Injury recovery - suggestions please

donal.casey · Joined: 18 Aug 2007 Posts: 15

I damaged by quadricep insertion to the patella back in July (very
very painful) and am now just about recovered(incidentally a weeks
skiing appears to have been the thing that has really helped most as I
think it excited the various ligaments and tendons back into action).

Anyway during the initial rehab exercises it was suggested that I
swing my leg with a pilates type band(football kick). Unfortunately
after a few weeks and some success with this and developing the knee
with one leg exercises principally at the gym I ended up getting a
groin injury!!!! This again very painful and has made sculling and
erging pretty much impossible since November. Though having had a
previous hernia scans suggest that nothing was torn. It was
excruciating for a number of weeks such that I thought some serious
damage had been done. The local doctors havnt been of much assistance
so I have pretty much resorted to rest and am just getting back to
things. (Id normally see a physio but for a variety of reasons I havnt
been able to on this occasion).

After quite a bit of research I think the injury is related to the
pubis synthis area and am looking for exercises that specifically
target this area. Of relevance, when I squat I find my left leg tends
to "drift" to one side. This I put down possibly to years of bowside
rowing as I have always rowed between rather than over the top of the
legs. Ive gone through some old photos and see that my lean to bowside
and the drop of the movement out of the left leg has become more
exaggerated over recent years. I am wondering therefore if this has
slowly loosened and weakend these deep muscle/ligament structures. If
so then Im sure Im not alone in this technical idiosyncracy and
coaches may like to think about whether this is poor technique (and
therefore correct it) or if acceptable that exercises are done
specifically to assist a probably difficult to exercise set of muscles/
ligaments so that their athletes dont develop the same injury. One of
the juniors I am coaching appears to have a similar injury which
sometimes affects him sculling or on the ergo though his appears to
have been incurred through years of swimming breaststroke at
competition.

At 15 though I think his recovery is likely to be rather quicker than
mine.

Any thoughts gratefully received as am keen to try to get fit again.

Donal

Archived from group: rec>sport>rowing

Robert Treharne Jones · Joined: 18 Aug 2007 Posts: 19

Donal

You seem to have tried self-diagnosis and then tried to theorise on
the possible aetiology, assuming your diagnosis to be correct! This is
dangerous territory. I suggest you consult a professional of your
choice and get yourself properly sorted. If indeed you have strained
the adductor origin on your pubic symphysis then a physio would be
able to both confirm the diagnosis and offer appropriate treatment,
which is likely to include ultrasound and other specific modalities
rather than exercises.

Robert

On Feb 27, 5:52 pm, "donal.ca...@gmail.com"
wrote:
> I damaged by quadricep insertion to the patella back in July (very
> very painful) and am now just about recovered.
>
> Anyway during the initial rehab exercises it was suggested that I
> swing my leg with a pilates type band(football kick). Unfortunately
> after a few weeks and some success with this and developing the knee
> with one leg exercises principally at the gym I ended up getting a
> groin injury!
>
> After quite a bit of research I think the injury is related to the
> pubis synthis area and am looking for exercises that specifically
> target this area.

Anne Rogers · Joined: 18 Aug 2007 Posts: 29

> After quite a bit of research I think the injury is related to the
> pubis synthis area and am looking for exercises that specifically
> target this area.

Presume you mean pubic symphysis?

Exercises for this area mostly focus on transverse abdominus muscle and
the pelvic floor. Learning to isolate the transverse abdominus (TA) is
pretty tricky, I can give tips, but it is something that input helps
with, if that can't be a physio, then a one off private session with a
pilates instructor could be a big help.

Here's how I was taught to isolate it. Lie flat on your back, bend you
knees and keep you feet hip width apart and place you feet about where
your knees were when lieing flat. Press your sacrum downwards such that
your pelvis in neutral, i.e. not rotated upwards or downwards. Now,
place two fingers of each hand on the corresponding hip bone and slide
them in about an inch so they are over soft tissue. Now contract your
lower abdomen, if you're getting the right muscle you should feel a
contraction under your fingers. Another way to visualise it is to think
of pulling the hip bones together.

Once you've got that muscle contraction there are numerous exercises to
work that area. You can start with just contracting and holding, then
breathing in and out.

Moving on to more complex exercises, it is crucial to keep the pelvis in
neutral and the hips level, which can be really hard to judge on
yourself, so ideally have someone watch you. You can drop one knee out
to the side as far as is painfree - keeping the opposite hip flat is
vital, otherwise you start working completely different muscles. You can
then move on to moving both knees symmetrically. Another one is to slide
one foot along the floor until the leg is straight and return to
neutral, again, it's vital to keep the hips completely still. Slide one
leg out and lift that leg - again the hips and pelvis all being in
neutral is vital. With a ball, or pillow folded in half between your
knees, squeeze and hold. There are many more, but those are the basic ones.

Some kind of pilates from a reputable instructor would be ideal.

This injury is really quite rare, it mostly affects pregnant women, or
women who have given birth (when, rarely, the ligament can rupture).
Amongst athletes, it mostly affects footballers. If possible you could
get an x-ray done, as there can be swelling, known as ostitis pubis, the
exercise treatment in the same, but there is evidence suggesting that
steroid injections in to the joint produce vastly superior results if
that process is occurring.

Cheers
Anne

Anne Rogers · Joined: 18 Aug 2007 Posts: 29

> You seem to have tried self-diagnosis and then tried to theorise on
> the possible aetiology, assuming your diagnosis to be correct! This is
> dangerous territory. I suggest you consult a professional of your
> choice and get yourself properly sorted. If indeed you have strained
> the adductor origin on your pubic symphysis then a physio would be
> able to both confirm the diagnosis and offer appropriate treatment,
> which is likely to include ultrasound and other specific modalities
> rather than exercises.

I entirely agree that it should be properly assessed, the exercises I
suggested, provided you are fairly confident you've achieved TA
contraction would be very unlikely to do any harm, if you haven't felt
the TA contraction, don't do them - you'd most likely be exercising
other muscles and result in further imbalance. If you don't locate the
TA muscle straight away you can continue the simple contractions in an
attempt to find it.

Robert - I'd be surprised to find a physio who wouldn't include some
exercises as part of treatment, if there has been an injury muscle
imbalance almost always results due to rest and altered gait and it
sounds like Donal is at the rehab rather than acute phase.

Cheers
Anne

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