I feel like the first two sessions (which were definitely rough) were the feeling out sessions before we really got down to business today. We definitely went longer than the first two sessions, with a lot of work going down on both my ankle and my knee.
Ankle:
Measured at a relatively easy 3", with 3.5" almost achievable with some push. Lots of work on the fibula side - there were some particularly tough spots up by my knee, and then down by my malleolus, but this side was not nearly as bad. When we switched to my tibia side, it felt like being repeatedly jabbed in a bruise down by my malleolus and that side in general was more of a fight to get through.
Re-tested again with a tough but doable 3.5" and he thinks that this may just be the reality of my ankle. I feel like tension through the anterior of my ankle and at this point we may be looking at how my bones sit/healed/are as opposed to clearing up adhesions. I asked if 4" would be a cause for celebration and he said that it would be pretty hard for me to get there. In terms ideal movement, my doctor (and a lot of functional movement assessments) considers 5" is considered to be a pass. If I could get 4", I think I'd consider that a major victory. We'll see if continued focus on my Bulletproof Ankles programming makes any difference.
Knee:
Now here is where we are seeing some serious improvement. My initial test felt way less restricted, and was 6". This is an inch of improvement from where we started in session two, and the sensation of where I feel tension/restriction is starting to change. It's no longer just all back of the knee/hamstring area. I'm feeling it there (but way less), and actually starting to feel quad tightness. This is exciting.
He went grinding along my joint line again, which did not feel as bad as last week. There's some places over my medial meniscus that are more uncomfortable, but definitely better than last time. He then started in on some manual work on my quads, which again wasn't too bad. Then shit got real and he did instrument assisted release along my VMO and my rectus femoris. This was insane. First off, apparently muscle should feel smooth - mine felt like a rumble roller. Sweet grindy noise too. VMO was bad, but rectus femoris was worse. He did six passes over the one spot and it was the longest thirty seconds of my life. Purposeful pain though - I re-tested at 5" and barely felt any restriction in the back of my knee - it was way more in the quad, which is where I would expect it to be.
Next Session: Thursday. He said he may start moving into my left ankle and both my shins. I know how much I hate it when my RMT does my shins, so I'm sure this will be quite the treat.
Tuesday, June 7, 2016
Friday, June 3, 2016
Session Two
I went in to this one knowing a bit more of what to expect, so that was good. I was mainly curious to see if we would be going over the exact same parts, or if we would move to different ones. The answer was some of the same, some new, with the goals remaining the same (ankle dorsiflexion and knee flexion).
Ankle:
I tested at a 3" dorsiflexion to start and felt stiffness through the anterior and towards my tibia. He worked on my ankle A LOT. This time we did work up the fibia side (along my scar) continuing past it and up towards my knee. In terms of discomfort, there was much above my malleolus, then not nearly as much for the middle part, and then it increased again as we got closer to the knee. We also worked the tibial side this time, which let me tell you was loads of fun. He finished off doing some work on the anterior part of my ankle.
Re-test was a 3.5" but it was definitely a more challenging 3.5" than my first session and I definitely still felt stiff.
Knee:
Initial test on the knee was at 7", which was an inch and a half of improvement over session one. Thankfully he did not focus long on the lateral side of my knee, which has a nice bruise and was super tender. He did work along the joint line, some more on the medial side, some more on the quad tendon/vastus medialis, and then focused a lot of attention further up the leg. This was tight. Once again, work on my knee flexion hurt way, way more than work on my ankle.
Re-test was at 5.5". The cool thing about the re-testing too was that I stopped just feeling the discomfort along the back of my knee and actually started feeling tightness in my quad. This was pretty exciting!!
Bruising:
A little bit more than last time - mainly right above my knee, some dots up my quad, and some dots of bruising on the back of my calf.
Ankle:
I tested at a 3" dorsiflexion to start and felt stiffness through the anterior and towards my tibia. He worked on my ankle A LOT. This time we did work up the fibia side (along my scar) continuing past it and up towards my knee. In terms of discomfort, there was much above my malleolus, then not nearly as much for the middle part, and then it increased again as we got closer to the knee. We also worked the tibial side this time, which let me tell you was loads of fun. He finished off doing some work on the anterior part of my ankle.
Re-test was a 3.5" but it was definitely a more challenging 3.5" than my first session and I definitely still felt stiff.
