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November, 2024

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Ask a Physical Therapist

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SkierPT
Posts: 2199 - Karma: 4,830
Hi guys. Dr. Nick here again. As the season gets going I want to start this thread again.

I am a sport and ortho PT.

Shoot me questions you might have about rehab, injury prevention, etc.

I’ll do my best to answer as best as I can!
Dec 6 2024 4:33PM
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KungKalmar
Posts: 1767 - Karma: 14,584
What is the meaning of life?
Dec 6 2024 4:48PM
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wyobro
Posts: 44 - Karma: 460
I did squats for the first time in months yesterday and I’m going to copper tmrw, how do I get unsore asap
Dec 6 2024 4:49PM
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SkierPT
Posts: 2199 - Karma: 4,830
wyobroI did squats for the first time in months yesterday and I’m going to copper tmrw, how do I get unsore asap


You’re cooked brother. Needed to start squatting months ago!
Dec 6 2024 4:51PM
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Jibbcore
Posts: 369 - Karma: 274
i have almost torn acl from like two years ago it was holding on to a string but i can do everything no problems now i can ski and train in the gym should i do something about it or not?
Dec 6 2024 4:55PM
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SkierPT
Posts: 2199 - Karma: 4,830
Jibbcorei have almost torn acl from like two years ago it was holding on to a string but i can do everything no problems now i can ski and train in the gym should i do something about it or not?


You could always get an updated MRI to see how intact it is. Otherwise if you’re functional and pain-free, it sounds
like you’re doing well!
Dec 6 2024 4:56PM
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Jibbcore
Posts: 369 - Karma: 274
SkierPTYou could always get an updated MRI to see how intact it is. Otherwise if you’re functional and pain-free, it sounds
like you’re doing well!

Okay MRI might be good havent got one since it happened over two years ago
Dec 6 2024 5:01PM
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Icant_kfed
Posts: 1279 - Karma: 11,591
I had cartilage grafted into my left a year and a half ago, what’s the biggest jump to a flat landing I can take safely?
Dec 6 2024 5:34PM
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Dlonetti
Posts: 1845 - Karma: 19,211
4th season post acl tear. feel confident on it and don’t have much issue besides it just gets tired quicker than my other one. any good in season knee exercises to do?
Dec 6 2024 5:50PM
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Getshifty
Posts: 347 - Karma: 2,126
Any suggestions for Chondromalacia Patella? More specifically fissures on the lateral and apex facet as a result of a kneecap subluxation last spring. Got an MRI, all tendons are fine besides a small partial tear in my patellar tendon from having jumpers knee, successfully rehabbed that last year.



Currently strengthening hamstring, glute and hip on affected side, and doing 15 min of light biking twice a day to help stimulate the cartilage / fill in the fissures with scar tissue. Taking chondroitin and glucosamine supplements as well.

Pain is manageable, doesn't affect my daily life, and has decreased throughout the last couple months. Interestingly, pain only occurs on initial loading of knee, but then goes away.

Any suggestions? Thanks.
Dec 6 2024 6:13PM
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BallClapper
Posts: 3018 - Karma: 12,503
@mikem now your chance.
Dec 6 2024 6:22PM
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brownetown
Posts: 439 - Karma: 4,275
Hey Dr Nick,

After riding hard my right knee gets super stiff and feels like it can’t bear weight at certain angles without feeling wobbly for a couple of days. This usually happens after skiing (but sometimes during if I take some heavy slams) and is noticeable when sleeping or after sitting for a while or when I’m playing water polo. I’m American but live in Switzerland so I’m hesitant to drop a band to get it checked out.. think it’s necessary to know what’s goin on or are there stretches / strengthening things I can do to ensure I don’t tear something?
Dec 7 2024 3:30AM
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mikem
Posts: 926 - Karma: 8,981
hello mr @SkierPT

I have bruised heel for 3 years now. it hurts to stand in my kitchen. I expect an instant fix.

