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I'm sorry to hear about your current struggles with your injury. I have so many questions to start with, but ultimately, does the current stabbing pain that you're describing feel like it's coming from the muscle/s in the calves or possibly the Achilles tendon itself?

​@@PTTimewithTim I have Achillies Tendonitis in my Left Foot, the sharp pain was in my right, that day I jogged a tiny bit even knowing my leg didn't feel great, this caused the sharp pain coming and going in waves throughout the night, when i woke up it was gone. It started with my Calves being tight when I was kicking pads at Muay Thai. When I came back I did some PT, trying to relief this, but I have been stretching now for 4 weeks in the shower, just those basic wall stretches 1-2 sets x 20 seconds hold. I Rock climb indoors with a friend 2-3 times a week, My fear is perhaps it's too much tension on my calves, toe/heel/crimps? Perhaps its preventing the healing process. I have no idea if this is good enough explanation, I was certain similar to shoulder injury from weight lifting it would just disappear over 8 weeks, or my pulley injury in my finger when it popped, which took 6-8 weeks to heal. Regarding my tendonitis the PT told me the reason for it was shortness in my soleus, that I needed to stretch to get the soleus in better form to resolve my tendonitis, I have had this tendonitis for about a year now. It feels better though, with all the stretches but the bulge is always there. Should I avoid rock climbing for a while? is that maybe preventing any of this from healing up, I always assumed it would heal slower but heal, not just prevent it from healing.

Thanks for the question, Brian. Snapping hip can last as long as the tissue is excessively tight. I've seen it in patients who have dealt with it for > 1 year. If symptoms seem to increase the following day, a consideration could be is to decrease the overall number of reps of each exercise (so decreasing the overall intensity of each exercise) to prevent the possibility of "over-doing" it and see how the body responds the following day. Then, make adjustments from that point. Also, make sure you check out my full article on snapping hip syndrome as it includes a lot of additional information on this condition that will be helpful to you. You can find it here: pttimewithtim.com/snapping-hip-syndrome-exercises/

@@PTTimewithTim Thanks for the response. Yeh seems to be a balancing act as I have been told to strengthen the muscles around it also in particular the gluteal region. Makes sense. Thanks.

You got this, Tim! Also, make sure you check out my full article on calf strains as it has a lot more in-depth information of proper steps to take after this type of injury. You can find it here: pttimewithtim.com/calf-strain-exercises/

Thank you for the lovely comment. You are very welcome!

Thanks

Thanks for the comment, Maram. Yes, bunions can cause issues all the way up to the knee. Bunions often are seen in people with low arches (flat feet), which causes compensations in the lower leg and can result in issues at the knee. You should read my in-depth article on bunions. You can find it here: pttimewithtim.com/bunions-foot-exercises/

Hi Patricia, typically we recommend that people do stretches on both sides, though if time is limited, then definitely focus on the involved side.

@@PTTimewithTim Thanks. I couldn't find the massage stick roller at Amazon. It is unavailable.:(

@@Patricia-nw9df Here it is: amzn.to/3QTMkH5

You are very welcome, Ellen

This is for both complete and partial tears. I have an in-depth article on ACL tears as well that has some useful information on how to decide whether to have surgery or not and alternative treatment options. You can find it here: pttimewithtim.com/acl-tear-exercises-without-surgery/

Just depends on how irritated the tendon is, if there’s just mild irritation then these could be performed everyday. However, if it’s moderate to severely irritated, then I would typically recommend 3-4x/week with a rest day in-between until the symptoms started to decrease. You should also check out my full article on this condition which explains things in much more detail. You can find it here: pttimewithtim.com/de-quervain-tenosynovitis-exercises/

Sorry to hear that, you should definitely read my in-depth article on biceps tendonitis as I have alternative treatment options and additional information that may be helpful. You can find it here: pttimewithtim.com/biceps-tendinitis-exercises/

Thanks for the comment, Michael. I can appreciate your initial hesitation as most people that are about to get a hip replacement have some degree of moderate to severe hip OA. These joint conditions make it not only painful, but also restrict the overall range of motion that the joint can move through. Please understand, though, that the exercises that I demonstrate can still be performed by those in preparation for a hip replacement. As I mentioned in the video, though, each exercise, will need to be modified by each individual in order to be successfully performed without aggravating the hip joint. Modifications can include reducing the overall range of motion of the movement, decreasing the repetitions per set, decreasing the # of sets, changing the exercise from a full movement to an isometric (which is when you push against something that doesn't move, i.e. squeezing both knees together while lying on your back). Ultimately, each person will have to pick and choose which exercises that he/she can perform because everyone's hip is going to act differently. Hope this helps clear up some confusion. Best of luck with your upcoming THA!

