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  1. #101
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    Quote Originally Posted by ovoleg View Post
    Wait you broke yours on Sunday? I thought you already broke it before? Sorry to hear that man
    broke my clavicle late feb and my femur on Sunday. Was leading a stage race at the time.

    The he clavicle recovery experience, among others, helps me to be optimistic. To be racing in 4 weeks and riding well in 8 inspires confidence. Of course, every injury is different and there are no guarantees, but I order to assume remarkable stuff is possible.

    I also feel that there is always adversity along the way to bing a champion, and character is defined more by how those champions overcame it.

  2. #102
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    Quote Originally Posted by tetonrider View Post
    broke my clavicle late feb and my femur on Sunday. Was leading a stage race at the time.

    The he clavicle recovery experience, among others, helps me to be optimistic. To be racing in 4 weeks and riding well in 8 inspires confidence. Of course, every injury is different and there are no guarantees, but I order to assume remarkable stuff is possible.

    I also feel that there is always adversity along the way to bing a champion, and character is defined more by how those champions overcame it.
    like spelling? come on Teton, put the percosets down!

  3. #103
    fuggitivo solitario echappist's Avatar
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    nah, he's jsut taking editorial cues from jsut

  4. #104
    Powered by Borscht ovoleg's Avatar
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    Quote Originally Posted by tetonrider View Post
    broke my clavicle late feb and my femur on Sunday. Was leading a stage race at the time.

    The he clavicle recovery experience, among others, helps me to be optimistic. To be racing in 4 weeks and riding well in 8 inspires confidence. Of course, every injury is different and there are no guarantees, but I order to assume remarkable stuff is possible.

    I also feel that there is always adversity along the way to bing a champion, and character is defined more by how those champions overcame it.
    if you broke your femur, especially at the neck(most common), then prepare to be out for awhile. It's a major load bearing bone.

    Mental toughness is great, I've got quite a bit of it but my expectations have dropped significantly in the past few weeks. I just did another x-ray yesterday and the bone is still broken(2 weeks post-op). It's positioned well and still has the hardware but my doc was right, it's going to take at least 6 weeks for the bone to heal to the point where you can start putting pressure. To get the hardware in, they cut through your muscles, prepare for some rehab there as well.

    Add to that the fact that you haven't done any kind of load bearing or any kind of serious PT work for at least a good month.

    I think you and I are going to be out for some time, just face the facts and let the body heal. I've read that rushing back into it is just as bad as not doing anything to help rehab.
    -Cat-3-o-meter: TBD :/

  5. #105
    powered by Racer Ex gsteinb's Avatar
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    There's a particular point where the hard man approach is ill advised. My collar bone and the injuries I had associated with that crash had a relatively low level of risk of me training. Since it was all indoors and my injuries would be self limiting trying to do what I could do was of a great value mentally, and trying to stay race fit saved my summer. I won races again in pretty short order…considering I was in icu it was a significant come back.

    When I broke my elbow it was an an entirely different set of circumstances. If I had some sort of set back it could impede normal movement of my dominant arm forever. There was no way I wasn't going to follow the very letter of what professionals thought. There was no upside to it. I wasn't racing again that season and there was no reason to push it.

    Forcing recovery in a circumstance where permanent damage could be done is a particularly bad idea. Ascertaining the difference takes an element of wisdom and confidence in ones doctors. In cases where rushing a comeback is ill advised, work on your therapy. Set goals. Eat healthy. Dream of racing again. It's not different than training for a race. I took PT really serious, and it paid dividends. I could have just as easily had a permanently fubared arm and not racing.

  6. #106
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    Quote Originally Posted by ovoleg View Post
    if you broke your femur, especially at the neck(most common), then prepare to be out for awhile. It's a major load bearing bone.

    Mental toughness is great, I've got quite a bit of it but my expectations have dropped significantly in the past few weeks. I just did another x-ray yesterday and the bone is still broken(2 weeks post-op). It's positioned well and still has the hardware but my doc was right, it's going to take at least 6 weeks for the bone to heal to the point where you can start putting pressure. To get the hardware in, they cut through your muscles, prepare for some rehab there as well.

