Exercises to Avoid when Recovering from an ACL Injury

by Joan Barker

Making a full recovery from an injury to the anterior cruciate ligament (ACL) is possible. However, a grade 3 ACL sprain, which is equivalent to a torn ligament needs to undergo surgery. The American Academy of Orthopaedic Surgeons specified that it requires a tissue graft, which is usually sourced from a tendon. It’s used to reconstruct the severed ligament. Coming back from the injury may take up to six months or more, and physical therapy is prescribed to speed up recovery. Here are two types of exercises that you should avoid at certain stages of recovery from a torn ACL.

Weight-bearing Exercises:

The first few weeks will have you relying on crutches. It will be impossible and/or painful—not to mention ill-advised—to perform weight-bearing exercises. Examples are lunges and squats. You should instead focus on reintroducing range of motion. It’s still possible to maintain quad strength by contracting the muscles around the knee (AKA isometric contractions) without moving the injured joint.

Terminal Knee Extension:

The knee is a hinge type joint, which means it can flex and extend. Fitness writer and health buff Jan Millehan explains that terminal knee extension (TKE) is the action of straightening the leg fully to attain the end of range of motion. TKE is not a bad workout per se, but it can exert unnecessary stress on the knee, especially when using resistance bands, cables, or machines. Avoid doing TKE, heel raises, and leg balancing exercises (specifically the ones performed in yoga) until the swelling has subsided post-surgery. Start by doing heel slides where you aim to gently stretch the leg forward while keeping heel contact on the floor.

If you want to do cardiovascular exercises, swimming is a good form of workout. You can also experiment with indoor cycling, which Nashville Fit Magazine has labelled a high-intensity low-impact exercise in a recent article. Set the resistance of the bike to low in order to minimize stress on the knees. After doing mobility training and strength and conditioning, most patients are able to move on to light jogging after 3-4 months.

Those who perform high-impact sports such as soccer, football, and basketball are at a high risk of sustaining knee injuries particularly concerning the ACL. In the world of sports, it’s regarded as a career-changer, or even -ender, as many people have experienced. Point guard Derrick Rose, for instance, tore his ACL in 2012, causing him to miss the entire season that year. He was 22 at the time and had a promising career ahead of him. But in the years that followed, he never seemed to return to his full capacity as a basketball player.

Assessing an ACL injury is difficult, so seek medical attention immediately if you feel that there is something wrong with your knee, particularly inflammation. This was the case with another NBA superstar, Kevin Durant, in 2017. Yahoo Sports reported that the athlete’s suspected torn ACL was actually a grade 2 sprain to his medial collateral ligament (MCL). His MCL was only partially torn which required a shorter recovery period of 1-2 months. He missed 19 games last year, but came back strong and was instrumental in claiming the championship that season. Kevin Durant is one of the highest earning sports stars in the world with a salary of $54.3m. However, his career remains unmarred by injuries, though things could have been different if he experienced the same situational injury as Derrick Rose. During recovery, Durant reportedly shifted his exercise routine away from his knees, and focused instead in strengthening his quads and hamstrings, which is commonly the same approach to an ACL injury.

While you can’t predict what will happen after an ACL injury, you can remain disciplined during your downtime. Even if you aren’t making a career out of sports, avoid situations where you might completely destroy such an important ligament in your knee.

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Recovering Methods: Kinesiology Tape

by Dr. Jennifer Hutton (Dr. J pop)

You’ve likely seen it on many athletes – the brightly colored tape intricately weaved across different areas of the body – most commonly shoulders, lower back, or knees. It ranges from skin-toned to black to a variety of neon colors. Needless to say, it stands out, however, it isn’t an athlete’s trending accessory. That, my friends, is called Kinesiology tape, otherwise known at K-Tape or KT.

The Kinesiology taping method was developed in 1980 by Kenzo Kase, a chiropractor from Japan, who used the KT to help maintain the postural gains of his own patients. It is known as a therapeutic taping technique not only offering added support but also rehabilitating the affected condition as well. KT has been used as a tool in the movement rehab world for years now and in the early 2000s gained mainstream popularity when people noticed popular athletes wearing it during major performances.

