In Spring of 2010, Melanie Byford-Young ruptured her left achilles tendon. She has taken the time to share her insights with us….thanks Mel.

First of all, it is a bad idea to rupture your Achilles tendon! Don’t try it, even if all the cool kids are doing it these days! But if you are going to do it, I highly suggest rupturing your left ankle- much easier to drive in North America.

I am now part of the Achilles rupture club; I am one of five in our ‘chapter’, and we are not accepting any new members. Two members ruptured while dancing and three of us ruptured playing tennis. Of the tennis players, one ruptured after serving, one running to the net, and me, while doing a split step. Makes you think.

My whole life changed in a microsecond Wednesday April 14, 8:32pm. I was 72 minutes into an awesome tennis lesson when I did a small split step, heard the loud pop and a fierce sting. I hoped that someone at the back of the court was being a jerk and had fired a tennis ball at me, but no. I knew what it was immediately. Everyone on the court heard the pop, and my poor instructor Sonia came running over in disbelief. Ice and phone calls to all of my PT friends to find out who is the best surgeon and where they would go. I did not go into shock, so I drove myself home, had a bath, got dressed with clean ‘presentable’ undies, and then drove myself to the Emergency room. Kevin was in Florida, and I was full of adrenalin, so there was no stopping me.

My brain went immediately into ‘uber problem solving mode’ and I wanted surgery NOW. I called in every favor possible, pushed, pulled and persisted, and fortunately, I only had to wait until Friday. If I’d had to wait longer, I would have driven myself and everyone around crazy. I was still running on lots of adrenalin! My AWESOME surgeon, Dr Crary, did his magic. My friends Annie and Michele rallied and got me to and from the hospital, and took care of me until Kevin got home. Thank God for great friends!!! Thank God for having done Pilates and being strong enough to get around on crutches!!!

There can never be good timing for an accident, but this was VERY bad timing! Very bad! I was scheduled to fly to Toronto, Singapore and the Philippines in three weeks to teach. The E.R. doctor just looked at me and said “Well, that’s not going to happen”. This was the beginning of a one year rehab. FYI- the greatest risk of re-rupture is between 10-20 weeks post surgery. This is when the tensile strength of the tendon is somewhere between 40-60% of normal but the patient is starting to move around more and feels better!!!

What predisposes someone to rupturing their Achilles? Usually it is men in their mid 40’s who are weekend warriors with tight calves who rupture during an explosive activity like tennis, squash, baseball, basketball etc. That description does not fit any of my group, nor David Beckam!!! Age, short calves, long calves (excessive dorsiflexion prior to heel during the gait cycle), a neural issue, maybe some medications, malicious guardian angels…… who knows?

First rule: do exactly what your surgeon says. I had to spend 10 days post-op with my foot elevated all the time. What this time did afford me was insight into how much I missed everyone at work, how lucky I am, and that I do not like to be held down!! My friends immediately spoiled me with deliveries of healthy food, books, coming over to play games, and taking me grocery shopping. Bad idea to go grocery shopping in the first week post surgery!

Next came three more weeks of non- weight bearing in a very attractive purple and green cast. Again, very thankful for a strong midback, arms and abs- you need them for crutch walking and getting in and out of the bath.

Dr Crary said no airplanes for 6 weeks post- op because of the risk of DVTs; that was enough to scare me and call off the trip. Sorry Joe and Vivian!!

Timing was that I could still go to Australia safely on week 9, wearing compression stockings and taking asperin in case of clots.

Second Rule: You need time to heal and you must rest. It was laughable that getting up stairs was enough to demand a nap, and working for several hours required several hours of napping to recuperate. Apparently it doesn’t matter how head strong (a.k.a. stubborn) you are, nor how much adrenaline you have, you need to sleep. If you have your foot down too long, it takes ages for it to settle and when it swells inside your cast, it is not so good! A rolling desk chair, a wheel chair, and great friends enabled me to work part time, and I was so thankful for that. BUT…. You need to rest (and I do say that from the perspective of someone who didn’t rest enough and paid the price for it! Carole, Kevin and my Mom are rolling their eyes right now).

Third Rule: Get a great physio/ therapist and do Everything they say. I am so fortunate to know a bunch of AMAZING physios/ therapists/ clinicians who I trust implicitly. My biggest issue was that I could not go to everyone who I respect and adore. I began my therapy while in my cast, making sure that my spine and hips stayed healthy, that my nerves could glide, that energy would still run through my calf and Achilles to my foot. It was critical to manage the effects of being on crutches.

