Physical Therapy day 3

Physical Therapy day 3 - Spondylolisthesis BJJ

Wednesday 6/29/2016.  They reversed the warm-up today.   1st was a timed exercise on a total gym machine incline body weight squats taking my legs to a 90 degree angle.  Continuous squats for 3 minutes.

2nd warm-up was 6 minutes on the stationary bike with resistance level of 4. 


Following that was resistance bands around both ankles as I did side walks down the path and back a total of 2 times there and back.  .

Hamstring door stretch: 

 

1 minute stretch each leg 2 sets 

Pelvic tilts:  

 

While lying on the therapy table I did 30 pelvic tilts - hold each while pressing my lower back into the table. 

Pelvic tilts and bridge:  Same movement as above but instead of pressing my low back into the table they had me hold the pelvic tilt and bridge lifting my hips off the table.

I held this bridge in the air for a count of 5 and then back down and relax for 1.  I did this for 3 minutes. 

Pelvic tilt crunches: 

I had never done crunches like these before and they were tiring on my abs.  Lay flat with knees bent like the picture above.  Do a pelvic tilt and hold it continuously while you do 30 crunches slowly just to the point where your hands go over your knees.  This gave a good abdominal burn! 

Modified bicycle crunches:  Another one that I had not done before.  I had done plenty of bicycle crunches where you are laying flat and you bring your opposite knee to your opposite elbow but this was different.  Instead of bring your elbow to your knee - you kept your arm straight and it went back behind your head as the knee came up and then switched for the other knee.  This was done for 3 sets of 30 seconds. 

Side leg raises: 

30 repetitions for each leg. I was surprised by how much they burned at the end.  The physical therapist also had me bring my foot slightly behind me as I was doing each leg raise.  This felt like it worked my glutes a little more by doing so. 

Isometric hands against knees:   Both knees at the same time (different from picture below)

With back flat on the table you lift both your knees up feet off the table.  Your cross hands to opposite knees and press against your knees while you try to pull your knees towards your hands.  Hold for 30 seconds.  2nd set was same as before but you switched your hands to be straight forward left to left knee and right to right knee.  3rd set was same as before but you put your palms flat on the ground  next to your hips and pressed into the ground with your hands while keeping your knees up. 

Table hamstring stretch:  Back on the table with on leg in the air hooked to the stretch strap in order to hold in place while the other leg lay flat on the table.  Pic below the bottom leg is meant to be straight.  

1 minute stretch for each leg 2 times each.


IT band stretch:  Keep back flat on the therapy table using the stretch strap to stretch my IT band.

One leg flat on the table with the other leg in the air held straight using the stretch strap to pull across my body.  Still very inflexible here and I need more work in this area.   1 minute each leg 2 times each. 


Inner thigh / Groin stretch: 

 

Laying flat I cross one leg and push my knee away.  1 minute each leg 2 times each.  

Buttock/Hamstring stretch:  

This stretch felt good as it stretched many muscles.  I will be adding this to my BJJ class stretches when I return to coaching. 


Thomas stretch:  This one was done with the assistance of the therapist.  

I sat on the front edge of the therapy table and then laid back and pulled one knee up into my chest while the therapist stretched the hanging leg down towards the floor. This time though the therapist showed me how my bottom leg pulled outward away from my other leg.  She said that was because my IT band on the outside of my thigh is so tight.  She pushed inwards during the stretch to help me stretch it. 

Lastly, I had mentioned to my therapist that right below my knee would start to hurt after about 20 minutes of walking.  I figured it was patellar tendonitis which she mostly confirmed after pressing on my tendon and talking to me about it.  She suggested using the ice cup for icing it. 

You can make you own or you can buy it online.  I will try and make my own and do as suggested using it each night for the next couple of night and also after walking or when it hurts. 

Next PT Session is Friday and I feel like I'm making good progress between the rest and the PT sessions.

Physical Therapy day 2

Physical therapy Spondylolisthesis BJJ day 2: 

Friday 6/24/2016.  Started me out with a 6 minute warm-up on the stationary bike with level 4 resistance.  My heart rate topped out at a 89 during the warm-up (I haven't done cardio in 4 weeks).  Next was a timed exercise on a total gym machine incline body weight squats taking my legs to a 90 degree angle.

I was told to continue doing squats for the duration of the time which was 3 minutes.

Following that was resistance bands around both ankles as I did side walks down the path and back a total of 4 sets.

Next was balance board and this really worked out my feet, groin muscles and core as I tried to balance on a square board with a ball on the bottom.

First set was keeping my balance front to back trying not to let the board touch the ground front or back for 1 minute.  2nd set was the same but this time trying to lower forward and back slowly with out touching the ground for 1 minute.  The next two sets were exactly the same but the board was set so that the balance part was right to left.  At the end of this my feet felt worked out similar to when I used to rock climb.  On to the therapy table where I did 30 pelvic tilts hold while pressing my lower back into the table.

This made my back feel better.

Next set was also for 30 reps and it was same as before but instead of pressing my low back into the table they had me hold the pelvic tilt and bridge lifting my hips off the table.

