Author Topic: Help me find a good PT/physio/chiro/anything  (Read 2188 times)

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Dreyth

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Help me find a good PT/physio/chiro/anything
« on: June 10, 2022, 06:06:27 pm »
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My knees have been suffering for years now. It's not the patellar tendonitis that I use to have which disappeared with VMO work and foam rolling IT band/hips.

It's a different pain. Glut med activation seems to give a bit of relief, as does stretching the TFL. But the relief doesn't stick around. It's not permanent. Really tired of this and I miss being able to play basketball multiple times per week. I can only play less than once per month now

I'm located in Philadelphia at the moment. Seems to be hard to find someone who isn't going to tell me something stupid like "ice your knees."
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seifullaah73

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Re: Help me find a good PT/physio/chiro/anything
« Reply #1 on: June 11, 2022, 06:36:50 am »
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Where's the pain located and what triggers the pain in terms of leg movement i.e. flexing, extending, rotating legs internally/externally, standing on the leg of the problem, or is it a pain under stress like jumping, running, stairs, sitting, etc.

I don't if relevant but I remember trying natural glute ham raise and flexing and extending causes patellar to move so doing the natural GHR caused patellar to move and then weight over the exposed knee join leading to bursitis and I couldn't sit or stand without pain, so I had to just rehab it, re-strengthening the muscles to sit, stand, then box squat and forward step downs off a box, etc.

Warm up drills
   - a walk, b skip quick powerful switch (heel to hams focus), a runs, dribbles small to big to run, straight leg to runs (force, reflex, go up/forward). force to hit the ground before it hits the ground knee/hip is at 90 degrees.
   - acceleration: low heel recovery, shin angle low, drive legs back before hitting the ground and drive thighs/knee forward not up
-------------------------------------------------------------
Measuring reminder:
5 toe to heel steps = 148cm
------------------------------------------------------------------------

�Strength comes from the legs, Power comes from the torso and Speed comes from the arm.� � Al Vermeil
Arm also aids the legs in driving it down with power - seifullaah73

My Progress Log
A Journey to Running fast and Jumping High
http://www.adarq.org/progress-journals-experimental-routines/my-journey-to-hypertrophy/

CoolColJ

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Re: Help me find a good PT/physio/chiro/anything
« Reply #2 on: June 11, 2022, 11:01:34 am »
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have you had any scans etc?

It sounds more serious than tendon or tracking issues. Could be internal like meniscus or the patella cartilage?

--

edit - maybe hit up the Squat University guy
« Last Edit: June 11, 2022, 01:33:31 pm by CoolColJ »

Dreyth

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Re: Help me find a good PT/physio/chiro/anything
« Reply #3 on: June 11, 2022, 04:36:30 pm »
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Knees hurt only under stress and not by much. But if i play bball, the next day they are swollen and hurt more. Its not debilitating or anything. But i cant run full speed or consistently play bball anymore

I had xrays done, i think i may need an MRI. The physical therapist i went to years ago said it’s either an MCL issue or a meniscus issue. I’d like to get a second opinion

I think i need an MRI but boy they are expensive
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CoolColJ

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Re: Help me find a good PT/physio/chiro/anything
« Reply #4 on: June 12, 2022, 04:39:35 am »
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Ok swelling means it's not a tendon issues, so it's likely cartilage
Might need key hole surgery to clean it up

From memory you hurt it on a single jump after a long lay off, which sounds like an internal injury.
tendon ones happen gradually over a long period of time from incomplete recovery

Dreyth

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Re: Help me find a good PT/physio/chiro/anything
« Reply #5 on: June 12, 2022, 07:27:34 am »
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So it wasnt a single jump, but you’re right that it happened after a long layoff.

I didnt play bball for about a year but kept lifting. Squat got up to the 400’s. Came back and played a high intensity full court game. Next day left knee was swollen, but painless. Didnt think much of it. Next week played another full court (swelling had subsided already). Painless. Day after that both my knees swelled up like crazy and i could barely bend them halfway

Today my right one seems worse than my left
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CoolColJ

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Re: Help me find a good PT/physio/chiro/anything
« Reply #6 on: June 12, 2022, 10:07:40 am »
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patella and quad tendon injuries definitely hurt a lot on the end parts of the tendon

Jumper's Knee can cause swelling in the knee though

Do you get pain when doing a leg extension? Under the kneecap or on the tendons?
tendon injuries do feel better and reduce in pain after ISOs like Wall sits and Leg extension holds at 60 degrees knee angle for 30-50secs
Whereas other types of knee pain just hurt no matter what when loaded







Dreyth

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Re: Help me find a good PT/physio/chiro/anything
« Reply #7 on: June 12, 2022, 01:39:27 pm »
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Pain isnt in the tendons. 10 years ago it was, strengthening VMO and foam rolling IT/hips took care of it 100%

Now the pain seems to be inside my knee or something. Like at the bottom of the femer, below the kneecap? Top of shin bone? Its tough to pinpoint

Ill have to try leg extensions tnite to see if i get pain
« Last Edit: June 12, 2022, 10:09:28 pm by Dreyth »
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Dreyth

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Re: Help me find a good PT/physio/chiro/anything
« Reply #8 on: June 12, 2022, 10:09:09 pm »
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Just tried knee extensions. Very uncomfortable in my right (worse) knee. A very weird feeling too.

