Day 10 Of Grade 3 Ankle injury

By: Dr. Terry Weyman

Well, Yesterday I got my MRI. You know its bad when the Radiologist is waiting out side of the MR scanner with a look on her face like "you did it good this time". She waved me into her office and said "I have not seen one this bad in a long time!" Great, just what I wanted to hear!

Complete Tear of the Anterior Tablofibular Ligament (main lateral stabilizer)

Avulsion fracture and partial tear of the deltoid Ligament (main medial stabilizer)

Partial tear of the Peroneal tendons (Both of them), partial tear of the Posterior tibial tendon

Partial tear of the calcaneal talar lig

6 bone contusions including a subchondral fracture of sustentaculum tali

Well, is that all? Here is the good news. I was able to go back to work on day 3 and put in a 12 hour day. I have cut my work days to just Mon, Wed and Friday so I can recover on the off days (tue, thur and weekend). Its a compromise I made. I need to work, I love my patients and I love what I do. So, if I am going to work, I need to work on recovery as well. I am not going to lie, this is hard. It will take alot of effort. Most people would take the time off, lay in bed as prescribed and take the 12+ weeks. I need to go to work for mental as well as to pay bills, but more importantly, I would go crazy staying in bed for that time!

It takes a lot of work, to heal and work. You have to combat the extra stress you are putting on the joints by standing with tissue recovery therapy to equal it out. The injury wants to heal and scar up. I NEED it to heal and scar up. There is a fine line between pushing through and ending up with permanent damage and pushing through and being ok in the end.

So far, what I am doing is working and I have a lot of people to thank for it. I am surrounded by other health care professionals with the same vision, they too work with high level athletes who, at times, can't rest the way they should.

On work days, here is my regiment. Are you willing to do what it takes, to get where YOU want to go?

Wake up early, take my supplements of proteolytic Enzymes, joint and bone care, omega 3 and Vit C. I repeat this process 4-5 times a day

Laser and light vibratory percusser to stimulate blood flow after supplementation and relax foot, coupled with light, non painful, passive ROM

Compression sock and boot. I can only walk when I have BOTH on.

Lunch time, more supplements, I head to the hyperbaric chamber for an hour. Inside I follow my Laser protocols for bone injury and ligament/tendon repair

Acupuncture, then light PT with passive ROM

Compression socks and boot back on for my after noon.

Chiropractic Adjustments to keep my pelvis and back aligned with my altered gait (don't want any new patterns to form) as well as keeping all the nerves to my ankle decompressed and firing

Evening, more acupuncture, followed by RICE (rest, ice, compression and elevation)

Good meals during the day, give the body what it needs

Before bed, more supplements to allow healing to take place while I sleep

Kinesio tape (see photo) before bed to aid in lymphatic drainage at night and to reduce over night swelling

That is during my work day, during my off days, I do the same thing, but add, Home Marc Pro use http://www.marcpro.com/ (use promo code GOTCSI). I do this to flush fluid through my ankle and foot. I want circulation to flow, capillary dilation/formation to happen and debris to be flushed out. This is a tool every athlete should have and it has helped tremendously. I am using the Marc Pro for 45 min every other hour while at home on top of the acupuncture, hyperbaric and laser work.

The world of Injury recovery is fascinating and their is so much out there. When injured, care for your body as it cares for you. Don't sit on the couch, make healing a full time job. Your body will thank you down the road and you will be able to continue your life after you heal. Its a lot of work, but worth it!

Dr. Terry Weyman is the owner of the Chiropractic Sports institute, for more information go to www.gotcsi.com

1 week Post Grade 3 Ankle Injury

By: Dr.Terry Weyman

Well, today marks the day one week ago this "journey" began. The reality of the injury has also set in. This is no quick fix and sometimes coming to terms with the reality of any injury is half the battle. Acceptance is also important since it displaces some of the false hope and doesn't allow the evil post injury depression to get its strong hold. No depression here, reality yes, depression no. I am confident in my choice of action, the team I have selected and the progress i have made so far.

The pain and lack of mobility is still there at a pretty high level. I went back to work last week on Wed and Friday. The ankle and foot were very sore but I survived. However, since I made the descision to go back to work early, that meant I had to increase the therapy to combat the extra stress I was causing. That meant an hour of therapy before work, two hours at lunch and an hour after work. If you want the rewards, you must be willing to do the work!

