Any physical therapists out there? Advice after cast removal please

[jrmasm]

the PT should tell you what is best at the appointment

 

[tarheelmjfan]

If I was going to try to do more, I'd call the PT's office & ask for guidance. That way you'll know you're not doing anything that could set him back or cause damage.

 

[lanejudy]

He is doing strengthening exercises and stuff in between appointments. But he can’t get back in until Friday this week which is a lot of time wasted if there is something I can do at home to help him with his gait.

If the PT thought the time between appointments was too long, they'd have suggested "do X for the first # of days and then you can do Y until I see you again." The PT knows how fast to push this. I wouldn't stress over it -- your stressors are the vacation and wrestling, both of which need your acceptance that it may not be as you/he originally planned. Disappointing, yes, but not worth risking damage to body.

But he wants to try and the dr is being supportive of the effort, so I’m going to try to help him with that. ... It would feel pretty crappy to give up on him if he’s not ready to give up on himself yet.

I suspect the doctor recognizes this as his primary motivation, maybe more so than the vacation. Nothing wrong with that, though hopefully the doctor was realistic about his chance of returning to wrestling in less than 3 weeks. Being realistic doesn't mean giving up on him; it means teaching him to face challenges head-on and overcome adversity.

 

[dez1978]

If the PT thought the time between appointments was too long, they'd have suggested "do X for the first # of days and then you can do Y until I see you again." The PT knows how fast to push this. I wouldn't stress over it -- your stressors are the vacation and wrestling, both of which need your acceptance that it may not be as you/he originally planned. Disappointing, yes, but not worth risking damage to body.


I suspect the doctor recognizes this as his primary motivation, maybe more so than the vacation. Nothing wrong with that, though hopefully the doctor was realistic about his chance of returning to wrestling in less than 3 weeks. Being realistic doesn't mean giving up on him; it means teaching him to face challenges head-on and overcome adversity.

so when we last saw the pt, which was the 3rd, we had another appointment scheduled for the 7th, which got canceled bc the PT was sick. So we missed the appointment that would have been right before he got his boot off. The next available appt they had was this Friday the 17th. The last time we saw her it was do 10 leg lifts, 10 of this and 10 of that, pretty much all versions of leg lifts. She said when that gets easy add 5 at a time. So he’s up to 50 of each exercise, which is pretty good, doing them 2x a day. We haven’t seen them again for them to say ok, add this or that. I’m not trying to go above and beyond what the pt has just recently told us to do, bc the situation is different than when he saw her last 10 days ago. That appointment focused mainly on how to use the boot to walk. I’m fairly certain the exercises would be different now if he’d been able to see her. But in the meantime, the week between getting the boot off and when he can see the PT again, he’s peg legging it around and that certainly can’t be good for him either. It’s got to be making his hips and back hurt walking like that.

I can’t change our trip, it’s for a convention. I don’t have a day in that. We’ll adjust our activities if needed, and it’s going to be pretty laid back anyway compared to our normal trips.

I’m not trying to push him beyond what he’s ready for by any means. But I don’t have access to a PT in person for several more days and he is frustrated because he feels like everyone is staring at him at school walking weird and he can’t figure out how not to do it. Yes, getting to wrestle is a big motivation for him but we’ve been realistic that it might not happen and so has his dr. The dr gave him what he needed to see from him before he’d clear him and I’m just trying to figure out how to get him there if we can. The dr said some of it will come on his own now that he’s cleared for PE and recess again and he starts playing and gets busy enough that he forgets to think about walking. And some of it will come from practice as he was cleared to practice, just not live wrestling. The only restriction he really has is not to run on uneven surfaces where he could step in a hole and no direct hits to the leg, hence no live wrestling. His note for PE was “may sit out if leg hurts” so basically just listen to his body and stop when it hurts. He says nothing hurts. So it seems more like his brain just forgot what to do, or he’s gotten so used to not walking properly that it’s just habit.

This is one of those parenting things where I feel like I’m not wording things well and people feel I'm trying to push him beyond the recommendations or capabilities. But there haven’t really been any recommendations from anyone besides get to this point… but not how to get there. The last recommendations we had focused on walking with the boot. I need to help him try to figure out how to do it without the boot now. I don’t think that’s wrong of me or too much. And yes, I know random internet people are not the best source, but its kind of what I have for the next 5 days.