Pilates-wise, I used the Cadillac and chair to keep me moving starting in week two. It felt amazing to be able to move with the leg supported. Because you spend so much time with your leg elevated, your back is always in flexion. Swan dive and Mermaid felt fantastic. Prone One Leg Kick helped me unwind my hip flexors which were on overdrive, and Side Leg Lift Series helped mobilize my hip and prepare my glutes to work again. From week five post-op, I was able to get on the reformer and begin small range footwork and Sleeper on light springs.

I will be ‘hanging out’ with my physio for months to come, and look forward to getting to do athletic return to tennis style drills somewhere near the end of the year. Now at week twelve, I can begin to load on more springs with footwork, and start to do more Ankle Lower and Lift, focusing on the eccentric strength.

Fourth Rule: DO PILATES TO PREVENT AN ACHILLES RUPTURE or TO MANAGE YOUSELF IF YOU DO RUPTURE YOUR ACHILLES!!!!

Here are the juicy tidbits for pilates instructors and therapists.

While this may sound sick, I have enjoyed learning the lessons associated with this injury, and observing the emotions that crop up. Maybe ‘appreciated’ is a better word than ‘enjoyed’. It is a crazy experience to not be able to balance on your injured leg, and not to be able to compensate or figure out how to do it for 7-10 days.  I am a coordinated, strong person, who understands motor patterns and balance mechanisms. I literally could not center my rib cage over my pelvis and leg to balance. It did not help to contract my abs/ inner thighs/ glute medius nor just to visualize centering over my midfoot. I now understand what that ‘lost or empty’ sensation is that clients have described. What did work was stepping to the side to balance instead of trying static standing or stepping forward. Interesting, eh?

And the emotions; the fear that goes along with the threat of re-rupture is intense. It was so valuable to be able to talk with Dr Crary, and to know that I was in good hands in my physios/ therapists care. You need an outside brain to be in charge of doing enough but not too much.

If you are working with clients who have ruptured, make sure you know the surgeons protocol and stick to it exactly!!!!! Your client is trusting you.

Prevention of ruptures (if possible): Eccentric training and plyometrics!!!! Awesome calves that have strength through range of motion. Balance and proprioceptive challenge. Great dynamic control of the feet, knees, hips (gotta get a Bum), pelvis and spine. Symmetry, suppleness and strength.

One of my great joys is teaching the fabulous gang in my Wednesday ‘Instructor Only’ class; the theme became ‘everything you need to have to cope with being on crutches’, and ‘preventing Achilles ruptures’. There were some sore tushes, calves and arms! Great work girls.

Management of Achilles Ruptures: Eccentric training and plyometrics!!!! Awesome calves that are neither too long nor too short. Great dynamic control of the feet, knees, hips (gotta get a Bum), pelvis and spine. Balance and proprioceptive challenge. Symmetry, suppleness and strength. Sound familiar?

Fifth Rule: You need insurance. One last major point….. Insurance. I have learned a lot about insurance. First of all, get some, some how, some way. That, or put a good amount of money away inyour just in case fund. You have no choice but to have medical intervention when you have a ruptured Achilles. Even with good insurance, an injury like this will cost you thousands of dollars in medical expenses. Medical insurance does not provide income replacement. Most disability plans kick in after three or more months of not working, but do not cover you for the weeks you would miss typically miss this kind of injury. Ironically, we were literally in the process of signing up for Aflac when this injury happened. If we had signed up with Aflac one week earlier, most of my medical costs would have been covered, and I would have been eligible for income replacement starting the day my injury occurred. This kind of support would have alleviated many worries. Please look into short term disability coverage.

I hope this gives you some insight into life post Achilles rupture. There is a lot of good information on the net, but most importantly, ALWAYS follow the surgeons protocol! Every surgeon’s approach is different so respect it!

I need to thank so many people for supporting me and putting up with me over the past 12 weeks. First and foremost is Kevin my wonderful husband!!!! Then my wonderful family, Leslie, Jean, Carole, Daphna (my personal chef) and all the girls at Pacific Northwest Pilates. All of my clients who have been patient with me (and laughed at me when I came back too soon). Michele, Annie, Lori.  Dr Crary, Matt Walsh, Dr Sheila Murphy, Debbie Lehner, Lisa Seitz, , Dr Chris Lord…. And many more! Thanks to everyone.

