Here is the Part 4 of a 5-part series on a young Iron Armour athlete who suffered a serious knee injury and how physiotherapy will help get him back to full health. Enjoy!
Please read the last few episodes to bring you up to date:
Part 1 – 5 days after dislocating his R knee cap
Part 2 – 2 weeks after his injury
Part 3 – 6 weeks post injury and allowed to start running!
Here’s the latest so far (quick summary):
- Davey suffered a R patella dislocation on Saturday 28 July 2018 and he’s now almost 3 months injury
- He’s returned to high level running and conditioning work with Iron Armour HQ
Davey has returned for a follow up physio session where we discussed where he should be in terms of his recovery.
He should be steadily building his running conditioning and continuing with his lower leg strengthening work.
Here are the 3 main things we want to monitor closely:
- Measure the amount of running to avoid overload
- Progress his strengthening work
- Avoid things that cause sharp knee pain or aching at night
We are still worries about how much running Davey completes because we are still working on strengthening his leg and pelvic girdle (backside/gluteus med).
Because if the pelvic muscles/gluteals are still weak then as he pushes the boundaries with his running it will cause overload and pain in his R knee.
One of the major challenges at this stage of Davey’s management is knowing when to pull up!
I always recommend the running program because it’s measured and you can safely progress back to full training once you’ve completed it successfully.
Progress Strengthening Work
Davey’s main strengthening program is now squatting with the theraband around his knees to improve the activity of his pelvic girdle/gluteals.
It’s also a very important action without developing any knee pain.
A way to assist his squatting form and ensure he’s activating the right hip muscles is to perform the squatting program with a theraband across his knees.
As he lowers into the squat he’s encouraged to push out against the band which will ‘switch on’ his gluteal muscles properly and not only improve his squatting form but reduce the load and pain onto his knee!
Monitor Type of Pain
At this stage of his rehab Davey needs to focus on 2 types of pain – sharp local pain that lingers > 5 minutes or increased aching at night.
The sharp pain tells us that he’s overloading the knee and he needs to ease off.
The aching pain at night suggests he’s suffering from inflammatory pain. That’s the swelling that aches collects around the injured knee and it aches a lot at night.
If Davey has either of these 2 pain signals then he’s overdone it. Remember we are looking to increase his strength and running but not to the point where he develops sharp pain or aching at rest.
In Part 5 of Davey’s Spotlight series we will show you Davey back in full swing – training fully and returning to playing Rugby!
I hope you’ve found this post helpful.
Big shoutout to Nick Longhurst Head S&C at ACE Performance for helping Alyssa with her ACL rehabilitation!