Wednesday, January 25, 2006
An Injured Tennis Player's Rehab & David's "Magic" Poles!
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For the past couple of weeks I have had the pleasure of working with an 18 year old tennis player. 'Tom' was ranked number 2 in Great Britain as an under 16 and prior to his injury 4 months ago he was ranked as high as number 250 in the world. Tom fell on court and badly damaged his ankle. He snapped 3 ligaments and damaged his archilles tendon and is on the slow road to recovery following ankle surgery.
Tom is a referral from a Physiotherapist that I have teamed up with recently. When I first met Tom two weeks ago, although he was able to walk it was a struggle. He limped around and when he put his injured right foot down it was noticeably turned out to the side (1st Photo). As he limped the inside of his ankle bone kind of lead the way.
Session 1 (1oth Jan): I worked with Tom for 30 minutes. This was basically just getting him used to using the poles. Nothing fancy - Just 'opposition' right arm / left leg and vice versa and the 'walk and drag' technique. I taught Tom just to hold the handles loosely and apply some downward force as the arm swung down to make the poles stick on the asphalt surface (therefore reducing the stress on his damaged ankle). Within minutes he found that it was easier to walk due to the support the poles gave him. At this stage we didn't focus on foot placement. I just had to remind him not to let the pole tips come forward of the hip but to keep the tips behind the hips (as in a traditional cross country skiing style).
Session 2 (11th Jan): We met for a 40 minute session. Tom had been out practising and he announced that the poles were 'Magic' ! At this stage Tom had only learnt the 'walk and drag'. After a 10 minute loosener walk I asked Tom to slowly walk without poles along a white line (photo 1) - Note how his right foot is pointed out to the side. Next using poles I asked Tom to walk along the line trying to put his foot down straight along the line. Because of the poles he was able to do this (photo 2). Tom was amazed, I must admit so was I! The rest of this session was
spent practising this exercise and working on developing the poling technique in particular 'working the straps although still only 'dragging' the poles. Homework for Tom was more of the same eg 'line walking' plus a daily 30 minute walk with technique practice.
Session 3 (17th January) 40 minute session. Tom had been practising he had noticed a big improvement in his walking ability. The foot was not turned out nearly as bad and when he thought about it he could walk and keep it straight. He had noticed the effects the poling was having on working his arms and upper body. The focus of this session was walking the white line without the poles. Tom managed this well although he wobbled a bit! I also introduced him to the 'Lift and Plant' which after so much practice 'dragging' he found a little strange at first. However, he quickly picked it up. He now referred to the poles as being "Brilliant" - Hey get this, an 18 year old lad telling me that my Nordic walking poles are Magic and Brilliant !!! Home work was to practice walking the white line without poles plus using the 'Lift & Plant' technique ('Pushing down to Hip).
Session 4 (24th January) - Today's adjective was 'Amazing'. My Nordic walking poles according to 18 year old Tom are now "Magic", "Brilliant" and "Amazing"!! It doesn't need me to tell you that Tom had had a good week! Jokingly I said "Are you running with the poles yet Tom"? He caught me off guard with his reply "No but I can now run on the spot". Back during session 1 Tom was in quite alot of pain and discomfort but now - Only two weeks into the program things had improved greatly. The intensity of the pain and discomfort had reduced significantly. There had been a noticeable improvement in Tom's ability to put his damaged foot down straight.
Note: If you check out your own foot placement when you walk you will probably find that your feet turn out a little - Well that's exactly what Tom's feet now did when he didn't think about it. When he did think he could put the foot down straight both with and without poles no problem.
What I did was have Tom walk the white line but this time instead of putting the foot down straight on the line we 'over exagerated' and Tom put his big toe down to the left of the line. This immediately threw him off balance but he soon got the hang of it.
Tom was struggling to achieve a natural rolling action through his damaged foot when he placed it down (although I had seen an improvement). Here is an analysis of correct foot action from the moment of contact to the push off: 1) The heel plants down first (toes up) 2) As you transfer your body weight forward over the arch of the foot there should be a weight bias towards the outside edge of the foot (some people have a bias towards the inside edge of the foot; this is bad as the ankles and knees roll inwards placing adverse strain on the ankle and knee joints) 3) You roll through the ball of the foot. 4) You push off through the toes with the big toe leaving the ground last.