 

[DLgal]

so when we last saw the pt, which was the 3rd, we had another appointment scheduled for the 7th, which got canceled bc the PT was sick. So we missed the appointment that would have been right before he got his boot off. The next available appt they had was this Friday the 17th. The last time we saw her it was do 10 leg lifts, 10 of this and 10 of that, pretty much all versions of leg lifts. She said when that gets easy add 5 at a time. So he’s up to 50 of each exercise, which is pretty good, doing them 2x a day. We haven’t seen them again for them to say ok, add this or that. I’m not trying to go above and beyond what the pt has just recently told us to do, bc the situation is different than when he saw her last 10 days ago. That appointment focused mainly on how to use the boot to walk. I’m fairly certain the exercises would be different now if he’d been able to see her. But in the meantime, the week between getting the boot off and when he can see the PT again, he’s peg legging it around and that certainly can’t be good for him either. It’s got to be making his hips and back hurt walking like that.

I can’t change our trip, it’s for a convention. I don’t have a day in that. We’ll adjust our activities if needed, and it’s going to be pretty laid back anyway compared to our normal trips.

I’m not trying to push him beyond what he’s ready for by any means. But I don’t have access to a PT in person for several more days and he is frustrated because he feels like everyone is staring at him at school walking weird and he can’t figure out how not to do it. Yes, getting to wrestle is a big motivation for him but we’ve been realistic that it might not happen and so has his dr. The dr gave him what he needed to see from him before he’d clear him and I’m just trying to figure out how to get him there if we can. The dr said some of it will come on his own now that he’s cleared for PE and recess again and he starts playing and gets busy enough that he forgets to think about walking. And some of it will come from practice as he was cleared to practice, just not live wrestling. The only restriction he really has is not to run on uneven surfaces where he could step in a hole and no direct hits to the leg, hence no live wrestling. His note for PE was “may sit out if leg hurts” so basically just listen to his body and stop when it hurts. He says nothing hurts. So it seems more like his brain just forgot what to do, or he’s gotten so used to not walking properly that it’s just habit.

This is one of those parenting things where I feel like I’m not wording things well and people feel I'm trying to push him beyond the recommendations or capabilities. But there haven’t really been any recommendations from anyone besides get to this point… but not how to get there. The last recommendations we had focused on walking with the boot. I need to help him try to figure out how to do it without the boot now. I don’t think that’s wrong of me or too much. And yes, I know random internet people are not the best source, but its kind of what I have for the next 5 days.

Is another PT office an option? That's really unacceptable on the scheduling front. They should be able to get your son in at the frequency recommended by his doctor. I'd start there. Try and locate another PT that has better availability.

It sounds like your son is dealing with stiff, locked up muscles/fascia or some impingement. This is something you need a PT to physically manipulate with massage or TMS therapy, foam rolling, etc. I'm guessing his hamstrings and hip flexor are at issue here. This is not likely something your son has any control over.

Can he walk on his heels? Can he stand on tiptoes? Can he bend over and touch toes withiut bending his knees? Any pain with these movements? This might help narrow down what is tight. You can have him do some stretches to increase flexibility. You can use You Tube for some guidance. I like the Bob and Brad channel. They are awesome PTs and you can search for several issues to see targeted stretches and exercises.

 

[luv2cheer92]

Is another PT office an option? That's really unacceptable on the scheduling front. They should be able to get your son in at the frequency recommended by his doctor. I'd start there. Try and locate another PT that has better availability.

It sounds like your son is dealing with stiff, locked up muscles/fascia or some impingement. This is something you need a PT to physically manipulate with massage or TMS therapy, foam rolling, etc. I'm guessing his hamstrings and hip flexor are at issue here. This is not likely something your son has any control over.

Can he walk on his heels? Can he stand on tiptoes? Can he bend over and touch toes withiut bending his knees? Any pain with these movements? This might help narrow down what is tight. You can have him do some stretches to increase flexibility. You can use You Tube for some guidance. I like the Bob and Brad channel. They are awesome PTs and you can search for several issues to see targeted stretches and exercises.

PT plan of care (including frequency) is determined by the PT, not the physician. But I agree, I would find another office if they can't get you in any sooner than that.

 

[DLgal]

PT plan of care (including frequency) is determined by the PT, not the physician. But I agree, I would find another office if they can't get you in any sooner than that.

You're right, now that I think about it, but I have never done PT after an injury where it's only once a week. That does not seem like enough at all, especially for an athlete.

Heck, I fell one week ago and injured my shoulder and am already scheduled for 3 PT appointments this week.

 

[luv2cheer92]

You're right, now that I think about it, but I have never done PT after an injury where it's only once a week. That does not seem like enough at all, especially for an athlete.

Heck, I fell one week ago and injured my shoulder and am already scheduled for 3 PT appointments this week.

