Ask a Physical Therapist Anything (plus content update)

SkierPT

SkierPT

Active member
Hello NS family,

Here for a little update. I hope everyone is enjoying their summer so far.

First, I want to take the chance to announce I will be starting weekly PTuesdays on NS where I will continue educational posts about strengthening, rehab, etc. I would love some more ideas for these posts !

Second, I am planning on (soonish) hoping my own Mobile PT side gig where I could see you guys at patients in-person or via Telehealth! Keep an eye out.

Third, I want to give the NS community the chance to ask me anything about rehab, PT, exercise, or life in general. I’ll do my best to answer every question to the best of my ability.

Thank you everyone for the support the last few years.

Stay safe and land gucci.
 
Do you have any suggestions for strengthening / stretching knees? I have had issues with the tendons on the top and bottom of my kneecaps for a couple years now. It's never been a problem while i'm skiing, but rather while i'm working out. I mostly do unweighted squats and resistance band workouts, but I get pain in the tendons above and below my patellas midway through a workout. It's not so bad that I can't complete my workout, but just sort of annoying. There wasn't an injury or defining moment that caused this, but just sort of came out of nowhere. Any help would be much appreciated!
 
14311685:junior1derful said:
Do you have any suggestions for strengthening / stretching knees? I have had issues with the tendons on the top and bottom of my kneecaps for a couple years now. It's never been a problem while i'm skiing, but rather while i'm working out. I mostly do unweighted squats and resistance band workouts, but I get pain in the tendons above and below my patellas midway through a workout. It's not so bad that I can't complete my workout, but just sort of annoying. There wasn't an injury or defining moment that caused this, but just sort of came out of nowhere. Any help would be much appreciated!
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Banded Spanish squats and reverse Nordics for quad stretching are two nice exercises to make squatting more comfortable and lengthen the tendon unit.
 
I have to get shoulder surgery in october and its supposed to be a 4-6 month recovery. I want to be ready as early as possible for ski season. Im gonna do the PT shit hard asf and take lots of cold showers too. Do you think its possible to fully recover in 3 months or is that unheard of. Also, does the 4-6 month range imply you will be back to full strength by then or is that just the amount of time it takes for it to feel not fucked anymore. Like roughtly at what point to do you think I can take minor slams on it. Do you have any other tips for a speedy recovery?
 
14311739:BLandz said:
I have to get shoulder surgery in october and its supposed to be a 4-6 month recovery. I want to be ready as early as possible for ski season. Im gonna do the PT shit hard asf and take lots of cold showers too. Do you think its possible to fully recover in 3 months or is that unheard of. Also, does the 4-6 month range imply you will be back to full strength by then or is that just the amount of time it takes for it to feel not fucked anymore. Like roughtly at what point to do you think I can take minor slams on it. Do you have any other tips for a speedy recovery?
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Start your Prehab now! The stronger you are before surgery the better outcome generally.

The timeline is a rough estimate. Shoulders are tough. Depending on the surgery you may not feel 100% for a year. Just be patient and work hard. Late season skiing should be possible.
 
I’m 16 and my biggest skiing related fear (other than dying) is having knee/shoulder/back pain and injuries as I get older. Is there anything I can do to avoid these thing while I’m still young?
 
Start an appropriate resistance training program! Strength is king for injury risk reduction. Squats, deadlifts should be your friend. Some injuries are impossible to prevent but you can reduce your risk for some injuries!
 
Any good exercises for laterally strengthening knees? besides one legged bench squats and pistol squats?
 
14311839:mrk127 said:
Any good exercises for laterally strengthening knees? besides one legged bench squats and pistol squats?
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Lateral lunge squats, reverse lunges, single leg straight leg deadlifts, single leg calf raises/presses
 
Last season I fractured my heel bone as well as my talus in my left foot, and i was going to PT appointments for a month or so to get my ankle strength back. Now I have most of my strength back, but I still feel pain when I do activities that involve a bit of ankle flexibility like skating, playing soccer, or hiking on rocky trails. Do you have any suggestions for stretches or exercises that could help me with this?
 