don't tell me to stop landing flat. I've done that and it still no heal.
Dec 7 2024 4:41AM
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SkiingNinja
Posts: 1970 - Karma: 901
I had a L5/S1 disc herniation with spinal and nerve compression in 2021. I had two surgeries and rehabbed fine. Got back to regular activity. For the past three months, I’ve been having nerve pain in the left gluteal region and thigh. It doesn’t go below the knee like last time. I’m awaiting results of an MRI to rule out the spine, and the doctor thinks it is muscle related. How should I build up my glute muscles without pissing off my nerve further?
Dec 7 2024 10:15AM
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quintcork
Posts: 331 - Karma: 2,233
Sore neck after skiing with helmet. How do I get a strong neck?
Dec 7 2024 10:53AM
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xblth
Posts: 34 - Karma: 166
My knees twist inwards and I can’t bend them fully (can’t touch my butt with my heels). Feel like mobility issues are a big risk… what can I do to fix it
Dec 7 2024 10:53AM
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micsinthetrees
Posts: 30 - Karma: 193
hey man, I always get shinbang around march/april. i’m riding pretty stiff skis with flexy full tilts. how to avoid it happening this year? thanks
Dec 7 2024 11:06AM
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Mtrob
Posts: 4 - Karma: 19
Yo. I’m 1.5 years out from acl and meniscus surgery. Did pt 2x’s a week for a year. Did 4 months of ATG with a coach. About a year in I woke up and my nerves didn’t work. Calf won’t flex and toes are limp or curl when I step. In the last 3 months my muscles atrophied and now my leg is 2 inches smaller than non surgical leg. I know I’ll be told get an mri but I’m uninsured and already 130,000$ dollars into it. Any ideas would be rad.
Dec 7 2024 6:13PM
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SkierPT
Posts: 2199 - Karma: 4,830
Icant_kfedI had cartilage grafted into my left a year and a half ago, what’s the biggest jump to a flat landing I can take safely?


Gucci plateau I would say.
But honestly work on box jumps in the gym and see how you tolerate progressing heights.
Dec 7 2024 6:14PM
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SkierPT
Posts: 2199 - Karma: 4,830
Dlonetti4th season post acl tear. feel confident on it and don’t have much issue besides it just gets tired quicker than my other one. any good in season knee exercises to do?


Single leg for all of these:
Wall sits
Leg Press
Knee Extensions
Split Squats
Reverse lunges
Dec 7 2024 6:16PM
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SkierPT
Posts: 2199 - Karma: 4,830
GetshiftyAny suggestions for Chondromalacia Patella? More specifically fissures on the lateral and apex facet as a result of a kneecap subluxation last spring. Got an MRI, all tendons are fine besides a small partial tear in my patellar tendon from having jumpers knee, successfully rehabbed that last year.



Currently strengthening hamstring, glute and hip on affected side, and doing 15 min of light biking twice a day to help stimulate the cartilage / fill in the fissures with scar tissue. Taking chondroitin and glucosamine supplements as well.

Pain is manageable, doesn't affect my daily life, and has decreased throughout the last couple months. Interestingly, pain only occurs on initial loading of knee, but then goes away.

Any suggestions? Thanks.


Shoot me a DM.
I have a few specific ideas for you!
Dec 7 2024 6:17PM
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SkierPT
Posts: 2199 - Karma: 4,830
brownetownHey Dr Nick,

After riding hard my right knee gets super stiff and feels like it can’t bear weight at certain angles without feeling wobbly for a couple of days. This usually happens after skiing (but sometimes during if I take some heavy slams) and is noticeable when sleeping or after sitting for a while or when I’m playing water polo. I’m American but live in Switzerland so I’m hesitant to drop a band to get it checked out.. think it’s necessary to know what’s goin on or are there stretches / strengthening things I can do to ensure I don’t tear something?


There are a few tests and measures you can certainly do without imaging to predict joint instability. I would love to discuss further. Shoot me a DM !!
Dec 7 2024 6:18PM
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SkierPT
Posts: 2199 - Karma: 4,830
mikemhello mr @SkierPT

I have bruised heel for 3 years now. it hurts to stand in my kitchen. I expect an instant fix.

don't tell me to stop landing flat. I've done that and it still no heal.


