Well we all know by now that Steven Stamkos is having surgery to repair a broken leg. What we don't know is where the break is or how severe the break is. Those two factors will be the determining factors in his time frame for recovery. It is not going to be his work rate or desire that slows him down. It will be his body's ability to heal and repair from the surgery and knit that tibia back together.

Obviously Stamkos wants to get back on the ice for the Olympics and for his Tampa Bay Lightning. To do so is a tiny timeframe, Inside 3 months, only just but still it is only 3 months. He is asking for a perfect surgery and perfect repair then a perfect, fast rehab. Not saying it cannot be done, just saying the odds are stacked against him.

Steve Yzerman has a tough balancing act here, as the GM of the Tampa Bay Lightning he needs to make sure Stamkos is able to recover 100% for the rest of his career, coming back early and not letting a broken leg heal fully will limit the amount of force Stamkos can put through his leg. If Stamkos is looking to add strength and power to his lower body post injury and the bone is not fully healed, well complications are going to occur.

Then again, as GM of Team Canada he will want Stamkos in Sochi, even at 90% he is going to be an important part of the team. Canada are not short on world class centers though, so Yzerman may want to look at taking only 'healthy' players as his get out of jail free card for Stamkos. It would keep his Tampa assest in cotton wool and allow Team Canada to take a healthy alternative.

As I stated earlier if Stamkos comes back before he has completely mended in that tibia then he is going to cause problems later on in his career. I am under the assumption he is smart enough to realise that, and if he is too determined to get back on the ice to his own detriment, then the family, friends, and his agent should be making him aware there is more than one Olympics.

One of the first issues in Stamkos' recover is his time in his cast. 12-16 weeks is the norm, well the norm for us mortals who don't play professional sports. One thing I have noticed about athletes is due to their heaiver body composition their bones are generally stronger. The extra muscle mass they carry force their bones to be stronger, it is one of the reasons older people are encouraged to lift weights or continue to be very physically active, it helps stave off broken hips and shoulders and osteoperosis. Stamkos could be luck and be out of the cast in 8 weeks, that would give him 4 weeks to relearn how to walk, flex his foot, and squat normally again. Then he has to skate again, trust it, and get his skating stride back with the same power he had prior to the injury.

The more I go through this, the less likely I feel he will be on the ice at the Olympics. Honestly I hope I am wrong.

The broken tibia can rehabilitation can be treated very similarly to ankle surgery recovery. Rob Scuderi is going through this at the moment, the reason for the simalarities is the immobilisation of the ankle joint. It basically renders the calf muscle obsolete until the foot is allowed out of the cast. You can imagine how much muscle atrophy an athlete can have after having a muscle inactive for 8-16 weeks in a cast, the longer Stamkos is in a cast or moon boot the longer it will take to regenerate all that muscle and power in his right calf, quad, hamstring, and glute.

One thing that will help Stamkos with his recovery will be his diet, making sure he is eating a high protien diet will help his body to regenerate, obviously lots of calcium for his bones is essential too. I'm not too sure if it will make him heal faster or just make sure the repair is stronger, but giving his body the best fuel to repair is going to be the most important thing Stamkos can do whilst in his cast.

I am giong to repost the ankle rehabilitation that I listed for Scuderi, they are designed to cover the same issues, the ankle joint is the joint that has been immobilised and getting plantar and dorsi flection through that point is essential to Stamkos getting back in the gym and beingn able to squat and complete calf raises to gather his strength back.

Rehabilitation Exercises

Range of Motion Exercises

All exercises (except The Alphabet) should be performed while sitting on the floor or another flat surface with legs fully extended, knees straight, out in front. Each exercise should be performed 10 times in a row.

Dorsiflexion

  1. Moving only the ankle, point the foot back toward your nose (while keeping knees straight). Continue until discomfort or can't tilt it back any further.
  2. Hold this position for 15 seconds.
  3. Return to neutral position.

Plantar flexion

  1. Moving only the ankle, point foot forward (while keeping knees straight). Continue until discomfort or can't move it any further.
  2. Hold this position for 15 seconds.
  3. Return to neutral position.

Inversion

  1. Moving only the ankle and keeping toes pointed up, turn foot inward, so the sole is facing other leg. Continue until either discomfort is felt or until foot cannot turn inward.
  2. Hold this position for 15 seconds.
  3. Return to neutral position.

Eversion

  1. Moving only the ankle and keeping toes pointed up, turn foot outward, away from other leg. Continue until either discomfort is felt or until foot cannot turn outward.
  2. Hold this position for 15 seconds.
  3. Return to neutral position.

The Alphabet

  1. Sit on a chair with foot dangling in the air.
  2. Draw the alphabet one letter at a time by moving the injured ankle and using the big toe as a "pencil."

