Davide Ballerini is back to running and he missed it a lot. we have already discussed. The first race in the jersey Astana Qazaqstan it was the Tour of Türkiye, after which he was called up to the Giro d'Italia. A recovery that cost him a lot of effort and some significant sacrifices, such as participating in the Northern Classics. The suffering in getting back on the bike and restarting the thread of his career was great.Martino Donati, the physiotherapist responsible for the Lugano Rehability Center.
«Davide came to us – says Martino Donati – on January 11th for a problem with his left knee, but with a pain that was difficult to classifyHe had cartilage damage that led to impaired pedaling, which in turn caused inflammation of the infrapatellar and suprapatellar tendons, which act to protect the damaged area. The damage was caused by three consecutive traumas: the first took place in March 2023 during the Tour of Flanders, the second in April at Roubaix and the third at the end of July. The most important one is the last one, which took place at the Tour of Belgium which led to patellar trauma and a consequent loss of power and fluidity in pedaling."
Rest
Ballerini himself had told us that the patellar trauma had been somehow underestimated and he had continued to pedal on top of it.
«By continuing the activity – explains the physiotherapist – the pain never went away. Davide had days when he suffered a lot and others when he could train calmlyThis was due to the fact that if the cartilage is left to rest, the pain decreases. The problem is that when pedaling the kneecap rubs against the femur. and if you have inflammation in your kneecap, continuing to train doesn't help."
So what did you do first?
We made the first visit at the request of Dr. Magni, a doctor from Astana who asked for our opinion. We have already collaborated with him at the time of Nibali e Well I liveBallerini arrived on January 11th, and we immediately took a medical history to understand his medical history. This operation was performed by Dr. Jeanclaude Sedran, a leading expert in the patellofemoral joint, and Dr. Magni. They performed an MRI with contrast, which revealed unrepaired cartilage damage.
What was done next?
The healing, not yet completely completed, It was carried out in three phases which took as many months of work.
What did the first part consist of?
That's what it's called inflammatory or acute phase, where the pain is severe and persistent. First, we immediately removed the bike and worked to reduce the bone edema. What we did through magnetotherapy, hyperbaric chamber and reinforcement therapy. An infiltration of PRP liquid and hyaluronic acid was also performed to accelerate the repair of the damage to the patella. we removed some blood and used the corpuscular part, rich in stem cells, to restart the inflammation process. A technique that allowed for a much faster recovery.
Then it was time for the second phase?
Yes, the subacute one where the pain is mild and there has been a tissue repair process. And' thus began the recovery phase of the lost muscle mass, both on the rollers and in the gymFirst, we performed a biomechanical assessment and adjusted the athlete's position on the bike, giving him a neutral position. The real reinforcement started in the gym, with dry work such as deadlifts, lunges and squats. A test carried out showed that Ballerini had a 23 percent deficit in his left legThe data showed how the right leg compensated during the push and braking phases.
Did you use any particular techniques?
To speed up recovery, the BFR (Blood Flow Restriction) technique was used. In short, it is a band that in Ballerini's case was applied in the hip area.. It works like a tourniquet, the leg works without oxygen and can thus load the muscle without stressing the joint. It's like working with a 200-kg barbell but without any weight on your body.
What was done on the rollers?
This phase was taken care of by his trainer Vasilis AnastopoulosThe training sessions were short, lasting forty minutes maximum, and all in Z2. The work to be done was maintenance.
Third and final phase?
The re-athleticization, which took place in the last month. Ballerini got back on his bike and started doing three-day work blocks in a progressive mannerWe started with an hour and a half of training on two consecutive days, then rested on the third. If the rider wasn't complaining of pain, we increased the training by 30 minutes, continuing each block until we reached five hours of pedaling. Again, only the base, no specific work required.On his rest day, however, he wasn't idle, but rather he worked hard in the gym.
Were any other checks done?
Just to monitor various adjustment pains, such as in the glutes, back, or right leg. Finally, we adjusted the position on the bike again, and on March 29th Davide left for Teide with the team.
Job done for you?
No. From a distance, while he was on retreat, our trainer Tommaso Doro, who followed him through every phase, still recommended some strength training to him in the gym. Less intense sessions, but always aimed at strengthening the left leg, also because the recovery had taken place, but not yet completely.
In what sense?
That Ballerini ended up with a deficit between his left and right legs of 6 percent. He still compensates with the other leg in the push phase, but this is normal.Now with his return to the race he will have the opportunity to finally recover.
Ballerini told us he still needs to monitor his injured leg.
Yes, at the end of the Giro we will continue working to recover as much as possible and we will carry it forward, race-compatible, until the end of the season. The important thing will be to work well starting next winter to completely cover everything.It will improve until the end of the season, then there will be a reconstruction to do that will start next winter.