14312035:Idahoe said:
Last season I fractured my heel bone as well as my talus in my left foot, and i was going to PT appointments for a month or so to get my ankle strength back. Now I have most of my strength back, but I still feel pain when I do activities that involve a bit of ankle flexibility like skating, playing soccer, or hiking on rocky trails. Do you have any suggestions for stretches or exercises that could help me with this?
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Look up closed chain Dorsiflexion test and compare each ankle. If one is stiff/ lacking range of motion, look up self ankle mobilization with a band. You could also go to PT for a bit more for some good manual therapy if you’re lacking range.
 
is there anything i can do for tendonitis in my shoulder? I've now gotten two cortisone shots but the doctor says i shouldn't get any more.

I've tried PT on and off for 10 years but it doesn't sound like it would help tendonitis?
 
14312180:VTshredder69 said:
is there anything i can do for tendonitis in my shoulder? I've now gotten two cortisone shots but the doctor says i shouldn't get any more.

I've tried PT on and off for 10 years but it doesn't sound like it would help tendonitis?
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Find a good local sports PT and get on a tendon loading program. Any solid sports PT will get your shoulders right. Tendonitis isn’t overly complicated to treat!
 
topic:SkierPT said:
Hello NS family,

Here for a little update. I hope everyone is enjoying their summer so far.

First, I want to take the chance to announce I will be starting weekly PTuesdays on NS where I will continue educational posts about strengthening, rehab, etc. I would love some more ideas for these posts !

Second, I am planning on (soonish) hoping my own Mobile PT side gig where I could see you guys at patients in-person or via Telehealth! Keep an eye out.

Third, I want to give the NS community the chance to ask me anything about rehab, PT, exercise, or life in general. I’ll do my best to answer every question to the best of my ability.

Thank you everyone for the support the last few years.

Stay safe and land gucci.
Click to expand...

i have this thing that looks like a splinter in my foot
 
14312184:SkierPT said:
Find a good local sports PT and get on a tendon loading program. Any solid sports PT will get your shoulders right. Tendonitis isn’t overly complicated to treat!
Click to expand...

Thanks bud
 
Thank you for doing this op!

What's your opinion on chiropractic treatments? I've used them and personally find them very helpful but it seems to be a divisive area depending on who you ask: family practitioner, vs ortho specialists vs pt vs trainers.

Same question about stuff like acupuncture & cupping.

Lastly what would you consider a good quick 5-10 minute stretching routine that you can do regardless of whatever other fitness & training you are doing. Almost like what might be a good get out of bed routine.
 
14312645:NotEnoughSkiing said:
Thank you for doing this op!

What's your opinion on chiropractic treatments? I've used them and personally find them very helpful but it seems to be a divisive area depending on who you ask: family practitioner, vs ortho specialists vs pt vs trainers.

Same question about stuff like acupuncture & cupping.

Lastly what would you consider a good quick 5-10 minute stretching routine that you can do regardless of whatever other fitness & training you are doing. Almost like what might be a good get out of bed routine.
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There are good and bad people in every progression. Lot of good chiros out there who can 100% help people. My opinion though is that is a lot of misinformation spread for “effective” treatments. That includes cupping, taping, etc. The research just isn’t there to support.

Dry needling and accu also are debatable. It’s my opinion due to the invasiveness of each that these treatments, paired with mobility/ strengthening can be a good treatment option. I’ve been dry needled a lot and I find it useful. I’m getting certified in it soon.

For a good mobility routine, look up the worlds greatest stretch routine on YouTube!!
 
kneesovertoesguy on youtube has been my go to for mobility work. I think the tibialis and VMO are very often overlooked in skiing.

