorption, and being more in tune with how your body reacts to what you feed it.

I’ve also adopted 12-hour intake windows and now I firmly believe that it’s unnatural for our bodies to be able to eat whatever we want, whenever we want. I believe that your metabolism shouldn’t run 7 am to 10 pm, not even if it’s just tea you drank to wake up. Per Rhonda Patrick, limiting your intake of everything but water to twelve hours a day keeps your body cleaner, lighter, and much healthier. This, too, is very easy to get used to, and it’s completely OK to break the routine once or twice a week.

Finally, I do a 36-hour fast once a month. Typically, I eat a lot on Sunday. Take seconds with every meal. Then I stop eating at 8 pm and take in water only through Tuesday 8 am. I sit down to break the fast that Tuesday morning, eat slowly, and choose light foods that re-line my stomach, such as bone broth. This helps clean the intestines further, and it also resets me.

It goes without saying that drinking a lot of water supports all of the above. If you’re fasting, you’re burning fat. Fat is where a lot of your toxins are stored. If you then don’t drink enough water, the fat can’t be flushed out of your body well.

12. Cold Therapy

I have a sauna at our condo complex and a steam room at the athletic club I’m with. I’ll do a long session a few times a week and end with a cold plunge one to five minutes long. This is another great opportunity for deep meditation, especially if you’re trying to brave the cold longer.

I also end all my showers on cold-hot-cold, thirty seconds on each. This pumps your blood, burns fat, trains your body to create its own heat, and relieves inflammation. Wim Hof cold therapy for the win.

13. Inversion

There’s something special about hanging or standing upside down. Running that much blood through your head wakes you up, raising your legs helps them regenerate. I’ll do a 10-minute inversion table session or savasana most days, as a part of my morning routine.

The inversion table is my favorite. Gravity boots are a great alternative. They decompress and create room in your spine and joints, which I feel is key to overall flexibility and alignment.

14. Listening to the Body

Last but not least, just listening to what’s going on with your body can often be neglected. When pushing our skills at sports, we tend to lean toward ignoring pain. Even more importantly, we often ignore signals that come before pain, and those are the ones you can do a lot about. Get better at it via meditation for energy flows, body scan, learning about alignment via chiro or yoga, resting enough, or applying the biofeedback method.

What’s Ahead

I’ve been at it for about a year and a half. My latest MRI shows no further degeneration from the previous one made a year prior. It doesn’t show a better condition of the cartilage either, but I do feel great. I’m fully functional, thirty years old and stronger than ever, more coordinated than ever, and almost pain-free.

I’ve been sent home by a surgeon who told me he wouldn’t work with me if I can engage in my level and frequency of sports without feeling significant pain. I have to say I do feel like a hypochondriac when I go for an ortho follow-up. Then we look at my imaging and I’m reminded the war is not won yet.

The process has been highly rewarding and I don’t need to try and remember to keep up my good habits and mindset anymore. It’s my standard now and it’s all highly enjoyable. The plan is to simplify my current routines, not to drop them when I’m done working on the knees.

The hard part is that I will indeed need to go for knee surgery on each knee eventually. I’ve bought myself time, all of the body works. I can keep going like this for a handful more years, which is huge. I may eventually need to go under to avoid further knee cartilage degeneration. A persisting problem, even when dealt with, is still a problem. I have an opportunity to undergo both surgeries this year, and I’m considering doing so in the fall. If I do, the awesome list above will help me recover much, much faster.

Please leave a comment and let me know what you think. Should I keep postponing the surgery as much as possible, now that I got the knees to great shape? Should I get it over with as soon as possible?

It’s Your Call, Not Your Doctor’s

Yes, healthcare professionals are thoroughly trained and well paid to take care of us. But they are not perfect and especially surgeons tend to have a hard time admitting there’s something they don’t know. In their role of high expectations and responsibility, that’s understandable. So, do not try to delegate your health. You can merely get help with it. You, yourself are the project director.