    Add to that the fact that you haven't done any kind of load bearing or any kind of serious PT work for at least a good month.

    I think you and I are going to be out for some time, just face the facts and let the body heal. I've read that rushing back into it is just as bad as not doing anything to help rehab.
    hey, ovoleg -- thanks. i respect your opinion and your injury.

    every injury is different, of course. i have been able to bear weight as of 12 hours post-op (doctor's advice), and per his phone call to me last night i have zero restrictions; pain is my guide. (i have other bone bruising and such from just taking a beating, but that is not stuff that compromises healing of my bone.)

    in fact, my doctor and the other folks i work with in treating these injuries share the opinion that improving circulation is a good thing, and a bit of exercise always helps. sometimes one just can't pedal a bike, so one figures out other ways to exercise. as for me, i've just set up my trainer and am going to see if i can spin a bit today, even if for 5 minutes.

    as for me, short of getting hit by a truck, there is nothing that will knock my hardware out, based on where it is. i could fall out of my chair here and it would be ok.

    no one should push beyond what they and their trusted advisors feel comfortable with.

    Quote Originally Posted by gsteinb View Post
    There's a particular point where the hard man approach is ill advised. My collar bone and the injuries I had associated with that crash had a relatively low level of risk of me training. Since it was all indoors and my injuries would be self limiting trying to do what I could do was of a great value mentally, and trying to stay race fit saved my summer. I won races again in pretty short order…considering I was in icu it was a significant come back.

    When I broke my elbow it was an an entirely different set of circumstances. If I had some sort of set back it could impede normal movement of my dominant arm forever. There was no way I wasn't going to follow the very letter of what professionals thought. There was no upside to it. I wasn't racing again that season and there was no reason to push it.

    Forcing recovery in a circumstance where permanent damage could be done is a particularly bad idea. Ascertaining the difference takes an element of wisdom and confidence in ones doctors. In cases where rushing a comeback is ill advised, work on your therapy. Set goals. Eat healthy. Dream of racing again. It's not different than training for a race. I took PT really serious, and it paid dividends. I could have just as easily had a permanently fubared arm and not racing.
    all good points. there's a time and place for all approaches, but i think your philosophy mirrors mine: you do what you can within the constraints of the injury. in pre-op, the doctor told me it might be 3 weeks before i am on the trainer, and i prepared myself to crush core workouts, upper body workouts, basic PT, etc. when we talked post-op and said the trainer is not at all a problem, i was ecstatic.

    MOST doctors that i personally have encountered (n=1, but i've had my share of injuries) tend to be overly cautious with injuries because they are used to dealing with average people. i don't blame them for that.

    i also realize that a high percentage of cyclists tend to be Type A personalities. if one doesn't know their body, know their limits AND have the ability to back off, then my approach is not for them.

    i think we've had this discussion before. in the end, people who want to push when it is not recommended will probably do so and will incur more harm. some people might be thinking/feeling they can do more.

    when i am injured i prefer hearing the tales of the amazing things people have gone on to do despite their setbacks. that stuff inspires me and i hope my own stories might inspire others. (i know they do--i have 3 friends who have suffered injuries in the past 8 weeks and all have drawn upon these stories. coincidentally, one of them just called me earlier today. this guy flew out here to ski then broke his ankle slipping and falling on black ice before he skied his first day. he did some major tendon damage and thought his cycling season was done. i talked to him a few days post-op and he was really down. we got him doing some upper body stuff with very very light weights, just to get his blood flow up, and he felt immediately better. he started to take some control of his recovery. a month later and he has been doing light pedaling (all with safety of his leg in mind) way WAY ahead of schedule.