At this point an injection might be a good idea. Cortisone or prolozone. Consult your physician. Are you sure its not plantar fasciitis?
Dec 7 2024 6:20PM
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SkierPT
Posts: 2199 - Karma: 4,830
SkiingNinjaI had a L5/S1 disc herniation with spinal and nerve compression in 2021. I had two surgeries and rehabbed fine. Got back to regular activity. For the past three months, I’ve been having nerve pain in the left gluteal region and thigh. It doesn’t go below the knee like last time. I’m awaiting results of an MRI to rule out the spine, and the doctor thinks it is muscle related. How should I build up my glute muscles without pissing off my nerve further?


Have you been assessed by PT recently?
Shoot me a DM, I want to give more info.
Dec 7 2024 6:21PM
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SkierPT
Posts: 2199 - Karma: 4,830
quintcorkSore neck after skiing with helmet. How do I get a strong neck?


Rows, pullups, shrugs, lat pull downs.

Lying on your side lift head to do side lifts,
Same idea with head lifts lying on your back and stomach.
Dec 7 2024 6:22PM
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SkierPT
Posts: 2199 - Karma: 4,830
xblthMy knees twist inwards and I can’t bend them fully (can’t touch my butt with my heels). Feel like mobility issues are a big risk… what can I do to fix it


You need to be assessed for hip, knee and ankle mobility.
Often times its an issue at the ankle.
DM me and Ill send you a few tests to try.
Dec 7 2024 6:23PM
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SkierPT
Posts: 2199 - Karma: 4,830
micsinthetreeshey man, I always get shinbang around march/april. i’m riding pretty stiff skis with flexy full tilts. how to avoid it happening this year? thanks


Better technique/ staying forward, less flexy boot tongue, booster straps are a few ideas.

Try strengthening the quads, gastroc/ soleus and anterior tibialis.

DM me if you want to go over more in detail!
Dec 7 2024 6:25PM
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Dlonetti
Posts: 1845 - Karma: 19,211
SkierPTSingle leg for all of these:
Wall sits
Leg Press
Knee Extensions
Split Squats
Reverse lunges

you’re such a dope resource for all of us. thank you
Dec 7 2024 7:41PM
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SkierPT
Posts: 2199 - Karma: 4,830
MtrobYo. I’m 1.5 years out from acl and meniscus surgery. Did pt 2x’s a week for a year. Did 4 months of ATG with a coach. About a year in I woke up and my nerves didn’t work. Calf won’t flex and toes are limp or curl when I step. In the last 3 months my muscles atrophied and now my leg is 2 inches smaller than non surgical leg. I know I’ll be told get an mri but I’m uninsured and already 130,000$ dollars into it. Any ideas would be rad.


This sounds like a major nerve pinch issue. I'd highly recommend getting updated MRI imaging. You can pay $300-$1000 out of pocket for one, or call your primary care physician to have them order through insurance.

You're likely too young for this issue. If you were my patient I would refer you to a spine orthopedic immediately.
Dec 8 2024 12:46PM
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SkierPT
Posts: 2199 - Karma: 4,830
Dlonettiyou’re such a dope resource for all of us. thank you


No doubt. Just use Chat GPT to create a split for you that works to progress strength over the next few months!
Dec 8 2024 12:47PM
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VTshredder69
Posts: 3132 - Karma: -7,130
SkierPTSingle leg for all of these:
Wall sits
Leg Press
Knee Extensions
Split Squats
Reverse lunges

These also good with two legs for strengthening and conditioning the legs for woods skiing?
Dec 8 2024 12:48PM
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Icant_kfed
Posts: 1279 - Karma: 11,591
SkierPTGucci plateau I would say.
But honestly work on box jumps in the gym and see how you tolerate progressing heights.