Also to be straight up the biggest improvements regarding my strength, mobility and joint health have come from using testosterone, growth hormone, and BPC-157. I don't know why there aren't more non-contest pros on a similar stack. I know tanner takes BPC, and wouldn't be surprised if he also has test and GH. I can feel the GH and BPC healing my old injuries and regrowing cartilage. The testosterone gives crazy neurological adaptations, better muscle memory, and way more confidence to try gnarly shit. Cerebrolysin is another cool one to play around with to enhance neurological function.

SkierPT my question to you is how important do you feel it is to train muscle groups such as chest shoulder and arms? I can see training shoulders being good for injury prevention. Chest and arms though seem a little pointless for skiing, maybe they would help with winding up for a 12 or something. Obviously almost every muscle in your legs, core, and back are important for skiing. I know this is an age-old argument in training for skiing, but what do people think? Is it really worth your time to do much like bench and curls to get ready for skiing? Would they help with either performance or injury prevention?
 
14312796:250r said:
kneesovertoesguy on youtube has been my go to for mobility work. I think the tibialis and VMO are very often overlooked in skiing.

Also to be straight up the biggest improvements regarding my strength, mobility and joint health have come from using testosterone, growth hormone, and BPC-157. I don't know why there aren't more non-contest pros on a similar stack. I know tanner takes BPC, and wouldn't be surprised if he also has test and GH. I can feel the GH and BPC healing my old injuries and regrowing cartilage. The testosterone gives crazy neurological adaptations, better muscle memory, and way more confidence to try gnarly shit. Cerebrolysin is another cool one to play around with to enhance neurological function.

SkierPT my question to you is how important do you feel it is to train muscle groups such as chest shoulder and arms? I can see training shoulders being good for injury prevention. Chest and arms though seem a little pointless for skiing, maybe they would help with winding up for a 12 or something. Obviously almost every muscle in your legs, core, and back are important for skiing. I know this is an age-old argument in training for skiing, but what do people think? Is it really worth your time to do much like bench and curls to get ready for skiing? Would they help with either performance or injury prevention?
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I would 100% not recommend taking the supplements you stated, especially to a mostly 18 and under website.

To answer your question I feel like having balanced strength is important for most sports. Strength is the biggest factor in reducing injuries in both lower and upper extremity. It also depends on your split. If you are just going for mass and doing a body building plan, I can’t see than translating to skiing much unless you also train power/speed. Plus look good, ski good!
 
14312803:SkierPT said:
I would 100% not recommend taking the supplements you stated, especially to a mostly 18 and under website.

To answer your question I feel like having balanced strength is important for most sports. Strength is the biggest factor in reducing injuries in both lower and upper extremity. It also depends on your split. If you are just going for mass and doing a body building plan, I can’t see than translating to skiing much unless you also train power/speed. Plus look good, ski good!
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Oh, I agree with that. I do think they are very valuable for the 30+ crowd in skiing, however. You don't have to feel like an old man in the park haha.

I also agree that a balanced approach to training for skiing is good, and you should work on some things like mobility, plyometrics, and agility training. However say for the case of ACL injury prevention, wouldn't adding a lot of mass to your hamstrings through hypertrophy training be your best bet of protecting your ACLs? I really don't see any use for heavier powerlifting type strength workouts, as skiing is more endurance-based and more akin to hypertrophy training.
 
14312810:250r said:
Oh, I agree with that. I do think they are very valuable for the 30+ crowd in skiing, however. You don't have to feel like an old man in the park haha.

I also agree that a balanced approach to training for skiing is good, and you should work on some things like mobility, plyometrics, and agility training. However say for the case of ACL injury prevention, wouldn't adding a lot of mass to your hamstrings through hypertrophy training be your best bet of protecting your ACLs? I really don't see any use for heavier powerlifting type strength workouts, as skiing is more endurance-based and more akin to hypertrophy training.
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What you aren’t considering is the “core” training involved in all compound lifts, including all upper extremity pressing.

as far as strength vs hypertrophy for skiing, I’d have to dive more into current research. Overall 1 rep max strength is shown as best injury prevention, though I do see how muscular endurance can be considered. Feel free to PM if you want to discuss in more detail!
 
