Rehab with gym exercise

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  • posted by Patricia1066
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    Hi,, I’m getting better on my feet after an ankle bone break, and want to be back running in early June.
    I am walking without a limp as long as I wish, and can cycle 10 minutes on the exercise cycle.
    I want to do stretching and strengthening exercises, but will I do it without a class, unlikely.

    My local leisure centre has personal trainers that could check my progress.
    The consultant said no swimming for at least 5 weeks so I didn’t mention running. He was ok about the exercise cycle.

    What qualifications in the trainer would be relevant for fracture rehab?
    Any thoughts on what classes I should look into?

  • posted by Squidge
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    Running, unlike a bike, is high impact and could damage your ankle – please do check with your consultant before you try. You could also ask them to refer you to an appropriate person to help with your rehabilitation.

  • posted by Patricia1066
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    Yes I totally agree about the running being harder on the feet. Some dance and yoga classes can be high impact too. That’s what I’ll avoid for now.
    I am discharged from the fracture clinic, I’ll get advice from the GP about exercise but unlikely to get a physio appointment because I have no walking impediment.

  • posted by caronl
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    Hi Patricia1066. It is good to hear that your ankle is so much better. And I hope you get some good advice from your GP on how to build up sensibly. Every fracture is different. I broke my ankle about 5 years ago. Most of my exercise tips I downloaded after a Google search (!) so I think you will be in a better position post GP advice. But one simple exercise I used to do while watching TV etc, was simply to spell out the alphabet with my foot. This seems to have given me back all the flexibility at least. Maybe you could check that suggestion with your GP, amongst others no doubt. Best wishes for your recovery.

  • posted by JGwen
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    Hi,
    What caused the problems for me with my ankle was not the break, but a lack of work with a physio. I had spent 6 months having my foot held in one position and being read the riot act about the consequences if I tried to put any weight on it and caused the bone fragments to move – So while I had mastered the art of walking short distances holding my foot in the perfect angle to land flat, that involved misusing my hips and back to balance, and all the ligaments had seized up. Because I could walk across his office without my boot on without pain the consultant signed me off and said I didn’t need physio. But of course that was walking a short distance on a flat surface, with my hips twisted so that I could swing my leg while keeping the foot as immobile as it had been in the boot. –

    If I get injured again I will first of all try to fight within the NHS to get physio, – I think it is a completely short sighted policy to not include physio to get someone back to normal use of a limb after an injury. Its a waste of someone’s life if they are left unable to live life to the full just because of some cost cutting pen pusher. – If I can’t get it on the NHS or if there is a long waiting list I will go private because I lost years of my life to being told if the consultant says this is as good as it will get then that’s it, and it was only good fortune that a trainee physio who was doing her work experience at the local hospital as part of her course decided to stay in my holiday let and turned my life around.

    Before I get off my soap box I will say that talking with the student physio to understand why the ankle had locked up and what work to do with it only took a couple of hours of her time to go through the exercises to strengthen it. Clearly from her explanation of the contents of her course I think any qualified physio would be the start point anytime I needed rehab after an injury. They have studied the ways in which muscles and tendons lock up and can be injured and the exercises needed to build them which is completely different to the sort of stretching program you go through in a gym.

    I have to say though that I have been very impressed by the Equi Pilates class. – It is a hoot an at the same time I didn’t realise how many tense muscles I had. – The stretching with pilates is on a completely different level to the stretching involved in physio when muscles and tendons are shortened. – Pilates is about subtle little changes to improve performance and think if you are using your body unevenly. I do think that the success of this class is down to the quality of the instructor, she both knows her stuff, and has a good sense of humour, and it involves exercises which are specific to horse riding which is very different to any other sport. – One of the people taking part in the class is a Pilates instructor, and the difference between the two in ability to engage with people is quite striking. I joined the class because its local, being held in the church hall by the local riding club, but I have enjoyed it so much that I am thinking about asking the tutor about one to one sessions and travelling to her place. – She has already said that this batch of 4 session in our church hall will be the only ones she can give because she can’t fit in travelling over to us, but maybe a group of us could car share and take it in turns to travel over to her.

    I don’t know if it would help giving a detailed description of what we do with the muscle training research program. But am happy to share that.
    We start by warming up with 6 minutes at resistance 7 on the machine they have in all gyms where you are copying the action like walking with skis, so you are both walking and using your arms. – They refer to it as a stepper in the notes, but I thought the steppers were like climbing stairs. – Anyway, I am sure you know the machine I mean.