Know When to Stop

Most of my injuries happened on days when I felt off. They happened on small features, when I had my guard down, but mainly when I was tired or distracted. Now I strive to understand and respect that feeling.

Yes, I do not want to just leave the hill when I’m a little tired. But it is indeed OK to keep it easy or go home early. That is not a failure. Pro athletes often say they pick their battles carefully; they don’t push it every day.

My Main Takeaways

When you need help, get at least a few qualified opinions. Complement those with your own research, observations, and goals.

Remember:

• Your body is yours and your health decisions are for yourself to make.
• Find balance between being proactive and patient.
• Adapt routines you enjoy so you can sustain them.
• There’s always an alternative.
• Tailor-make your own unique list of routines and procedures.
• Mind is over matter, indeed.
• Small changes in how you do your sport can have a big impact on your health.

I hope this detailed elaboration serves you well and helps you be strong and healthy. Please let me know how you were able to apply it. Reach me on my Instagram account. It’ll be rewarding to read about your own thoughts and experiences.

The post The Awesome Things Helping Me Regenerate Knee Cartilage, Avoid Surgery and Snowboard a Whole Lot appeared first on Breaking Muscle.

Yes, you want to continue to build and strengthen these muscles. But you need to balance strength periods with rest periods. You need to build this habit now before your body speaks up through an injury. But how do you get muscle groups that are raring to go to chill out and relax?

It is about efficient timing of muscle firing. You don’t truly want to ever have a muscle loose, but relaxation is critical. To fully engage your muscles, you need to provide periods where these muscles fully relax. Giving these muscle groups a long overdue break will help to increase their strength, flexibility, and power.

The Stabilizer Muscle-The Iliopsoas

The iliopsoas is the only muscle that connects your core and your legs, impacting both your posture and stability. This muscle group is key when it comes to controlling large movements in your body. But that’s not all, the iliopsoas is extremely important for both your parasympathetic and sympathetic nervous systems. Located at the T12, iliopsoas is sometimes known as the flight or fight muscle, as it often tenses up during periods of stress. Failing to relax this muscle group impacts your entire body from your balance to overtaxing your adrenals.

Giving this muscle group some downtime will support your entire nervous system, including your brain, while decreasing the overall stress levels in your body. But that’s not all, you will begin to regulate cortisol more efficiently, your kidneys will work better, and it will help clear out toxins, leaving you feeling healthier and happier.

So, how do you get this overworked muscle to take a long overdue break?

Relaxation Pose 1: Gentle Lunge Crescent

Go into a deep lunge, hands on the ground, your front leg bent at a 90-degree angle, your back leg on the floor at 90 degrees. This is a great way to allow your body to regulate itself and just take the pressure off. This simple posture relaxes your pelvic floor, helps increase your balance and your overall vitality. Simply hang out and breathe, get comfortable, and relish this moment. Repeat on the opposite side.

Relaxation Pose 2: Let It All Go

To truly decompress, lay fully prone on the front of your body and let it all go.

Aching Adductors

Whether you’re a runner, swimmer, or bodybuilder, your adductors are probably crying for a break. It is so easy to overdo action in this muscle group. Even the simple act of sitting can create tight adductors. If you want to prevent injury, you need to give your adductors a rest. Relaxing your adductors helps to balance the entire muscular system. Adding these simple releases to your routine will support full diaphragmatic breathing and help with regulation and balance.

Relaxation Pose 1: Side Leg Raise Lying on Back

A yoga strap is a great tool to help give those adductors a much-needed release. Lie on the floor and place a strap around one foot. Gently use the strap to lift your leg towards the side. Repeat on the opposite side.

Relaxation Pose 2: Sleeping Butterfly

An alternative pose is bound angle posture, lying either on your back or on a gentle ramp and letting your legs slowly open like a butterfly. For additional support, place a couple rolled towels or cushion underneath your hips so that your legs can gently relax and open. Put on your favorite tune, as you hang out and give the adductors so much needed rest.