I’ve been more focused on unilateral stuff to try to bring my balance back but I’ll def give that a shot
Dec 9 2024 6:01PM
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SendyMcSendyface
Posts: 2828 - Karma: 24,028
Thoughts on the long term impact of tele skiing vs alpine?
Dec 9 2024 6:02PM
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BallClapper
Posts: 3018 - Karma: 12,503
Quads will be swole af. Less foot pain too. Might affect your ability to attract females tho…
SendyMcSendyfaceThoughts on the long term impact of tele skiing vs alpine?
Dec 9 2024 7:14PM
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nCrow
Posts: 1216 - Karma: 7,930
Got some whiplash and a concussion from faceplanting in sticky snow a year and a half ago. Still get some sharp neck pain every once in a while on one side if I move my head the wrong way, usually to the side and down on that side, but doesn't bother me while skiing. Any advice on rehabbing that?

Thanks for doing these! Us park skiers with beat up bodies in our late 20s really appreciate it.
Dec 9 2024 8:39PM
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SendyMcSendyface
Posts: 2828 - Karma: 24,028
BallClapperQuads will be swole af. Less foot pain too. Might affect your ability to attract females tho…

So far 2/3 are correct
Dec 9 2024 10:04PM
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bertBertson
Posts: 267 - Karma: 4,294
Late to the thread but any tips for lower back muscle rehab? Overdid it shovelling/skiing a DIY setup on the weekend and now everything at the base of my spine feels super seized up and painful.

Gonna go see a doc obviously but was wondering if you'd be willing to share any advice ๐Ÿ™
Dec 10 2024 10:24AM
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SkierPT
Posts: 2199 - Karma: 4,830
VTshredder69These also good with two legs for strengthening and conditioning the legs for woods skiing?


Yes!
Dec 10 2024 10:38AM
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VTshredder69
Posts: 3132 - Karma: -7,130
bertBertsonLate to the thread but any tips for lower back muscle rehab? Overdid it shovelling/skiing a DIY setup on the weekend and now everything at the base of my spine feels super seized up and painful.

Gonna go see a doc obviously but was wondering if you'd be willing to share any advice ๐Ÿ™


I've had this issue before. I went to a chiropractor for a few weeks and it definitely helped.

He also asked if i was doing incline treadmill. Which I was doing heavily. Since staying off that my lowie backie has been awesome. but def see a doc.
Dec 10 2024 10:46AM
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SkierPT
Posts: 2199 - Karma: 4,830
nCrowGot some whiplash and a concussion from faceplanting in sticky snow a year and a half ago. Still get some sharp neck pain every once in a while on one side if I move my head the wrong way, usually to the side and down on that side, but doesn't bother me while skiing. Any advice on rehabbing that?

Thanks for doing these! Us park skiers with beat up bodies in our late 20s really appreciate it.


Try neck retractions with rotation to the painful side. It’s a tricky exercise to do correctly. YouTube it or message me!
Dec 10 2024 10:57AM
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SkierPT
Posts: 2199 - Karma: 4,830
SendyMcSendyfaceThoughts on the long term impact of tele skiing vs alpine?


I have no experience with tele but I’d imagine your tendons would be very strong
Dec 10 2024 10:58AM
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SkierPT
Posts: 2199 - Karma: 4,830
bertBertsonLate to the thread but any tips for lower back muscle rehab? Overdid it shovelling/skiing a DIY setup on the weekend and now everything at the base of my spine feels super seized up and painful.

Gonna go see a doc obviously but was wondering if you'd be willing to share any advice ๐Ÿ™


Look up lumbar spine McKenzie self management. It’s where I start with most patients with low back pain!
Dec 10 2024 10:59AM
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SkierPT
Posts: 2199 - Karma: 4,830
Going to plug my IG:

https://www.instagram.com/pinpoint_physical_therapy/profilecard/?igsh=Zzd1ampsZ3p2Yjk3

and PT site:
Pin-PointPT.com


im a private solo PT practice trying to build the dream, located in Ohio.