Since the swelling still comes and goes and the pain is still at a fairly high level, I am waiting no longer to find out exactly what I have done. I am getting an MRI tomorrow. Most athletes wait 6 weeks because that is what their insurance company states as "their rule". This is not "MY" rule. I want to know now what is up so I can make sure I do everything I can. An MRI will show what Ligaments are torn, the severity of the fractures and how the healing is doing at this early point.

The first two weeks are Crucial, according to the research studies I have read, in setting up the overall outcome of any injury rehabilitation. How you handle the first 2 weeks can be the difference between a successful outcome or long term complications such as Chronic Joint instability, Severe bone stress, RSDS (Reflex Sympathetic Dystrophy) or Chronic impingement. Surgery still is not out of the question for me since I have disrupted the entire lateral ligament complex. An MRI will show any positive signs or negative signs which will also enable me to make the proper decisions. Again, I don't want to wait weeks before I make these critical decisions.

The good news is, the therapy so far is working. The combination of the laser and Hyperbaric Chamber have been key. I am able to get 30-45 degrees of pain free ROM in the chamber when used with the cold laser. When I am doing this after Acupuncture the results are even better. I can tell the difference on the days I use Acupuncture and Hyperbaric/Laser when compared to the days I just use stim, ice and massage.

On the weekend, I am unable to get to the Chamber or have Acupuncture so my hourly routine, which seems to be working well so far, is as follows:

Take my supplements 4 times a day, 20 min prior to my therapy sessions

Using my home Hwave unit, I am pumping fluid through my ankle at a very light rate for 30 45 min every other hour

I am using a Percussor (strong vibration therapy) at the base of my foot to again stimulate circulation along with the laser set for healing, tissue recovery and neurological support. I also use the percusser to losen my calf and relax protective guarding to allow increased circulation to the injury.

I continue to do my push ups and situps daily to maintain the core strength necessary to maintain spinal health since I am using crutches. Also, when I am not doing the above therapy I am on the couch with ice, my leg elevated and in my boot to keep my foot at 90 degrees to maintain neutrality on the injured ligaments. When ever I am up, I have the compression socks and boot on. Again, resting the ligaments these first two weeks is so important. Take a small passive step so I can take aggressive steps in the future.

My goals are:

pain free ROM

then Passive weight bearing

full weight bearing

walking without crutches

transitional drills

running and jumping

I know not to move to the next step until the current step is completed. How long it takes you to finish each step is up to each individual and each injury must be given individual attention. For me, I am still stuck at the first level. That is ok, some levels take longer than others, Patience and persistance is important. Have you even noticed that people will spend more time, money and give more care to their "prized automobiles" or to their "priceless airlooms" then the do to their bodies? You only get ONE body, how priceless can you get? Treat your health and your body as if its the ONLY ONE LIKE IT ON EARTH, because it is!

Tomorrow is MRI day, I am looking forward to this as it will give me more direction and a better time frame. Well, enough typing, my timer just went off, time for more work:-). Keep smiling, keep moving forward and loving life!

Dr. Terry Weyman specializes in tissue and injury recovery. He has worked with Professional and high level Amateur Athletes for over 21 years. He can be reached at www.gotcsi.com

Grade 3 Ankle Rehab continues!

By: Dr. Terry Weyman

I know a daily blog, means a daily blog, but I confess, I missed yesterday. However, Yesterday was busy and turned out to be a great day. Today is day 3 since the diagnosis and day 4 of the injury and already the injury is making a positive turn

Ever wonder how the pros bounce back so quick and the "common man" doesn't? Are they superheros? Do they have something the average person doesn't have? Yes, you could argue they have the resources and financial means to make things happen, but is that all? I hear so many times "they just get a shot and they are good to go", Really? NO! There is another world out there with the emphasis on tissue recovery, injury rehab and wound management. The difference between the pro and the "common man" is the pro thinks "I have to get back tomorrow to make a living" and they are willing to put in the work. They also are surrounded by professionals whose job is to get them back. They view their body as the biggest and most precious commodity they have and will do what it takes to get it back to working order. They don't let insurance dictate their health, they know they will lose more money by being out then they will spend on getting better. This is the line that most "common people" don't cross. They don't put together a team to get well and do what it takes to do so. This is what I have done and so far I am already weeks ahead of schedule!