  7. #107
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    Quote Originally Posted by MDcatV View Post
    like spelling? come on Teton, put the percosets down!
    haha.

    actually, i've been posting and emailing from an iPad. my fingers are too fat and i type too fast -- autocorrect keeps nailing me when there is an extra or an undetected space and the response is to move a letter forward or back + change a word. i should just turn autocorrect off, as then the only problem will be the spacing!

    i got off the narcotics as soon as i left the hospital. i'm only taking tylenol. drove myself to work with someone who can help with inflammation today (worked really well with my clavicle), tooled around the grocery store (turns out a cart was perfect for me to work on my stride while taking a little weight off), and to DMV to get my handicap placard.

    current mission is reducing inflammation and perfecting my stride so i can ditch the crutches ASAP.

  8. #108
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    Quote Originally Posted by tetonrider View Post
    haha.

    actually, i've been posting and emailing from an iPad. my fingers are too fat and i type too fast -- autocorrect keeps nailing me when there is an extra or an undetected space and the response is to move a letter forward or back + change a word. i should just turn autocorrect off, as then the only problem will be the spacing!

    i got off the narcotics as soon as i left the hospital. i'm only taking tylenol. drove myself to work with someone who can help with inflammation today (worked really well with my clavicle), tooled around the grocery store (turns out a cart was perfect for me to work on my stride while taking a little weight off), and to DMV to get my handicap placard.

    current mission is reducing inflammation and perfecting my stride so i can ditch the crutches ASAP.
    Heal quickly everybody - your positive outlooks are certainly inspirational.

    Teton, bonus points if you use the unexpired handicap placard to park in a handicap space at race which you win...

    *edit* Teton mentioned it, but Ovo you probably have one too....

  9. #109
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    Quote Originally Posted by rapwithtom View Post
    Heal quickly everybody - your positive outlooks are certainly inspirational.

    Teton, bonus points if you use the unexpired handicap placard to park in a handicap space at race which you win...
    oh, that's rad!!! it expires in 4 months.

    this just happened, and i am so pumped. it was literally 1W average for 30 minutes.
    Jackson Hole-20140501-00030.jpg

    i feel so, SO much better for it.off to watch my boy's soccer game. don't think anyone will expect me to show up there.

  10. #110
    Senior Member robabeatle's Avatar
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    Quote Originally Posted by tetonrider View Post
    when i am injured i prefer hearing the tales of the amazing things people have gone on to do despite their setbacks. that stuff inspires me and i hope my own stories might inspire others. (i know they do--i have 3 friends who have suffered injuries in the past 8 weeks and all have drawn upon these stories.
    Me too and thank you for your stories.

  11. #111
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    Quote Originally Posted by robabeatle View Post
    Me too and thank you for your stories.
    uh oh...i saw some bold highlighting in a quoted post and thought i screwed up spelling or grammar again!

    (MD's post was a good one!)

  12. #112
    Powered by Borscht ovoleg's Avatar
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    Just met with the surgeon/doc, absolutely no weight bearing for at least 4 more weeks and confirmation by the xray that it's healed. He did say it was okay to rock out on the trainer but not to put any pressure on the bad leg.
    -Cat-3-o-meter: TBD :/

  13. #113
    Senior Member hack's Avatar
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    ^ 4 weeks of one legged drills?

  14. #114
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    Quote Originally Posted by rapwithtom View Post

    Teton, bonus points if you use the unexpired handicap placard to park in a handicap space at race which you win ...
    No. Not bonus points just unbelievably inconsiderate. I know people who need motorized wheelchairs and scooters who can't get out of the car if there isn't a handicapped space available. In fact they've had to leave parking lots and come back later because all the spots were full. So the idea you think it's funny that an able-bodied person would take the space just because they had a placard is something I find repugnant.

  15. #115
    Senior Member shovelhd's Avatar
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    Quote Originally Posted by tetonrider View Post
    haha.

    actually, i've been posting and emailing from an iPad. my fingers are too fat and i type too fast -- autocorrect keeps nailing me when there is an extra or an undetected space and the response is to move a letter forward or back + change a word. i should just turn autocorrect off, as then the only problem will be the spacing!

    i got off the narcotics as soon as i left the hospital. i'm only taking tylenol. drove myself to work with someone who can help with inflammation today (worked really well with my clavicle), tooled around the grocery store (turns out a cart was perfect for me to work on my stride while taking a little weight off), and to DMV to get my handicap placard.

    current mission is reducing inflammation and perfecting my stride so i can ditch the crutches ASAP.
    Just be careful with too much NSAIDS as they damage your organs when used in high doses over long periods of time. You are much better off taking half a Percocet than 8 Tylenol.