But, What About Your Butt?

A conversation about overused muscles wouldn’t be complete if we failed to chat about the glutes. The glutes consist of a group of four muscles: gluteus minimus, gluteus medius, gluteus maximus, and a tiny, often forgotten, muscle known as the piriformis. Each one has their own job to do.

The piriformis assists with rotating the hip and external rotation, minimus assists with hip extensions, and medius is for balancing. Maximus, which is one of the strongest muscles in our body, is all about extension and hip movement. These four muscles are a part of almost every movement, while also being the stabilizers for our pelvis. They are working all the time, whether you’re sitting, standing, or moving, your glutes are in action. The truth is that our muscles won’t balance if the glutes aren’t fired first. In fact, a lot of hamstring issues are a direct result from the improper firing of the glutes, and almost all pelvic floor issues can be attributed back to our rear.

So, give your glutes some love with these wonderful relaxation poses.

Relaxation Pose No 1: Seated Forward Fold Crossed Legged

Release the glutes muscles simply by sitting cross-legged and folding forward. Place your hands down to the floor, and let the tension go.

Relaxation Pose No 2: Rich, Deep Squat (Mala)

Place your feet slightly wider than a hip-width apart and bend your knees, slowly moving into a squat until hips are just a few inches off the floor. Stay in this position and enjoy this gentle release.

Give Yourself a Break

With the push to perform, it can be hard to give these three core muscle groups a long overdue break. However; if these foundational muscle groups only experience tension then, over time, stress is created, making you prone to injury. There needs to be a balance. These moments of downtime will provide these muscle groups the opportunity to relax and regenerate, decreasing the risk of injury while helping to increase your overall performance.

The post Three Major Muscles to Always Keep Loose appeared first on Breaking Muscle.

Now, there is so much more we know in terms of balance, stability and strength as it relates to an ankle injury. Now, a more global approach is taken to make sure an athlete gets the most out of his/her rehabilitation or preventative program. (Please note: If you are beginning a rehabilitation program for an injury, make sure there are no other underlying conditions, such as a hairline fracture, by seeking the appropriate medical care.)

What do I mean when I say global approach to rehabilitation? In this case, I mean looking away from the ankle and incorporating the entire body as part of the rehabilitation or preventative program. It is not only the ankle that helps to stabilize itself, but it is aided by the knee, the hip and the core.

The core is best described as the “lumbo-pelvic-hip girdle.” This area helps to stabilize our body in so many ways – posture, walking, running, sitting, etc. How has this affected the way I treat an athlete? Good question. The answer – I look to this area to see how it reacts as an athlete stands on a single leg.

The ankle, when injured, loses its sense of proprioception quickly. The recovery can be tricky. Originally, I used to only look at how the ankle was reacting as the person stood on the single leg. Now, I look to see if the knee is turning inward, the hip is rotating, or if the hip drops out. What does this mean if these things happen? Simply put, it means that other muscles within the kinetic chain are not capable of handling a functional load after an injury, or maybe the musculature was weak to begin with.

A key focus area in this whole picture is the gluteus medius. The gluteus medius is a smaller muscle within the posterior chain, responsible for hip abduction as well as hip stabilization. If this muscle is weak, the hip will drop out, the knee will turn inward, and the ankle will not be able to stabilize properly. As a result of this, the rehabilitation program for the ankle injury may need to include strengthening for the hip. This is how the global approach to care becomes a part of overall rehabilitation program.

I know, you’re thinking it’s only an ankle injury. Well, have you ever noticed while working with an athlete that he/she is not progressing as planned? Weakness in another part of the body may be part of it. How can this be helped? Simply put, add additional exercises for the gluteus medius or any other muscle imbalances that may be noted.

The gluteus medius, albeit a smaller muscle, plays an integral part in the process of hip stabilization. The simplest way to work on strengthening this area is side-lying leg raises. I instruct the athlete to line his/her toes and heel together and lift from there. This causes activation of the gluteus medius.

