We recently teamed up with Think Head First, a local organization formed specifically around concussion awareness and management, to create our own concussion recovery program.

Check out this video, featuring our very own physical therapist Karen Procino, talking about the HB204 and our new program.

Jason Morgan, ASM Personal Trainer, Doing What Comes Natural.

strength and conditioning. I love working with developmental athletes, and this past winter I had a great opportunity to combine my love of baseball with my knowledge of strength and conditioning.

Throughout the course of this winter and spring I worked with the members of Park City High School’s baseball team as their strength and conditioning coach. We started the off-season workouts in December with a movement screen and analysis of each player, which gave us the information needed to develop an individualized program. After reviewing the results of the screenings, I came up with a set of goals, that included increasing hip mobility, core stability and power in each athlete, which would allow them to develop baseball specific skills more effectively. However, given the various age and developmental differences that occur within a group of teenaged athletes, this was no easy task.

I’ve never been a big fan of loading a teenager with heavy weights, mostly because they are still growing and I would rather emphasize proper technique at this point in their development. With this in mind, the majority of the exercises we performed were compound movements that utilized body weight and focused on completing entire range of motions with perfect technique. I designed the training program so that I would slowly increase the load added to each movement while decreasing the volume of sets and repetitions performed. This concept is crucial to safely and effectively progress an athlete through the multiple phases of a program (hypertrophy, strength, power and speed). To compliment the work we were doing in the weight room, I also had the players working on speed and agility multiple days a week. Baseball is a sport that consists of short bursts of very intense movements that are primarily reactive in nature, so it is crucial to not only work on pure foot speed, but speed as a function of reaction time. Our speed and agility drills were all designed around the athlete reacting to a stimulus, which would better represent game type situations (stealing bases, advancing on a passed ball, tracking balls in the field…)

At this point in the season, it’s safe to say that the training program was a success; The Miners are all noticeably bigger, stronger and faster than they were last season. They have shown significant improvement in every major category, including: home runs, doubles, stolen bases, batting average and slugging percentage. Defensively, the improvement in athleticism has allowed the boys to stay healthy and make plays that they were unable to make last season. Overall, I am very pleased with the work we did, and I can’t wait to continue with the next crop of up and coming players.

I have now crossed the 6 month mark post operatively from my bilateral knee replacements. It sure has been a long winter…in many, many ways! Surgery at the end of October, and 3 unanticipated bilateral knee manipulations over the course of the following 6 months! I would definitely say that I have not had a smooth, or normal recovery from my knee replacements. I do feel as if I lost about 3 months time throughout my recovery due to the pain and unexpected Range of motion issues I encountered.

Basically, even though I am now 6 months out of surgery, I feel as if I am realistically at about 3 months out if things had gone smoothly. The root of my problem has been a really tight fit with my new knee joints. In the long-term, this should be a good thing and I should end up with good, solid, stable knee joints. The problem that I have encountered ( and am still dealing with) has been my soft tissue structures surrounding my knee joints have been subjected to a constant stretch. (muscles, tendons, ligaments,capsule,etc) Basically, my soft tissue structures have been under a constant pull and simply have not accommodated to the new length created with my new replaced knee joints. I do feel as if I can ride out the storm and give it more time that things will work themselves out and both my knees will accommodate to the new length. This “tight fit ” issue has caused me to have pretty constant knee pain and a lot of difficulty with the range of motion of my knees.

As time went by this past winter, my primary focus was on maintaining and improving my knee Range of Motion. I had to put strengthening on hold until my Range of Motion was adequate. Currently, my knees are still very painful and stiff, but at least my Range of Motion is at a functional level. I am back working my normal daily schedule, helping coach my daughters Lacrosse team and now that the weather has finally started to improve, riding my road bike fairly consistently. I can spin without pain, but hills are still painful, especially when I stand and pedal. But I feel as if bicycling this Summer and Fall is really going to be the difference maker for me. I have already pledged to make this summer my ” comeback year on the bikes”!

Even though it still hurts, I am not going to stop! My ultimate goal is to return playing routine adult rec ice hockey! I am ready to gut it out for the long haul to be able to get myself back skating again. Anyway, I hope to see you all out this summer on the road bike or on the trails mountain biking. Right now I am not too tough to spot… I am the slow guy……but getting faster everyday!

Mark

She graduated from Daemen College in Buffalo, New York in 1994 and moved to Salt Lake City that same winter (and yes, she moved here to ski). She worked at a Skilled Nursing Facility along with doing home health care before she changed paths and started work at St. Mark’s Hospital. Here she spent several years working on the surgical and medical floors as well as the TCC. In 2004 she moved to IHC’s Outpatient Neuro Rehabilition clinic in Salt Lake where she worked with patients with various neurological diagnosis including CVA (stroke), Multiple Sclerosis, balance disorders, and patients needing general conditioning. She focused on fall prevention and high level functional activities from the young to the geriatric population.

She came to Alpine Sports Medicine in 2006 to further her experience and career as a physical therapist in the

Karen Trail Running Above Main St. Park City

orthopedic setting. Here she works with patients of all ages to maximize their safe and successful return to sport, work, life and health. She also continues to work with patients with neurologic rehabilitation needs.

She is married with 2 boys and moved to Park City in 2002 for the outdoor lifestyle and quality of life.  You’ll probably see her out on the trails of Round Valley  this summer running.

