Any physical therapists here

I pulled a muscle or a tendon in my lower leg two days ago.(between the calf and the back of my ankle)

I have been iceing it for twenty minutes every few hours and it is almost better. I am guessing that it will be ok tomorrow or the next day.



I need it good for a bunch of long portages starting a week from tomorrow.



Can you recommend an exercise to strengthen it?



Jack L

using a shsrp saw
it off.

unsure if its a muscle or tendon
strain…or Achilles



To the best of my knowledge there is no way to strengthen an injured tendon in ten days nor a muscle.



At this point you really don’t seem to know what it is…



You can just enjoy the 90 miler at a slower pace.

Life sometimes sucks



Enjoy vitamin I

Got experience with shoulders but
legs, not (thank goodness). R.I.C.E. ??



http://www.webmd.com/first-aid/tc/rest-ice-compression-and-elevation-rice-topic-overview



Maybe gentle stretching once you’re pain free, but - as my orthopedist advised me - if it hurts, back off.



Wishing you a very speedy back to normal.

You may try…
… to wrap the leg above the ankle with duct tape to take some pressure off the tendon. Maybe one of those elastic ankle braces.



Good luck

Gee whiz what a bunch of pessimists
Not a PT but have chronic condition I work around successfully. If you do not make it worse in the next 10 days you will have succeeded in healing it, and there is no reason it can’t be done.



Just in case it’s the muscle, before you get up out of bed, be sure to massage the area of your calf muscle with your hands. This really helps, in my experience. Some people want to make this a big ritual with the floor, a tennis ball, a roller… pfttt, just use your own fingers. Flex the foot & leg too, before weighting it. Don’t stretch UNLESS you are already warmed up by walking. Also, you may have to sleep carefully in a position with something kept propped under the knee of the problem leg, like a small flat pillow, to keep the knee slightly flexed.



First, what were you doing when this happened? Was it routine, or something unusually torquing or lifting something heavy in an awkward position? Did this happen after sitting in the kayak a long time? Try to analyze the situation. It could be a posture change, for example. It could be the muscles over the backs of the hip, or the spine actually messing up something lower down.



Second, for your portages, WEAR DECENT SUPPORTIVE FOOTWEAR. Cannot emphasize this enough. It is better to be annoyed at using time to change into good trail shoes or decent very lightweight hiking boots with strong arch support/ankle support than to re-injure at a bad moment.



Third: longer term, nothing helps this sort of annoyance better than making your ankles stronger, and you can do that by walking/jogging up and down hills and/or steps. Not fast, just routinely. When I go down the road sometimes I am going (carefully) from one side to the other depending on the road bevel, and also going up and down on the shoulders over the ditch, moving along between the rocks on the critter trails. Yeah, this takes a long time but if you can do “this” on uneven surfaces, while wearing a pair of trail running shoes which do not have much of a heel you can do ANYTHING. At first this may make those Achilles sore but eventually it pays off. Other people like to do specific gym exercises with bands, or go up and down a step over and over, which are great for people 1/3 my age but I would likely not survive them, especially when it is being presented as some sort of miracle 10 minute high-intensity exercise routine meant to replace actual workouts. Yeah, sure. (eyeroll…) as if anyone actually does those routines for more than a week. Find a hill and make it part of your routine.



About 4-5 years ago the first time I went down and then back up a trail several hundred feet in elevation each way wearing a pair of Hokas, I thought I was going to die the next day, but it is possible to strengthen bad arches and pitiful tendons.



Nutrition: trace minerals (such as magnesium, selenium) can be important in this situation, no matter what the source. I didn’t think this would make a that much a difference, but it does. So there I am diligently either munching on this or that, or even, during the hottest parts of the summer, taking a magnesium supplement a few times a week if I can’t do it all from food sources.



Drugs: it turns out that having taken certain things in the past per medical Rx can contribute to tendon problems in the future. Ugh. Probably not your problem, but use the google.



Mark Sisson at Mark’s Daily Apple recently had some writing up about strengthening tendons.

http://www.marksdailyapple.com/why-training-your-tendons-is-important-and-11-ways-to-do-it/#axzz4J48D4lQM



http://www.marksdailyapple.com/tendon-edition/#more-62459

ski boot ?
we see, women mostly, wearing a ski boot in line at Wal. Always in line never at the meat aisle. ?



I ask about the HD or weather in Aspen, they look confused…



Probably oxycontin n fentoonull…



It’s an orthopedic foot brace.



Wear one n duc tape it to your shin.



Buy a guitar n a Lear …



At your age, a chair n foot stool for 6 weeks.

Good Morning, Jack

– Last Updated: Sep-02-16 7:49 AM EST –

I'm not a therapist. And I'm not the rapist. But... I had an orthopedic guy stress the importance of a long slow warmup to avoid inflammation. I have found that it works. I soft pedal my bike 20 or 30 minutes before the 'spirited' stuff starts and it keeps the knee pain-free.