Adrienne

I have struggled for many years of my life trying to find a form of movement and/or exercise that I liked and could enjoy, not just go through the motions for the sake of exercising.  I also have struggled on and off with weight and currently have some areas of pain in my body.

I took dance as a young girl and thought that maybe I would enjoy pilates having never tried it before.

Nikki was absolutely wonderful. She was so encouraging, thorough, reassuring, and energizing to work with. It was truly a pleasure to feel my muscles move.  Nikki is delightful and I hope to work with her again at some time in the future. I thank her for helping me feel excited about truly moving again.

May light, laughter, and love surround you.
Peace,

Amy B.

1. What am I trying to accomplish and

2. What are the steps needed to get to that ultimate goal?

I will sit with my eyes closed and SEE my body MOVE into the position. In my mind I am really GOOD at using all the body mechanics and in such perfect form! Oh if only my reality was the same.

So after slowing down and closing my eyes, I begin to visualize a LIGHTBULB over my head. I start to get some light coming in and filtering down to the body where the mental awareness of my body mechanics are making better sense. The light may be dim at first but as I take it through the above process, it becomes brighter and brighter until the LIGHTBULB “POPS” into an

EXCLAMATION POINT! By George, I think I’ve got it!!!

The Exclamation Point will be challenged when I do the intermediate or advanced form of the same exercise. So my process will begin again. But that is what I love about Pilates; endless challenges.

I would also like to share my MOMENTS that I try to stay alert to throughout my day.

1. Ah-Ha Moments; that is the light bulb turning on and creating an awareness to be focused on at that moment.

2. Hurrahhh Moments (sense of ahhh in that moment); when my body really feels the ah-ha. Mind and body are working well as a team.

3. Ha-Ha Moments (I try for as many as possible); these are moments that come from the belly laugh which is a sneaky way to find and work the transversus abdominus!

4. Duh Moments; when I will gently tap the side of my temple saying “why did this take me so long”.

5. At the end of all this comes a big TA-DA Moment of pure joy. I like to throw my arms into a big “V” and look up in wonder as I say out loud “TA-DA!.

6. AHHHHHH MOMENT- A time to be quiet and release my thoughts….But just for a moment.

Scottie Johnson

]]> http://www.pacificnwpilates.com/blog/impressions-from-a-pilates-student-the-mind-body-connection/feed/ 1 http://www.pacificnwpilates.com/blog/knee-stability-post-surgery/ http://www.pacificnwpilates.com/blog/knee-stability-post-surgery/#comments Mon, 01 Feb 2010 23:38:07 +0000 Jean Leavenworth http://www.pacificnwpilates.com/blog/?p=809 We just got this question emailed to us from a student:

This is Christi Tuck from Colorado Springs YMCA. I am a certified STOTT PILATES instructor and I have a question.
I have an inquiry from a possible student regarding some knee issues and if the reformer would be beneficial and are their any concerns. Basically they had surgery recently and the doctor informed them they have no cartilage around the knee. I believe they had the meniscus repaired.
My guess is the reformer would be helpful to strengthen the surrounding muscles and that starting at light resistance would be best. I welcome any comments or suggestions.

Hi Christi-
Thanks so much for your question. As far as your client’s issues are concerned; yes, the reformer would be very beneficial to her recovery. Doing footwork starting with lighter resistance is a great start. I would also do single leg pulses in a variety of positions–laterally rotated, parallel and medially rotated. Make sure when she is doing footwork or single leg that she is really using her quads to draw the kneecap up as she straightens the leg. VMO (vastus medialis oblique) is especially important for knee stabilization and it tends to be weak for many women. I find I really feel the VMO muscle more when doing lateral knee pulses, but that may vary from person to person, so check in with her to see if she is feeling that muscle. Strengthening the posterior leg muscles will also help to stabilize the knees, so make sure you are doing some glute and hamstring work as well.
Melanie Byford-Young has a great workshop on Knee Stabilization if you ever get a chance to take it! She created an exercise where you are sitting on the reformer carriage with no springs attached. One foot is on the floor between the rails and the other leg is lifted up supported by the hands or with a flexband around the thigh. If you have a rotational disc, place the foot on top of the disc and keep the ankle, knee and hip tracking as they slowly move the carriage out and in. This helps to stimulate and strengthen the popliteus muscle which is another deep knee stabilizer.
The more those stabilizing muscles are activated and strengthened, the less wear and tear will occur to the knee and the remaining cartilage. Eventually, you can increase the resistance as those muscles get stronger, but at the beginning we don’t want to overload those stabilizing muscles.
Let me know how things go or if you have any other questions.