My but knees are swollen right now from 5 full courts a few days ago. When not this swollen, i think the knee exts are painless

Edit: my knee fees a bit better after the exts so i did a few more sets.
It feels more lubed/mobile.
« Last Edit: June 12, 2022, 10:58:07 pm by Dreyth »
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CoolColJ

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Re: Help me find a good PT/physio/chiro/anything
« Reply #9 on: June 13, 2022, 05:43:18 am »
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usually tendinopathy takes more than just release work and stretching to fix, since the tendon itself gets damaged, and takes many months of gradually higher, long duration loading from ISOs and slow tempo quad work to fix. Shallow angles to start so the tendon doesn't get compressed against the patella as it will be swollen from the injury.
And stop loading it while you do the rehab

This is a sound progression, but you can use other exercises like leg extensions which isolate the problem area
https://www.jump.science/2020/12/jumpers-knee.html

Sounds more like patella tracking issue you fixed.

If the pain is below the knee cap then it's most likely a meniscus damage or the cartilage on the bottom surface of the knee cap.
Need an MRI to see which.

Meniscus damage on the outer side can heal naturally , but inner damage won't, due to no blood flow
« Last Edit: June 13, 2022, 05:46:38 am by CoolColJ »

Dreyth

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Re: Help me find a good PT/physio/chiro/anything
« Reply #10 on: June 13, 2022, 01:55:04 pm »
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Sounds like I need an MRI!

Dr John Bergman has an excellent video on healing inner meniscus damage and yep - it centers around getting blood flow into that area:

https://www.youtube.com/watch?v=hMF4vXFqqpk


Was thinking of flying to his clinic in LA but I'm looking at local alternatives first to save money
« Last Edit: June 13, 2022, 01:56:54 pm by Dreyth »
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CoolColJ

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Re: Help me find a good PT/physio/chiro/anything
« Reply #11 on: June 13, 2022, 02:50:24 pm »
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Yeah cartilage likes compression and relaxation cycles.

So start walking more, which has helped me a couple of years ago, along with the backwards walking up a slope.

I think I have some cartilage chip off the back of my left knee cap, which the MRI I had never showed....
I originally got my MRI for a possible meniscus surgery, but the knee specialist surgeon said mine was fine with even some fat inside it for lubrication - even after years of hard jumping on concrete.
But I had clicking/pops and pain in that knee from the cartiledge catching in there once in a while... which one of the female assistants pointed that there might be damage there but the doctor ignored it...

Soft tissue work and stretching did eventually fix the patella mistracking that caused it, and then that period of walking and backwards walking did the rest.
But it was originally hurt on one jump I took after a multi year break from BBall, where I was fat, poor mobility tight and weak muscles, and years of sitting on my ass.
It still clicks and pops when I do quick unweighted leg extensions, but no pain, and not every time.
And I can feel a "bump" when doing it slowly

Lesson - don't jump when your out of shape! And ease back into it.
Body does not like valleys and peaks, keep to a steady upward slope of stress increase.

« Last Edit: June 13, 2022, 02:53:03 pm by CoolColJ »

Dreyth

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Re: Help me find a good PT/physio/chiro/anything
« Reply #12 on: June 13, 2022, 03:43:03 pm »
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Quote
Soft tissue work and stretching did eventually fix the patella mistracking that caused it

What exactly did you stretch and release in your case?

Long walks will make my knees swell up a bit. But walking backwards (up stairs, or on a treadmill turned off) feels great
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CoolColJ

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Re: Help me find a good PT/physio/chiro/anything
« Reply #13 on: June 14, 2022, 10:20:57 am »
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walks do not need to be long, I'm thinking like 15-20 mins, but I would wait till your knees settle down first

Every area of my quads, outer, inner, top , bottom,
glutes and adductors
calves and tibs
foam roller wasn't enough I had to use harder balls and rolls

couch stretch, hamstrings, calves/ankles, glutes, piriformis, internal hip rotation

like the above video showed, you need to fix every area

It was a lot of work, but how much do you want it?

Dreyth

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Re: Help me find a good PT/physio/chiro/anything
« Reply #14 on: June 14, 2022, 05:57:16 pm »
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Another great knee vid by dj John bergman

https://www.youtube.com/watch?v=bt2P_eYkN40

And yeah, I need to go on a serious stretching routine and log it
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