    Then we use the chest press machine. You use it at the maximum weight you can do 5 plus reps at. You are aiming to increase the number of reps you can do beyond 10 reps. Then you rest for 2 minutes, do another set of reps, rest for 2 minutes and do the third set of reps. – You are aiming to build up to being able to do 10 reps on the first 2 sets, once at that level then you increase the weight and work on building up the number of reps.

    You do the same with the leg press, and with the chest pull. Working at the maximum weight you can.

    Finally you finish with a 6 minute warm down either on the tread mill or exercise bike.

    We do this just once a week. The aim is to put the muscles under enough stress that they choose to increase the blood supply within the muscle and build up strength of bone and muscle. If you just work with enough weight that you can do 15 reps each set you are not giving your body the signals to increase strength, you need to work to exhaustion to signal more muscle is needed.

  • posted by Patricia1066
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    JGwen, caronl, squidge really appreciate your thoughts.
    I had a very disabling ankle sprain 15 years ago, and the physio offered only one advice – get off crutches. That was it.
    I limped for a year after, but managed to get good form ( if I was a horse😁) because yoga was my passion then.
    I think physio has improved since then, and I will press for a few sessions.
    I’m really into running now, I lost 4kg the previous month just because of my running routine. My fall was when walking chatting not looking where I was going.
    Yoga and stretching and cycling just doesn’t seem to affect my weight or inches.

  • posted by Patricia1066
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    I found a physio with good reviews locally, so I will ask him to advise on exercises.

    Today I have done 5 minutes of gentle exercise cycling for 5 minutes. Ok walking on flat, but as soon as I walked upstairs wow my metatarsals ached where they really didn’t want to bend. No pain on stairs earlier today.

    But I was told that the boot will be needed for extended walking, and it eases the cramp.

  • posted by arcticfox
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    Hi Patricia, I agree that starting with a physio may be best if you can manage it. I have also found that so many GPs don’t seem to think that physio is necessary when it really should be a standard part of rehab. I had a fairly minor foot injury a few years ago and as it didn’t seem too bad my GP didn’t want to refer me to physio so I never went, and I really regret it as it still flares up from time to time. I have found that many physios are very happy to have a patient who is strongly motivated to return to activity or sport and some will let you do just a couple of visits initially and then provide you with a progressive plan. That makes it more affordable if you do have to go private. Also, after one of my injuries I got my physio to refer me to the kinesiologist who worked in the same clinic and that gave me some sessions that were less expensive than the physio but she was still highly qualified and was able to design a program just for me and based on what my physio told her I needed.

  • posted by Patricia1066
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    I had first session today, and got advice on excercise and how to get out of the boot safely.
    I have loose ligaments around the injury, preexisting and I need to correct this.
    Very useful to have physio at an early stage.

  • posted by Patricia1066
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    Update on ankle injury.
    The physio saw me twice, and adjusted the exercises for my improvement.
    I have very little swelling, and can walk on rough ground in supporting boots.
    I have flexibility exercises that I do 3 times a day, and balance and modified lunge exercises also.
    I can use the cycle machine at home, and am doing 20 minutes easily now.

    I did strain my ankle by traveling for a few hours over the weekend, and had some short term swelling, so I know not to assume all is ok.

    I do feel bored, taking things so gently but it’s for my own good (I keep telling myself that!) JGwen, thanks again from the bottom of my heart for your help, physio really has helped me avoid further injury.

  • posted by alliecat
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    This is very positive news, Patricia! What you refer to as physio, we refer to as rehab over here. I’m so glad that
    you were able to access these services. I know it’s hard to feel like your “wings have been clipped”, but it will all
    be worth it if you can learn how to strengthen the ligaments in your foot. Just hang in there with it, and the rewards
    will be yours 🙂

  • posted by Patricia1066
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    Hi Allie, I have gone for private physiotherapy , as NHS consider the foot is good enough by resting it.
    How are you doing? I’m really glad to see you on the boards again.

  • posted by alliecat
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    Thank you Patricia! I’ve missed the gang, too. I did at last accept antiobiotics, which can be useless, depending on
    whether the infection is viral or bacterial. I did add some alternative medicine techniques to my cause, i.e., crystallized
    ginger (which I washed most of the sugar off of), as well as oregano oil, applied to the soles of my feet. I weighed
    the pros and cons, and ultimately decided it was worth it to use these products to strengthen my immune system,
    as well as my lungs. Feeling much better now, and very happy to be back! Take good care of yourself 🙂 The U.S.
    is in the throws of a single payer health care system vs. private care too. I don’t know what forces will prevail,
    but I’m happy that you have alternatives available to you! Just “resting” your foot doesn’t sound proactive enough
    for me, either. As always, JGwen has good advice to share xxx

  • posted by Patricia1066
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    That’s interesting, Allie. Is crystallised ginger a way of improving immune system? I know people recommend unprocessed honey for its antibacterial properties.
    Have you taken probiotic yoghurt? That will support your digestion when you take the pills.

