Wednesday, May 14, 2008

Progress Report

Even though I'm back in regular shoes and on my own two feet, I'm still in the middle of the rehab process for my ankle injury. The rest of the company is hard at work in the studio every day, rehearsing for the last three ballets of the season, and I'm hard at work at the physical therapy clinic, looking for every gained inch of mobility and ounce of strength. I go there about four times a week for actual hands-on therapy, which includes soft tissue work, joint mobilization, and what they call "scar mobilization"--- that's the loveliest treatment of all. It means doing cross-fiber friction massage directly on the scar to break up the adhesions underneath it. Everyone says it's very important, but it feels so gross that I'm wondering how much I care about having a mobile scar.

The other aspects of my sessions at PT are less unpleasant. The therapist works on getting some more degrees of flexion in my still-stiff ankle joint by basically teasing it further and further, coaxing it along as I resist and then let it stretch further. I'm having a lot of trouble with all the tendons surrounding the area where the repair was made, so we do a lot of flushing and scraping of my Achilles and posterior tibialis tendons to get them less irritated by the sudden uptick in load that they're being put under. When such weak muscles are suddenly asked to take some strain, they often seize up in response, so I do get a bit of calf rubbing to work out the protest knots. Then I'm turned loose into the gym to do my exercises, which can take quite a while since there's really no end to what I can work on. The major focus for the ankle itself involves getting back basic strength and stability. So I do a series of exercises on the balance board and Airex pad, which are unstable surfaces, to re-train my legs and feet to stabilize themselves. There are basic calf raises, but also a lot of work on controlled strength as opposed to just straight repetition. The latest one has me balancing on one leg on the balance board while tossing a ball back and forth to someone. That is hard enough on a "normal" leg. I pretty much started to quiver in fatigue after about a half a minute.

Here are the tools of my current regimen. There's the balance board (also called a rocker board), the blue foam Airex pad, the half-foam (I use that for calf raises and more balancing work), my friend the Magic Circle (adductor strengthening), and the family of Therabands for my foot exercises.

The pig is named Oliver and he's the cheering section.

In addition to ankle-focused therapy, I have a little routine of whole-body maintenance exercises that I do every day to make sure the rest of me will be in good dancing shape when my ankle is ready to go back to the studio. I do several different kinds of core strength exercises, hamstring curls, pushups, and a few times a week I get onto the Pilates reformer for more of the same. One of my favorite/least favorites is the "clam shell", which is hard to describe but is the best turnout strengthener around. There's also a half hour of cardio on a stationary bike and a bunch of different stretches. That stuff is invaluable, and honestly I'll probably be stronger in some ways than before this injury happened.

After all the physical work is done for the day, I do a really good ice-down, massage some Traumeel into my ankle and foot. At some point each day I also do a contrast bath, when I stick my leg first into a bucket of ice water, then into hot water, and back and forth for 15 minutes. That's the best way to flush blood into the area and also helps loosen up the joint even more. While my foot's in the hot water I do toe curls for the intrinsic muscles on the bottom of my foot.
And last thing before bed every night is another ice-down, preferably with my foot elevated over my head, since there's still a fair amount of swelling that happens by the end of the day, especially if I've been up and about a lot.

This whole routine is keeping me busy. I have to say that a lot of it comes from knowledge I've picked up over the years (and from the various injuries and therapies), so although there are always a lot of unknowns I do feel a fair amount of confidence in how I'll come out of this episode of my career. And there are always interesting things to be learned about one's body and mind when going through something like this.


  1. Wow Gavin! 4 times a week for PT? I would imagine you're exhausted by the end of the week! You'll probably heal MUCH quicker with 4 days a week than I did with my twice a week. :) I thought the Airex pad was the hardest to get used to when I was standing 1 footed on that! Isn't it a weird feeling when your muscles start shaking after just 10-20 seconds?... kinda humbling. But, at least you have Oliver to cheer you on. :) After the joint mobilization and soft tissue work do they eventually have you doing different weight lifting exercises to strengthen the ankle and calf or is the flexibility more what you need to have for your ankle (I'm thinking of your calf which you said was a tad small after the cast was taken off). Do you know if you'll be able to start doing basic dancing again by summer? At least we're starting to get warmer weather - that always helps with stiff muscles. :)


  2. Thanks for the posts - always interesting, always well-written. It would be really interesting to hear what you are learning about your mind through this rehab process. I have always thought it must be the strongest part of any dancer.

  3. Hello, Seth-
    Yes, I work with the therapists four times each week, but I'm working out myself every day on top of that. It IS a good amount of physical work, but still isn't equitable to the usual rehearsal day. Just different.
    They do have me doing a lot of resistance exercises for my ankle and calf, though not what you would call weight lifting. I do a lot with the therabands and also using my own body weight for resistance. Gaining back tons of strength in tandem with the range of motion is the goal.
    It's progressing really well and I'm hoping to be able to start trying some easy barre work by next month.
    Thanks for your interest!

  4. And thank you, Trevor, for YOUR interest as well! Frankly, writing this blog has been interesting in terms of self-discovery. Putting down into words and explanations the things I'm going through right now had been a good exercise in perspective and motivation. It's true, the mind of a dancer is perhaps her strongest part, but that's just the way it looks to the observer. Our inner selves are full of criticism and confustion! The hard part is channelling those feelings, along with determination, into a healthy and productive attitude.