View from the cascina

I explained that the pole dancing was a package deal. My daughter, Cally, and I co-teach the classes together; spotting, assisting and guiding women. Five months later Cally and I were on our flight to Milan, Italy with two rifle cases containing our heavy-duty removable commercial poles capable of extending to their fourteen foot ceiling. The rifle cases had been revamped a bit, embossed with an aluminum veneer and butterfly pattern, which did not detract from their 60 pound weight!

When we arrived at the Cascina we found waiting for us, three British women; one working for the office of the Prime Minister, a lawyer from London, a woman training to become a Pilates instructor; and 3 Americans. One of these comrades was my client and two were a married couple from Chicago. All looking for a good time to relax, get healthy; and “let their hair down” so to speak.

Guests received multiple amenities, among them, unlimited daily Pilates (both apparatus and mat; taught by me), unlimited use of the gym, lap pool, and sauna/steam room; daily Culinary Arts classes, all meals beautifully prepared using market fresh ingredients and organic produce from the farm; unlimited Private Label wine from the Cascina’s own grapes, trips to local village markets and an added bonus with Cally and I there…unlimited Pole Dancing for Fitness!

Trisha in the pilates studio with her pole

Out of literally thousands of Pilates instructors worldwide vying for an opportunity to serve as the retreat’s featured instructor, I am humbled and ecstatic that they chose to feature me again last summer. Cally couldn’t go, so I brought another of my instructors, Heather Christopher and 7 clients of my own. We had another wonderful visit. For more info Email Trisha Hatfield Graves:trisha@pilatesatplay.com or Visit: www.cascinapapaveri.com

I started with a beginner jump start mat class. The pace was a little too fast for me so I tried a gentle Pilates class with Sue. The slower pace of that class is what I needed. The class also had people like me suffering from a variety of different injuries. Eventually I got strong enough to start going to Sue’s beginner mat classes and as her schedule opened up I started doing private lessons with Sue as well. The first year was a slow journey for me. I was afraid of re-injuring my back so I was overly cautious. It also took a long time and lots of private lessons for me to figure out how to correctly get in a proper “neutral” position and stop “tucking.” It took time to get stronger but eventually I did.

The summer of 2007 my family spent two months in Europe. I was not able to go for my Pilates classes.

I was on my own and spending lots of time on trains, buses and airplanes and sleeping in a different bed every week. I continued doing basic Pilates exercises I had learned to keep my core and back strong. I don’t think I would have enjoyed my trip as much as I did without Pilates. Pilates played a big role in keeping me mentally and physically healthier that summer.

Along the way there have been set backs, like the time I was in a hurry and tried pulling my dog out of the car when she wouldn’t budge. That was a month before I was heading to Europe for the summer! But with Pilates basics under my belt recovery was easier and faster. Last December I went sledding and severely sprained my ankle. Again with time and Sue working on my injured ankle, Pilates once again made a huge difference in my recovery.

Rosie Fiallo

27 years ago when I had just arrived in Portland my left SI did its usual slipping out and I was hosptialized at Saint vinnie’s for two weeks, and put into traction on valium and codeine for two more months at home. I worked from my home setup with an old-fashioned traction device. I was not given any PT after being released from the hospital, and told to remain in bed for as long as it took to reduce the muscle spasm. 12 months after this episode, I gave birth to my first child(and had been confined to bed for the last 3 months of my pregnancy due to the threat of an early birth–which didn’t happen) You can just imagine what poor physical shape I was in for that event!!

Several years later, the same thing happened, and this time I was given a half inch lift to wear in my right shoe–which I did for about 6 years, and sent back to my PT, whom I had met through my first child’s pediatrician, who sent me there for a crik in the neck from long middle of the night feedings, and continued Si dysfunction.) I continued to have episodes; when the orthopedist who put in the lift sent me away in the middle of one such crippling episode (now I was home with 2 little ones, and my husband was travelling!!!)I turned to a friend , a DO, who set me up for x-ray studies of leg length and cranial sacral treatments with a colleague.

Fast forward through MANY cranial treatments(several practitioners), acupuncture, 3 car accidents and 2 surgeries, and PT: About 1 1/2 years ago, my PT sent me to Melanie after several attempts on my part to undertake exercise programs on my own. After several sessions with Mel, she turned me over to dear Janet, and I have been happy ever since.