Knee:
Initial test on the knee was at 7", which was an inch and a half of improvement over session one. Thankfully he did not focus long on the lateral side of my knee, which has a nice bruise and was super tender. He did work along the joint line, some more on the medial side, some more on the quad tendon/vastus medialis, and then focused a lot of attention further up the leg. This was tight. Once again, work on my knee flexion hurt way, way more than work on my ankle.
Re-test was at 5.5". The cool thing about the re-testing too was that I stopped just feeling the discomfort along the back of my knee and actually started feeling tightness in my quad. This was pretty exciting!!
Bruising:
A little bit more than last time - mainly right above my knee, some dots up my quad, and some dots of bruising on the back of my calf.
Post-Session Feels:
My patella is cracking like crazy. It's not painful, but it is definitely loud. If I go from sitting in flexion for a little while and extend, it's essentially a guarantee for some noise.
Knee feels more mobile. I've felt a bit more discomfort in the back of my knee than normal, but it feels more like being able to move in a way I haven't for a long time as opposed to "bad pain".
Ankle has been a bit sore, but it's more usage sore as opposed to "wow I'm in pain from this" sore. It is absolutely nothing compared to December/January, when I would still limp from the pain in my ankle.
Session number three is booked for Tuesday.
Session One
I wasn't exactly sure what to expect out of my first appointment. I knew from googling whatever I might be able to find, and from friends' experience with Graston, as well as my own experiences even from massage, that it was going to be uncomfortable. But other than that, I wasn't too sure where he was going to be working or how long it may last.
Answer was about 15-20 minutes. The first session focused on two locations - my ankle to try and regain some dorsiflexion, and my knee, trying to regain some flexion.
Ankle:
Focus was on the lateral (fibial) side. This is the side where I had my plate and seven screws (thankfully removed last October). Overall it was not super pleasant, but the discomfort level wasn't off the charts.
Knee:
Whereas my ankle was all manual release, for my knee he brought in the instrument adhesion release. Essentially, a piece of metal stripped away at the lateral side of my knee which was way more uncomfortable than anything on the ankle had been. He moved a bit across the joint line and did a bit of work on the medial side as well and then proceeded to above my patella and hammered away at my quad tendon/vastus medialis. The last thing he did was a bit of work on my lateral quad - he said the two quads (so I'm assuming vastus lateralis and intermedius) were stuck together.
Test/Re-Test:
Initial test on my ankle was a difficult 3" dorsiflexion, with restriction in the anterior compartment. Re-test was a fairly easy 3.5", with far less feeling of restriction.
The day's test on my knee was initially 8.5" short of being able to touch my heel to my butt while laying supine. We finished at 6", which was pretty significant.
Bruising:
There was redness in my calf, but it was really no worse for wear:
Next Day Feels:
My ankle was stiff, but not painful. My knee was a bit of a different story. I started to have a lot of discomfort alone the posterior line of my knee when trying to move into extension. It was super weird. I wound up spending a lot of time doing knee extension work. I got a lot of relief from doing banded terminal knee extensions.
Answer was about 15-20 minutes. The first session focused on two locations - my ankle to try and regain some dorsiflexion, and my knee, trying to regain some flexion.
Ankle:
Focus was on the lateral (fibial) side. This is the side where I had my plate and seven screws (thankfully removed last October). Overall it was not super pleasant, but the discomfort level wasn't off the charts.
Knee:
Whereas my ankle was all manual release, for my knee he brought in the instrument adhesion release. Essentially, a piece of metal stripped away at the lateral side of my knee which was way more uncomfortable than anything on the ankle had been. He moved a bit across the joint line and did a bit of work on the medial side as well and then proceeded to above my patella and hammered away at my quad tendon/vastus medialis. The last thing he did was a bit of work on my lateral quad - he said the two quads (so I'm assuming vastus lateralis and intermedius) were stuck together.
Test/Re-Test:
Initial test on my ankle was a difficult 3" dorsiflexion, with restriction in the anterior compartment. Re-test was a fairly easy 3.5", with far less feeling of restriction.
The day's test on my knee was initially 8.5" short of being able to touch my heel to my butt while laying supine. We finished at 6", which was pretty significant.
Bruising:
There was redness in my calf, but it was really no worse for wear:
My quad tendon/vastus medialis/whatever started turning a bit purple about an hour after we finished:
The lateral side of my knee was much the same, and bruised a bit within an hour.
Next Day Feels:
My ankle was stiff, but not painful. My knee was a bit of a different story. I started to have a lot of discomfort alone the posterior line of my knee when trying to move into extension. It was super weird. I wound up spending a lot of time doing knee extension work. I got a lot of relief from doing banded terminal knee extensions.
