Post Op Rehab

Devon Lad

After tearing the ligaments in my left ankle playing rugby, then returning to rugby after 3 months with the aid of heavy taping (all the while cycling regularly), I was told at the end of the season by the team physio I would never be able to practice serious sporting activities to a decent level again unless I had the ankle ligaments reconstructed and re-stabilised.

5 weeks on from the operation with my lower leg immobilised I'm dying to get back on the bike! The cast comes off next week and basically the question is, how should I return to cycling? The doctor at a conservative guess advises that cycling out on roads is out of the question until Christmas however turbo trainers are OK and the call ultimately rests with the physio.

On removing the cast for showers, my calf muscle is almost half the size of the other, how quickly will I regain lost muscle and fitness? Also should I taper my effort on the turbo, or just train as hard as I can? (bearing in mind the action of cycling has no effect in exacerbating the injured ankle)

Any advice and/or uplifting stories of those who have had similar experiences would be greatly appreciated.

Thanks in advance
Will

desweller

Recommend you put this one in Road/Training...

Devon Lad

Sorry, just posted it here as I consider myself very much a beginner to road cycling and have had no previous experience of cycling rehabilitation, or turbo training for that matter...

However it seems as if this section of the forum is reserved exclusively for "what first road bike for £500" questions :P

Sarcasm aside however, thanks for the advice, have posted it in the training section.

Thanks
Will

wishitwasallflat

Do what the physio advises and if you doubt their advice ask for a second opinion from another physio. I would urge you not to follow the advice of anyone who hasn't seen your medical history or examined you. Everyone is different and any physio worth their salt will provide you with tailored rehab and monitor your progress and amend your programme as needed (and yes you can still get physio on the NHS free at point of access!).

BruceG

So you are already talking to a physio and seeking the advice of your surgeon, but you thought it would be a better idea to ask a total stranger on an internet forum. JEEZ

Devon Lad

Seeing as neither my surgeon or my physio cycle, yes, I did think asking a total stranger on a cycling forum on how to regain fitness on the bike would be a good idea..... :roll:

Thanks wishitwasflat I will of course follow the physio's programme however it will mostly be concentrated on helping me to walk properly again.

Was hoping to find some other advice, but thanks BruceG, not quite sure why you even took the time to post that, as however flawed my decision to post this on the forum may have been your reply adds nothing whatsoever. :?

Bobbinogs

Heh heh.

I am sat here with a broken collar bone also surfing the web to see how other folks fared on their recovery and any tips, hints, comments that go with it. Yes, I will listen to my consultant when I see him tomorrow... and the physio when I doubtless get the privilege of paying for that (Glos only do dial-a-physio to save money) but the other stuff all helps us injured folks make sense of it all and I think can help the medical team too (I read about foam rollers when I got itbs and my physio agreed it was a good idea...works brilliantly and I use it daily...or did until yesterday).

Nothing I can offer you Devonlad this time though. Stick with it mate.

high_tower

Hey Devon,

I had my ACL reconstructed after landing badly playing rugby a few years ago. I was devastated at the time and throughout my recover and operations. It unfortunately took a lot longer to recover than anticipated. However since i'm back on my feet I'm fighting fit and waiting to head to Afghan in the new year.

The only thing stopping you is yourself. It seems to many people have the operation but don't commit the time when away from the physio or the rehab classes to complete the required work. I will say cycling was a brilliant way of regaining strength in my knee (even if most of it was on a turbo as i feared hurting myself if i fell off).

Just get stuck in and take the rough with the smooth.

-High Tower

BruceG

Devon Lad wrote:

Seeing as neither my surgeon or my physio cycle, yes, I did think asking a total stranger on a cycling forum on how to regain fitness on the bike would be a good idea..... :roll:

And how many on here are surgeons and Physio's?

As for what I added, it may just make you think enough to realise that you could end up taking ill advised (how ever well meaning) advice and NEVER get back on your bike again

Devon Lad

Thanks a lot Bobbinogs and High Tower, exactly the kind of stuff I was hoping to hear, collarbone and ACR both sound incredibly painful, although I've only broken a colarbone myself, mates of mine have told me that ACR is awful.

BruceG I'd jut like to clarify, everything I will be doing will be under the guidance of surgeon and physio, and as you point out, I would really not do anything without first asking experts, for risk of damaging myself further and not getting back on the bike. I appreciate your concern. I was just hoping for specific real life experience from people who have been in a similar situation.

Hope you mend quickly Bobbinogs and the physios and doctors let you back out quickly! Good luck in Afghanistan High Tower.

Another thing I have been pondering over my lay-off is, how quickly will my previous level of fitness return? Do I have to earn it all over again? Or has the groundwork previously been done and returning to a previously attained level is faster than before?

Many thanks
Will

wishitwasallflat

Hi Devon Lad - Don't worry too much about whether your physio or consultant cycle or not.

The most important aspect of rehab (especially in the early to mid stages) is generic i.e. common to all injuries. The most important thing is the recovery of function in the affected area and the restoration of as much normal tissue (or failing that pain free scar tissue) in the affected soft tissues. The processes and steps to do that are largely the same no matter what sport or activity the client enjoys.