So I introduced Tom to a new exercise - 'Rocking Horse':
Any Aerobic class enthusiasts may recognise this move. Tom placed his damaged right foot forward and his left foot was back. The exercise is simply to rock forward and back on the spot transfering your weight from the back (left) foot to the front (right) foot to the back foot and so on. Tom used his poles to give added stability. The emphasis was on performing the exercise slowly. Each time Tom rocked his weight back over his left foot he stayed still (held) a position with the toes of his right foot lifted, thereby giving him an achilles and calf stretch. He held each stretch for 10 - 15 seconds. Within a space of a few minutes Tom's ability to roll through his foot had improved significantly. A point that particularly impressed Tom.
We also did more work on developing the technique eg 'pushing behind the hip' and 'opening the hand' to release. Tom struggled a bit with this, of course having released the pole you then have to catch it again (many people struggle with this initially).
So we did lots of practice using just one pole; then double poling (this slows things down and gives you more time to eg 'push behind hip' and 'open hand'). Finally we went back to 'opposition'. This practice had resulted in a big improvement in Tom's technique. Finally I got Tom to walk across the park without the poles. This was amazing, he stepped out and if you didn't know he had a damaged ankle, you would have been hard pushed to realise.
I keep having to encourage Tom to keep his head up when he walks. This seems to be a 'cool' thing to do for teenagers (certainly here in the UK), they walk with their head down. It's almost as if they have no confidence. Tom strode confidently across the park, posture up, head up swinging his arms, planting his damaged foot down straight!
...What an amazing transformation in just 14 days that could only have been achieved with the poles. The Physio said to him last week that he will be back on court in about 3 months time? I hope this increadible improvement is going to take Tom forward in leaps and bounds and enable him to be back on court far sooner!
I will list Tom's 'homework' in a seperate posting.
Kind Regards
David
For the past couple of weeks I have had the pleasure of working with an 18 year old tennis player. 'Tom' was ranked number 2 in Great Britain as an under 16 and prior to his injury 4 months ago he was ranked as high as number 250 in the world. Tom fell on court and badly damaged his ankle. He snapped 3 ligaments and damaged his archilles tendon and is on the slow road to recovery following ankle surgery.
Tom is a referral from a Physiotherapist that I have teamed up with recently. When I first met Tom two weeks ago, although he was able to walk it was a struggle. He limped around and when he put his injured right foot down it was noticeably turned out to the side (1st Photo). As he limped the inside of his ankle bone kind of lead the way.
Session 1 (1oth Jan): I worked with Tom for 30 minutes. This was basically just getting him used to using the poles. Nothing fancy - Just 'opposition' right arm / left leg and vice versa and the 'walk and drag' technique. I taught Tom just to hold the handles loosely and apply some downward force as the arm swung down to make the poles stick on the asphalt surface (therefore reducing the stress on his damaged ankle). Within minutes he found that it was easier to walk due to the support the poles gave him. At this stage we didn't focus on foot placement. I just had to remind him not to let the pole tips come forward of the hip but to keep the tips behind the hips (as in a traditional cross country skiing style).
Session 2 (11th Jan): We met for a 40 minute session. Tom had been out practising and he announced that the poles were 'Magic' ! At this stage Tom had only learnt the 'walk and drag'. After a 10 minute loosener walk I asked Tom to slowly walk without poles along a white line (photo 1) - Note how his right foot is pointed out to the side. Next using poles I asked Tom to walk along the line trying to put his foot down straight along the line. Because of the poles he was able to do this (photo 2). Tom was amazed, I must admit so was I! The rest of this session wasspent practising this exercise and working on developing the poling technique in particular 'working the straps although still only 'dragging' the poles. Homework for Tom was more of the same eg 'line walking' plus a daily 30 minute walk with technique practice.