    When I tore up my shoulder about this time last May I didn't like what I was hearing from my doctors, one of which is a friend. I tore it up pretty bad, 3 out of the four tendons that hold your shoulder together. There is no socket joint in your shoulder, it's basically your shoulder blade butting up against your arm bone with some gushy stuff in the middle tied together with tendons and muscle. It was dropping about two inches. The first doctor said it would heal fine without surgery if I was religious with the PT. It hurt like hell at first, but I did everything just like they said. It wasn't getting strong enough fast enough so I sought a second opinion. They completely concurred with the first doctor. It's the worst kind of surgery they do. 50% success rate, and a high degree of possibility of reinjury. So I kept plugging away at the PT. I was bridging a gap to a P/1/2 breakaway in 6 weeks post injury and I came home with two national medals 3 months post injury. PT works. It hurts like hell but it is absolutely critical to proper, lasting healing. 9 months post injury I was lifting the same amount of weight as pre-injury. I still have leftover issues that will never go away but they are manageable.

    Point being, listen to your doctors, listen to your body, and put as much into your recovery, in whatever form that takes, as you would with your training for racing.

  16. #116
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    Quote Originally Posted by shovelhd View Post
    Just be careful with too much NSAIDS as they damage your organs when used in high doses over long periods of time. You are much better off taking half a Percocet than 8 Tylenol.
    NSAIDS (e.g. ibuprofen) should not be taken during bone healing.

    Nonsteroidal anti-inflammatory drug... [J Trauma Acute Care Surg. 2014] - PubMed - NCBI

    NSAIDs and fracture healing. [Curr Opin Rheumatol. 2013] - PubMed - NCBI

    Tylenol is not an NSAID but is very hard on the liver - so you don't want much of that. A normal dose of acetaminophen potentiated with a narcotic is the safest approach.

  17. #117
    Powered by Borscht ovoleg's Avatar
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    Quote Originally Posted by hack View Post
    ^ 4 weeks of one legged drills?
    not even. I'm just going to spin at like 50W to keep themovement and circulation going. I dont want to hammer the right leg to death cause then I'll probably have an even bigger left/right discrepancy to work with when I can actually use my left leg.

    I'm not all that eager to jump back into it being injured and all. Unlike tenton, I'm just chillin and enjoying myself a little while I'm down. I want to do what I need to do to make sure my rehab is as fast as possible but I dont want to risk any long term injury.

    I'm still very very afraid of developing AVN.
    -Cat-3-o-meter: TBD :/

  18. #118
    Senior Member grolby's Avatar
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    Quote Originally Posted by Enthalpic View Post
    NSAIDS (e.g. ibuprofen) should not be taken during bone healing.

    Nonsteroidal anti-inflammatory drug... [J Trauma Acute Care Surg. 2014] - PubMed - NCBI

    NSAIDs and fracture healing. [Curr Opin Rheumatol. 2013] - PubMed - NCBI

    Tylenol is not an NSAID but is very hard on the liver - so you don't want much of that. A normal dose of acetaminophen potentiated with a narcotic is the safest approach.
    The doctors do advise against NSAIDs for bone healing, but based on what I've seen/read, the effect on bone healing is limited enough that taking them occasionally during the healing process isn't something to worry about. I can only speak for myself, but acetaminophen has extremely weak analgesic effects for me, while even 200 mg of ibuprofen will do a lot of good.

    That said, I agree with the recommendation for the narcotics. Other than people with a history of bad reactions or who are at risk of dependence - and you just aren't on it long enough after a fracture for this to be a significant danger - I don't see what the big deal is. And of course, not taking them before driving or making important decisions. But seriously, when I was still in the early stages of healing my collarbone, narcotic painkillers were a lifesaver. I would have been all but unable to sleep without them for days following the initial break and surgery. Of course, from what I've heard since then, I had more discomfort than normal.