I do telehealth sessions !
Dec 10 2024 11:03AM
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BlueTrees
Posts: 1 - Karma: 11
After a long career of wrestling I have a pretty sizeable bursa in my knee, what are some stretches I could do to help reduce it?
Dec 10 2024 11:21AM
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Slugger66
Posts: 122 - Karma: 773
How careful do I need to be coming back with a bulged disc? I still have pain but lifting is helping immensely. I skied several days of groomers with minimal pain this week. I want to ease back into park and tree skiing, but I know the constant compression may aggravate it.

Also, do you recommend any specific exercises for impact preparation beyond squats and deadlifts?

**This post was edited on Dec 10th 2024 at 10:23:40pm
Dec 10 2024 10:20PM
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bertBertson
Posts: 267 - Karma: 4,294
SkierPTGoing to plug my IG:

https://www.instagram.com/pinpoint_physical_therapy/profilecard/?igsh=Zzd1ampsZ3p2Yjk3

and PT site:
Pin-PointPT.com


im a private solo PT practice trying to build the dream, located in Ohio.


I do telehealth sessions !

Followed, thank you for the advice ๐Ÿ™
Dec 15 2024 1:37PM
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fdWEARer
Posts: 270 - Karma: 298
rolled my ankle and heard a super loud pop/ crack a month or 2 ago, took it easy for a few weeks, when putting that foot into and out of my ski boots it hurts like hell. no pain while skiing, but after it hurts to the touch, and rotating it down or to the side hurts super bad (rotating my foot pinkie side downwards) pain is near my ankle area.

I figured it was just rolled, but its been a while, and it still feels the same.
Dec 15 2024 4:56PM
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-skian-
Posts: 358 - Karma: 1,669
I have 4 squashed discs (C7-T4) and have been doing my physio every day for it since August. (Full confession: I missed last night I got to bed really late and my gf is visiting, only the 2โฟแตˆ day I have ever missed) It is not that doing anything hurts it, during activities it is mostly consistent, but it is a constant everliving pain, is that something to expect for the rest of my life? Painting/drawing/writing letters hurt because I bend my head forwards to see detail. Also if I keep my chin down but tip my neck back sometimes it makes a loud sort of squishing noise and feels like a sharp crack in my spine with shooting pain down and up into my skull base. It really sucks and I expect the answer to be yes, this is life now. It is just sad that I never am not in pain 9 months in :/
Dec 16 2024 9:24AM
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SkierPT
Posts: 2199 - Karma: 4,830
BlueTreesAfter a long career of wrestling I have a pretty sizeable bursa in my knee, what are some stretches I could do to help reduce it?


Compression sleeve.
Heel slides lying on your back.
Quad Sets lying on your back.
Hamstring. calf and quad static stretches
Dec 18 2024 9:17AM
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SkierPT
Posts: 2199 - Karma: 4,830
Slugger66How careful do I need to be coming back with a bulged disc? I still have pain but lifting is helping immensely. I skied several days of groomers with minimal pain this week. I want to ease back into park and tree skiing, but I know the constant compression may aggravate it.

Also, do you recommend any specific exercises for impact preparation beyond squats and deadlifts?

**This post was edited on Dec 10th 2024 at 10:23:40pm


This would depend on where the injury is and how bad the symptoms are. Shoot me a DM with more info !
Dec 18 2024 9:18AM
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SkierPT
Posts: 2199 - Karma: 4,830
fdWEARerrolled my ankle and heard a super loud pop/ crack a month or 2 ago, took it easy for a few weeks, when putting that foot into and out of my ski boots it hurts like hell. no pain while skiing, but after it hurts to the touch, and rotating it down or to the side hurts super bad (rotating my foot pinkie side downwards) pain is near my ankle area.

I figured it was just rolled, but its been a while, and it still feels the same.


It sounds like you damaged tendon/ ligament. I would recommend PT to get assessed and to get on a treatment plan to try to save your ski season. Shoot me a DM if you have any questions.
Dec 18 2024 9:20AM
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