Email Follow Up
- Pain seems to be a little worse this week bottom of foot and achilles
- Held on elliptical due to pain after trying it once and having increased pain
- Unable to tolerate pallof press position
- Questionable if tape is helpful
- My reply
- This sounds like a good week to regroup a little bit
- Let’s get back on track with focusing your ability to load the achilles short of pain
- Movements in standing, whether it is the pallof press or elliptical and going to be difficult on the achilles and other aspects of your foot if the calf is too weak to support you in a standing position
- Let me know where you are at with the band loading and if you are able to progress to a ery light weight on the leg press
- Elliptical Progression:
- HOLD on elliptical this week….Stick with the bike
- LEVEL 1(WHERE YOU ARE NOW)
- 4 minutes
- LEVEL 2
- 6 minutes
- Each level will continue to increase by 2 minutes…now this is not rocket science but I want you to follow the soreness rules below that I use to progress athletes back to running. This will gove you guidance in regards to frequency and level progression
- SORENESS RULES LINK
- Weekly Organization
- Day 1: Daily Movements + Strength Circuit #1 (2-3 sets)
- Day 2 : Daily Movements
- Day 3: Daily Movements + Strength Circuit #2 (2-3 sets)
- Day 4: Daily Movements
- Day 5: Daily Movements + Strength Circuit #1 and #2 one set of each
- Week 9 Updates below in BOLD
- Daily Sequence
- Self MFR Calf VIDEO
- use a tennis ball or lacrosse ball
- Hit 2-3 spots on the calf, NOT ON THE TENDON for 30to 60sec
- Band Plantarflexion/Gastroc Activation VIDEO
- There are a variety of band resistances
- Try to start with something that allows you to get through as much ROM as possible
- If you have significant pain with any motion, try to start with just an isometric hold for 30sec-2 minutes
- If you are able go through as much range as possible with minimal pain, go really slow on the negative 4-5 sec as you slowly load into the stretch
- Self MFR Hamstring VIDEO
- Same concept as above
- Hamstring Isometric with Contralateral Leg Raise VIDEO
- This can be done with an exercise ball of feet up on couch/chair
- Try not to push directly onto heel as it is likely tender
- Push more so into the calf
- hold each 5sec, 8-20 reps
- Cross Leg Contract Relax Posterior Hip VIDEO
- This is to activate the posterolateral glute in a lengthened position
- This will be important as we progress into single leg stance
- Hold each 5 seconds and complete 8-15 reps each leg
- 29.1) Prone to Supine Quad Stretch, Isometric, Active Motion VIDEO
- Be careful with the isometric portion that there is no pain
- Self MFR Calf VIDEO
- Strength Sequence:
- Now we will begin to separate out 2 strength circuits
- i want to focus on getting to fatigue without significant pain
- To do this we are going to minimize standing activities for right now
- Circuit #1
-
- Band Around Knees Bridge Progression VIDEO
- Keep tension in the stomach as you raise up
- 8-20 reps slow and controlled
- If you have any knee pain bend your knees less as discussed in the video
- PHASE 2
- Squat Pulses In Short Range VIDEO
- TRY DOING THE QUAD STRETCH RIGHT BEFORE AND SEE IF YOU ARE ABLE TO GET BACK TO THE PULSES
- 30sec to 2 min is the goal
- You can keep the band around your knees with this one as well similar to the bridge
- PHASE 2 PROGRESSION
- Sidelying Leg Raise Progression to a Stretch VIDEO
- really focus on form with this one
- Hip Thrust Progression
- 99) Double Leg VIDEO
- 8-20 reps
- Band Around Knees Bridge Progression VIDEO
-
- Circuit #2
- Band Plantarflexion/Gastroc Activation VIDEO
- There are a variety of band resistances
- Try to start with something that allows you to get through as much ROM as possible
- If you have significant pain with any motion, try to start with just an isometric hold for 30sec-2 minutes
- If you are able go through as much range as possible with minimal pain, go really slow on the negative 4-5 sec as you slowly load into the stretch
- DURING THE STRENGTH SEQUENCE, TRY TO PUSH YOURSELF WITH THE ENDURANCE OF THIS ONCE
- LETS TRY TO GET YOU UP TO 3-4 MINUTES BEFORE WE GO BACK TO OTHER LOADING OPTIONS
- WHERE ARE WE AT WITH THIS ONE….I WOULD LIKE TO TRY THE LEG PRESS AS A WEIGHT OPTION THAT IS LESS THEN YOUR BODY WEIGHT
- 126.4) Heelraise Loading Overview Isometric to Increased Range VIDEO
- AT THE END OF THE VIDEO I SHOW AND DISCUSS THE LEG PRESS OPTION
- LEVEL 1
- THE LIGHTEST WEIGHT, 2 FEET HOLD ISOMETRICALLY FOR 30SEC TO 2 MINUTES
- LEVEL 2
- SAME WEIGHT TRY TO PROGRESS MORE OF THE LOAD ON THE INJURED SIDE, STILL HODING ISOMETRICALLY (75% INJURED SIDE AND 25% NON-INJURED SIDE)
- 94.1) Tibialis Anterior Band VIDEO
- Activates the antagonist or opposite of achilles
- MAKE SURE TO STAY IN A COMFORTABLE RANGE OF MOTION
- THIS SHOULD NOT ACTIVATE THE ACHILLES AT ALL BUT CAN CAUSE SORESS IF YOU GO TOO DEEP INTO THE RANGE OF MOTION
- YOU CAN EVEN HOLD THE FOOT STILL AGAINST RESISTANCE AND DO AN ISOMETRIC IF THAT IS MORE COMFORTABLE
- I would go for a time goal with this of 30sec-2min
- 98.1) Quadruped Hip Extension progression VIDEO OR 98) Hip Extension Over Table/Bed VIDEO
- OVER THE BED OR OVER THE BALL TRIES TO MINIMIZE WEIGHT ON THE FOOT
- CHOOSE WHICH EVER ONE WORKS BEST
- 91) Rolling with Side Lying Rotation VIDEO
- Slow and controlled rolling with a thoracolumbar stretch in between each
- Tightness in the low back can often contribute to the achilles sensitivity so I like to include some lateral trunk stability which we will start off with in a non-weight bearing position
- NEW
- 157) Band Extension Deadlift VIDEO
- THIS IS MORE OF A GLUTE AND HAMSTRING EMPHASIS WHILE ALSO INCORPORATING UPPER BODY INTO A PULLING MOTION
- 8-20 REPS SLOW
- 157) Band Extension Deadlift VIDEO
- Band Plantarflexion/Gastroc Activation VIDEO
- Daily Sequence