The day begins:
Yesterday I decided I needed to get back to work, more for mental than physical. I needed to be in an environment that invoked positive attitude and healing. I started the day with my nutritional cocktail of Proteolytic Enzymes (zymain), Omega 3, Ligaplex and joint support. http://bit.ly/healingsupplements This cocktail is so important. Again, you would not build a house or repair a fence without the necessary tools and supplies. When you are injured you need the necessary chemicals at hand to make the repairs. If you don't supplement your diet where is the body going to get what it needs? From your diet! If you diet doesn't have it the body will find them but this takes time and time is not what you have. Let me tell you, I am taking these supplements 4 times a day and my urine is clear. What does that tell you? My body is using everything I am giving it. Again, have the biochemicals on hand so your body can take what it needs!

I put on my compression socks, again KEY, to keep the joint supported and fluid being pushed through the foot with any movement. http://bit.ly/compressionsocks I then put my boot on and go to work. Its only Wed and I am back to work!

Lunch hour treatment continues
I grab a quick bite of protein and veggies and head to Dr. Shari Phillips, Acupuncturist, to get needled up. Acupuncture is so important to keep circulation moving through the injury. The goal this first week is to flush out "stagnant blood" and bring in new blood that is rich in the biochemistry and oxygen. By using Acupuncture and Stim you can target the area you want to work on and enhance the circulation without compromising the integrity of the joint.

After Acupuncture its off the Hyperbaric Chamber, for some Cold Laser (using the Erchonia Cold Laser) and ROM exercises while inside the chamber for maximum benefit. I am in there an hour. Performing passive ROM exercises while using the Erchonia cold laser. Within 30 min the I can feel the ankle joint losen and soften and my foot begins to work in a more controlled manner.

The swelling is going away fast and the blood is coming to the surface. My foot is turning black and blue faster than I expected and in the chamber today I was able to flex my foot 30 more degrees in dorsi flexion than the previous day! So far so good!

This is week one. The point of week one is to provide nutritional support for healing since a majority of healing happens in the acute phase (the first week). To provide adequate amount of O2 and blood flow through the injury and to establish pain free passive range of motion.

Week two will be anther story. For now what I am most happy about is I was able to go to work 3 days after the accident with modified wt bearing in the walking boot. I had minimal pain and discomfort and my foot and leg are feeling good. Now its off to Hwave for another 45 min, take my supplement cocktail and rest. Tomorrow we do it all over again!

A special thanks goes to my team. Without them this would not be possible. Dr. Shari Phillips, who is an extrodonary Acupuncturist with advanced knowledge in Orthopedicts and Nutrition. She can be reached at info@shariphillipsacupuncture.com. To My Doctor at CSI, Dr. Amir Mahmud, for his skill as a Sports Chiropractor, getting adjusted is key to biomechanical as well as Neurological well being. Dr. Grace Hameister, the "Laser Guru" This Doctor is the guru when it comes to Lasers and tissue healing. She is also so well versed in Hyperbaric Chambers and combo therapy. She has helped many Pro Athletes as well as trained some o f the Top Athletic Doctors in the field. I am so blessed she is my friend and is helping out. She can be reached at docnextdoor@yahoo.com. Rob Bolton and Billy Miller for allowing me to use their Hyperbaric Chamber. If you need one call on "The ELite Factory" in Westlake, Awesome place to train and heal.

Day 1 rehab- Grade 3 ankle injury

Dr.Terry Weyman

Woke up with a very swollen and non functioning foot. First order of business, bring nutrients to the injury in a non wt bearing, stressless manor. Introducing the Hwave!http://doiop.com/h-wave By using the home Hwave I can stimulate capillary dilation without stressing the muscle. Bringing healing nutrients is vital to recovery as well as flushing out stagnant debris that will inhibit the healing process.

Bring on the nutritional Calvary!

I started my morning with my cocktail. Proteolytic Enzymes, Ligaplex, Joint support and omega 3s. Also, checking my diet http://doiop.com/reduceinflammationwithdiet Nutritional support is something that many athletes forget or tend not to focus on, yet it is SO important. You would not put the best parts on your race car then put junk gas in the tank would you? Supplements are just that, they give added nutrients when your body needs them. In this case, my body is trying to heal, so I am giving it the nutrients it needs to rebuild. Another analogy, when you are building a house and its foundation time, you bring in a lot of cement, when its roofing time, you bring in a lot of tiles, not one at a time. Same thing here. Give your body the building blocks it needs to repair.