I held this bridge in the air for a count of 5 and then back down and relax for 1.  30 reps.

The second half of my session was stretching.  I have been told that with spondylolisthesis, it is common to have very tight hamstrings and that is true for me.

1st stretch was a hamstring stretch using the therapy table.

Start seated on the table with one leg straight on the table and the other off the side of the table to the floor and stretch the straight leg.  1 min stretch and the turn and switch legs.  I did both legs twice.

2nd stretch was lying on my back with on leg in the air hooked to the stretch strap in order to hold in place while the other leg lay flat on the table.

1 minute stretch for each leg 2 times each.

3rd stretch was over at a bench where I place one leg up on the bench and tilted forward at the hips with my back straight doing a traditional hamstring straight leg stretch.

After 1 minute I turned outward and the stretch hit my groin and inner hamstring.  After that 2nd minute I turned back inside and crossed over the other way and the stretch got my IT band.  After doing all three of those back to back for 1 minute each position I then did the other leg. 


4th stretch was back on the therapy table using the stretch strap to stretch my IT band.

One leg flat on the table with the other leg in the air held straight using the stretch strap to pull across my body.  This is an area I need a lot of work on.  Often times when I get a massage, the therapist tells me my IT band is very tight so this was no surprise for me.  1 minute each leg 2 times each.

5th stretch was called the Thomas stretch. 

I sat on the front edge of the therapy table and then laid back and pulled one knee up into my chest while the therapist stretched the hanging leg down towards the floor. 

Physical Therapy day 1

1st day of physical therapy meeting the head PT - spondylolisthesis BJJ:

Thursday 6/23/2016.  I have never had PT before and had no idea what to expect.  1st day was introduction, evaluation and demonstration.  He introduced himself, took a patient history and listened to me explain what I was going through in terms of pain and what were my goals with PT.  I told him my main goal was to return to BJJ, strengthen my core, reduce pain and protect my back.  

I consider myself a flexible person but after the evaluation It was apparent I have some very inflexible muscles that I was not aware of.  In the past, I could do the splits but I haven't been able to do that for years.  Overall I feel flexible but the areas he checked today would seem to show otherwise ;).  

We went thru around 6 stretches he wants me to do and talked about measuring and progressing over the next several sessions.  I am going to do 2 PT sessions a week for the next 4-6 weeks and then will see my physican to check my current state and see if he clears me to return to light BJJ training.  

Tomorrow is my first active PT session.

Spondylolisthesis - New Hope

2nd opinion: Spondylolisthesis BJJ:

I went to see a different physician today and after evaluation, looking over my X-rays, and talking to me he said no need for surgery at this point.  He feels that with 4-6 weeks of rest from Brazilian Jiu Jitsu and other stressful type activities/exercise and physical therapy, he may be able to release me back to Jiu Jitsu on a light level.  I have a grade 1 Spondylolisthesis and he showed me on my X-ray that it is really like a half grade 1 as mine shows to be around 15% slipped forward.  I am to focus on core strength and flexibility in PT to help stabilize it.  I'm excited to Start PT soon.  I have no idea what to expect.

Spondylolisthesis - The beginning discovery

Week 1 - the pain leading to the discovery. 

I have been practicing BJJ (Brazilian Jiu Jitsu) for a long time and coaching for many years.  I had never heard of Spondylolisthesis before but was about become very familiar with it on a personal level.  I spend a good part of my working day sitting at a computer in my office.  I get up every once in a while and walk around but on this particular day I had just returned from a week of vacation and spent most of the day sitting catching up on email and work.  At the end of the day, I left my office and walked to my car.  On the way to my car my back started to feel a little pain.  No big deal I thought as I'd been sitting longer than usual that day.  This was Monday.  As I drove my car it got worse and that was the beginning of a week long episode of low back pain.  The next day was Tuesday and I made an appointment with my chiropractor for a massage and an adjustment.  I didn't feel any better or worse and my back was still super tight and painful.  I could NOT bend over without severe pain.  I saw my chiropractor again on Thursday.  She recommended I get xrays of my low back since I had never done so and was in such pain.  Xray showed I have grade 1 Spondylolisthesis with a pars fracture.  After viewing the xray and seeing that I was still in a lot of pain she recommended that I see a physician and see if some kind of anti-inflammatory might help.  I saw an MD and he prescribed prednisone (steroidal anti-inflammatory).  This seemed to help tremendously.  It was a 5 day course and by the end of the 5th day my pain was down considerably and only hurt when I arched back or if I sat and tried to put on my shoes.  This was still a huge improvement over the painful week I had just experienced. 

Week 2 - relief and sadness. 

I'd put the pain from week 1 at an 8 out of 10.  The second week was 4 out of 10 and even less if I was walking slowly or laying down.  I had begun reading about Spondylolisthesis every night and trying to search forums and the internet for others that had it.  Specifically I was looking for BJJ and martial artists but wasn't have a lot of luck finding people and the few I did it was hard to contact them for more information.  I got an appointment with an Orthopedic surgeon for Friday.  He started talking about surgery with screws in my spine and I started to get really sad.  I asked about Physical therapy and he just brushed it off and I believe his words were "Nah."