Assessment
Hips. This is where my back starts to round:
Knee flexion. My left (ACL) is straight up awful, but my right isn't optimal either (ie. also fails):
And finally, there's my knee extension and just how my left leg sits while I'm laying down, compared to my right:
So my three-pronged diagnosis of my immobile lower body was adhesion, nerve entrapment and degeneration. None of these things surprised me as the whole point of me coming was adhesion, I've felt the pins and needles/burning of the nerve issues, and many an ortho has told me about degeneration, making my goal to degenerate less over the next many years.
Having been assessed, it was now time to book my first treatment, which I scheduled for the next day. No sense wasting time getting this show on the road.
Strength Imbalances, Mobility and Adhesion Release
Having broken my ankle and had my ACL reconstructed and having that go along with already not being the most mobile person in the world before both those issues came about, it would probably be an understatement to say that there are some serious holes in my mobility game. Coming out of my year of surgery, I have started to take proper form, mobility, recovery, etc. a lot more seriously, instead of just going HAM all the time and dealing with the (often painful) consequences afterwards.
Despite my efforts to clean up the imbalances in strength between my right and left legs, I had been starting to see some favoring of my right leg creeping into my squat videos. Some days worse than others, certainly worse with multiple reps. The other major problem that I've actually been trying to deal with via the ostrich-head-in-the-sand approach was my complete inability to squat properly without the help of oly lifters. Deep down I've known that this was a dumb decision, but after a year and a half of rehab, I really just wanted to feel "normal" and do powerlifting training for realsies instead of feeling like a permanent bench-only candidate.
My back issues have catalyzed me jumping full on into this corrective programming, but originally I committed toes in. I heard about Performance Care first through a friend, but then again on a podcast that I respect a lot. Two points of recommendation was enough to get me on their website checking things out and I decided that hey, it couldn't hurt to try.
As I was going through their week one baseline testing, one of their "tips of the day" emails sent fear and trepidation shooting through my body. "You should be doing these without belts, knee sleeves and lifters". Belt, ok whatever - I'm fine with beltless work. But knee sleeves and, most importantly, lifters? Oh geez.
So I did the rest of my testing in my inov8s. And then started my week two workouts in them as well. Knee sleeves I've been doing my best not to wear, but on days where my knee feels a little sad, I've been rocking the single rehband. For this week's (W3) front squats I actually went with SBDs as I decided with my back feeling wonky, I wasn't willing to go naked knees too. Progress, not perfection.
What I quickly noticed (well, re-noticed - I already knew this from knee-hab) was that air squatting or back squatting in inov8s was an exercise in instability. Essentially, I became this creaky, unstable creature doing something vaguely resembling a squat. Given that my hips were on fire, I felt they were part of the problem, but wanting to know more I posted a video on the Bulletproof Facebook group asking for the designers' perspective. What they immediately noticed was my ankle mobility - or lack thereof. Not all that surprising considering my history. But what they suggested was different than the mobility/physical therapy road that I've been on for the last 18 months or so. What he suggested was that I go see a guy about adhesion release.
So I check out the website and decide to give them a call. I was initially a bit skeptical as the first thing the receptionist tells me is the price for the initial visit (higher - not surprising, assessments typically are) and that there is no treatment on first visit. I've been to a lot of assessments, but this is the first time I was getting told that there would be no treatment. Here is the part I actually super respect - she got the doctor to call me, and he explained the what and why behind that. The fact that he took the time to call and explain it to me was what pushed me on board, and I booked an assessment for the next day.
Despite my efforts to clean up the imbalances in strength between my right and left legs, I had been starting to see some favoring of my right leg creeping into my squat videos. Some days worse than others, certainly worse with multiple reps. The other major problem that I've actually been trying to deal with via the ostrich-head-in-the-sand approach was my complete inability to squat properly without the help of oly lifters. Deep down I've known that this was a dumb decision, but after a year and a half of rehab, I really just wanted to feel "normal" and do powerlifting training for realsies instead of feeling like a permanent bench-only candidate.
My back issues have catalyzed me jumping full on into this corrective programming, but originally I committed toes in. I heard about Performance Care first through a friend, but then again on a podcast that I respect a lot. Two points of recommendation was enough to get me on their website checking things out and I decided that hey, it couldn't hurt to try.
As I was going through their week one baseline testing, one of their "tips of the day" emails sent fear and trepidation shooting through my body. "You should be doing these without belts, knee sleeves and lifters". Belt, ok whatever - I'm fine with beltless work. But knee sleeves and, most importantly, lifters? Oh geez.