After my cocktail and healthy breakfast of fresh fruits, yogurt and protein, I go back on the Hwave to drive those nutrients to the injury site. Keeping my ankle elevated I stay on my machine for 30+ minutes.

CARDIO TIME

With sitting, comes a decrease in cardio output. I don't want this. I want blood flowing and my heart and lungs to work to aid in the healing process. How do you do this and not stress out the ankle joint? Good ol push ups and sit ups. 5 sets of 20 with a 1 min rest in between. I use the perfect sit up http://doiop.com/perfectsitup to keep my core in shape and not stress my ankle. Keeping the core strong is vital since I am on crutches and don't want my back affected in this process with my altered gait.

Next step, heading to the office for some therapy. Even though its day 2 there is a lot that can be done. Restoring passive ROM, Acupuncture to stimulate circulation to flush out old blood then onto the hyperbaric chamber with the Erchonia Cold Laser to get more O2 to the area to stimulate healing. Getting well sometimes is a full time job, but what are the options? You only get one body and I can't afford to be down or have a weak ankle in the future.

For stability, to decrease swelling and to aid in compression, I put on my CSI compression socks. These are so important for stability and healing any lower extremity injury. http://doiop.com/compressionsocks

Ok, I am out, got my socks, crutches and desire. Heading to the office to keep the plan in motion. Talk to you tomorrow.

Thanks to my crew, Dr. Shari Philips Acupuncture (shariphillipsacupuncture.com), Rob Bolton at the Elite Factory (hyperbaric chamber), Dr. Amir Mahmud (CSI Sports Chiropractor)

Severe Grade 3 Ankle injury- The rehab begins

By Dr. Terry Weyman

48 hours ago I was at a Motocross track watching my son, Tyler, practice. It was an awesome day, the track was great, Tyler was riding great an smiles were everywhere. Then it all changed. Tyler was doing a jump section that involved 2 big doubles, the first one 40+ feet and the second 80+ feet. He was coming up on two riders on 450s who were not as skilled. He passed the first rider and committed to the second jump to pass the second rider. When Ty was in the air the second rider bobbled in front of Ty and his bike kicked him into the line that Tyler was committed to. Tyler landed right on him in a horrific crash. I was standing on the opposite side of the track and took off running with one thought in mind, to get to my son. Ty hit the other rider with such force that the subframe of the other riders 450 bikes was bent at a 45 degree angle. God was watching over both of those riders as both got up and checked out ok with only minor bumps and bruises. Myself, not so lucky. In the frantic run I stepped on the edge of the track and snapped my ankle on the 10" lip. I kept running till I got to Ty and checked him out. He had pain in his hip and wrist, which later dissipated with quick therapy at CSI, however, my ankle continued to swell. Once I got us home I was unable to put weight on it and I knew I was in trouble.

The following day I went to an orthopedic friend of mine, Dr. Pierre Durand who took Xrays and examined my Ankle. The good news, nothing broken. The bad news, I ruptured all the main ligaments in my ankle. I have a grade 3 tear (full rupture) of the ATF (Anterior Talar Fibula lig), the PTF (posterior Talar Fib) and an avulsion fracture of the Deltoid Lig. I was told to wear a boot, 24/7 (yes even to sleep) for 2 weeks, then stay in the brace for 6-8 weeks. After this begin rehab for another 4+ weeks. For those of you who are not good in math, that is 3+ months before I can rejoin my life!

The purpose of this blog, is to track my recovery. To show you that the body is an amazing thing, given the right tools and the right knowledge it can heal and do amazing things. I am at the start, You will follow me all the way to the end. I will do things out of the box as well as in the box. To just sit and do nothing for 8-12 weeks is not an option. We do things different at CSI and now you will see it first hand. Share this blog to others who have had similar injuries. Follow along as my team works on me. This may not be reality TV, but its Reality Blogging, healing style.

New Research links Postural function to health

Dr.Terry Weyman

Posture is no longer something that is pure visual or something your parents remind you of “sit up straight now” but an inter relation to your physical health. In the Journal AJPM the Authors noted that “posture and normal physiology and function are inter-related”.

