Help For My Dad.

He’s in his late 50’s and just starting to work out, He recently quit smoking and is beginning to lift and swim in order to improve his type II diabetes.

I have given him some general ideas and pointed him in the right direction, but one of the major hurdles here is that he was in a motorcycle accident last year, and has limited motion and extreme pain in his hands and one of his knees. I have him doing partial range of motion body weight squats, and I’m not really sure what to do for his hands.

The main reason for posting this is that I am considering getting him professional training for christmas. I really want to encourage him, but I’m not sure who would be best to hire for him, given his circumstances. I was hoping T-Nation would have some good suggestions in this regard.

Thanks!

No one has any suggestions? To restate I am looking for someone to help my dad with an injury sensitive training program.

Thanks.

Sorry you haven’t got more help, but don’t you think you should get the professional judgement already before you decide on the type of exercises?

I would suggest a visit to a sports physician followed by whatever exercise programme he proposes.

Look, this is my first post here, and I am out-of-shape and recovering from some injuries myself - though of different type and severity than your dad’s. I am also most definitely not a physician, physical therapist, personal trainer, or elite athlete. There you go, full disclosure - I will give what advice I feel I in good conscience can, and leave it to those who know better to augment or contradict what I say:

You don’t mention specifically the sorts of injuries your dad has, only that he has “extreme pain and limited range of motion in his hands and one of his knees,” due to his motorcycle accident. You also don’t mention what sort of treatment/diagnoses he’s received thus far. If he has nerve damage in his hands, for instance, the implications might be different than if he just had a lot of scar-tissue. It would make a difference if he?s torn up the cartilage or ligaments in/around his wrists vs. if he just broke some bones.

From the limited amount that you say here, and also because the hands/wrists are much more complex than the knee, those are the injuries that worry me more. Further, your hands are your interface with weights in most resistance exercises (as well as other things in most day-to-day activities)… I’m sure you see where I’m going with this.

The first thing I would do is see ? if you haven’t already, and maybe even if you have ? a good physician. A good physician in this case is one who not only knows his or her shit, but one who is sympathetic to the goals of athletes in general and to you and your dad in particular.

It has been my experience that a lot of physicians treat running, lifting, swimming ? anything out of the “ordinary” that might cause someone to strain something in some way ? as a disease. These are the same people who, if an opera singer came in to them and said, “Doc, my throat ? it hurts when I sing,” would say, “Stop singing.” They miss the point ?

the point being to help people to be active and to do the things they enjoy (even if not in exactly the same way as before), not to make them feel like fucking cripples and the things they love out to be diseases.

A good physician will also coordinate with the specialists (physical therapists, surgeons if necessary) whose job it will be to get Dad through the tough process of going from being put back in one piece to working like everything’s of a piece.

I saw my own dad do this after a shoulder surgery, and it was friggin’ hard. Took him two years to regain most of his shoulder function/strength/ROM, and he was at it relentlessly, every day, like a machine. I went through it myself post knee-surgery (and am still, to a small extent), and I can tell you that even with good people working with you, a major - if not the primary - factor in success is the patient?s belief in himself and determination.

Still, you want good people working with you. When I hurt my knee, I called up the office of the local pro hockey team. Left messages, talked to secretaries - eventually, the manager called me back. I found out who they used for knee surgeries, physical therapy, and that?s who I went to. You can also ask physicians/surgeons/PTs for patient references - that is, you can talk to a patient/client with whom they’ve worked and see how they liked them.

If you are anywhere near the Chicago area, this place is supposed to be among the best in the world:
www.ric.org/about/

They deal with athletes, dancers, and performing artists - including musicians - so they have an intimate understanding of big stuff like knees and intricate stuff like hands.

Even if you can’t go there, you should check out their site ? anyone in a boat like your dad’s should ? they have lots of good info.

It sounds to me - though, again, I?m working from limited info - like your dad would benefit from that more than from your typical personal trainer. I could be wrong, though, and maybe you’ve already gone that route. A really knowledgeable personal trainer might be able to help him a great deal - but be picky in choosing one. Tell him/her your dad’s situation, and see how they react.

Finally, it is good to do some reading/research on your own. With my knee, for instance, the PT was helpful. Probably necessary. But after a point I didn’t see improvements with it. I started researching articles on my own and have had good luck with incorporating lateral resistance (for example, monster walks and sideways shuffles with a strong elastic band around my ankles) and, recently, things like split-squats (which I read about here) into my exercise regimen.

They?ve strengthened and stabilized my knee a lot, and I?ve been able to start running again (albeit in a limited fashion ? for now).

Years and years ago, before I knew anything about PT or how fucked up our medical system is, I developed pretty bad tendonitis/carpal tunnel syndrome in both of my wrists. (I am a musician, and I use my hands a LOT in that and at school and in work).

