to PT or not to PT, that is the question ....

SportiGrl · Jan 29, 2011

MRI showed I've not got a torn ligament .... merely strained and tendonitis in my posterior tibeal tendon and something in the bottom of my footsie ... been in THE BOOT for a couple weeks so far ... 
 
I am healing ... and am VERY relieved no tear = no surgery required

what I don't know about is going to PT 2-3x/wk and wearing THE BOOT till they decide I don't need it (prolly 2-3 more weeks) and not running for about another month ... hmmmmmmmmmmm
 
 
 
and much talk about orthotics comes from the lips of the PT lady .... motion control shoes hobble me w/i a couple miles - I cannot imagine orthotics :-(
 
 
 
is PT for a non-surgical recovery really something people do? Or just something a doc recommends to alieviate responsibility if things don't go so well after the initial visit? I'm very torn on this and not wanting to waste time and money for something I think I might be perfectly capable of dealing with in my own 'special' way ...
 
 
what say the Peanut Gallery?

Rainey · Jan 29, 2011

I suppose you could do it my solution is get in the pool and aqua jog. I think its the fastest. I just think passive modalities are a waste I almost never use them (electric,Ultrasound etc.) addressing any mechanical problems helps, I don't buy overuse as the cause of every injury.
 
Were you doing or increasing training dramatically or doing aything new?
 
I'm just about to head to the pool now!

crazyfrog · Jan 29, 2011

I would go...I've been twice for a similar issue (had to go back the second time cause I didn't go long enough the first time and didn't do my "homework" like I should have). it's a complete pain in the ass since you have to go 2-3 times/week but worth the risk of the injury getting worse. the key is finding a place you like and a PT who knows their shit.

Captain · Jan 29, 2011

Hey Kim,
 Sorry to hear that it is still ongoing, but if you have to be hurt I guess this is the best time of year, cause the weather and trails kinda suck at least around here. It sounds like I am battling a very similar problem as my MRI also revealed no tear. I have tried ART treatments, Accupuncture, Shock-wave. ultrasound, massage and am now trying foot manipulations. Cost a fortune and really can't say much improvement. 
 I am finding more relief by taking it slow, really focusing on my gait and shortening my stride to avoid heel striking. (That image on the home page of Kickrunners is how not to run!) Also really looking at shoes and trying to minimalize them as much as possible. I wore orthotics and motion control shoes for years and really believe they are responsible for a lot of my injuries. 
 My suggestion would be to ride out your time in cast. Try to determine what casued injury and obviously try to avoid same error. Start back slowly. Ice after every run. Start with a run/walk at first. Take a good look at footwear. 
 Try to keep in mind that you want to run long term, so smart changes now will have major impact 20-30 years down the road.
 Keep moving forward.

Grizzly · Jan 29, 2011

I'm funding my PT's son's college education (the kid is 9).
 
Should you go? I don't know, your results may vary. It's painful but I have far more range of motion than I did a month ago.

RaisingArizonainNH · Jan 29, 2011

You can also try a different PT. You may need another referral.. but they have different ideas and methods. Is this a sports focused PT?
 
 PT is what you make of it too.. I went for my knee... they wanted me to go 3x a week but the copays added up so I started with 2x a week, but I was (and still am ) very conscientious about doing the exercises they gave me to do.

SportiGrl · Jan 30, 2011

I've only been to the assessment so far ... I think they know their stuff ... and are sports minded as they treat members of the local hockey team and other college athletes, etc ... and my PT runs marathons herself.
 
 
I'll likely go for a week and see whassup ... I really don't think orthotics are going to be my answer ... but I do have things that need addressed and tweaks I already knew needed to be made ...
 
 
mine was most definitely NOT a trauma thing ... it flared up really bad after a 4+ hour run on very muddy trails in the rain on New Years Day ... it hurt during but that's not entirely uncommon for me ... what was uncommon is it didn't stop hurting after a few days *sigh*
 
I think my PT is knowledgable I just don't know if my bio-mechanical limitations are fixable other than resting up and just doing what I do ... I am glad to know it's not the onset of RA

Rainey · Jan 30, 2011

I am taking an educated guess that what happened in you have one or several slips with excessive lateral movement and the ligament got stretched. Do you remember that? I did a 30k in mud last month but I basically tip toed through the gooey sections but I could see several places where folks had involuntary skiing episodes.
 
