So How Is Everyone's PT Going...

[maillotpois]

Trinena - thanks for the ice reinforcement. I wore an ice wrap for most of the night last night (after my first ride in 2 months) and it doesn't hurt today! Yay!

[trinena]

Thanks Rocknrollgirl for the encouragement and sharing your recovery experience. It gives me hope! I am limiting the walking and no more hills. I was diagnosed with Pes Anserine Bursitis & PFPS (i'm embarassed to admit I forgot what that stands for but I think it's about wear and tear of the knee) a month ago. I am returning this Thurs. for a re-check. When I first saw the sports dr. it was mainly the bursitis pain (she attributed it to overpronation - I have superfeet but now I'll be getting ortho inserts) but soon I began having very sharp kneecap pain (miniscus tear?). Can you believe I did not remember that our big dog had run into my right knee cap when we went snowshoeing in mid Jan.?! A couple weeks before that I had strained my back from carrying something heavy (I already have lower back disc L4 L5 S1 protrusion so that's a no-no ) and I had a mild calf strain in the right leg. So it's probably an accumulation/cascade of issues. I think its time for an mri but I can't blame the doc for not ordering one yet since I had not told her about the 90 lb dog running through me! I would think that if the main injury was in mid-Jan I'd be better by now.

Maillotpois I'm glad the ice helped and you got to go for your first ride in months! I haven't tried an ice wrap overnight. I think I'll try it since I'm waking up with some pain. I guess it's still inflamed from earlier this week. Happy healing everyone. Sigh - my hubbie just left for a long ride and the day is gorgeous.

[Wahine]

I was diagnosed with Pes Anserine Bursitis & PFPS (i'm embarassed to admit I forgot what that stands for but I think it's about wear and tear of the knee) a month ago. I am returning this Thurs. for a re-check. When I first saw the sports dr. it was mainly the bursitis pain (she attributed it to overpronation - I have superfeet but now I'll be getting ortho inserts) but soon I began having very sharp kneecap pain (miniscus tear?). Can you believe I did not remember that our big dog had run into my right knee cap when we went snowshoeing in mid Jan.?! A couple weeks before that I had strained my back from carrying something heavy (I already have lower back disc L4 L5 S1 protrusion so that's a no-no ) and I had a mild calf strain in the right leg. So it's probably an accumulation/cascade of issues. I think its time for an mri but I can't blame the doc for not ordering one yet since I had not told her about the 90 lb dog running through me! I would think that if the main injury was in mid-Jan I'd be better by now.

PFPS = Patellofemoral pain syndrome, it's a nice catch all phrase for pain around the knee cap that sounds impressive but doesn't really tell you what the root cause of the problem is.

Based a lot on what I learned in my running biomechanics course this weekend, I would suggest a few things. First off are you using a motion control shoe with your orthotics? If so you could have an over correction and may need a more neutral shoe now that you have the orthotic correction. Second, your orthotics are not going to do your knee a lot of good if part of the problem is coming from poor movement control at the hip. A good screening test is to see if you can do a side plank. Go up and down into the position repeatedly for 1 min with smooth control. If you can't do this, you likely have some hip weakness and you may need help from a PT to sort it all out and give you the right exercises.

Now more from my background with a lot of extra training in spinal mechanics, pathology etc... L4, 5 and S1 problems lead to muscle balance issues in the hip and lower leg that go with your pattern of problems and probable (because I haven't actually assessed you) movement dysfunctions. I would strongly recommend that you should also be doing rehab that involves your low back and hip if you want this to be corrected to the best of your ability.

Hope that helps.

[trinena]

Thanks Wahine for such an informative reply. I've printed it out and I'm taking it with me to the P.T. tomorrow morning. Thurs. I am seeing the ortho doctor right before I see the sports medicine doctor so I will be able to ask him about my motion control shoes (new pair of brooks adrenaline) and the orthotics.

I was told that I do have hip weakness (planks are hard for me), my right side is particularly weak. I was also told that I have to get my glutes to fire more (esp. for running). Through the pilates portion of the PT I also learned that I wasn't really engaging core muscles.

My P.T. told me she thought my knee issue had to be connected to my back (my doc didn't think so) but I need all of this clarified with more detail. I have a vague notion of what's going on in my body so I know I need to learn more and ask more questions. It helps to know what questions to ask!

[rocknrollgirl]

Trinena,
PFS is what I was diagnosed with also. Mine is being caused by muscle imbalance and a very tight ITB. I too had very sharp pain under the knee. I was convinced that the meniscus was torn. How could it not be with that much pain? I had the MRI and it was totally intact. All of that pain was from the poor tracking and the rubbing of the kneecap.

So getting to the root of the problem is KEY. Once they find out where the source of the problem is, they can give you the exercises and stretches to deal with it.

In my case, I just have to realize that I have to do the homework for the rest of my life, smallprice topay for getting going again.

Keep us posted.

[Wahine]

Thanks Wahine for such an informative reply. I've printed it out and I'm taking it with me to the P.T. tomorrow morning. Thurs. I am seeing the ortho doctor right before I see the sports medicine doctor so I will be able to ask him about my motion control shoes (new pair of brooks adrenaline) and the orthotics.

I was told that I do have hip weakness (planks are hard for me), my right side is particularly weak. I was also told that I have to get my glutes to fire more (esp. for running). Through the pilates portion of the PT I also learned that I wasn't really engaging core muscles.

My P.T. told me she thought my knee issue had to be connected to my back (my doc didn't think so) but I need all of this clarified with more detail. I have a vague notion of what's going on in my body so I know I need to learn more and ask more questions. It helps to know what questions to ask!

This to me sounds like your PT has a good handle on what's going on. She may not have articulated things in the same way but she's got you working on the right stuff. What's really important is that as you get better control at your hip doing slower exercises in easier positions, like lying down, you eventually progress to faster movements that mimic rate of muscle contraction with running speeds and in weight bearing positions. But you can't do those until you have good control with slower movements.