KT is a definitive technique designed to facilitate the body’s natural healing process. It is meant to provide support and stability to muscles and joints without restricting the body’s range of motion. KT also provides soft tissue manipulation in order to extend the benefits of manual therapy after administered by a trained physician. Thus the tape assists in recovery and healing in three specific ways: managing pain, reducing inflammation and improving body awareness for movement.

This tool is used mostly for assisting the recovery of various injuries, especially as the patient begins to enter activity again. Or simply, it can be used to improve your movement patterns. KT gives aid to improving posture and coordination to enhance performance. After all, the more efficiently you move, the less likely you are to deal with injury or re-injuring the same problem area.

In order for KT to work, those problem areas are encompassed and positioned strategically in order to provide support. Placed on your skin, the largest organ in your body laced with nerve cells responsible for sensing touch, temperature, and pressure, KT lifts the skin and creates a better environment underneath the outer layer. This helps reduce swelling. When those sensories (nerves) are sparked, they send messages to the brain. The brain takes that information and determines the body’s response. For example, when KT is applied to your skin, the nerve cells attempt to return a message to override the signals causing pain.

By targeting different receptors within the somatosensory system, KT alleviates pain and facilitates lymphatic drainage by microscopically lifting the skin. This lifting effect forms convolutions in the skin thus increasing interstitial space and allowing for a decrease in inflammation of the affected areas. The nerve cells also determine where a body part is in space, allowing you to move it more efficiently. This also structuralizes some technical cues for safe movement patterns.

There are many techniques when applying KT, however, its relevance depends on the condition and the patient’s needs. The most common taping techniques are for knees and shoulders. While tape can be self-applied by anyone, it is always beneficial to be assessed by a movement professional (physical therapist, chiropractor, athletic trainer etc.), particularly if you have inexplicable pain. If you were to self-apply KT, do so with a gentle stretch when placing on the skin. Refrain from excessive stretch in the material in order to avoid possible irritation. For small areas of pain, one strip covering the area is sufficient.

It is important to note that KT will not heal an injury on its own – it aids the recovery process by taking pressure off the sensitive site and the surrounding area. It should not be used in place of the potential need for a brace, like strained or pulled muscles and ligaments. Again, it is to reinforce functional movement patterns, reduce stress, and provide a passage for inflammation to either exit or subsidize. And of course, if you have pain that persists with exercises, find your nearest provider for an assessment.

KT is safe for all ages, ranging from pediatric to geriatric, and benefits a variety of orthopedic, neuromuscular, and other medical conditions, along with providing positive physiological effects on the skin, lymphatic and circulatory system, fascia, muscles, ligaments, tendons, and joints. It is a helpful source of recovery, specifically for those nagging aches. When applied properly, it promotes the recovery of post-workout soreness and can decrease exercise-related pain. It is a valuable addition to a multitude of other treatments and methods effective during the rehabilitative and chronic phases of an injury as well as being used for preventative measures.

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Methods of Recovery: Float Therapy

by Lindsay Miller
with Pure Sweat + Float Studio

Of all the cutting-edge recovery methods available today, float therapy might just be the most relaxing. Also known as sensory deprivation therapy, floating is one of the recovery services Pure Sweat + Float Studio offers at its two locations in Belle Meade and Cool Springs. You’ll spend 40 or 60 minutes floating peacefully in its state-of-the-art flotation pod filled with 95-degree water and nearly 1,000 pounds of Epsom salt. The density of the Epsom salt solution makes the water so buoyant that your body becomes weightless, levitating on the surface. To further the effect, Pure Sweat + Float Studio’s contemporary float pods have customizable features to create your optimal healing environment, including ambient lighting, calming music, and an adjustable lid that can remain open or closed.