Another simple way to improve strength to this muscle is to do clamshells. Here, the athlete has his/her knee bent and externally rotates the thigh while the feet remain in contact with each other. If properly done, this will cause some major ‘burning’ in the muscle. As strength becomes more apparent, more functional strengthening can begin. This incorporates balance with slight knee bend and focusing on getting the gluteus medius to “fire.”

I like having the athlete do two different types of exercise depending on his/her strength levels. During this whole process, the focus shifts to what the knee and hips are doing compared to what the ankle is doing. To start the athlete stands in front of a mirror and uses self-feedback to correct any positional errors that may occur. For example, while the athlete works on a step-up and step-down motion, he/she focuses on making sure the knee does not fall inward and the hips remain level. After a few repetitions of this, the athlete will usually comment on how they feel the muscle working. This is a good way to get more functional work/strengthening done to help with the ankle proprioception.

Another highly useful exercise is having the athlete balance on a single leg with a band around the opposite one. One the athlete has engaged the abs, gluteus medius and ankle stabilizers, the athlete is then asked to move the opposite leg causing the center of balance to shift based on band tension and direction. The athlete is asked to move forward, backward, sideways, and inward with the leg. Here, focus is on the lumbo-pelvic-hip girdle, knee position, and ankle stability. By incorporating multiple facets, the idea is to improve overall stability, performance, and reduce the chance of further injury.

It’s amazing how over the years as we gain more knowledge through research, experimentation, and good old trial and error, we find how important it is to involve the body in rehabilitation. In this case, a more global approach to the lower limb injury can help to correct not only the major problem at hand, but also to help begin the process of correcting other biomechanical issues that may be affected by the kinetic chain.

Today, it’s not about only treating the site of injury, but about treating the whole individual. When I say treating the whole individual, I mean looking at their movement, functional tests, and special tests that relate to the injury. If anything is noted as being abnormal, I try to educate the athlete about the importance of adding such exercises to his/her program to help enhance rehabilitation and ultimately performance.

In the end, the ultimate goal is to get an athlete back to playing as quickly and safely as possible. If, through simple education like this, I can get a person to realize the importance of strengthening our entire global and local systems, then I hope I have accomplished something good for that person.

The post Ankle Injuries: The Secret to Preventing and Healing Them appeared first on Breaking Muscle.

When an athlete has WBA there is an increased likelihood of reinjury and a decrease in overall performance potential. These effects of imbalance are magnified by the fact the majority of athletes are unable to detect the lack of symmetry on their own.

Some of you may have experienced some high-tech ways of detecting and rehabbing muscular imbalances – but what about the Nintendo WiiFit? One of the components of the WiiFit is the Wii Balance Board, which is similar to force platforms used by research laboratories and includes the visual feedback of the computer screen.

In a recent study published in The Journal of Strength and Conditioning Research scientists examined using the Wii Balance Board as a method of improving weight-bearing asymmetry in both trained (athletes) and untrained individuals.

In the study, participants were tested on two different occasions with the Wii Balance Board – one time with visual feedback and one time without. They performed six squats, taking six seconds to perform each repetition. Participants stood on two Wii Balance Boards, one under each foot. In the sessions with visual feedback, custom software was used to display the weight distributions in real time on the computer screen in front of the participant so they could adjust their movement accordingly.

While reductions in WBA were observed in both the trained and untrained participants, the improvements in the athlete group were statistically insignificant. The degree of WBA had been lower to begin with in that group, so there was also less space for improvement. In the non-athlete group, however, significant improvements in WBA were measured.

For doctors these results means untrained patients with WBA could make major improvements in their condition through the use of visual feedback while performing rehab exercises. The Wii Balance Boards offer an inexpensive and portable way for doctors to apply this practice, whereas previously this technology was only available in research laboratories.

The post Can the Nintendo WiiFit Rehab Your Injuries? Science Says Yes! appeared first on Breaking Muscle.