You're absolutely correct. A fully torn ACL cannot be reconstructed without surgery. However, this video is about those who choose to rehab without having surgery as not everyone who tears their ACL necessarily need to have surgery. Some people are older and do not really need a fully functioning ACL in order to live their daily lives. Others simply do not have the financial or medical means to get surgery. You should check out my full article on ACL tears as I go into detail on who can cope without getting ACL reconstruction surgery and who should get it. You can find it here: pttimewithtim.com/acl-tear-exercises-without-surgery/

Thanks for the comment. I'm not sure that I'm following the entire question, though. It is common for the leg muscles to atrophy after an injury like this due to disuse and "protecting" that side. However, are you saying that you think you sprained your ankle during the initial injury and you're wondering if I have exercises for a sprained ankle? If so, I have an article and video on that, which you can find here: pttimewithtim.com/ankle-sprain-exercises/

Thanks for the comment. If someone is unable to get into any form of the piriformis stretch, then there's no reason to attempt it. It would likely just aggravate the joint. We would simply just focus on all of the other exercises that the person could tolerate without joint irritation. After the surgery, it will require extra time and effort in order to get that hip rotation (as achieved with the piriformis stretch) as the muscles will have severely shortened from the lack of motion prior to surgery, but it will be possible eventually.

@@PTTimewithTim Thanks for responding. Unfortunately, I’ve let myself get weak. Plus side, I started using a walker. My ego got in the way and I should’ve been using it years ago. I went on a trip to Spain and I managed to do 10k-15k steps a day with the help of Tylenol. Since being back I go on a 2mi walk every other day. It’s been great for my confidence and mood. I swear like a tweaker but I figure I just have a lot of strength to rebuild. I know it’s hard to answer specifics over the internet, but I have an extremely tight hip flexor on the left side. To the point I can’t let my leg hang over the side of the bed to stretch. Anything I can do that’s more gentle?

​@@starbrightinfinity3329 That's so great of you to keep getting out there. It can be difficult to find the right balance of staying active, yet not pushing so hard that it sets you back too much if the joint gets irritated from too much walking. For someone who has significant hip OA, I would not expect them to be able to get into too much hip extension (letting the leg get behind you) as the hip joint simply won't allow it because of the poor joint quality. However, it still should be possible to find a position to gently stretch the hip flexor muscles without feeling pain in the hip joint. Typically, I'll have someone lie on their back (in bed) with the opposite knee bent and the other leg (stretch leg) straight. If they don't feel a stretch in this position, then we would advance to the side of the bed and begin to slowly lower the stretch leg down from the side of the bed while still having the other knee bent until a comfortable stretch is felt in the front of the hip/thigh of the downward stretch leg. Additionally, I would only have them hold the stretch for about 30 seconds so that the hip joint doesn't get stiff.

@@PTTimewithTim Hey, I appreciate you writing such a thorough response. You’re right, when just laying flat with one knee bent, I can feel a stretch. Im only 38 so dealing with AVN for the last few years has been a big blow to quality of life. I’m now more determined to get back on track. Cheers!

Hi Kimberley, thanks for the comment. You're exactly right, most people experience significant tightness after surgery. Prior to surgery, the joint is very stiff and painful, so people protect the joint and don't take it through it's full range of motion. This, in-turn, causes the muscles to tighten up over time. After the joint has been replaced, the muscles are still very tight and will need to to be stretched gradually back to their original lengths. In particular with the Piriformis Stretch, I typically start my clients out by having them lie on their back with the goal of getting the heel to rest on the opposite thigh near the knee and holding that stretch. Once that position is easier to get into, then they can slowly slide the heel towards mid-thigh, and then eventually they can begin to gently push the knee of the stretch leg outwards into more of the traditional figure 4 position (as seen in the video). All of the these advancements are expected to take a couple of weeks to progress through, so it's a gradual process.