So I did the rest of my testing in my inov8s. And then started my week two workouts in them as well. Knee sleeves I've been doing my best not to wear, but on days where my knee feels a little sad, I've been rocking the single rehband. For this week's (W3) front squats I actually went with SBDs as I decided with my back feeling wonky, I wasn't willing to go naked knees too. Progress, not perfection.
What I quickly noticed (well, re-noticed - I already knew this from knee-hab) was that air squatting or back squatting in inov8s was an exercise in instability. Essentially, I became this creaky, unstable creature doing something vaguely resembling a squat. Given that my hips were on fire, I felt they were part of the problem, but wanting to know more I posted a video on the Bulletproof Facebook group asking for the designers' perspective. What they immediately noticed was my ankle mobility - or lack thereof. Not all that surprising considering my history. But what they suggested was different than the mobility/physical therapy road that I've been on for the last 18 months or so. What he suggested was that I go see a guy about adhesion release.
So I check out the website and decide to give them a call. I was initially a bit skeptical as the first thing the receptionist tells me is the price for the initial visit (higher - not surprising, assessments typically are) and that there is no treatment on first visit. I've been to a lot of assessments, but this is the first time I was getting told that there would be no treatment. Here is the part I actually super respect - she got the doctor to call me, and he explained the what and why behind that. The fact that he took the time to call and explain it to me was what pushed me on board, and I booked an assessment for the next day.
Banking Too Much on Things Going Well and Pushing Them Over the Edge Into Not Well
So my training since my last competition has been going pretty well. I competed near the start of April, and did not go in feeling particularly confident in my abilities - most specifically in my squat. It became pretty evident to me during my peaking weeks before the meet that things were not going to go like I had hoped - I failed at what I had been looking to take as a second attempt during my last heavy week of training, so that sucked. To make a long story short, I finished with 105/80/160 for a 345 total. This was good enough to qualify me for Regionals, but 20kg short of my national total. I knew going in I would need a near-perfect day to get it and I didn't. Not going to lie and say I wasn't disappointed, but dealing with disappointment is also part of the game. There's also quite a lot of 2016 left for me to nail down that total so hey, live to fight another day.
I took the week after my meet off as a deload. The week after that I was off on a semi-vacation and a set of work meetings, so it was also a pseudo deload. The only work I did in those two weeks was three squat sessions to kick off a three-week higher volume program. One day involved 3x10, one 5x5 and the other 8x3. I had run this back in November when I was finally getting back to squatting and saw a ton of improvement, which was the motivation in me wanting to run it again. I re-integrated the other two lifts in week three post-competition when I got back to Edmonton, starting on a four week block of the Stinn System. I modified the squats in the first two weeks of that block to allow me to finish out the volume cycle.
I came out of the volume feeling great; my first workout back into the Stinn cycle I easily hit a double at 97 and then proceeded to singles at 100, 103 and 107 (more than my meet), all beltless. Great start. A week after that, I went for a single at 110 belted (my failed third at the meet) and then a new PR of 112.5 and hit that too.
It's at this point I made a series of poor decisions.
Poor Decision The First - I went to football practice. This wasn't necessarily a super poor decision in and of itself. I wanted to see how my knee would react and this allowed me to do so. The poor decision was less doing football practice and more what came afterwards. The answer to how my knee would react was "by swelling, a lot". Two days later I sat on a bus for 11ish hours going to/from a football game to watch from the sidelines, which also didn't do much that was great in terms of getting swelling out of the joint.
Poor Decision The Second - As I was perusing videos I had previously uploaded to Facebook, I discovered one of me squatting 215 for 9 and the little hamster in my brain starts spinning on its wheel. This is now five days after I've gone to football practice and the swelling has not resolved itself. I squat 215 for 10. Beltless.
Poor Decision The Third - Thursdays are supposed to be my rest day, but I'm doing some baseline mobility and strength testing for a program that I want to run. It calls for a 10RM sumo deadlift. Thinking that I won't be able to do that much for a 10RM, I decide to go for it on my rest day. I undershoot my 10RM twice, meaning I do three sets of deadlifts (225, 255 and 270). I'm not going to lie - this actually felt really damn good. I was thinking "wow, when I re-test my 1RMs things are going to be sa-weet!"
Poor Decision The Fourth - Friday when I go in for my workout, things are starting to break down. My depth (which is normally never an issue for me) is creeping up for squats and my deadlifts feel heavy as fuck (go figure, considering how many loads I have blown this week). I figure I'll be "smart" and in addition to my Saturday rest day, I'll take one Sunday as well and that should fix everything.