Ligament is pretty deep. If that is true it wasn't caused by any imbalance and running rest is the answer, again back to aqua jogging, eliptical is too much weight bearing, cycling maybe somewhat better but still stressful.
 
Don't completly rest, I would aqua log is my leg was broken, blood flow helps! I aqua jogged with a major disc protrusion with sciatica and muscle weakness, two months later I was running without pain and without the recommended surgery!

Shadow38 · Jan 30, 2011

I can only go by my personal experience. I have been to PT for three separate injuries (hip tendonitis/bursitis, IT band and achilles tendonitis). For the most recent AT, I found (with help from a PT friend) a therapist that was orthopedics certified and also certified in ASTYM. He's also an ironman triathlete. He did more than address the AT injury. He found that I had some other problems too (SI joint). He used ASTYM on my AT. One thing that really stood out was the being active to increase bloodflow (the ASTYM also helps with this).
 
I think PT is helpful, if nothing else, it can identify weaknesses and find ways to fix them. I suppose it will heal regardless, but I think PT can help restore strength and make healing a little quicker.

SportiGrl · Feb 1, 2011

yeah .. I skiied a couple times

but it's happened before and not caused this but there's always that ONE time, so you're likely right on on this one ...
 
I walk at my jobs 6-13 hours at a time so there's no getting away from weight bearing ... but it does seem to be getting better now that I'm wearing the BOOT at work and letting the ligament take a break - I know it'd likely be quicker healing with less time on my feet but I can't afford to quit/lose my jobs, so it is what it is

as for aqua jogging ... after working in the chlorine for 8 years straight and being wet for 4-5 hours at a time it's very difficult for me to opt for getting up before the buttcrack of dawn to dip in the cholrine with already winter dry skin and know I'll wreak of chlorine at work all day and have to get ready in public at the Y for work ...
 
I'm all ready to run before dawn and shower at home and go to work when I am healed but the pool is sort of like a prison I escaped last spring ;-) 

<div class="quote-container">Quote:
<div class="quote-block">Originally Posted by Rainey <a href="/forum/thread/72389/to-pt-or-not-to-pt-that-is-the-question#post_1980588"><img alt="View Post" class="inlineimg" src="/img/forum/go_quote.gif" style="border-bottom:0px solid;border-left:0px solid;border-top:0px solid;border-right:0px solid;"></a> I am taking an educated guess that what happened in you have one or several slips with excessive lateral movement and the ligament got stretched. Do you remember that? I did a 30k in mud last month but I basically tip toed through the gooey sections but I could see several places where folks had involuntary skiing episodes.
 
Ligament is pretty deep. If that is true it wasn't caused by any imbalance and running rest is the answer, again back to aqua jogging, eliptical is too much weight bearing, cycling maybe somewhat better but still stressful.
 
Don't completly rest, I would aqua log is my leg was broken, blood flow helps! I aqua jogged with a major disc protrusion with sciatica and muscle weakness, two months later I was running without pain and without the recommended surgery!
</div>
</div>

SportiGrl · Feb 1, 2011

thanks for sharing your experience ... I had to cancel my first session due to horrid weather today but plan to go on Thursday and see what shakes out - and I've been doing the stretches and such I was given last week and going sans boot a couple hours at home each day and trying to walk normally rather than flat-footed to prevent engaging the ligament ...
<div class="quote-container">Quote:
<div class="quote-block">Originally Posted by Shadow38 <a href="/forum/thread/72389/to-pt-or-not-to-pt-that-is-the-question#post_1980597"><img alt="View Post" class="inlineimg" src="/img/forum/go_quote.gif" style="border-bottom:0px solid;border-left:0px solid;border-top:0px solid;border-right:0px solid;"></a> I can only go by my personal experience. I have been to PT for three separate injuries (hip tendonitis/bursitis, IT band and achilles tendonitis). For the most recent AT, I found (with help from a PT friend) a therapist that was orthopedics certified and also certified in ASTYM. He's also an ironman triathlete. He did more than address the AT injury. He found that I had some other problems too (SI joint). He used ASTYM on my AT. One thing that really stood out was the being active to increase bloodflow (the ASTYM also helps with this).
 
I think PT is helpful, if nothing else, it can identify weaknesses and find ways to fix them. I suppose it will heal regardless, but I think PT can help restore strength and make healing a little quicker.
</div>
</div>

to PT or not to PT, that is the question ....

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