    The NHS is great, I got excellent care up to the point where my foot is in a good place to heal. But I can afford a few physio sessions and it’s certainly given me strength without risking my ankle.

  • posted by alliecat
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    I think the health properties from ginger have a long history in Chinese medicine, Patricia. I try to use fresh ginger
    root as often as I can. It has a whole host of properties, though in crystallized form (because of the sugar) it isn’t
    an ideal way to use it. I have a U.S. source that is particularly fresh, so I made the judgement that it was the best
    way to get a lot of it “on board” at once. It could easily become addictive though, so I’m resisting buying another bag.
    Someone on here grates an entire hand of ginger, skin and all, and steeps it. It becomes concentrated, and a very
    good idea to add to our quota of water each day. I’ll be trying this next!

  • posted by sixturkeys
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    I was interested to read Allie’s post re antibiotics. If there’s a hint here that the infection could be viral, then those in my experience, are not prescribed. Understandably a concern about increasing antibiotic resistance (tho as farmed animals are stuffed full of them on a regular prophylactic basis, one does wonder…). But Allie, I am sure pneumonia, with probably horrible crackly lung sounds, meant that you needed that boost. I knew ginger had anti-nausea properties, viz morning sickness, but not immune system support. And yes re honey, Manuka I think especially, but more for open wounds I thought. I do agree, for all its limitations at times, the NHS is great. I think (without starting a polemic…) that ObamaCare was misrepresented, and reading that T1 diabetics cannot afford insulin in the US, the world’s largest economy, just sounds…wrong?

  • posted by alliecat
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    The conversation about differing healthcare systems is always of interest to me, 6T. I have learned over a long time on
    these forums, how wide are the misconceptions about what is actually happening on each side of the pond. The
    majority of Americans (80+%) have private healthcare through our employers, and the rest of the population have
    access to medicaid, which functions to provide care to the poor. All cutting edge drugs are available to the majority
    of the population, with a small co-pay. I can never remember hearing that insulin is limited to those that need it. The
    way the NHS is presented to us, it’s always categorized as short on funds, and is a system dependent on quotas and
    extended waiting periods and rationed care. From what I’ve managed to absorb, it does seem that urgent care is
    well managed, but elective procedures, maybe not so much? Once our politicians become involved, they use this
    all to try and frighten the population, because what is really more important than receiving the best care possible?
    I’ve never had to wait more than a day for treatment, and no more than a week for a surgical procedure, from the
    doctor or hospital of my choice. Obamacare has been an unmitigated disaster, and the sooner that it is thrown in
    the garbage heap of history, the better. What it has succeeded in doing is to double or triple the deductibles for
    most families, so they end up putting off treatment because they can’t pay the deductibles. What good is an
    insurance card if you can’t access care? Worthless! Always interested in your thoughts,

    Allie

  • posted by sixturkeys
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    Allie, that is interesting; I just spot things here and there in the news. When you say that 80% are covered by employers, is there a cut off? I gather that you are not employed, tho your O/H still is, and maybe a New England college has a good policy for employees and their dependants. Does that carry on post-retirement? Till death? I did read about the insulin for T1 sufferers!

  • posted by Patricia1066
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    6T, I googled the issue and found a New Yorker article on T1 diabetes and access to insulin which backs up your comment. Even those on insurance have to copay for insulin, about 1,000usd per month until the deductible is exhausted. That may be the Obama care increase Allie was referring to. I can see how it could be unaffordable to the average working diabetic.

    https://www.t1international.com/usa/
    This is the US chapter that is seeking to rectify the situation.

  • posted by alliecat
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    My goodness, Patricia. $1000.00 a month? That really is shocking! Between my husband and myself, our med costs
    are valued at over $2000.00 a month, and our co -pay is about $40.00 per month. I guess we are very fortunate! Under
    Obamacare, this would cost us $1500.00 a month in premiums, if the college didn’y pay for the majority of it. If O/H
    was in retirement though, we’d have this burden to bear ourselves. The medication costs are more or less a wash, but
    it’s the cost of serious illness where we are ahead of the game. My husband incurred costs of several hundreds of thousands
    dollars for his surgery and multiple post operative emergencies, and our out of pocket expenses were no more than
    $5000 dollars. It’s all in the perspective, though. It’s really good to learn as much as I can about NHS policies, though.
    Particularly because it effects all of you! Thanks so much for your thoughts 🙂

  • posted by sixturkeys
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    Allie, the USD 1k a month is in your country…

  • posted by alliecat
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    I guess that should have been “affects”!

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