So my husband is a pro strongman and was competing this weekend. He ruptured his Achilles. As a high caliber athlete, he’s gonna want to push the recovery and I want to do everything I can for him to come back better and stronger. I know he’s not Aaron Rodgers, but I’m wondering about his approach. The doc who is doing the surgery is an NFL level surgeon so knows the load that will go back on his Achilles. Share with me your tips and tricks for pre and post Achilles repair.

Thursday night lights. Myself and the doc on scene were not able to reduce this player’s dislocation. 1st question: would you try to reduce this before a doc tried if you knew how to properly? We were at an away game and the other team’s doc was luckily onsite. He also happened to be an elbow specialist. We went back to the locker room, try multiple attempts, and elected to send him to the ER. Very strong musculature so couldn’t reduce it without sedation. I got word for the mom that they still hadn’t been able to reduce it under mild sedation. Since he’s 17, they had to transfer him to a peds hospital. I’ll update as I know more. Question 2: what are your thoughts on reducing dislocations? I’ve heard many opinions on this from ATs and docs.

Quick update on the professional basketball player I previously posted about with the chronic right SI-region pain following a fall. We’ve gotten some new information that has made the case more interesting. He had an MRI reviewed by his physician, which showed L5-S1 disc degeneration and a disc tear. The physician said it’s difficult to determine whether his symptoms are referred from the L5-S1 region or coming from the SI/sacral region. They recommended an epidural for now, with PRP potentially being considered later if that doesn’t help. His symptom presentation has also changed quite a bit. Initially, his pain was primarily right-sided low sacral/SI pain, but recently he has felt it on the left side, and after a harder workout it became more caudal, almost down toward the tailbone, along with some deep pelvic-floor discomfort. He says he can’t really pinpoint one exact location anymore. A few other findings: - No pain with lumbar flexion or extension - Significant right lower-back tightness with a left thoracic-locked/lumbar extension-rotation position - Approximately 50° vs 20° compared to the opposite side in that position - Still significant right hip IR restriction - Right hip adduction is 5° vs 20° on the left - Leg-length/pelvic presentation changes quickly with MET - We did some soft-tissue work around the SI region, and he said he felt a little better the next time he played The big question I’m trying to work through now is: How would you guys differentiate L5-S1 referred/discogenic pain from SI/sacral pain in a case like this, especially when the symptoms are diffuse and seem to move around? And how much weight would you put on the fact that lumbar flexion/extension are completely pain-free, but he has a significant asymmetrical restriction/tightness response with the thoracic-locked lumbar rotation position? Would love to hear what you guys would test next and what findings would make you lean more toward lumbar/discogenic vs SI vs hip/pelvic/sacral contribution.

In your careers and experiences, are there specific continuing education courses that you found beneficial for advancing your clinical care? Here are a few that helped me along the way: 1. Active Release Technique (ART) - Since manual therapy is apart of my background (especially with Muscle Energy Technique from MSU), having a way of addressing soft tissue adhesions is quite beneficial. 2. Champion Performance Specialist (C-PS) - Mike Reinold’s C-PS course was superb in assessing movement, identifying movement abnormalities, having a plan to address movement abnormalities (some may call them dysfunctions), and progressions for the fundamental movement patterns (squat, lunge, rotation, gait, hinge, push, and pull). If you haven’t already done so, go seek out Mike Reinold’s content on social media. 3. Personalized Blood Flow Recovery (PBFR) - Owens Recovery Science helped start BFR and it has helped me tremendously for gaining strength (especially rehabilitating from surgery). There seems to be more literature coming out on passive BFR, which can be done post-surgery. I am genuinely curious to see what has helped everyone in their careers. If you want to include books or specific podcasts you found beneficial, feel free to add it.

Working with a professional basketball player with a couple month history of SI joint pain on his right side after a hard fall, even feels random painful tensing down into his pelvic floor. Not my area of expertise but wanting to help him out as best as I can. Any advice guys?