Session 3 (17th January) 40 minute session. Tom had been practising he had noticed a big improvement in his walking ability. The foot was not turned out nearly as bad and when he thought about it he could walk and keep it straight. He had noticed the effects the poling was having on working his arms and upper body. The focus of this session was walking the white line without the poles. Tom managed this well although he wobbled a bit! I also introduced him to the 'Lift and Plant' which after so much practice 'dragging' he found a little strange at first. However, he quickly picked it up. He now referred to the poles as being "Brilliant" - Hey get this, an 18 year old lad telling me that my Nordic walking poles are Magic and Brilliant !!! Home work was to practice walking the white line without poles plus using the 'Lift & Plant' technique ('Pushing down to Hip).Session 4 (24th January) - Today's adjective was 'Amazing'. My Nordic walking poles according to 18 year old Tom are now "Magic", "Brilliant" and "Amazing"!! It doesn't need me to tell you that Tom had had a good week! Jokingly I said "Are you running with the poles yet Tom"? He caught me off guard with his reply "No but I can now run on the spot". Back during session 1 Tom was in quite alot of pain and discomfort but now - Only two weeks into the program things had improved greatly. The intensity of the pain and discomfort had reduced significantly. There had been a noticeable improvement in Tom's ability to put his damaged foot down straight.
Note: If you check out your own foot placement when you walk you will probably find that your feet turn out a little - Well that's exactly what Tom's feet now did when he didn't think about it. When he did think he could put the foot down straight both with and without poles no problem.
What I did was have Tom walk the white line but this time instead of putting the foot down straight on the line we 'over exagerated' and Tom put his big toe down to the left of the line. This immediately threw him off balance but he soon got the hang of it.
Tom was struggling to achieve a natural rolling action through his damaged foot when he placed it down (although I had seen an improvement). Here is an analysis of correct foot action from the moment of contact to the push off: 1) The heel plants down first (toes up) 2) As you transfer your body weight forward over the arch of the foot there should be a weight bias towards the outside edge of the foot (some people have a bias towards the inside edge of the foot; this is bad as the ankles and knees roll inwards placing adverse strain on the ankle and knee joints) 3) You roll through the ball of the foot. 4) You push off through the toes with the big toe leaving the ground last.
So I introduced Tom to a new exercise - 'Rocking Horse':
Any Aerobic class enthusiasts may recognise this move. Tom placed his damaged right foot forward and his left foot was back. The exercise is simply to rock forward and back on the spot transfering your weight from the back (left) foot to the front (right) foot to the back foot and so on. Tom used his poles to give added stability. The emphasis was on performing the exercise slowly. Each time Tom rocked his weight back over his left foot he stayed still (held) a position with the toes of his right foot lifted, thereby giving him an achilles and calf stretch. He held each stretch for 10 - 15 seconds. Within a space of a few minutes Tom's ability to roll through his foot had improved significantly. A point that particularly impressed Tom.
We also did more work on developing the technique eg 'pushing behind the hip' and 'opening the hand' to release. Tom struggled a bit with this, of course having released the pole you then have to catch it again (many people struggle with this initially).
So we did lots of practice using just one pole; then double poling (this slows things down and gives you more time to eg 'push behind hip' and 'open hand'). Finally we went back to 'opposition'. This practice had resulted in a big improvement in Tom's technique. Finally I got Tom to walk across the park without the poles. This was amazing, he stepped out and if you didn't know he had a damaged ankle, you would have been hard pushed to realise.
I keep having to encourage Tom to keep his head up when he walks. This seems to be a 'cool' thing to do for teenagers (certainly here in the UK), they walk with their head down. It's almost as if they have no confidence. Tom strode confidently across the park, posture up, head up swinging his arms, planting his damaged foot down straight!
...What an amazing transformation in just 14 days that could only have been achieved with the poles. The Physio said to him last week that he will be back on court in about 3 months time? I hope this increadible improvement is going to take Tom forward in leaps and bounds and enable him to be back on court far sooner!
I will list Tom's 'homework' in a seperate posting.
Kind Regards
David