So I have an abdominal hernia. It started a few years back when I hucked a drop inbounds. It felt like a screwdriver was shoved just above my belly button. I skipped a few days due to the pain, but was able to get back on my skis when the pain went down.

That day, I felt a ripping sensation while dropping another huck, but this time it felt 100% fine the next day.

Last year, I was taken down by it for a few days. It was found by a physician while undergoing a marine medical exam but he didnt recommend doing much about it due to the size.

Now I can see a pertrusion about half an inch long and I am getting worries that this will start to be a problem. I plan on seeing a physician for a consult on what to do to repair it.

So can these things be prevented? What can I do in the meantime while waiting? What can I expect for physio after?

thanks for your help!
 
14313501:freestyler540 said:
So I have an abdominal hernia. It started a few years back when I hucked a drop inbounds. It felt like a screwdriver was shoved just above my belly button. I skipped a few days due to the pain, but was able to get back on my skis when the pain went down.

That day, I felt a ripping sensation while dropping another huck, but this time it felt 100% fine the next day.

Last year, I was taken down by it for a few days. It was found by a physician while undergoing a marine medical exam but he didnt recommend doing much about it due to the size.

Now I can see a pertrusion about half an inch long and I am getting worries that this will start to be a problem. I plan on seeing a physician for a consult on what to do to repair it.

So can these things be prevented? What can I do in the meantime while waiting? What can I expect for physio after?

thanks for your help!
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Let me get back to you !
 
14313525:SkierPT said:
Any more details?
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I broke my tibia and fibula like 4-5 months ago and am walking on it, dirt biking, standup jetskiing, and some moderate biking. It doesn’t really feel strong enough for skiing yet though. Not sure what other details other than that lmk
 
14313524:SkierPT said:
Let me get back to you !
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Thanks man! Looking forward to some real advice. The doctor situation in Nelson, BC is disgusting. It wont be for another year that I will get an appointment. I still wanna huck this year!
 
14314530:freestyler540 said:
Thanks man! Looking forward to some real advice. The doctor situation in Nelson, BC is disgusting. It wont be for another year that I will get an appointment. I still wanna huck this year!
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This is why I don’t care when people rip on the US for expensive health care. I’d rather pay more than have to wait a year to get taken care of. Sorry to hear that man.
 
I was about to make a thread but this works.

Torn cartilage in chest -

back when I was a young teenager skiing i cased real bad and whiplashed so hard it ripped something near/above my sternum. Couldn’t cough or talk loud without nerve pain in my chest. It just kind of went away slowly and I lived with it. Since then I’ve injured it 4 times to the point of serious pain- I was just trying some push ups after injuring it recently at the pain came shooting back in my chest all over again. I feel like it never really heals I just learn how to breath around it. Anyone have experience with this or know what to do? I feel like every time I isolate my chest I’m at risk of injuring it
 
What do you know about new stem cell therapies for cartilage/blood flow?

ive now torn my left ACL twice and damaged medial and lateral minisucs in that knee on two different occasions.

I know I will eventually feel good/strong enough to returning to skiing how I like to…. The question is, should I? I feel like the chances of another catastrophic (and potentially worse) knee failure are incredibly high now.

is there strong evidence that these new stem cell therapies can help “regenerate” cartilage and re-introduce blood flow to these dead areas?

tldr: what’s the deal with stem cells for cartilage, been looking into this place down in salt lake
 
I blew my ACL in February, got surgery in June, have been doing thorough PT every other day. Broke my femur on the same leg in 2015 and didn't do any PT. I paid the price. The knee has started to get a bit sore again recently after returning to work. Could I expect to ski (not jump) this season?
 
