Helen and Carl are right on track with their preparation towards the Spartan. Carl continues to do an excellent job in tailoring the program to allow a peak and then wind down in preparation for the Spartan on the 16 March 2013. Carl is also continuing to mix up and marry together the CV work and deep core & stability work that Helen needs if her goal is to remain injury free.
You will remember that we have been looking at reducing the issues that Helen had involving her Right Shoulder and Right side of her neck, as well as her Right SIJ, so today we continued with these.
Pleasingly with the combination of the physiotherapy and stabilising work form Carl, Helen has noticed some marked functional improvement in her Right SIJ symptoms and Right shoulder symptoms which is very encouraging. Clinically she is also testing better. The areas that have been manipulated over the past weeks have remained mobile, and today we only needed to do some gentle soft tissue release treatment around the right side of her neck and also the right Quadratus Lumborum.
In addition, due to the heavy nature of the session that Carl and Helen performed 2 days ago, she had some Delayed Onset Muscle soreness (DOMs) in her calf. – I also treated this with some soft tissue techniques including gentle trigger point release work.
Today it was great to see, as I was treating her neck, (with her lying on her back) that her Right foot, was now pointing out towards the wall. You may recal that this was an issue in the previous sessions but today the Left and Right foot were nicely relaxed out and turned towards the wall.
The Right side of her pelvis was also improved
Like in the last posts – I feel I again need to point out that these examination and treatment techniques for the pelvis have so far proven to be difficult to prove in clinical trials and are therefore controversial in their application. Although I have been doing them for years, and for whatever reason I find them to give good immediate results such as today. However this is only half the battle, the patient is given a window in which to practice and needs to do a lot of core stability and postural work to encourage this to ‘stick’ as Helen has been doing with Carl.
The knee seems to be going well as she reported no problems with this today. She should carry on with the eccentric exercise program for at least another 4 weeks.
She also needs to continue with the gentle stabilisation work and massage to help her recovery
I will see her next week prior to the departure and get her as good as possible before they leave on for Australia on Wednesday.
Carl has continued to exercise and despite the increased workload and demands on his foot he reports some improvement in his symptoms with the combination of core work around the pelvis to improve the proximal control and remove some of the overload to the foot, the acupuncture, and the change of footwear.
He reported today that he felt that his upper back and neck had felt much better following the manipulations during the last session. Today he still had some stiffness lower down his thoracic spine, so I also manipulated this today for him given the positive effects of the last session.
For his Left foot I repeated the acupuncture today for the third time. From my experience acupuncture may take up to 4 sessions before any signs of improvement are noticed. In Carl’s case he noticed improvement immediately and I would expect it to continue to improve with each session up to 4. From then onwards the improvement is more gradual, and the sessions can be spaced out more each time.
I have also reiterated the need for them both to remain on Helens dietary recommendation to help with regeneration and repair as well as to reduce inflammation
I will continue to help with acupuncture, Helen and Carl will continue with their diet and training. Not long to go now!
Posted by Willis Street Physiotherapy