Weekend rehab

Still AROM, balance, and closed chain strengthening all weekend 3x per day. I've backed down a little as I was starting to get more soreness just from the volume. Swelling is coming down but posterior tib is starting to hurt more now, probably from the boot and compensating how I am walking.

My parents came down and we celebrated my birthday with pizza, brownies, and ice cream. It was a fun day, except that I was supposed to be throwing in California. Silver linings, I was happy to see everybody.

Lower / Rehab

Feeling better, I had the day off work intending to fly to Sacramento today, but that's not going to happen, so I took the day off anyway and tried to relax and not think about my ankle or throwing. It didn't work...

Rehab:

Bike 10'

Pumps x50x2
Circles x50x2
Alphabet x2

Toe Crunches x100

Step through

Single leg stance

Agility ladder slow steps

Lower:

Deadlift
Testing it out to see if it hurt. I had a hard time with the set up as the ankle was stiff into DF so once I stretched it out, it felt ok.
135x10
225x10
315x10
405x3x3 no straps
405x10 straps - Shrugs x20

Squat
SSB Hatfield squats
245 x10x3, x20x1

Core twists

Not bad, ankle was pretty sore in the evening but not sure if that was from deadlifts, squats, or rehab, or the fact that it's squished in the boot and the swelling is starting to go down. I'll back off on the higher level stuff and stick with ROM, Strengthening, and NMR.

Upper / Rehab

Thursday means upper body and a shit ankle means rehab.

Rehab:

Pumps x50
Circles x50
Alphabet x2

Heel Raise

Toe Raise

Single leg balance

Hip Abd - band

Step through

Chops

Squats

Upper Body:

Bench w/ Pad
255x5
295x5
335x8

Floor Press/Row
225x10x3

Russian Twist

Lower / Rehab

Today I got the boot and it feels much better in the boot. I also had a massage that was previously scheduled for pre-game work but now is more for my own mental health than anything else. I was able to get into the gym for some rehab at the end of the day which really went well.

Heel raises 

with BFR and without

Toe raises 

with BFR and without

Heel slides

Toe Curls

Step throughs

Squat

SSB vertical shin angle x20x4 with BFR thigh

Deadlift

Light Bands vertical shin angle x20x2

KB Swings 

70# x20

Minimal pain with exercise today

Upper and Rehab

X-ray results showed a big os trigonum but no fracture! Good news. We feel that I probably crushed that accessory bone between two other bones and have a deep bone bruise in that area which is causing all the bleeding into my feet. They are pretty purple after all day at work on my ankle in the ASO. Doc agreed that we should get a boot to take the stress of the tissue and allow it to heal. So, scheduled to get the boot tomorrow and then we'll go from there!

Ankle felt pretty good after work and being in the brace all day kept the swelling down around the ankle itself, but toes are pretty swollen. I took the opportunity to do some upper body work after gameready and compression every chance I had a work for my rehab for the day.

Seated Log Press
150x10x4
Seat Log Clean
150x10x4

Bench
135x10
225x5x8 with stop 2 inches above the chest and quick press out

Core twists and side bends seated.

Shot Put and Bad Vibes

Well...Shit

Throwing shot on Saturday, feeling decent, getting ok distances but feeling a lot better about the R leg turning and getting the hips through. Started to put some more speed on it and on my last scheduled throw of the day, drifted a little to the left, reversed my R foot right on the far left part of the box and rolled my ankle pretty hard. Felt a good pop but could put weight on it. Of course, it swelled up and I've been battling the swelling over the past few days. I have been doing a lot of voodoo band compression and elevation which has helped quite a bit overall but this thing is still pretty bruised and puffy. Ottowa ankle rules say that I probably should get an x-ray, so I did that this morning and am still waiting to hear back on the results. My fear is a posterior tibial fracture which may mean immobilization for 4-6 weeks. Shit. Hopefully not, but I saw the x-ray and I would guess I either have an os trigonum (rare) or a shepherd's fracture (also rare). We'll see what doc says, hopefully no surgery.

Heavyweight

Felt ok up until the end of the day when I started to get more tired and had a headache. I don't think I drank enough water today but I think I did well on my nutrition. Just trying to get more calories in to help recover better and keep things moving.