I pretty much never do 3x a week, I don't find it necessary, unless someone is really struggling after a surgery. Usually 2x for most. 1x is pretty common for young athletes further along in recovery that do their homework lol (still too early for that in the case of this thread). And I'll do 1x a lot for people that just need a little guidance along the way. Give exercises to do on their own, check back the next week, see how they are going, progress as needed, repeat.

 

[dez1978]

Is another PT office an option? That's really unacceptable on the scheduling front. They should be able to get your son in at the frequency recommended by his doctor. I'd start there. Try and locate another PT that has better availability.

It sounds like your son is dealing with stiff, locked up muscles/fascia or some impingement. This is something you need a PT to physically manipulate with massage or TMS therapy, foam rolling, etc. I'm guessing his hamstrings and hip flexor are at issue here. This is not likely something your son has any control over.

Can he walk on his heels? Can he stand on tiptoes? Can he bend over and touch toes withiut bending his knees? Any pain with these movements? This might help narrow down what is tight. You can have him do some stretches to increase flexibility. You can use You Tube for some guidance. I like the Bob and Brad channel. They are awesome PTs and you can search for several issues to see targeted stretches and exercises.

that is the only PT option where I live which is why it’s so booked. My least favorite thing about living where I do is lack of things like this. I’ve called to see if I can get the referral sent to an office in a different town about 45 min away. Maybe I could get him in somewhere else sooner that way. In my state PTs can’t see you without a referral, so that’s another road block. Thank you for the recommendations. I’ll check them out. I wouldn’t be surprised if he does have some stiffness in his ankle. I have been trying to get him to work on range of motion things with his ankle. But I’ll def check out the YouTube videos tonight.
He can bend over and touch his toes. I’ll have him try tiptoes.

 

[dez1978]

I pretty much never do 3x a week, I don't find it necessary, unless someone is really struggling after a surgery. Usually 2x for most. 1x is pretty common for young athletes further along in recovery that do their homework lol (still too early for that in the case of this thread). And I'll do 1x a lot for people that just need a little guidance along the way. Give exercises to do on their own, check back the next week, see how they are going, progress as needed, repeat.

I expected 2x a week. But the only time they’ve had available is 6am and I can’t make that work with 2 kids and getting them ready and to school on time. So far we’re once every 8-9 days here

 

[jo-jo]

When I was recovering from a fractured ankle, I had to really focus on keeping both feet pointed forward and stepping heel to toe. Maybe you could make up a goofy rhyme or song for him to remember what part of his gait he needs to focus on...something like "bend the knees so legs don't freeze" or whatever would help him. My PT always started with time on a stationary bike to warm up the muscles. If there is a very long time between appointments you might want to see if he can add an extra set of reps to his exercises after 4 or 5 days. Also, I would suggest checking his shoes for wear and possibly replacing them. I underpronate so I always wear our shoes unevenly.

Years ago I had a broken ankle. I went to grocery to walk the lines on aisles. My foot didn’t want to listen. I’m walking staring at my feel.

 

[Mackenzie Click-Mickelson]

IDK I'm going to take it like Mahomes here...high ankle injury..gets into decent enough strength to not be on the injury list like 2 weeks later and play but obvious hesitancy on using it to the full strength. Gets hit and wham injury again and in obvious pain.

These things do truly take time to heal and playing a sport too quick could just lead to further more damaging issues.

He is young so healing is different than how we are as adults but I would just focus on the injury healing, full strength will take a while and a PP had a good point about atrophy. I know it's been a while since he's been in that boot (I was remembering from the SWA thread). The trip I would do a wheelchair/walking combo so that way he's not over-doing it and then honestly leave wrestling as the furthest from the goal. If it were months away that would have changed but just a few scant weeks is asking a lot on the body and it's more than just this year to be concerned about. I think focusing on the wrestling part may just lead to more mental and physical stress.

 

[DLgal]

that is the only PT option where I live which is why it’s so booked. My least favorite thing about living where I do is lack of things like this. I’ve called to see if I can get the referral sent to an office in a different town about 45 min away. Maybe I could get him in somewhere else sooner that way. In my state PTs can’t see you without a referral, so that’s another road block. Thank you for the recommendations. I’ll check them out. I wouldn’t be surprised if he does have some stiffness in his ankle. I have been trying to get him to work on range of motion things with his ankle. But I’ll def check out the YouTube videos tonight.
He can bend over and touch his toes. I’ll have him try tiptoes.

If it's ankle stiffness, have him sit on a high chair or edge of a table where his legs can dangle. Have him write the letters of the alphabet with his toes, in the air. This helps with loosening up the ankle.