14314769:STEEZUS_CHRI5T said:
This is why I don’t care when people rip on the US for expensive health care. I’d rather pay more than have to wait a year to get taken care of. Sorry to hear that man.
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Its because of Covid. All the doctors in my area are working double shifts in the hospital to save stupid peoples lives. BC has a horrible system in general but Usually I can get an appointment in less than 2 weeks.

Money should not affect peoples value of life. All life is equally valuable. I am happy to have a nationalised health care system.
 
14314775:percs said:
I was about to make a thread but this works.

Torn cartilage in chest -

back when I was a young teenager skiing i cased real bad and whiplashed so hard it ripped something near/above my sternum. Couldn’t cough or talk loud without nerve pain in my chest. It just kind of went away slowly and I lived with it. Since then I’ve injured it 4 times to the point of serious pain- I was just trying some push ups after injuring it recently at the pain came shooting back in my chest all over again. I feel like it never really heals I just learn how to breath around it. Anyone have experience with this or know what to do? I feel like every time I isolate my chest I’m at risk of injuring it
Click to expand...

Could it be an SC joint injury?
 
14314808:bait said:
I blew my ACL in February, got surgery in June, have been doing thorough PT every other day. Broke my femur on the same leg in 2015 and didn't do any PT. I paid the price. The knee has started to get a bit sore again recently after returning to work. Could I expect to ski (not jump) this season?
Click to expand...

Does your current PT know this is your goal? There are plenty of “return to play” testing they can use to help guide you. The best advice I can give you is to wait a MINIMUM of 10 months to return to sport post- ACL repair. Any sooner and risk for reinjury is much higher.
 
topic:SkierPT said:
Hello NS family,

Here for a little update. I hope everyone is enjoying their summer so far.

First, I want to take the chance to announce I will be starting weekly PTuesdays on NS where I will continue educational posts about strengthening, rehab, etc. I would love some more ideas for these posts !

Second, I am planning on (soonish) hoping my own Mobile PT side gig where I could see you guys at patients in-person or via Telehealth! Keep an eye out.

Third, I want to give the NS community the chance to ask me anything about rehab, PT, exercise, or life in general. I’ll do my best to answer every question to the best of my ability.

Thank you everyone for the support the last few years.

Stay safe and land gucci.
Click to expand...

I’ve dislocated both shoulders , probably torn rotator cuff in both sides. My dominant sided shoulder is pretty bad, has came out 5+ times this year. Help !! Tips appreciated
 
14315185:ScootSkiLyfe said:
I’ve dislocated both shoulders , probably torn rotator cuff in both sides. My dominant sided shoulder is pretty bad, has came out 5+ times this year. Help !! Tips appreciated
Click to expand...

Strengthen and stabilize. Your labral tissue is probably damaged. Check my IG, I have a few nice shoulder stability posts.
 
I tore my MCL and LCL last season as well as strained my meniscus and ACL

Some days there is no pain but can still feel tension/tightness in the knee and others there is shooting pain/soreness on the knee all day. Was not able to see an orthopedic surgeon for 3 months after the injury and they kind of just moved me along. I would say about 65% of the time I straighten my leg after sitting for a period of time I can feel the knee “catching” and it will pop (assuming it has to do with cartilage) but there is no pain associated with it just an uncomfortable feeling.

I have pretty much taken the whole summer off from surfing and have been very light on sports to save me knee for the winter. However with winter approaching my knee doesn’t feel as strong as it should even though I am still doing PT.

Is that normal or should I try and schedule another visit with the doctor to make sure that I am able to ski hard this winter? Or is there an at home physical test I can do?

Any good exercises for strengthening the LCL in the off-season?
 
I have very limited range of motion in both of my ankles and I'm not sure if they're strong and healthy or not.