  19. #119
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    Quote Originally Posted by hack View Post
    ^ 4 weeks of one legged drills?
    soon Ovo going to look like a cycling version of

    twitter.com/ygduf
    strava.com/athletes/ygduf

  20. #120
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    Quote Originally Posted by shovelhd View Post
    Just be careful with too much NSAIDS as they damage your organs when used in high doses over long periods of time. You are much better off taking half a Percocet than 8 Tylenol.
    percocet is basically oxy with acetomenophin.

    technically tylenol is not an NSAID, it is acetomenophin. the reason this is worth mentioning is that doubling up on tylenol and percocet can be really bad. people shouldn't do stuff like that unless they know what's up.

    oxy does bad things to me, and i personally just dislike it a great deal. straight up oxy (w/o acetomenophin), in fact, does not at all reduce my pain--it just makes me not care about it.

    as a result, i prefer to use something like oxy or percocet only when i feel i have no other viable options (it was necessary for me a few times with my clavicle break in order to sleep, or typically to transition off of general anesthesia). it is always my goal to use the pain-killing element, acetomenophin, on its own. i also try to get off of even that as soon as possible, being careful with total dosage.

    the research i've done and discussed with medical professionals has shown that damage can occur with long-term NSAID usage. this is especially important for endurance athletes who do things like use NSAID to endure more pain during training. there is evidence in lab animals that massive NSAID dosages inhibit bone growth, but to my knowledge we have not seen any studies show that an early, initial dosage of NSAIDs has any negative impact on bone healing.

    as a result, i make a decision -- when necessary -- to use NSAIDs to reduce early inflammation if i feel that inflammation is inhibiting me from doing other things that will promote healing, such as inhibiting motion which in turn restricts circulation.

    liver damage is permanent and no joke. i don't take it lightly.

  21. #121
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    Quote Originally Posted by ovoleg View Post
    not even. I'm just going to spin at like 50W to keep themovement and circulation going. I dont want to hammer the right leg to death cause then I'll probably have an even bigger left/right discrepancy to work with when I can actually use my left leg.
    there is HUGE healing power in being on the trainer, even at 50W. it retains neuromuscular firing patterns (good when you do return to cycling) and increases circulation and therefore blood flow. even this light cardio will, i'm sure, have great positive result on your outcome and reduced time for healing.

    Quote Originally Posted by ovoleg View Post
    I'm not all that eager to jump back into it being injured and all. Unlike tenton, I'm just chillin and enjoying myself a little while I'm down. I want to do what I need to do to make sure my rehab is as fast as possible but I dont want to risk any long term injury.

    I'm still very very afraid of developing AVN.
    it might not have been clear above, but i am very risk averse when it comes to long-term injury that could be exacerbated by jumping back into things too quickly. i would not do any of what i was doing now if the medical professionals i work with were not comfortable with it (e.g., riding the trainer the day after being discharged from the hospital).

    one of the first questions i ask in almost any medical interaction is "what are the long-term implications of this <medication, treatment, rehab, injury, etc.>?"

    that is ALWAYS at the top of mind. usually i find returning to activity sooner is a good thing, but there is often a line one needs to be careful not to cross.

    in the case of *my femur fracture* and *my surgical repair* and *my doctor's assessment of my health and bone's ability to heal*, there is currently no risk of me riding a bike with as much pressure as i would like. nothing i can do (even falling) will damage that repair.

    ovoleg, you definitely know your own situation best, and you have the mental discipline to lose weight. (i lost 45# too over a few seasons, so i know where you're coming from.) i just find that during these recovery times it is SO easy for others as well as ourselves to "let us off the hook" -- e.g., 5 people brought me cookies, caramel and ice cream while i was in the hospital, and that was in 4h post-op. i was grateful for the gesture and really really wanted to eat it all. i allowed myself a treat but also knew that i did not want to make a deeper hole for myself. i'm now at the lean end of the scale and further weight reduction is really, really hard compared to, say, dropping the first 40 of those 45#, so perhaps i am more sensitive to such things now.

    i wish you the best in your healing process.