When it was just a tingle and some slight weakness and I wasn’t sure what was going wrong, the doc sent me to a specialist who stuck a needle through my bicep, measured the current traveling down my arm, and told me I was ?within normal levels?.

That was it, as far as he was concerned, nothing was wrong with me. I told him that I knew something was, because my hands felt clumsy and weak, and hurt sometimes when I played the bass. He said, deadpan, “So stop playing the bass.” He didn?t give a fuck.

So, I stayed away from the medical community after that (I was 18). When things got much worse afterward and I could no longer avoid going to the doctor, all they did was put my hand in a rigid brace and told me to stop doing everything ? no pushups, no pullups, no weights, no volleyball, no music for the rest of your life. I was miserable, and my hands became really weak and injury prone (because they were so weak).

I suffered like this for close to two years before I said ?fuck what they say,? did my own research, and designed a rehab program for myself. It took a long time, but today I?m 95% percent free of any symptoms of wrist-tendonitis and, whatever my other failings/injuries, do not lack for either manual dexterity or grip strength.

Okay, I strayed off-course with those last two paragraphs of personal rant, but they do underscore the importance of finding an athletic-minded doctor/PT.

Other things at random:
Outside Magazine recently had ran an article of several pages titled ?Bombproof your Knees? or ?Build Bulletproof Knees? or something like that. You might try searching online for it or seeing if your local library has it.

Eric Cressey and Mike Robertson here (there may be more, but as a noob, those are the two I know) have written several articles that might be helpful here.

With my dad?s shoulder and my knee ? and anything, really, it seems like you?ve got to ?massage the extremes? ? you can?t blow past your current safe/comfortable ROM without injuring yourself, but if you don?t push it at least a little, it will never increase.

I?ve only recently started squatting again (baby weights) and when I started, it felt like I?d never get below 45 degrees above parallel ? not without severely rounding my back ? but I?ve pushed it just a tiny bit every time and, several months later, I go down to maybe 5 degrees above parallel with good form. I figure I?ll break parallel in the next month or two, and then start going below.

That?s nothing special with 135 on your back, I know, but they?ll be real squats, and then I can start adding plates (I could only use the bar a few months back).

Incidentally, in addition to the knee (which is improving), I am also re-habbing a shoulder and a back injury. I feel like I?m making progress with the back? shoulder?s slow going, but I think I?m making progress there, too, if not as quickly as w/knee and back.

You might also check out deep-tissue massage, ultrasound, or even acupuncture if your dad?s got lots of scar-tissue (I?m speculating here ? never tried the last two).

That?s everything I know and then some. It?s 5:00 AM here and I?ve got a shitload of homework to do.

Good luck. I won?t be playing internet-jockey again ?til after finals in a couple weeks, so see you then.

P.S. I typed this in Word then pasted here – don’t know why lots of punctuation’s been replaced with numbers.

I don’t know about bad knees, but for problem hands, you might want to try straps from flexsolate.com. I’ve not tried them, but it looks like they might do what you want. You don’t use your grip when you use them, so it should take the hands out of the exercise.

You never mentioned his weight. If he is fat, you should work on that first. Losing the extra weight and improving his diet will do more to help his diabetes than lifting. For aerobic and strength conditioning, swimming is the ticket.

Sounds like your dad needs some rehab work before hitting the weights. Do like the other said and get him medically evaluated by an osteopath or sport medicine doctor. In my uneducated opinion, a few months in the pool doing laps and some walking is where you should take him first.

Mike Robertson article: “18 Tips to Bulletproof Knees”.

http://www.T-Nation.com/readTopic.do?id=1127149

When I did PT for my knee, there was some pool-work initially – ham and quad exercises (like standing one-leg extensions/curls) and simply walking forward, backward, and side-to-side against resistance of the water. There were some others, but those were the core of the water-work (prelude to work on land).

He’s past the point of going through normal physical therapy, his doctor didn’t proscribe an ongoing rehab plan. He is 6’1 and approximately 170lbs and his diet is pretty good.

He just started working out and told me he was having pain when he did certain things and I want to find a trainer who can help him develop a program and work towards his goals while accomodating for his circumstances.

Thanks for the replies.

I am sure there are more programs than ?Z? health, but it is a good one. I bought the DVD, and do not do it exactly but I have bastardized the program. It has really helped my range of motion. I do it on my off days. You have to tell your father to enjoy his workout so he does not get discouraged. Good luck to you and your Father

If you Google for “How to choose a personal trainer” you’ll find lots of articles that will help you choose the right trainer for your situation. Read five or six of them and you’ll see trends like “checking creditials” “asking for references” etc.