Sam's Commentary

July 15, 2016 Commentary Archive

Cryotherapy: The latest in "Sam's Big Comeback"

by Sam Kouvaris
Posted July 15, 2016 ===========================================================================

For those of you who have followed by journey since my stem-cell surgery in November, first I want to say thank you. Somebody asks me about my knee, the procedure, the braces I wore or my rehab everyday, and I appreciate it.

Since the stem-cell procedure is so new in the US, the experts are still gathering information the rehabilitation process.

"It's all over the map," said Mike Ryan, the former Jaguars athletic trainer who now runs Mike Ryan Fitness in Jacksonville Beach as well as other projects and commentary for NBC Sports. "The physical therapists are coming up with ways to rehab from that procedure but there are a lot of different opinions."

Mike's right about that but from somebody who's undergone the procedure, I can tell you the rehab is closer to coming back from knee surgery than anything else. The first two weeks are filled with a lack of mobility and a lot of soreness. As I mentioned in the original story the advice from my longtime friend and medical advisor Dr. Paul Shirley was "Ice and prayer." So I did a lot of both.

As I've progressed through this process, I started an upward trend to feeling better with less knee pain starting at about two months and getting progressively better into month five.

"That makes sense," Dr. Stephan Esser from SE Orthopedics said as I filled him in on my progress. "The stem cells are immature when we first line your knee with them and it takes a while for them to mature and start to replicate."

I tried to follow Dr. Esser's instructions on recovery and was probably an "80%" patient, probably being too aggressive on more than one occasion during the early stages of rehab. After four months, they cleared me for a step up in the intensity of my therapy and I had my good days and my bad days. I had lost some flexibility and mobility in my left ankle and my left hip in the beginning of the process so I had a lot of soreness through my hip flexors, quads and lower leg.

"No surprise," was again the answer when I met with noted physical therapist Dr. Mark Baughman in Jacksonville Beach. Mark has his doctorate in physical therapy so when he put me through my first evaluation, he and I laughed when he said I was a "classic case of dysfunction."

Finding the "links" to where my lack of mobility and soreness was coming from, Dr. Baughman worked from the ground up using the old phrase, "we'll be chopping wood for a while" when he discovered the lack of flexibility I had in my left ankle and left hip. Through a series of sessions with Mark I've regained a lot of that but there's still work to do. Sitting in a chair at work, in the cockpit of the airplane, the car or riding my bike promotes a shortness in just about every muscle in the front of my body so I spend a lot of time counteracting that with stretching, the Swiss ball and sometimes just laying flat on my back on the floor.

At right about the six-month mark I was experiencing some associated pain around my knee so Dr. Esser suggested I come in for some "nerve retraining." I had no idea what that meant but found out quickly it was an aggressive form of acupuncture combined with some electric stimulation.

That's always seemed a little bit like hocus-pocus combined with voodoo to me but I was quickly converted. Going to treatment five out of seven days, Dr. Esser worked on the muscles around my knee as well as some of the meridians flowing through my knee and gave me instant relief and results. Shortly thereafter I rode my bike in Europe for a couple of weeks, even climbing the iconic L'Alpe d'Huez with no ill effects. And if you've seen me, I'm not built for climbing! Stephan has suggested regular acupuncture and I'm a believer.

Recently I've started a cryotherapy routine looking for another nudge forward. Ice baths and cold therapy have been around for a while but this is supposed to be the next step in recovery or managing chronic, old injuries.

"We get it down to negative 302 Fahrenheit (degrees)" Beau Dominiak, the owner and trainer at Outlast Cryotherapy in Ponte Vedra told me before one of my treatments.

"It's basically pulling all of the fluid out of your extremities, sending all of the blood back to your vital organs," he explained of the three minute. "When you come out of there as you return to a normal state you're sending fresh blood carrying nutrients and oxygen back to your extremities."

Dominiak is a former pro soccer player in Scotland and uses the machine himself up to six times a week. "It's great for chronic injuries I've had and sometimes I even use it before a workout as pre-hab."

"Very positive results," is how he described what his clients have talked about. "It's intended to be an everyday tool, a couple times a week is probably ideal."

I can tell you it's had some positive effects using cryotherapy along with the other protocols in my rehab program. I can also tell you the first two minutes you're chilly but it's OK. The last minute, you want to get out.

"It's that fight or flight response that's what you're looking for," Dominiak said with a laugh. "It's supposed to have your body want to protect itself. It's promoting both body health and brain health."

I'll keep you posted on the results!


Commentary by Sam Kouvaris

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