Thursday, February 02, 2006


Tom - One Week On (an update)

For those who have found reading about my client Tennis player Tom, who is rehabbing from serious surgery, interesting - Here is a summary of this weeks session plus homework:

We established a method to analyse Tom's pain and discomfort level when weight bearing on his right foot / ankle. These were the results on a scale of 1 – 10 (1 = no pain / discomfort), 10 = unbearable pain / discomfort.

Session 1 (at the Physios 3 weeks ago to the day):

- Walking (with difficulty) 'without' poles 8 out of 10

Session 5 (this week):

- Walking 'without' poles (rolling through ball of foot) = 5 out of 10
- Walking 'without' poles (no roll) = 3 out of 10
- Walking 'with' poles (rolling through ball of foot) = 2 to 3 out of 10
- Walking 'with' poles (no roll) = 1 out of 10 (no pain or discomfort)

Tom's Goal: One of Tom's goals is to achieve a 1 out of 10 eg no pain or discomfort whilst walking without poles rolling through the ball of the foot (currently it's a 5 having started 4 weeks ago as an 8)

We practiced walking the white line. Tom was very comfortable doing this whilst placing his foot down straight using poles. He was fine placing the foot down straight without poles although there was a degree of discomfort. We also did further practice on rolling through the ball of the foot.

Hills - I decided to try Tom out on a hill:

Uphill technique:

- Lean into hill (the steeper the hill the more the lean). The lean comes from the ankle not the waist.
- Strong arms
- Maintain pace Tom needed to adapt this depending on the degree of discomfort)

Note: Walking uphill will encourage Tom to roll through the ball of the foot which is why I chose to do the hill exercise.

Downhill technique:

- Bend knees & sit back (the steeper the hill the more the bend & sit back
- Slow your pace
- Emphasise heel plant more
- Bear down on poles to control descent

After the hill session we looked at and discussed the topics for his homework this week as set out below.

Tom's Homework practice this week:

Continue with last week’s exercises and in addition:

Note: Tom found that upping his walking time didn't work for him. After 30 minutes walking he felt that his ankle had had enough. So we are sticking with 30 minute walks for now.

Do plenty of ankle mobility work eg sat in a chair focusing on putting the ankle through its ranges of movement very slowly. Eg: Point & flex / Turn inwards and outwards / Ankle circles in both directions (biggest range of movement possible on all exercises).

Remember before attempting any exercise know ‘why you are doing it’. Focus on that reason or reasons as you do the exercise.

When you go out for your walks, don’t just walk for walking sake. Decide what exactly it is that you are working on at any particular moment. Eg 1) Focus on walking the white line, placing foot down straight / slightly turned in 2) Focus on planting the heel down and rolling through the ball of the foot. 3) Focus on pushing down hard through the straps to engage the upper body muscles harder 4) Focus on ‘Push behind hip’ 5) Focus on ‘open hand’ (releasing handle) .6) Focus on ‘double poling’. Remember: Totally focus on one thing at a time.

Note: These are guidelines only – Tom knows that it is important to listen to what his body / ankle is telling him– Don’t over do it but don’t under do it either. The ‘rest’ that his ankle gets is as important as the ‘work’ it gets.

Hi My mame is Aki .Im japanese .
Im a Nordic walking instructor too.However I have not had many students yet. Ive been doing class everyweek end.
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