Float therapy relies on the weightlessness created by large amounts of Epsom salt to enhance the recovery process. The lack of gravity and pressure on your joints and muscles provide a therapeutic context for them to rest and relax, while your skin absorbs the healing effects of magnesium sulfate (the ingredients of Epsom salt). It has been shown to reduce lactic acid and inflammation brought on by sore muscles, speeding up recovery time for those aches and pains. Owner of Pure Sweat + Float Studio, Candice Bruder, says “We’ve helped a lot of people in pain. Floating is great to integrate with rigorous training and high impact sports. If you don’t properly recover your body, you can’t sustain the constant workload. It’s essential to performance.”

It’s no surprise that float therapy has been growing in popularity among elite athletes. Basketball star Steph Curry is a devoted Floater and Tom Brady even has a pod in his own home. Bruder says, “We’ve welcomed athletes from the Titans to the Vanderbilt Basketball team and even the Nashville Ballet. Interestingly, some athletes will float the day before a game. It gives them A-game focus. We also utilize the same float pods as the New England Patriots.”

Along with easing tight muscles, one study at UC Irvine confirms that floatation therapy is a “long-lasting and versatile treatment” for chronic tension headaches. The zero-gravity state soothes an array of chronic pain like arthritis, fibromyalgia, back and neck discomfort, inflammation and tendonitis. Dedicating the time to truly rest your full body will decrease muscular tension, accelerate full-body recovery, and potentially boost overall athletic performance.

Research shows that floating measurably reduces your blood pressure and heart rate, which will also lower stress levels. Even if you aren’t an athlete and just need to recover from a long day at work, the zero-gravity effect will fight a long list of issues brought on by high stress and anxiety. Lowering your blood pressure also insures significant preventive measures and risk reduction in strokes and heart attacks.

One of the most popular experiences of float therapy is the ability to simply R-E-L-A-X. According to the CDC, stress will be the second most debilitating disease by 2020. Numerous reviews of Pure Sweat + Float Studio have expressed their experience as an incredibly effective and accessible way to reduce stress related symptoms. “Everybody has stress, and it’s remarkable how it debilitates our mind, body and spirit,” says Meredith Lile, Owner of Pure Sweat + Float Studio, Cool Springs. “Creating time to remove that stress is truly a necessity for vitality.” In nationwide studies, participants encountered elevated moods, better sleep, and reduced cortisol levels. “It’s like having the feeling and benefits of a deep power nap,” says Bruder.

The brain’s response to floating is also quite phenomenal. Our brain waves are in constant motion and continually producing waves at multiple frequencies. Of the five main frequencies, sensory deprivation targets what is known as the Theta state, which is a drastically slower state for brain waves. It is most common during deep meditation and just before falling asleep. It is also the first phase in which we begin to dream. Theta waves are always creative, characterized by feelings of inspiration and usually combined with vivid imagery, very clear and creative thoughts, sudden insights, and feelings of happiness. This is all thanks to the release of endorphins, the body’s natural opiates.

Because float therapy is known to stimulate creativity, it has become a common practice for major business owners and artists to accelerate mental clarity and learning. It also provides an avenue for practicing or developing a deeper meditation.  “Some people, like me, have a hard time meditating at home or even relaxing. When I float, I have no choice but to unplug and let go. I need that context. It’s amazing what we can achieve when we quiet our minds and listen within,” says Bruder.

The benefits of floating will help achieve a shorter recovery time from anything performance or injury related, along with issues due to stress. Floatation therapy not only helps you relax, but puts you in a state of mental and physical weightlessness allowing for a ridiculous amount of health related benefits. From lower back pain to writer’s block, a visit to Pure Sweat + Float Studio could very well provide that method of recovery you have been looking for. It’s a quick and easy trip to pure relaxation.

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Methods of Recovery: Myofascial Release

by Lindsay Miller
with Steve Kravitz Physical Therapy

Developed in the 1960s by an osteopathic physician, Myofascial release, is a method of hands-on therapy that releases pain and tension with slow, prolonged stretching to affect a change in the connective tissues of the body, otherwise known as fascia. Think of the fascial system as a giant web internally wrapped around the entire system of the body surrounding every structure. It is one, head-to-toe, continuous unit, existing without interruption that permeates the body and enables all systems to operate in an integrated manner.