Poor Decision the Fifth - So I've blown my load a few times over-exerting myself. I've also started integrating this imbalance/mobility work into my programming - because obviously by doing so that's going to fix my problems. At this point, I also start running a peak cycle because I want to re-test my numbers on my ACL surgery anniversary. To make a longs story short, this was a bad idea. I lasted a week.
Thankfully it doesn't seem like my back is too bad from all of this. I've progressed from unable to roll over in bed, put on socks, or get my shoes on, to being able to do all those things again. I tried some light squats tonight with no ill effects. Same goes for a light dead. I have learned enough from the above to not be like "woo, hop back on the peaking program and let's continue as planned". I've quickly realized that the strength imbalance/mobility stuff is taking way more out of me than I thought it would and that if I want to see some true improvement from it, I need to focus on long game, and drop the heavy weights for the short term. So I'm going to come up with something different but difficult and fulfilling to do on my surgery anniversary and give myself the opportunity to re-test later, when I'm more ready.
I took the week after my meet off as a deload. The week after that I was off on a semi-vacation and a set of work meetings, so it was also a pseudo deload. The only work I did in those two weeks was three squat sessions to kick off a three-week higher volume program. One day involved 3x10, one 5x5 and the other 8x3. I had run this back in November when I was finally getting back to squatting and saw a ton of improvement, which was the motivation in me wanting to run it again. I re-integrated the other two lifts in week three post-competition when I got back to Edmonton, starting on a four week block of the Stinn System. I modified the squats in the first two weeks of that block to allow me to finish out the volume cycle.
I came out of the volume feeling great; my first workout back into the Stinn cycle I easily hit a double at 97 and then proceeded to singles at 100, 103 and 107 (more than my meet), all beltless. Great start. A week after that, I went for a single at 110 belted (my failed third at the meet) and then a new PR of 112.5 and hit that too.
It's at this point I made a series of poor decisions.
Poor Decision The First - I went to football practice. This wasn't necessarily a super poor decision in and of itself. I wanted to see how my knee would react and this allowed me to do so. The poor decision was less doing football practice and more what came afterwards. The answer to how my knee would react was "by swelling, a lot". Two days later I sat on a bus for 11ish hours going to/from a football game to watch from the sidelines, which also didn't do much that was great in terms of getting swelling out of the joint.
Poor Decision The Second - As I was perusing videos I had previously uploaded to Facebook, I discovered one of me squatting 215 for 9 and the little hamster in my brain starts spinning on its wheel. This is now five days after I've gone to football practice and the swelling has not resolved itself. I squat 215 for 10. Beltless.
Poor Decision The Third - Thursdays are supposed to be my rest day, but I'm doing some baseline mobility and strength testing for a program that I want to run. It calls for a 10RM sumo deadlift. Thinking that I won't be able to do that much for a 10RM, I decide to go for it on my rest day. I undershoot my 10RM twice, meaning I do three sets of deadlifts (225, 255 and 270). I'm not going to lie - this actually felt really damn good. I was thinking "wow, when I re-test my 1RMs things are going to be sa-weet!"
Poor Decision The Fourth - Friday when I go in for my workout, things are starting to break down. My depth (which is normally never an issue for me) is creeping up for squats and my deadlifts feel heavy as fuck (go figure, considering how many loads I have blown this week). I figure I'll be "smart" and in addition to my Saturday rest day, I'll take one Sunday as well and that should fix everything.
Poor Decision the Fifth - So I've blown my load a few times over-exerting myself. I've also started integrating this imbalance/mobility work into my programming - because obviously by doing so that's going to fix my problems. At this point, I also start running a peak cycle because I want to re-test my numbers on my ACL surgery anniversary. To make a longs story short, this was a bad idea. I lasted a week.
Thankfully it doesn't seem like my back is too bad from all of this. I've progressed from unable to roll over in bed, put on socks, or get my shoes on, to being able to do all those things again. I tried some light squats tonight with no ill effects. Same goes for a light dead. I have learned enough from the above to not be like "woo, hop back on the peaking program and let's continue as planned". I've quickly realized that the strength imbalance/mobility stuff is taking way more out of me than I thought it would and that if I want to see some true improvement from it, I need to focus on long game, and drop the heavy weights for the short term. So I'm going to come up with something different but difficult and fulfilling to do on my surgery anniversary and give myself the opportunity to re-test later, when I'm more ready.
Subscribe to:
Posts (Atom)