I rolled my ankles a lot as a kid skateboarding, so they were always prone to that, but as I got older I have kept them from rolling by wearing ankle braces when I skate. About 3-4 years ago I stood up out of bed one day and couldn't walk. I went in to the doctor and basically they said I have a partial or full tear in 1 or more ligaments in the middle of my ankle between the ankle bones. They did not do an MRI due to cost and the fact that they said I would not need surgery either way, only PT. I was on crutches for awhile and healed up just fine over 8 or so months. That being said, prior to that happening, when I would land backseat on skis I had a sharp pain in my ankle in the same spot (which is obviously what ended up being the tear) and I would try to stay off of it by landing switch (lol). Anyway, I have felt pretty good for some time, but skateboarding a lot my ankles get sore and I have really limited range of motion after skating hard or for long periods. I always wear braces when I skate on both ankles and haven't had any rolling or spraining since prior to my partial tear. If I hold my leg up and roll my ankles around, I hear and feel some popping and cracking noises. To me that doesn't sound very good...

So I guess my question is, how can I tell if my ankles are doing ok? Or when to know I need to stay off them? And what kind of PT I could do to strengthen them and increase ROM?
 
14316211:Redeem said:
I tore my MCL and LCL last season as well as strained my meniscus and ACL

Some days there is no pain but can still feel tension/tightness in the knee and others there is shooting pain/soreness on the knee all day. Was not able to see an orthopedic surgeon for 3 months after the injury and they kind of just moved me along. I would say about 65% of the time I straighten my leg after sitting for a period of time I can feel the knee “catching” and it will pop (assuming it has to do with cartilage) but there is no pain associated with it just an uncomfortable feeling.

I have pretty much taken the whole summer off from surfing and have been very light on sports to save me knee for the winter. However with winter approaching my knee doesn’t feel as strong as it should even though I am still doing PT.

Is that normal or should I try and schedule another visit with the doctor to make sure that I am able to ski hard this winter? Or is there an at home physical test I can do?

Any good exercises for strengthening the LCL in the off-season?
Click to expand...

What does your program look like currently? You can’t strengthen ligaments but you can beef up the muscle around it. I’d hope your program includes heavy squats, deadlifts, agility and jumping.

you can look up ACL return to play testing. Jump tests, shuttle run, T-run and strength testing are commonly used to assess return to sport!
 
14316466:Schoess said:
I have very limited range of motion in both of my ankles and I'm not sure if they're strong and healthy or not.

I rolled my ankles a lot as a kid skateboarding, so they were always prone to that, but as I got older I have kept them from rolling by wearing ankle braces when I skate. About 3-4 years ago I stood up out of bed one day and couldn't walk. I went in to the doctor and basically they said I have a partial or full tear in 1 or more ligaments in the middle of my ankle between the ankle bones. They did not do an MRI due to cost and the fact that they said I would not need surgery either way, only PT. I was on crutches for awhile and healed up just fine over 8 or so months. That being said, prior to that happening, when I would land backseat on skis I had a sharp pain in my ankle in the same spot (which is obviously what ended up being the tear) and I would try to stay off of it by landing switch (lol). Anyway, I have felt pretty good for some time, but skateboarding a lot my ankles get sore and I have really limited range of motion after skating hard or for long periods. I always wear braces when I skate on both ankles and haven't had any rolling or spraining since prior to my partial tear. If I hold my leg up and roll my ankles around, I hear and feel some popping and cracking noises. To me that doesn't sound very good...

So I guess my question is, how can I tell if my ankles are doing ok? Or when to know I need to stay off them? And what kind of PT I could do to strengthen them and increase ROM?
Click to expand...

Quite the ankle history! At this point it’s diagnosed as chronic ankle instability. I’d say wearing braces during skating is fine! Also joint cracking and popping (if not painful) is actually pretty normal, especially in athletes.

You can absolutely improve ankle mobility and strength. The closed chain ankle hinge test is a nice easy test to quickly compare ankle range of motion.

here are a few ideas to get the ball rolling:

https://www.instagram.com/p/B9YLNp9lC0J/?utm_medium=copy_link

https://www.instagram.com/p/B9nUza-Fua6/?utm_medium=copy_link
 
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