@@PTTimewithTim thank you for the explanation

Hi Judy, thanks for the comment. It all just depends on the severity of the hip arthritis. Most people wait off quite a long time to get a hip replacement, so I’d say those people probably wouldn’t tolerate the aggressive kicking motion. However, someone could always give it a try and see how the joint feels during and after the activity as a quick test. Normally, I recommend that my patients do walking through the water in a pool up to at least waist deep water. They can walk forwards, backwards, and side stepping which is actually more work than you might expect at first glance.

@@PTTimewithTim Thanks! I'll go and see how it feels and try the walking if the lapping has become to hard - it started 2 yrs ago (didn't know what it was) but n the last month it got bad quicker and I'm 8-9 on a cane ... waiting for surgery. Torn because everyone says to get strong.

@@judylindow2739 I completely understand. There's a lot of deconditioning that occurs in the surrounding hip muscles due to the disuse over time, which leads to significant weakening of these muscles. I wouldn't think of it so much as though I need to "strengthen" my hip seeing as there would typically be a lot of pain in the joint if you were to truly try to strengthen it in the traditional sense of the word. Rather, I would think to myself that I want to prepare my hip as much as possible for surgery, so that my rehabilitation afterward is a quick and optimal as possible. If a patient came to see my pre-op who had severe hip OA, we would start with very basic and limited-range stretching to try and improve or at least maintain whatever hip range of motion is left. We would also begin with isometric-hold exercises (where you press against something so the muscle engages but there's no actual joint motion occurring) to engage the muscles, but not aggravate the joint. I highly suggest that you read my hip joint replacement article, which gives you all of the pre-surgery information that you should incorporate in your planning. You can find it here: pttimewithtim.com/exercises-before-hip-replacement-surgery/

You are very welcome!

Sorry to hear about your injury, Sharlene. First, I would highly recommend that you read my full article on ACL injuries as it has some really helpful tips in it. You can find it here: pttimewithtim.com/acl-tear-exercises-without-surgery/ Also, in general, these exercises can be performed with a brace on or off, however if the brace is on, then it would need to be unlocked. Ultimately though, you should always follow whatever instructions that you were given by your specific doctor or medical provider 😁

Thank you for your comment. I can say that, in general, there is no problem with gradually getting back into cycling on either a stationary bike or road bike is an appropriate activity for most people. It is very important to focus on strengthening exercises after a hip replacement because the muscles are typically very weak leading up to the surgery.

So happy to hear that! Thanks for leaving a comment.

Depends on the severity of the injury, but most people can start with the easier exercises (gentle stretching, light massage and submaximal isometrics) within just a few days after the injury. I highly recommend that you read my article on calf strains. You can find it here: pttimewithtim.com/calf-strain-exercises/

@@PTTimewithTim thank you!

You are so welcome, John!

You got this!

During the submaximal isometrics, a person is supposed to only push up until the point of pain and hold at that point, not pushing any harder. Eventually, over time, increased force will be able to be applied prior to feeling pain.

Do you feel that you can’t move the toe independent of the others because you’re lacking the coordination or because the toe physically can’t move?

I’d say coordination. They can move together but not independently of each other.

In the case of limited hand/eye coordination or hand/toe coordination, the only way to improve your ability to isolate toe movement is to practice it. It would be similar to you trying to learn how to wiggle your ear. It will take time and practice, but eventually you’ll get it and your brain will make the connection. Keep at it 🙂

These can be performed 1-2x/week as maintenance program for injury prevention.

Happy to help!

Hi Rachel. These shouldn’t be a problem, but as always, if any of the exercises seem to increase discomfort then try to modify the position or just skip it altogether and revisit it at later date.

These can be for a complete tear or partial tear. I would highly recommend that you read my full article on ACL tears. You can find it here: pttimewithtim.com/acl-tear-exercises-without-surgery/

Thanks for the comment. Obviously, each person is going to tolerate each exercise differently depending on how advanced his/her hip osteoarthritis has become. These exercises are for best case scenario and each individual will need to modify as necessary or even skipping the exercise/s altogether. I think you should read my full article on best ways to prepare for a total hip replacement which discusses all of the important considerations for surgery and what to expect afterwards. Best of luck to you with surgery. You can find the article here: pttimewithtim.com/exercises-before-hip-replacement-surgery/

It depends on the severity of the initial injury, though typically the gentle stretching, submaximal isometrics and massage can begin within a few days.

We typically recommend at least one week of relative rest before starting gentle exercises.