  22. #122
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    Quote Originally Posted by tetonrider View Post
    percocet is basically oxy with acetomenophin.

    technically tylenol is not an NSAID, it is acetomenophin. the reason this is worth mentioning is that doubling up on tylenol and percocet can be really bad. people shouldn't do stuff like that unless they know what's up.

    oxy does bad things to me, and i personally just dislike it a great deal. straight up oxy (w/o acetomenophin), in fact, does not at all reduce my pain--it just makes me not care about it.

    as a result, i prefer to use something like oxy or percocet only when i feel i have no other viable options (it was necessary for me a few times with my clavicle break in order to sleep, or typically to transition off of general anesthesia). it is always my goal to use the pain-killing element, acetomenophin, on its own. i also try to get off of even that as soon as possible, being careful with total dosage.

    the research i've done and discussed with medical professionals has shown that damage can occur with long-term NSAID usage. this is especially important for endurance athletes who do things like use NSAID to endure more pain during training. there is evidence in lab animals that massive NSAID dosages inhibit bone growth, but to my knowledge we have not seen any studies show that an early, initial dosage of NSAIDs has any negative impact on bone healing.

    as a result, i make a decision -- when necessary -- to use NSAIDs to reduce early inflammation if i feel that inflammation is inhibiting me from doing other things that will promote healing, such as inhibiting motion which in turn restricts circulation.

    liver damage is permanent and no joke. i don't take it lightly.
    I'm always looking for the mechanism of action and am far less interested in the magnitude of the effect. Certainly moderate doses of NSAIDs can be tolerated but I would argue that the early, initial doses would do the most damage with regards to recovery. It is in the initial highly-inflammatory period where the prostaglandins are doing their signalling role - with the resulting pain - but that signalling is what triggers the healing. It is would be in the later phases of healing where loading stimulus (early return) takes over and NSAID impact would be limited.

    Just my opinion; you are obviously very bright.

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    Quote Originally Posted by Enthalpic View Post
    I'm always looking for the mechanism of action and am far less interested in the magnitude of the effect. Certainly moderate doses of NSAIDs can be tolerated but I would argue that the early, initial doses would do the most damage with regards to recovery. It is in the initial highly-inflammatory period where the prostaglandins are doing their signalling role - with the resulting pain - but that signalling is what triggers the healing. It is would be in the later phases of healing where loading stimulus (early return) takes over and NSAID impact would be limited.

    Just my opinion; you are obviously very bright.
    i always consider informed opinions and am open to changing mine based on more/better information. i am considering all that is written in this thread. the opinion i expressed above reflected my thoughts as of that moment, but it could change in time.

    (i say that as i am taking my final dose of aceto & vitamin I for today.)

    FYI, i took nothing at all from the time of injury, ~11am on sunday, through going into surgery tuesday afternoon. they gave me the dilaudid drip overnight, which i hit very infrequently (we tracked it). they prescribed percocet but i declined. since perc was prescribed, my doc wants me to take aceto for pain, so it's mainly the NSAID that is in question, and i've taken 2 doses of it and will continue for another couple days, max. i'm also taking far less than many docs prescribe in an acute injury (not saying that is right, but in the past i've had many docs tell me to take 1600mg at a clip when i was playing lots of hockey and basically always in some injured state).

    the 30' of spinning today dramatically reduced my swelling to the point where i was able to walk noticeably better immediately afterwards. it was stunning. i was able to go to my son's soccer game and even kick the ball a bit with him afterwards. i picked up some visitors from the airport and actually walked a bunch without crutches. i'm very wary of overdoing it (i've done so in knee rehab before) but have no indicators of pain or soreness at the pace i'm going.

    can't wait for tomorrow. may put some pressure on the pedals. may be riding outside by the weekend. ;-)

  24. #124
    Senior Member shovelhd's Avatar
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    Lotta drug experts in this thread. Hmm.

  25. #125
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    Teton, if I were you, i'd just roll one state southeast and get some pain killing brownies!

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