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  1. #1
    Join Date
    Sep 2007
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    2,503

    Sweet...I severed my perineal nerve....

    ...and broke my fib coming up a bit short on a gap on my DH bike. The fib is a non-issue but the nerve damage sucks. I have partial paralysis in my left foot causing dropfoot. This means I can't lift my foot/toes upward but pushing down is fine. When I walk my toes drag and I have a tendancy to roll my ankle which is nutty because I cant feel it. So the Neurologist says nothing about regaining function. I ask him point blank and he just says "maybe, nerves are funny things, sometimes they can heal". I have nightmares about turning right and being stuck in the backseat all winter. Anybody have any experience or PT recomendations? Thanks in adv, Phil

  2. #2
    Join Date
    Jul 2007
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    Whistler
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    531
    I am not a doctor...but was the nerve damage a result of surgery or the initial injury?

    I would rehab like crazy, defiantly see a good Neural PT (not msk specific), Personally I would work on strengthening your Ant tib to increase natural tone to help keep your foot from plantar flexing so bad. The doctor should not know much since he is most likely a MSK specific trauma doctor, go see a neural specialist, regaining function takes time(swelling could be impinging upon the nerve), or a growth of new connections if the nerve is completely severed. Further down the road I would have said Neural PT also look at your gait, you most likely are "hip hiking" to clear that foot and it can cause further MSK problems in your knees/hips/back.

    edit: depending on if this is recent or old: make sure your foot stays stretched into dorsiflexion quite a bit while your leg is healing or your Achilles will shorten and you will loose range with that excessive plantarflexion...in short, regaining range is painful and timely

    Heal up dude

  3. #3
    Join Date
    Sep 2007
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    Thank you Look! Yes the nerve damage resulted from the crash. I am "hiking my hip" but I am stretching all the time. Im gonna print this and show it to my PT. Thanks man.

  4. #4
    Join Date
    Jul 2007
    Location
    Whistler
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    Just an FYI your perineal nerve supplies your balls and such

    I think you mean you damaged your peroneal nerve

    How long has it been since the injury? Did you have surgery for the fib break? I assume you broke the neck of the fib

    Can you extend any of your toes? or are they pulled completely into flexion?

    I assume your Pt is doing active assisted movement when you stretch, they would be telling you to try to dosiflex while he/she goes through the movement with you. (mentally helping them as they stretch the foot into dorsiflexion and then resisting against them as gravity lowered the foot into plantarflexion.) if not i would suggest starting, it might feel the same as passive stretching but neural activation of mentally trying to move can help rebuild signal pathways.
    Last edited by lookinback; 09-15-2011 at 08:14 PM.

  5. #5
    Join Date
    Jul 2007
    Location
    Whistler
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    531
    I would also talk to your pt about skin care, at this point its just as important as learning to walk correctly. down the line tight ski boots and a lack of proprioception cause warning bells to go off in my head. when that time comes i would seek a uber custom liner

  6. #6
    Join Date
    Sep 2007
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    HAHAHHAHA Balls still work! Injury 3 weeks ago, no surgery. Minor fracture on fib. Toes are in a normal position but toes and foot cant be lifted up. PT is giving me electric current type stuff which combined with the mental thing is just starting to show slight improvement. All day long I try to send the signal and it makes you crazy trying. I now can understand the frustration a cord injury patiant must suffer. So it sounds like your saying the pathways can be rebuilt and an acceptable recovery is pssble?

  7. #7
    Join Date
    Jul 2007
    Location
    Whistler
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    easy there killer, small goals first

    the PT is giving you Elec stim most likely on your ant tib, at 3 weeks there still might be a bit of swelling kickin around and only time will tell but its looking like you did damage the nerve. Do you wear a brace(AFO) at night to keep the foot from dropping?

    as everyone i imagine has told you by now, acceptable recovery is subjective and you may or may not be back to how you were before the injury, only time will tell. yes nerve pathways can repair themselves, but many times do not. Stick hardcore with PT especially early within the first few months-year. and keep in mind your getting responses off a skiing forum with titty posts in the padded room

    best of vibes man

  8. #8
    Join Date
    Mar 2008
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    3,173
    Damn dude, I am humbled by your gimpness. Good point ^^^ about the possible dubious nature of medical advice sought here. Sounds like lookinback knows whats up, you're a good man to help out philth like that. Seems like every day I learn of a new way to fuck oneself up mountain biking that I never thought of before. Best wishes, I'll be rallyin for ya, keep us updated!
    "The skis just popped me up out of the snow and I went screaming down the hill on a high better than any heroin junkie." She Ra