Warm up
Bike
Hip Swings
KB Swings
Agility ladder

HW
Probably took around 30 throws total
15 or so above 40' but didn't feel any consistency. I know anything above 40 is good, but when I hit the distances I did at the end of last season, it doesn't feel like enough.

I am rushing the start and getting all out of position at the finish. Towards the end of the session, I was able to slow down the drive and get into a better finish position but was too gassed to really hit it hard. I know the distances will come as the volume improves, I just need to be patient...it's just hard when I hit world record distances towards the end of the season.

Snatch
Worked up to 110 at hole 3 and missed 120. Hit some 2s and 3s at 110 before moving up.

Floor Press/Bent Row
worked up to 225+80# of chain before the AC joint started to get sore so I shut it down.

Med ball slam/QR Toss

Saving some for LW tomorrow, hopefully I can get some good distances and start to feel a little more confident in the knee. I have been going without sleeves and feeling decent about things, I still have some subconscious guarding about it I know.

Hammer

Throwing Hammer today, knee is doing OK, R is a little more sore than L today which is good. WHOOP says 60% recovery.

Med ball warm up
18#

Heavy and Light hammer
One winds
Heavy 100+ but it took quite a bit of work, Light 120+ but again, not easily.

Full Throw
Heavy 109
Light 130

Not great, but ahead of where I was this time last season. I looked back and didn't crack 130 for a few games, so I have to look at the progression and not expect to start where I ended last season.

Took a lot of hammer throws and was pretty beat after. The knees were doing ok, but the right was being a pain.

Training:
Clean
Worked up to some singles at 160 for hang clean with no catch
140x3 with quick response

Squat
315+80# chain
x3x8

Side Lunge
135x5 each no pain

SSB Twists

Ended with Cold Tub for 10 Minutes followed by hot shower.

Braemar

WHOOP shows low recovery, so I tried to take it easier today. Yesterday I did a lot of explosive movements and I'm wondering if that is the cause of the lower recovery.

Braemar, probably took around 20 throws including a very gradual warm up. Still didn't feel the pop but made 35' with my 26# stone. It's a heavy stone and I think my best every is right around 40. Still not a lot from the left leg, but that's ok for this point. I would like to be consistently over 40 with competition braemar stones.

Training:
Bike
Speed Ladder
Side Step
Hip Swings

Snatch
worked up to 130x3x4 QR Hip Snatch to hole 5

Bench
Bar toss
45x5x3, 65x5x3
Worked up to 315x3x3 as fast as possible

Accessory
Blast straps
Pull aparts

Shot and Light Weight

Catch up from the weekend.

I was at the in-laws for Easter weekend so we left on Friday night. So no training on Friday, but I was able to get out to their shot put ring and do some shot and light weight.

Took probably 50 shot put throws, nothing great, but was feeling pretty slow and terrible. Managed 50+ for best. Light weight was better, throwing off cement and hit an 83' one turn and an 86' full with minimal knee pain. Then hit 10 toe board throws. I haven't had that much throwing volume in a while and felt it the next day. The WHOOP said I was pretty decently recovered on Sunday so after the drive home, I did a good explosive workout with low weights. I have been feeling like I haven't had the "pop" that I have had in the past, so I'm going to add a lot more explosive work in other than jumps and the Oly lifts.

So, yesterday's work was:

Driveway "Hill" runs
x10

18# med ball throw for height
x10

Speed Ladder

Circuit 135#
Bent Row
Clean
BTN Jerk
Step Up Knee Drive
Jump Squat
x10 each
x3

Thursday: Heavy Weight

Feel a little better today overall with less knee pain. WHOOP says good recovery today so I should be good from that standpoint.

Started with KB power position throws. Started to feel better connection and good warm up. Went to 1 turns and took about 500 of them before I started to get a little more consistently over 40'. Took 3 additional once I hit 40 to see if I could push it out to 43' but the most was about 42'. Full throws took it slow to feel the connection with the weight and was able to start pushing them out to 45' on my last few with better "sink" in double support. This did hurt the knee a bit which is why I'm hesitant to do it I suppose. 

Snatch Pulls

Hole 6

Worked up to 150 from the hang which is a PR for that hole and from the hang.