To answer your question, if it was me I'd do a long, gentle warmup then walk up and down some hills.

cycle ?
try chondromalacia exercise n vastus medialis ex…see EXRX.COM



chondros are done holding thigh still, raising lower leg/foot 2-3" rpt rpt.



add 5 pounds on toes



then twist ankles n try ankle back n forths strengthen the ankle muscles (2-one each side)



chondros lube knee sliders n strengthen the tendon running knee to shin.



Jack may need new shoe heels or inside lift patches.

I don’t play one on TV but
I’ve strained my achilles. Not sure what you did but it doesn’t sound dissimilar.



A few exercises I remember: sitting with your legs straight in front of you, take a sock or towel and hold it in both hands with it looped around your sole. Pull the towel but provide resistance with your foot / ankle. Similar exercise, stand on a step and hold the handrail, lift yourself up by standing on your toes.



IIRC I had to rest for a week before doing any of these but I had a pretty bad strain, had no strength in my foot/ankle and it wasn’t improving.

Just finished a round of PT
For Achilles tendonitis.



Mostly it was stretches but there was some strengtheners.



Stand on a stair step with your toes on the step, heels in space, knees straight.

Raise yourself on tip tie as high as you can using both feet.

Take good foot out and lower yourself as slowly as possible until your heel is as far below the level of the step as possible.

Use both feet to raise yourself up on tip toe.

10-15 reps 3 sets. Exercise the non hurting leg also to prevent injury there.



The next one was the azz kicker for me.

Do the exact same exercise with the knee slightly bent,

No 10 day fix, I did it for 6 weeks with therapist and he says 6 more weeks on my own should do it. Hold a 5 or 10# weight in one hand when it gets easy.



Stretches are the normal calf stretches from HS football. I got the most from what they call “hooker stretches”

To exercise the left foot put your rt hand out and lean on a wall, street lamp, or sign post. Cross left foot in front of right and put outside of foot(or top of foot) on ground. Lean towards the wall bending at the hips. Think like a prostitute. Hold for 30 seconds. Do 3 sets going both directions.



For immediate relief get heel cups in your shoes which raise the heel up, shortening the tendon. This is extremely bad to rely on for long as it masks the problem and will make the condition worse over time as the tendon grows use to the shortened position…



Set your foot on an incline and lean into it. Do with knee straight and knee slightly flexed.

Thanks
I like the sounds of that first exercise.



As soon as I feel it is safe enough I’ll give it a try.

Maybe tomorrow or Sunday.



Jack L

REST
no ex

One more thing

– Last Updated: Sep-03-16 6:57 AM EST –

You are not going to "strengthen" it in a week (especially since it is currently injured.) You need to heal the injury. THAT you should be able to do in a week or so. First, stay off it! let it rest. Don't do anything that aggravates it.

Second, amp up the healing process: A year or so back I had really bad tendonitis in my elbows (SUP paddling) I was told by my pt that tendons have very poor circulation and do not heal very quickly. He gave me this routine to do at home to improve blood circulation and healing response to the injury site:

Ice for 10 minutes followed by heat for ten or 15 minutes. (wet heat if you can get it. wet heating pads can be found at most pharmacies for like $35) Then massage the area for 5 minutes. Repeat 2 or 3 times for and hour or so. Do that twice a day.

I had tried all sorts of things for 6 months, including lots of rest, but nothing worked so I had my ortho MD send me to a pt. This routine cleared up my tendonitis in a week or two. They've been fine ever since. Good luck.

just putting it out there
Most people don’t understand that a damaged tendon or ligament can be a serious injury. Kinda like out of sight out of mind. It’s under the skin so you don’t see it but it could be a serious tear. If it is getting better fast then it might have been just a strain on the ligament but if it still hurts it could be something worse. I’m all for RICE and gentle stretching, it works wonders. BUT, stop if it hurts at all. It would be kinda like cutting your hand and then while it’s healing you keep stretching it to see if you can still see inside. It will never heal, get it.



If it is still giving you problems, SEE A DOCTOR. I’m sure there are a few medical proffesionals on this site but most won’t give you there oppinion, and for a good reason. they haven’t seen you. Most of us aren’t doctors and taking medical advise from us for an injury like this is sort of like taking meds from someone because they had a similar sickness. If it gets better on it’s own with rest and ice and gentle stretching, then good… but if it still is giving you trouble after a week or so, see a doctor. jmho

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Good advice here if u don’t know Jack
And would apply if Jack had asked for a diagnosis.

I have seen Jack give the RICE advise himself so he knows that.



There is a good a chance he was paddling on the Holiday I was born on half a century ago so it’s safe to say he knows the difference between therapy and mindlessly aggrevating an injury.



He and I have argued “see a doctor” vs “take Ibuprofen”.



The OP was asking “does anyone know an exercise…”

Once it feels better it is time to stretch it out. Go at it slowly and carefully.

As JackL pulled that muscle five years ago, pretty sure it’s been resolved by now.

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I often wonder how Jack and Nanci are doing. They have to be in their 80s now.

We have an aging group trying to stay active. Posts about PT are always relevant.