Thanks for the comment, David. Glad you were able to do most of the exercises without issue. It’s perfectly fine to skip any of them and revisit them once the symptoms have decreased significantly. I would also highly recommend that you read my article on this condition as it has some important information on alternative treatment options and prevention techniques. You can find it here: pttimewithtim.com/de-quervain-tenosynovitis-exercises/

That’s a good question, Patrick. While I’m unable to provide specific medical advice, I can speak generally that there is a small calf muscle that is found behind the knee called the Plantaris. If someone presses their fingers in the middle area behind the knee and follows the middle part of the upper calf, the Plantaris will be quite tender if it’s involved. This muscle assists both the knee and the ankle. If someone strains the Plantaris, they usually respond well to similar rehab exercises as if they had a general calf strain. You should read my full article on calf strains as it can guide you through the process: pttimewithtim.com/calf-strain-exercises/

@@PTTimewithTim Thanks for the response! Going to check out that article now. 💪

Thanks for the comment, Rudy. Typically you switch between ice to heat once the initial swelling has reduced significantly. To throw out a generic timeframe, maybe around 1 week after the injury. I think you should read my article on this injury as it has some really helpful information including alternative treatment options and preventative techniques. You can find it here: pttimewithtim.com/calf-strain-exercises/

Thanks for the question. Think of shoulder tendonitis as an umbrella term that could be used to describe several the inflammation of several different muscles/tendons that are located in the shoulder. Biceps tendonitis, however, is only specifically describing inflammation of the bicep muscle/tendon that is located on the front side of the arm. Pain with lifting the arm out to the side of the body is more often caused by Rotator Cuff Tendonitis rather than biceps tendonitis. I have a couple of great articles that guide you in how to determine if you have each that I think you should read. You can find them here: pttimewithtim.com/rotator-cuff-stretches/ And here: pttimewithtim.com/biceps-tendinitis-exercises/

Thanks for the comment, Natalie. I’m sorry to hear that this condition has gotten so bad with your hand. DeQuervains is an overuse condition and if someone continues to use the wrist tendon/s heavily, the condition will only continue to worsen. If I were treating someone with a severe case such as the one that you’ve described, I would likely recommend that they schedule an appointment with a hand specialist doctor to discuss the possibility of getting a corticosteroid injection. Unfortunately, it sounds like you may not have easy access to medical care. I do recommend that you take the time to read my full article on this condition as it provides a lot of great information on alternative treatment options and activities to avoid. You can find it here: pttimewithtim.com/de-quervain-tenosynovitis-exercises/

@@PTTimewithTim hey, I just saw your response today. I never expected you to respond but I want you to know how much I appreciate the fact that you did. I'm about to go to the link you shared. I did buy the wrist thumb splint. It has helped a lot! I can do more but the damage has been done and the injections are probably the only way that healing can begin. The wrist is such a bad area to hurt because you basically become handicapped. I always prided myself on my strength and flexibility so this has me at a disadvantage. I really appreciate your comment. It says something about you and your sincere desire to help people through your videos and your expertise. You've helped me more than you know! Big thanks!!!

@@natalie25431 Thanks again for the lovely comment. You're totally right, our hands are used with almost every action that we do throughout the day and we don't really think about it until we have pain. It can be very limiting. Best of luck with your recovery!

I’m sorry to hear that 😕

Thanks for the comment! The lopsided walking style that you're speaking of could be caused by a couple of different things. The first possibility is that the glute muscles (more specifically the hip abductor muscles such as the gluteus medius and minimus) are commonly weak with those who end up having hip replacement surgery. They become weak overtime from disuse when the person begins to stop using that leg as much because the joint is causing pain. The second possible reason is that it is fairly common to see people end up with a leg length discrepancy after hip replacement surgery. Did your PT happen to check for that post-surgery? If there is a leg length difference, using a shoe lift insert on the shortened side can help level out the sides. I like that you're still using the walker to try and improve your walking pattern symmetry. Eventually, we would try to advance someone to a single point can as hip and leg strength improves as long as the person doesn't have any significant balance deficits. Hope this has helped inform you. Best of luck!

If I’m working on the muscles to help my bursitis, can I also work on the hip at the abductor muscles that are weak?

Absolutely, a lot of the hip bursitis exercises do target the hip abductors, so there is a lot of carryover.