  9. #9
    Join Date
    Apr 2009
    Posts
    689
    couple things that might help.

    if your rolling your ankle have the discussion with your PT about using and AFO or walking until the peroneal muscles kick back in, theres a ton of options. protecting the ligaments you can't feel is just as important until you get your natural stability back. it will also limit how many bad motor planning habits you'll have to correct later.

    work the piss out of the other legs peroneal muscles. its not a huge return but there is support for cross activation strength gains, it will have more impact once you begin to get muscle activation on your affected side, but lighting up the motor neurons at the spinal chord level may help (it certainly won't hurt)

    in that same vein, work on a variety of exercises, not just focusing on strength (as mentioned in the earlier post), dicking around with isolated, light intensity, muscle contractions is what really enhances motor cortex synapse development. do it on both legs. again, it will have a bigger impact once your begin to get peroneal activation but is so easy you might as well be doing too. include exercise that utilize combinations of muscles (i.e. hip abduction initiated with ankle eversion, etc)

    its a peripheral nerve, which can regenerate vs. a central spine nerve which can't = good.

    besides, it could be worse, you could have torn your perineal nerve

    good luck

  10. #10
    Join Date
    Jan 2006
    Location
    Burlington, VT
    Posts
    186
    I had a knee dislocation which caused poroneal nerve damage. it did not severe the nerve. but bruised it severely. I was in an external fixator for my other associated injuries, but while I was i had a metal spike drilled into my foot and connected to the fixator to prevent the foot drop you are talking about.

    I remember at first the lack of sensation in the lower leg was so strange. it felt like a piece of meat. I regained functional dorsiflection, but it was a hard process getting back range of motion. which is still not 100 percent over 5 years out. I have no experience with a complete nerve severe...but this nerve can heal if it is damaged...but nerves take A LOOOOOOONG time. Sensation and control come back very very slowly. not to mention there is scar tissue that can form along the nerve restricting it sometimes. Give this lots of time and don't get down if you don't see immediate results.

    I also do remember some show I watched a long time ago about a downhill mountain biker who severed his poroneal and then had a surgery to either switch a nerve or a muscle around to control his dorsiflexion. name of the show escapes me right now. Best advice I think would be to go see an expert in the field.

    Good luck with this - I feel for ya. You'll get back with hard work though.

  11. #11
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    Sep 2007
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    Thanks All. You mags are very informative and helpful. I will post up as the rehab progresses.

  12. #12
    Join Date
    Apr 2008
    Location
    Treading Water
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    Wow. That really sucks. I'm sorry you're going through this.

    If it were me, I'd try some accupuncture. Try to find a medical doctor who does it. I saw HUDGE improvement in my dog after he suffered a nerve injury. I'm sure the natural healing process had a lot to do with it, but it seemed fucking amazing how he started progressing faster as soon as the accupuncture started (like a minute after the first session ended, he started moving his foot!)

    Good luck.

  13. #13
    Join Date
    Jan 2004
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    4,115
    Quote Originally Posted by caddah View Post
    I remember at first the lack of sensation in the lower leg was so strange. it felt like a piece of meat. I regained functional dorsiflection, but it was a hard process getting back range of motion. which is still not 100 percent over 5 years out.
    So true, two back surgeries, the first one i had drop foot and dragged my foot around for a couple weeks. I loved dropping shit on it and not feelling a thing.
    My nervrs where impeeded so i regained feeling.
    Second back surgery, i had quada equnia, a very serious condition. Could not feel my ass, or balls. Could not take a piss or poo. Pretty scary stuff.
    Anyway, my nerves were severily bruisded but not severed. It took about 3 months to get all my feeling back.

    So was the never completly severed? Or just partially?

  14. #14
    Join Date
    Sep 2009
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    in the trench
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    not sure if it applies but i have seen a therapy used for nerve damage to limbs and/or phatom limb pain(person loses a limb and feels pain in the missing limb even though its not there). it isn't always successful but it involves exercising the opposite limb in the mirror thereby trying to trick the brain into believing you are using the injured limb. i think they do it for a month to see if its helping. maybe ask your PT. another i saw was a person with nerve damage to their hand. they would reach in to a jar of marbles and try to find the nuts and bolts mixed amongst the marbles. heal up. just about to start some more rehab myself(compression fractures to 4 vertabrae from riding). just a lil hurtlocker time until we can play some more. take care

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