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The SISM Blog

Shane McHales Recovery at the SISM Clinic

By SISM Clinic | In SISM Blog | on January 31, 2015

Tyrone v Mayo - Allianz Football League Division 1 Round 2I ruptured my Achilles tendon last August, this required surgery for repair which I had within one week of the injury. I was in a hard a cast for the next four weeks. Following this, I was put into a removable air cast.

It was at this time that I started my treatment and rehab with Martin. By this time, the calf muscle in my injured leg had almost completely disappeared and was less than one third the size of the other leg.

My main concern at this stage was that the range of motion and flexibility was extremely poor. However, Martin advised me that, the main focus of my rehab was to build the strength back into the Achilles first and with time, the range of motion and flexibility would gradually improve. He also advised me that if I were to undertake any forceful stretching of the Achilles at this time, I could irritate the injury and cause further damage.In order to build up the strength in my Achilles Martin prescribed a rehab programme, initially, it consisted of a variety of very basic strengthening exercises using therabands and proprioception exercises to help with balance. These exercises were carried out twice daily.

Over the next few weeks, my rehab programme was revised on a weekly basis, gradually progressing onto weight bearing exercises which increased in difficulty/intensity. This prevented further muscle wastage and improved the muscle tone in my calf. However, the bulk did not begin to return to the muscle until I started walking (nine weeks post surgery) and after the air cast had been removed.

Alongside the rehab, I received weekly treatments from Martin and Mark in the SISM clinic in Castlebar. These treatments entailed laser therapy, soft tissue massage and Achilles mobilisations.

During this time, I found these treatments to be of great value as they helped to reduce the pain and inflammation in the injury site. Once back walking, the rehab progressed at a much faster pace as I commenced much more advanced strengthening exercises.

At this stage,, I was doing two rehab sessions per day, which enabled me to get to the level of strength required to train on the isokinetics machine, (12 weeks post surgery). Isokinetics allows for very controlled loading in isometric, concentric and eccentric muscle contractions. This machine is used for strength training of the calf and the Achilles in a very controlled manner. From my own perspective, one of its main advantages is that it plots the resistance that I use against the machine on a screen. This screen is connected to the iso machine in a way that allows me to track my progress from session to session. Along with this, I also noticed a huge improvement in the strength of my Achilles and calf. This helped me to walk much more freely and unrestricted. My sessions in the SISM clinic increased to twice weekly, consisting of isokinetic sessions followed by treatments from Martin. This resulted in an increase in the mobility of my ankle, it also focused on removing some tightness in my calf muscle which had now begun to bulk up again.

At this stage the strength and flexibility in my ankle had greatly improved and I was very anxious to start back running again. However, Martin advised me to wait until the level of strength in my injured leg was built up to the same level as that in my other leg. Martin explained that a return to running at this stage, while there is an imbalance in the strength between both legs, could lead to further injury complications. These complications could include poor running technique as the uninjured leg would be doing the bulk of the work.

He advised me that, holding out until this imbalance is corrected will allow my running to progress at a faster pace than if I were to attempt it too soon. He advised me to continue with my isokinetics and rehab sessions, he also prescribed pool and bike sessions to work on my fitness.

At this stage (18 weeks post surgery), in preparation to return to running, I am jogging in the pool and increasing the intensity and difficulty of my rehab sessions. I am building towards getting running following my isokinetic assessment while allows us to assess the strength of my Achilles, soleus and gastroc. I need to be within 20% of my uninjured side before I am allowed to begin my end stage rehab which include my running program and once we have achieved that we are going to asses my running biomechaincs to ensure I am not overloading my Achilles. Once we have achieved that I can really accelerate my rehab.

Really looking forwards to getting running now and I will get you posted on my end stage rehab.

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