I am still struggling in choppy waters!  My knees are very stiff and tight with limited range of motion. This is still causing me difficulty with walking, negotiating stairs, and even sitting in a chair.  It has been very frustrating to be working my knees very consistently, yet not make any progress in the range of motion department.  After consulting with my surgeon, I underwent a bilateral manipulation under light general anesthesia nearly 4 weeks ago.  My surgeon was able to achieve 130 degrees of knee flexion bilaterally in the Operating Room with  manipulation.   immediately after, I went right to Alpine Sports Medicine to begin my Physical Therapy regimen. I utilized a CPM machine set at 0-120 degrees at home as much in the daytime as I could and at night while trying to sleep. The best I was able to get was 130 degrees on my better knee and 120 degrees on my worse knee.  Both my knees have since stiffened up  and I am currently in the 100 degree ball park with my better knee cold and 115 degrees warmed up and stretched out.  My worse knee is about 90 degrees cold and 100 degrees warmed up and stretched out.

I am still having a significant amount of pain and discomfort associated with my knees as well. I am still utilizing pain meds 2 x daily, otherwise I can hardly move my knees are so stiff and hurt so much.  My daily routine consists of waking up at 5:45 am and stationary cycling 1 hour daily, knee Range of Motion and  stretching exercises. I also jump back on the bike in the afternoon and evening for 10-15 minutes as well. I am performing resistance exercises 3 x weekly, but I feel that I can’t proceed full speed ahead with strength exercises while I am still having so much difficulty with my knee-joint ROM.

I am still not back at work yet treating patients. My original plan was to return to work after 6 weeks. I am now almost 12 weeks out and still feel as if I am not capable of returning to work in my usual capacity. If I only had a desk job, it would be no problem at all. But with all the up and down, running around, standing, kneeling and walking required with my job as a physical therapist, I still feel that I am not ready. I am very concerned that my knees will stiffen up even more!  I am returning for a consult with my surgeon in two weeks. There just might be another manipulation in my near future.

This has definitely been the most challenging recovery I have gone through in my career of 12 knee surgeries. I know it will all work out in the long-term and I am willing to make any short-term sacrifices necessary to achieve a good long-term result. My experiences throughout my own rehabilitation are serving as a good reminder of what many of my patients have to deal with on a daily basis. It really is a good example of how everyone’s body reacts differently.  I will try my best to keep chugging forward and hope I can return back to work soon! I will update you all again following my consult with my physician!

I was a bit nervous about volunteering for an event on such a large-scale as course driver. I did not want to make a mistake (i.e. wrong turn and end up on ESPN Sports Center every hour- Thank god that did not happen). I believe I volunteered via the Tour of Utah web page in April stating the times and dates in would be available to help. I receive my first e-mail from John Cotter in early July describing my preliminary assignments, duties and important training dates, along with asking for more volunteer time if able. I went from 1 day to 3 days as a volunteer. Several dates were provided to attend training that accommodated my schedule. My initial training consisted of an introduction of the Tour organizers and there roles, safety education and breakout groups with the organizers to go over our roles in more specific detail. My second, meeting was the Race Director and Caravan Coordinator. It was mind-blowing all the information that was provided for the safety of the rides, community, course motorcycles and drivers. As a cycling enthusiast who has seen the Tour de France on TV many times I never knew how much behind the seen coordination must go on a daily basis to orchestrate a safe race. I now have a little richer appreciation of all the Grand Tour races.

An estimated 10,000 people came out to support an Epic bike race on Main Street. Park City fans are the BEST. It was great to see some of the local rides perform at such a high level. Rides like Brad Gehrig, Todd Hageman, Billy Demong, Burke Swindelhurst, Jeff Louder to name a few. The future is bright for the Tour of Utah. I only hope that big name racers like Leipheimer, Mancebo, Hincapie and others continue to come and support a great Utah race.

Just a quick update on my progress > I was able to get rid of the forearm crutches exactly 2 weeks after my surgery. I was  also able to begin stretching out the doses of pain medicine at 2 weeks as well, from every 4 hours to every 8 hours. At Post op week 3, I was able to cut down the pain meds to 2 x daily. It is still difficult to get comfortable while sleeping. I usually wake up every couple of hours and try to get comfortable again. I have not been too concerned about the restless sleep because I still have not had to go back to work yet. If I need a nap during the afternoon before the kids get home from school……I can!  My staples were removed 3 weeks following surgery and the incisions are  now fully closed and I am able to soak my knees in the tub. The heavy feeling in my thighs is gradually reducing and I am achieving better quadricep control. I am now 4 weeks out of surgery and walking fairly well. The biggest problem that I am faced with is limited Range of Motion and stiffness in my knee that was replaced. I would still describe my left knee as feeling like “cement.”  I am having a very difficult time getting my knee to bend…. even just to 90 degrees! I have been working my ROM daily and have been have been stuck around 95 degrees. My world record is now 101 degrees but that is completely MAXED OUT. My quadriceps muscle feels as if it is going to rip off my quad tendon. With all my prior knee surgeries, I  have usually been on the tighter side and have always had to work hard to get my ROM (“Range of Motion” for those of us not in the business) back. However, this time is definitely the tightest and stiffest my knee has ever been! I have had to rely on assistance from Janna and Andrea to lean on me a little bit just to make any progress! I have been able to ride the stationary bicycle daily , but I still haven’t been able to get rid of a hip-hike on my left side when I get to the top of the pedal stroke. It still hurts to do it, but I suppose it is a hurt so good type of pain, I know that I need to do it. I still do not have great standing endurance yet. The longer I am on my feet, the more my knees swell, get stiff and hurt. Overall, I feel I am doing well….. just having a ROM problem at this point. I will keep you posted on my progress.

Until next time…