 

Isometric Strengthening Exercises

These exercises to strengthen the muscles around the ankle. This will provided added support to the joint. Each exercise should be repeated between 5 and 10 times; increase the number of repetitions as it gets stronger.

Eversion Isometrics

  1. While seated, place the outside of the injured foot against a table leg or closed door.
  2. Push outward with the foot into the object the foot is against (the ankle joint should not move) causing a contraction of muscles.
  3. Hold this muscle contraction for 15 seconds.
  4. Relax for 10 seconds.

Inversion Isometrics

  1. While seated, place the inside of the injured foot against a table leg or closed door.
  2. Push inward with the foot into the object the foot is against (the ankle joint should not move) causing a contraction of muscles.
  3. Hold this muscle contraction for 15 seconds.
  4. Relax for 10 seconds.

Resisted Strengthening Exercises

These exercises will also work to strengthen the muscles around the ankle. This will provided added support to the joint.

Each exercise should be performed with a Theraband providing resistance to the movements. Perform each exercise 10 times in a row.

Dorsiflexion

  1. Moving only the ankle, point the foot back toward your nose (while keeping knees straight). Continue until discomfort or can't tilt it back any further.
  2. Hold this position for 15 seconds.
  3. Return to neutral position.

Plantar flexion

  1. Moving only the ankle, point the foot forward (while keeping knees straight). Continue until discomfort or can't move it any further.
  2. Hold this position for 15 seconds.
  3. Return to neutral position.

Inversion

  1. Moving only the ankle and keeping toes pointed up, turn foot inward, so the sole is facing other leg. Continue until either discomfort is felt or foot can no longer turn inward.
  2. Hold this position for 15 seconds.
  3. Return to neutral position.

Eversion

  1. Moving only ankle and keeping toes pointed up, turn foot outward, away from other leg. Continue until either discomfort is felt or foot can no longer turn outward.
  2. Hold this position for 15 seconds.
  3. Return to neutral position.

Partial Weight-Bearing Exercises

These exercises will help put more weight on the injured foot as well as strengthen it. Each one should be performed 10 times in a row.

Seated Calf Raise

  1. Sit in a chair with the injured foot on the floor.
  2. Lift heel as far as possible while keeping toes on the floor.
  3. Return heel to the floor.

Single Leg Stand

  1. Stand upright while holding onto a stable object.
  2. Shift some weight onto the injured foot.
  3. Hold the position for 15 seconds.
  4. Relax and put weight back onto uninjured foot.

Full Weight-Bearing Exercises

These exercises will help put more weight on the injured foot as well as strengthen it. Perform each one 10 times in a row.

Single Leg Stance

  1. Stand on the injured foot while lifting the uninjured foot off the ground.
  2. Hold the position for 15 seconds.
  3. Relax and put weight back onto uninjured foot.

Standing Calf Raise

  1. Stand on the injured foot while lifting the uninjured foot off the ground.
  2. Raise up, standing only on the ball of the injured foot and lifting heel off the ground.
  3. Hold the position for 15 seconds.
  4. Relax and put weight back onto your uninjured foot.

Lateral Stepping

(Increase the speed of this exercise as healing progresses.)

  1. Place a rolled towel or short object on the ground to the side of injured foot.
  2. Step over the towel with the injured foot and remain on that foot.
  3. Then bring the uninjured foot over the object and stand on both feet.
  4. Step back over the towel with the uninjured foot and remain on that foot.
  5. Then bring the injured foot back over the towel and stand on both feet.

Lateral Jump

(Increase the speed of this exercise as healing progresses.)

  1. Place a rolled towel or short object on the ground to the side of injured foot.
  2. Hop over the towel and land on the injured foot.
  3. Then hop back over the towel and land on the uninjured foot.

 Balance Activities

Towards the end of rehabilitation performing balance activities is an important way to prevent future injury. Perform this exercise 10 times in a row.

Single Leg Stance on a Towel

  1. Fold a towel into a small rectangle and place on the ground.
  2. Stand with the injured foot on the towel.
  3. Lift the uninjured leg off the ground standing only on the towel with the injured leg.
  4. Hold for 15 seconds. (As balance improves, increase stance time on injured leg up to 45 seconds.)
  5. Return uninjured foot to the floor.

From here Stamkos will have to get back into squatting, deadlifting and lunging. It will almost be like starting again back in his rookie year, his lifting pattern and power will be lost, it is going to be a lot of work. I really have laid out the longest process here, I have watched a player here in the AFL come back too early from a broken leg and watched him fall short of his full potential due to complications the rest of the playing career, the NHL, us as fans, and most importantly, Steven Stamkos deserves a different fate. 

Refrences

http://orthoinfo.aaos.org/topic.cfm?topic=A00522

 

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