I've been in physical therapy for two weeks now. Since beginning weight bearing on July 22, following 7 weeks on crutches due to my pelvic (acetabulum) fracture, I've faced these challenges:
1. Right calf and arch weakness from non-weight bearing;
2. Left Achilles irritated from having my left leg do all the work for 7 weeks;
3. Walking with a limp due to difficulty straightening out my right leg and hip due a very tight hip joint;
4. Incredibly weak right hamstring and glutes.
To deal with 1 &2, I began a program of eccentric heel drops on both sides (http://fredippides.blogspot.com/p/since-oct-31-i-have-been-doing-twice.html) particularly to strengthen the calf and arch of the foot on the right; and at the same time to rehab the achilles on the left, and strength the achilles on the right to prepare for a return to running later this year. The right calf muscles were really weak at the start: I couldn't do a full set when I started out. Beginning with a set every other day, by the end of the first week the calf was extremely sore. The second week I started one set each day; the third week I began two a day sets. This week I have begun adding weight- 25lbs in a backpack. Its progressing nicely.
The more serious issue is 3&4- walking with a limp due to tight hip joint and weak/atrophied glutes and hamstrings.
My PT has had me doing the following exercise and stretches:
1. Two-leg Glute Bridges, 3 x 10, for the glutes, hamstrings and lower back: (http://backandneck.about.com/od/exerciseandsport/ht/Lower-Back-Exercise-Strengthening-Your-Back-With-The-Abdominal-Bridge.htm)
2. Standing hip clams with a rubber strap. Started with 3 x10; progressed to 3 x20; 2x daily.
3. Standing hip extension exercise with rubber strap: 3 x 10, 2x daily.
4. Supine Straight Leg Raises (3 x10, 2x daily).
5. Hamstring stretches- lying on my back, using a strip of webbing to pull my straight leg up, 3 x 30 sec, 2x daily.
6. Quad stretches lying on my stomach (prone), with strip of webbing looped around my foot to pull it up against my butt. 3 x 30 sec 2-3x daily
7. Calf stretches on ramp, 3 x 30 sec 2x daily.
7. This week: Started 1-leg Glute bridges.
The most difficult of the exercises above has been the glute bridges. It is somewhat akin to trying to wiggle my ears: my right glutes don't seem to want to "fire". The right glute is noticeably smaller than the left; I suspect the issue has to do with the surgical wound required to access the acetabulum to perform the ORIF surgery.
My PT has therefore directed me to do glute squeezes: Both glutes together, then one-sided. lying down --to keep the buttocks safely shielded from view for the benefit of all concerned -:). This seems to have been working as I am finally getting the right glute to "fire" and the muscle is sore. A good sign that I am finally getting access to the muscle to strengthen it.
I am no longer walking with a limp!
I will continue these exercises and assuming things continue to progress I will start walking in a month. My program will focus on walking through the fall and hopefully I'l be able to start running by Juanuary in preparation for the 2015 ultra season.