Last winter I suffered round of a frozen shoulder; the previous episode had me stopping all activity , including walking, because of the pain. Janet urged me to continue with the pilates, and modified the workouts according to whatever shape I was in at the time. She is patient, cheerful and very supportive, skillfully reading my readiness for her routine at any given moment, and adapting them on the spot to my ability on a given day. This past summer I went through another period of frequent “slips” in my pelvis, which were, I believe held in abeyance by Janet’s skill in straightening me out, literally, in a session. She encouraged me to supplement with visits to the chiropractor if I asked for her opinion.

Unfortunately, due to financial difficulties at home, I have had to postpone my next round of 10 sessions. I am having major jaw surgery in November, and have every intention of coming back asap, as I believe that working with Janet will speed my recovery from that major event. I will be back for her professional and personal touches in my “healing process”, and can absolutely attest to the success that one-on-one pilates has brought to my long-standing skeletal problems. Janet has given me some exercises to continue at home (without the reformer, which I will sorely miss) and has convinced me of the utility of one-on-one instruction for my circumstances. I am not ready to “take a class” and am suspicious of the many venues where people are teaching “pilates” just by saying so (indeed, I have the same opinion about many yoga classes), and have developed a good understanding and respect for, under Janet’s care, just how much training goes into a good instructor of pilates. She is always caring and professional.

I hope to be back in the studio very soon. I will miss my weekly dose of Janet’s enthusiasm and skill for the next little bit—

I worked out the the gym, doing step aerobics and then spinning.  One day, a fellow spinner told me about Traci’s Pilates class at the downtown Bally’s Total Fitness.  I tried it and I was hooked.  The mind-body training began to make a difference as I learned to get my abdominals to wake up and do their job.  I’ve continued with weekly classes (moving to Pacific NW Pilates with Traci).  I took Melanie’s Pilates for Rehab class at Pacific NW Pilates and that solidified my understanding of the basic principles.  I did not get the certification, but do incorporate the principles and exercises in my work whenever possible.  I also have several “routines” I do at home (with the help of Moira, PJ and others on DVD!), and it is such a fabulous way to start my day.  The good news is that I rarely have low back pain anymore, even after gardening, crawling around after little kids, and doing housework.

I continue to learn about my body and how to keep it happy.  After a spell of very uncomfortable neck pain, followed by PT, home traction, massage, and still residual pain, I had 2 sessions with Melanie.  She “nailed” the source of the aggravation and gave me a great home program.  It is not easy for a 60 year old body to change her posture, but the awareness  of what needs to change, and the tools to work on it are beyond value!  The arthritis won’t go away, but the pain does, and that is life changing.

A happy PS is that my husband and I planned a 5 day kayak trip for our vacation in September.  I was concerned that all that shoulder work would aggravate my neck. The good news is that by stabilizing my shoulders as I held the paddle, my good posture was easy, and I never felt better than when my paddle was in my hands! We had a fabulous week in the Gulf Islands, and I did “my Pilates” on the water, every day.

Thank you to Melanie, Traci and all the folks who keep your studio such an awesome place to be healthy!

Jocelyn Goodall (Physical Therapist)

Then, on 9/9/08, I experienced a serious fall caused by a spontaneous break of my right femur. The process of my femur breaking caused me to land on my left arm. My left ulna then broke in five places and my left radial head was demolished. I was hospitalized (of course) and had two surgeries to repair my broken bones. Of course, I had to take a break in my pilates lessons.

However, I was back to Pacific Northwest Pilates and working with Cheryl in private lessons by December of 2008. For a month, we worked together to assess my current situation and awaken my sleepy muscles. By January I was strong enough to begin participating in group mat and reformer classes. I have continued those since that time. I have also involved myself in a great deal of water therapy.

By now (10/31/09) all my bones are healed; I can walk without a limp; my arm has more range of motion and strength than my surgeon thought was possible. My arm injuries were actually more serious and required more intricate reconstructive surgery than did my leg. My surgeon is amazed at my recovery.

And, my original goal of strengthening my hip and core muscles, so I could avoid (or postpone) replacement hip surgery, has been achieved. It is VERY rare for me to experience any hip pain.

And, this seems very significant in light of the intervening injuries I sustained and overcame!

I attribute all of this to my work with Cheryl and pilates. Gradually, she and I have seen my muscles become stronger; my endurance and strength have increased tremendously.

Thank Goodness for pilates!

Thanks, Carol