"Kneecap Training"

[Wahine]

Elliptical: 8min/0.56mi
Knee taping
Electrostim (russian): 15min
Hamstring stretching on foam roller: 2min
IT band stretching on foam roller: 2min each leg
Hamstring stretching with band: 30sec x3, each leg
Leg press: 20 x 78#
Thigh abduction: 20 x 68#
Thigh adduction: 20 x 68#
Leg extension: 20 x 78#
1 hour total time

That sounds a little better. I'm glad you're stretching. I still wonder about the knee extensions tho.

[KnottedYet]

Yeah, I wonder about the knee extensions, too. Ask your PT to explain why they are doing "open kinetic chain" exs rather than all "closed kinetic chain"? (open chain, you aren't putting weight thru your feet. perhaps not an optimal situation with the quad/knee business.)

(and what's with the Russian stim? was that on your VMO? Are you unable to contract the muscle on your own?)

Very glad to hear you are stretching! And glad they put the McConnell tape in the right spot!

Straight leg raises with the leg rolled out a little are really fun, cuz you can FEEL and SEE the vastus medialis obliquus contract. Way cool. Hillslug, you might get a kick out of them, ask your PT to show you.

3 diff PTs in 3 visits is pretty interesting. It will be nice if you can keep the current one for the rest of your visits.

Edit: BTW, I really like ChiRunning.

[Wahine]

With Knott's support on this, I'd have to say that I'm really not a fan of knee extensions for a person with patellofemoral problems. I'm with Knott, you should be doing almost all of your exercises with your foot planted on something so that you have a better chance at acheiving good alignment of the Hip-knee-foot. The exception to the rule tis the straight leg raise with the knee turned out and that's only an exception because it heavily biases the VMO.

[HillSlugger]

The only exercises I do with feet planted are the elliptical and the leg presses. Why no concern about the thigh abduction and adduction? What other exercises would you see me doing?

The vastus medialis obliquus (VMO) is above the knee to the inside? The first two times I had electrostim, one pad was here and one pad was on the outside. Yesterday, one pad was on the outside and the other was further up the thigh (can't remember if it was inside or outside). Last week I was told to contract and relax my muscles (push knee down into the table) while the stim was on and rest while it was off.

How do I do the "straight leg raise with the knee turned out"?

At PT I stretched my IT on the foam roller, but at home I'm using other stretching methods. Would it be worth it to get a roller for home? It hurt so good (I own The Stick, but the roller seemed more effective).

[OakLeaf]

You've got it. The VMO is the quadriceps muscle nearest to the inside.

Straight leg raises: recline on the floor with your legs extended straight in front of you, supporting your upper body on your elbows. Rotate one leg from the hip so that knee and toe are pointing to about two o'clock. Then lift your leg straight up while maintaining the rotation. Hold for a few seconds, lower and repeat.

I've never used the foam roller. As an alternative, I like to use an elastic band to stretch the IT band. (You can use either the tape type or the round type elastic.) Lie on your back with your leg perpendicular to the floor. Pass the elastic band around the arch of your foot. Hold both ends of the band in the hand opposite the leg being stretched. Keep your hips square and both buttocks flat on the floor, and gently pull on the band to bring the foot toward the opposite shoulder.

I'll let the PTs answer your other questions. I'm just an aerobics, Pilates and strength training instructor with personal experience of issues similar to the ones you're having. Why don't I teach spinning? Because the bikes' crankarms are too long for my knees - which is a perfect excuse because I HATE all cardio machines

[Zen]

you should be able to get a foam roller from the PT clinic. I don't know that they're used directly for stretching but for myofascial release which would facilitate stretching.

I don't know how leg extensions can be good for anything except to drum up business for chiropractors. I cringe every time I see some guy kick up a heavy load and arch his back to assist. I cringe just thinking about it.

[Wahine]

It would totally be worth buying a foam roller. As Zen said, you should be able to get one at the PT clinic. We charge $22 for ours. If they want to charge you a lot more, let me know and I'll send you some links to order one online.