Re concentrating on walking - if you recover a normal gait then you will have/get (or be well on the way to) normal ankle function. Once you have normal ankle function then building back fitness and technique on the bike is pretty much as it was when you began. If you tell your physio about your cycling they should note that and take it into account in progressing and developing the later stages of your rehab.

My main concern was your cast in not yet even off - you have a few steps (no pun intended) before your rehab will need to be (or should be) activity specific.

The first steps are to get you back a normal functioning ankle. Go through that process carefully as that is the essential foundation for your future cycling. In my experience when people rush that basic first stage of rehab and try to get sport specific and/or push it too quick yes they do get back to the activity they love sooner but often if the basic structures and mechanics are not in place they are storing up trouble for the future. For example I have seen loads of very high level sports people who went through rehab but years later start to develop traumatic OA through having trained and played with mechanical imbalances that they learned to compensate for and pushed on with as they loved their sport so much. If the fundamentals had been done right FIRST and the return to sports specific activity structured carefully and monitored that doesn't have to happen.

I have had loads of great advice on this forum and have a huge respect for the many many very experienced people who give advice here - but - please if anyone gives you rehab advice ask them what medical qualifications they have and be sure they understand the process of inflammation and soft tissue repair as that is the key to most ankle rehabs. Once your doc and physio give you the all clear re getting back to training then yes this forum and other can be a great source of advice and one I use myself.

Patience is the watch word my friend and I have no doubt if you are sensible and follow the advice of the health professionals looking after you you will be fine and enjoying your cycling again.

high_tower

Will,

not sure how your rehab is managed but I had 3 mornings a week at the physio doing classes from running on a treadmill to step aerobics. I was there for about 12 months total but as I went on the physio encouraged me to do new activity such as get back to running but with limits. I'd feedback how I felt for strength/stability and then we'd work on the problems that I was having.

quite honestly I couldn't have asked for anymore from the team. I lost the belly I'd put on sitting around before the op. The only dramas I had was confidence in the graft which took about 12 months to be convinced and it being weird to kneel on that knee, but that took time and activity to get back to normal.

If i can run around carry the kits i need to do my job in Afghan then I'm happy with the job they've done!

wishitwasallflat

PS - Sorry BruceG is spot on and I should have added I am a Physio and worked many years in Sport Injury Clinics and private practice!

The Real Radioactiveman

Just remember that tendons/ligaments heal much slower than bone.

I am Still recovering from partial rupture of my patella tendon in a climbing accident. Hopefully you get a good physio if not definitely consider private if you can afford it as I think I have lost a lot of time through poor physio.( I am sure not all physio's/hospitals are bad )

NHS said I am fixed now because i can bend my leg > 90degrees and walk but my leg is as strong as a wet spaghetti. My advice having been unable to do much for 2/3 months is take your time. You want a quality recovery if you can do it fast that is great but dont rush it as you risk doing further damage or papering over the cracks.

Also important to rebuild your body's balance it wasnt until monday when my new physio pointed out how much my good side was compensating for my weak side.

Good luck and be patient

Peddle Up!

Bobbinogs wrote:

Heh heh.

I am sat here with a broken collar bone also surfing the web to see how other folks fared on their recovery and any tips, hints, comments that go with it. Yes, I will listen to my consultant when I see him tomorrow... and the physio when I doubtless get the privilege of paying for that (Glos only do dial-a-physio to save money)...

You were offered a physio!? Even a virtual one? I was told "not to do any heavy lifting". :?

Bobbinogs

Peddle Up! wrote:

Bobbinogs wrote:

Heh heh.

I am sat here with a broken collar bone also surfing the web to see how other folks fared on their recovery and any tips, hints, comments that go with it. Yes, I will listen to my consultant when I see him tomorrow... and the physio when I doubtless get the privilege of paying for that (Glos only do dial-a-physio to save money)...

You were offered a physio!? Even a virtual one? I was told "not to do any heavy lifting". :?

mmm, I could rant about my experience when I had knee problems. I was given the phone number of the Glos NHS dial-a-physio (by my GP) and when I called (at my expense) the lady proceeded to try and talk me through some exercises despite me being in a stairwell at work and her obviously unsighted as to how I tried to keep up with her. After about 20 mins I just said "sod it", albeit rudely I'm ashamed to say, and ended up paying to go private with a decent sports physio. I wonder who's bright idea dial-a-physio was (I guess they might say it worked in that the NHS saved money and I got the right treatment, in the end). Grrrrrrr.

Peddle Up!

"Dial-a-physio". As convincing as a ventriloquist on the radio.

gmacz

Cycling will be great for your recovery. You can actually ride the bike properly with a left or right side that is not up to full speed. The other side will take the strain as the problem side slowly repairs and starts to catch up.Strength and stamina will soon come to both sides. You realise this when you start to put the power down on both sides at 360 degrees using spds. Knightmare is when you start to push it too early and it fails.
Take it slowly and enjoy the biking and the fitness will surely come

mattshrops

one thing i learnt from my own experience with muscle wastage is try not to limp. might sound a bit weird but by limping your'e not working the muscles in your calf etc and exasperating the problem. the bad news is it takes a long time to rebuild your muscle, the good news is you can do it. Its hard work but just take it one day at a time. good luck