Most Medical physicians do not address posture when they talk about the overall well being or health of their patients yet the Doctors of this study discover “significant evidence points to the point that posture affects physiology and function of the human body”. “Observations of the striking influence of postural mechanics on function and symptomatology have led to our hypothesis that posture affects and moderates every physiologic function from breathing to hormonal production. Spinal pain, headache, mood, blood pressure, pulse, and lung capacity are among the functions most easily influenced by posture” stated Norman Shealy MD.

Seek out Chiropractic care not because you have back pain, seek out chiropractic care for true health. When you have good posture you have more than a healthly look, you have a healthy body!

Dr.Terry Weyman is the clinic director at Chiropractic Sports Institute, wwww.gotcsi.com

“The Foot bone is connected to the Thigh bone…”

By: Dr. Terry Weyman

Come on everybody, sing alone, “the thigh bone is connected to the, hip bone”! As fun as that song was, there is so much truth to it. As humans, our skeletal frame is kinetic, which means it’s all connected and moves as a whole unit. As with a race car or a bike, the more aligned it is the better it moves. The more you understand this concept, the more you can put it to use when it comes to your health and athletic performance.

Fall is here and that means school sports are upon us. The football fields are in full swing, the soccer fields are packed, Cycling is at its best and the Dew Tour is in full swing for the action sport athletes. One thing all these sports have in common is balance and lower body coordination. For ultimate balance you need to look down, down to your feet.

Our feet are the foundation to our physical movement and balance. The feet are the first joints that withstand forces thru our body during movement. These forces, if altered, can cause a dramatic effect on how the rest of the body is going to move, leading to different pain syndromes. If the foundation is not able to stabilize the rest of the body, then it is not long before we start to see wear and tear on other parts of the body.

To understand how the foot is working we need to look at the Gait Cycle. The Gait Cycle is a term that represents the period of time between successive ipsilateral(same side) heel strikes; that is, it begins when the heel first strikes the ground and ends the moment that the same heel strikes the ground with the next step. So what happens to the foot that can cause pain during the gait cycle? Two of the most important motions that occur during the gait cycle are pronation and supination.

Pronation refers to the inward roll of the foot during normal motion and occurs as the outer edge of the heel strikes the ground and the foot rolls inward and flattens out. A moderate amount of pronation is required for the foot to function properly, however damage and injury can occur during excessive pronation, more commonly know as hyperpronation. An easy way to check if you are hyperpronating is to look at the back of the Achilles tendons. If they are bowing inwards, you are hyperpronating! Also look at your shoes, either dress or athletic, look at the wear pattern and see if it is even with the other foot. Is there excessive wear or is the bottom of the shoe wearing evenly. If your foot pronates excessively then this will flatten out the arch and stretches the muscles, tendons, and ligaments underneath the foot. This condition leads to Achilles tendonitis, plantar fascitis, medial knee pain, lateral hip pain (bursitis and ITB syndrome) and lower back pain.

Supination is the opposite of pronation and refers to the outward roll of the foot during normal motion. A natural amount of supination occurs during the push-off phase of the running gait as the heel lifts off the ground and the forefoot and toes are used to propel the body forward. However, excessive supination, which is called hypersupination (excessive outward rolling) places a large strain on the muscles and tendons that stabilize the ankle, and can lead to chronic ankle sprains.


Prevention and Treatment

1)A comprehensive gait analysis must be done to determine if your foot is either over pronating or supinating. Have a skilled Doctor watch you walk, evaluate your shoes, check your alignment to insure your kinetic chain is functioning at its best

2) Specific Biomechanical adjustments to the foot, ankle, knee, and low back to help restore normal motion through out the body.

3)Specifically made orthotics (if needed) are tailored to your foot and to the kind of activities you like to participate in. Sometimes, just changing shoes or an over the counter insert is fine, but make sure the selection is right for your condition.

4) Specific exercise and stretches to help restore strength and flexibility to the Foot. DON’T forget this step. The lower body must be given proper therapy to achieve specific goals for your sport. Old patterns must be broken and new proprioceptive goals must be achieved for ultimate success.

Taking care of your feet and fixing any of the above biomechanical faults, maybe the most important goal to achieve maximum output for your sport. If you’re experiencing any of the above symptoms, please, listen to your body, and don’t wait for it to lead to something else.

Dr. Terry Weyman is the clinic Director of the Chiropractic Sports Institute and is the Sports Chiropractor on staff at Pepperdine University in the Athletic Training room. For More information go to CSI website at www.gotcsi.com