Myofascial release is unique because many injuries are not necessarily muscular in origin, but are connective tissue injuries within ligaments, tendons, joint capsules, and other fascial structures. These injuries may create pain in the local area or seemingly unrelated areas of your body, known as referred pain, and is commonly thought to derive from trigger points. Trigger points are described as hyperirritable spots in the fascia surrounding the skeletal muscle where it is often difficult to know the exact source of the pain. The goal of myofascial release is to find the source of the pain and treat it with specificity, whether it is a fascial structure or a trigger point, to smooth out tension and restore mobility. New research supports the importance of maintaining healthy fascia in functional training and general exercise, considering it is the governing layer to our muscles. Due to the connective tissue having ten times as many sensory nerve endings as muscle, maintaining healthy fascia plays a major role in the movement, function, and position of the body during physical activity and everyday life.   

Dr. Steve Kravitz, P.T., D.P.T., C.S.T., owner of his private practice for 20 years, offers myofascial release treatments that help patients regain function and flexibility along with reducing and treating chronic pain. He says, “We offer a unique form of Physical Therapy by providing a one-hour, hands-on approach that is tailored to the patient’s specific needs.” Dr. Kravitz has also earned advanced certifications in over ten therapeutic disciplines including Myofascial Release and Trigger Point Therapy. He explains, “We pay special attention to the fascial system in each patient, where we identify problem areas and use manual therapy throughout the fascia to treat the whole body as a unit, rather than individual parts like traditional rehab.”

As a doctor of physical therapy, certified in therapeutic massage and bodywork, Dr. Kravitz combines many hands-on modalities to provide an effective, lasting, therapeutic, benefit through his progressive approach. Dr. Kravitz and his team of trained and accredited doctors of physical therapy use techniques that aim to mobilize and stretch the fascia in an attempt to free up the whole region of the body that is restricted. This creates greater flexibility, reduces pain, and improves functional and physiological movements.

Dr. Gena Thurston, P.T., D.P.T., C.I.D.N., of Steve Kravitz Physical Therapy says, “Myofascial release is an extremely effective way to access any layer of tissue tension. Often times, doctors refer to tight areas as trigger points and use injections with pharmaceutical substances to try and relieve the area.” She has also found dry needling as an adjunct to myofascial release highly effective and says it is a “swift treatment method for reducing these myofascial trigger points,” while avoiding the use of toxic substances.

One of the many benefits of Myofascial release is how relaxing the actual treatment can be for the patient. It is delivered through varying degrees of light touch to deeper pressure, which is highly effective at smoothing out the multiple layers of fascia, muscles, and surrounding structures. Patients often share how thrilled they are, because, during myofascial release, the patient can lie down and be relaxed throughout the entire treatment. The health benefits can be felt for weeks and months while still enjoying a calming restorative experience during the treatment itself.

There are a plethora of modalities to choose from when it comes to chronic and acute pain. Most common are chiropractic treatments and massage therapy. Chiropractors mainly use spinal manipulation to restore the mobility of the joints restricted by tissue tensions. While this can be effective at providing temporary pain relief, if the fascia is left untouched it will revert back to its previous state. Myofascial release aims to release these specific governing layers around the joint. This way, the joint and the associated tissue can remold into alignment without adjusting the bones beneath.

Although massages can help decrease tension, stress, and pain, these techniques can often glide over the problem spot and sometimes cannot access the deeper layer where the source of the problem exists.  Myofascial release therapy aims to specifically locate these problematic areas in the body and release this tissue tension for improving physiological function, decreasing pain and tightness, and restoring optimum health.

According to Dr. Kravitz, when pain and tightness occur in the body, it is best to go to a professional to be evaluated and treated. While pain and tightness may occasionally resolve naturally, if the discomfort persists, this can cause long-term issues in the body. Many people feel they can manage with self-care techniques like self-massage, stretching, rest, ice, heat, or pain medications. However, self-care methods may not address the deeper issue.  Myofascial release is effective at finding and releasing abnormal tissue tensions to help reduce the chance of long-term dysfunction, repetitive stress injury, and muscular imbalances to help improve overall flexibility, function, and athletic performance.

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