Log

200 x3x5 working on good push from the legs to the arms with as much speed as possible.

Bent Row/Floor Press

135x15

225x10

225+40# chain x10

225+80# chain x10x2

PhysioBall Band twists

Plate twists/SB/Winds

Tried some jumps but they were a little more sore than I would like.

Tuesday: Hammer

First day of training after the new rehab plan was put in place. After evaluating my hammer, I realized that I was blowing past the finish and never putting force on the throw. This happens to me in the early season, because mentally I am still throwing at the end of last year where everything was lining up and I was able to really put the speed on it and still catch it in good positions. I always have to remind myself that it's a new year and taking 4-5 months off of throwing is always going to result in a re-learning curve for me.

So I started with a bunch of one-winds. I was able to push those up to 100' in the heavy and around 125' in the light (which was super embarrassing, and telling considering I hit maybe 123 in the last comp). I followed this up with probably 10 full throws with each heavy and light ending with around 109' and 131'. Very happy with this, slowing down the 1st and 2nd and adding tiny bits of acceleration instead of trying to get it all on the first and being behind it the whole way helped a lot...just like it alway does!

This was followed up with:

Cleans
130kg x3x5

Squat
SS Bar, Box, Chains
425+80 x3x5

Nothing extra as I was late for an appointment already, but a good day. I felt like the hammer work counted enough towards core, and I warmed up with some 18# shot/med ball throws too.

Day 1 rehab success.

Rehab has also begun!

Being a Physical Therapist comes with some advantages when you find yourself with aches and pains.

Here is the plan to deal with this knee and still progress with throwing and training:

1) Manage the pain
This is an injury where if it hurts, it's going to continue to hurt. You can't fix a joint issue by making it hurt or pushing through the pain. It just doesn't work. It's not going to miraculously get better if you keep hitting it with a hammer, so to speak.

2) Allow the tissue to heal
This will go along with manage the pain, if it hurts, it's not helping. I will also be doing a lot of perfusion/restriction and BFR training on the L to maintain strength and garbage out, groceries in.

3) Continue to progress
In order to continue to be competitive, I need to keep throwing as much as possible with as little pain and as little compensation as possible. I will be taking a very comprehensive warm up prior to throwing and then easing into throwing as deliberately and as cautiously as possible. I also really need to look at some biomechanics with jumping and throwing to ensure the patella is tracking as appropriately as possible. I will be adjusting to high box squats with chain loading to stay out of the painful ROM, I will be taking all cleans and snatches from the hang with no catch. Jumps will be avoiding deep countermovement, and unilateral work will be shallow lunges, step ups, and side steps. Another thing to check will be heel drop with footwear. I will not be using olympic shoes or shoes with a high heel. Squats and cleans with be done on a slight decline (in my garage I'm either inclined or declined, so I'm choosing the one that will reduce as much stress on the patellofemoral joint as possible.

This will get tweaked as I go along, but I will be sticking to my regularly planned days and workouts with minimal adjustment there. The things that will change are the individual exercises done that day.

Updates as they are available...

Wish me luck!

Season has begun!

Welp! The first real games has come and gone and I am pretty disappointed.

About 2 weeks prior, I was throwing hammer and felt some pretty good pain in the lateral patellar area. I have had this before but this seemed worse overall. After quite a bit of poking and prodding, I felt pretty confident that it was some type of patellofemoral issue along with some patellar tendonitis. This is not an easy injury to manage especially on the block leg for a thrower. I felt like it was coming along but then, a few days out from the opener, I was doing some weight throwing and felt the pain but way worse. I was not pumped.

Combine the above with a nasty stomach issue that had me about 10-12 pounds lighter than I was a week out and it made for a pretty rough day.

The knee only hurts when I get to a certain point in the ROM, so it's like waiting for an ice pick in the knee every time I squat or sink in the weights or hammer. When you have pain like that, you can't work through it and just grit your teeth, so you start to compensate. I could feel it happening despite my best efforts to power through on game day. I had no leg drive, no finish in any throw, and it generally was a pretty disappointing day. The two upsides were: I finally cleared 18' in the WOB which was a huge goal coming into the offseason, and I didn't have much pain except for caber and HWFD. Overall, a pretty lackluster day and disappointing weekend. So, what's next?