On September 12 2012 17:11 ThunderGod wrote: Help me eshlow! I have had back troubles for years and planning to see a specialist when I get back from holiday in November, as physio has been ineffective. Not really sure what the problem is, but general back area is not feeling good. Just want to be painfree again! + Show Spoiler +
1. Google a pic and mark where it hurts.
Red hurts most. Orange middle. Edit: The top orange one is recent injury and should be a red. (Hard to pinpoint pain when everything is sore). Yellow least.
Recent: 2 days ago, injury lower back on centre-right, went ping when sitting down after deadlifts. Hurt same place at start of year (gardening), was told L4 partial tear. 3x chiropractor for immediate relief then 10x1/week physio + stretching everyday - no improvement with physio/stretching. Feels in same spot but not as bad as start of year. Old: Sore ropy muscle around top of glute, centre to sides Old: Side of back and slightly on front as well, very tight and sore (hip flexors?) Right side is worst. Old: Erector spinae on right side, sore when pressed/massaged, otherwise don't notice it. Other: Physio said I had very tight hamstrings and back muscles. Had a few lower back injuries when in highschool ~10-12 years ago, don't really remember.
2. What exercises hurt? Which shoulder articulations hurt? Make sure you check both with passive motion and resistive/active motion. + Show Spoiler +
Ham string stretch: fine Bird/dog: fine Gluteal stretch: Sore on sides/glute/hip flexors Flat on back, soles together, knees wide: Sore on hip flexors Cat and camel: Recent injury (will call lower back) sore on cat Pelvic tilt: lower back sore on upwards tilt Partial curl: fine Extension: lower back sore Side plank: lower back sore when right side facing down.
3. What type of pain is it? Burning? Ache? Tingling? Sharp? Ache, sharp on some movements (getting out of low car is most painful movement).
4. What would you rate the pain at on a 0/10 scale? 0 being no pain, 10 being go to the emergency room. 2-3. Always there in background, esp when sitting.
5. Acute or chronic (chronic more than ~6-8 weeks)? What date was onset? How has the pain improved since the initial injury? Acute and chronic, see above.
6. Have you been training through pain? If so, how long? I go to the gym and train. Not in last two days.
7. How deep is the pain? Is it more superficial tissues? Or does it seem to be more inside or around the joint? Describe it. Old pains feel muscular, moderate depth. Recent injury is in a bony area.
8. What have you been doing for recovery purposes? Few painkillers, resting it. will resume stretching in a few days.
9. What seems to help? What seems to make it worse? Is it constant? Does it increase/decrease with certain activities? Standing/lying feels best. Sitting bad. Rising and twisting (getting out of a car) is worst.
10. Check the tissue quality of the surrounding muscles. Which ones are tight? Which ones are tender? Is there any swelling? Tissue quality is tight and sore all over lower back.
11. How does it feel after exercise (if any)? How does it feel at the beginning of the day? How about the end of the day? Feels best in morning. Not too different throughout day though.
12. Any previous injury history? Yes see above
13. How's your posture? Standing: ok Sitting: not the best (I sit down for a job but make sure to get up and stretch, walk a little every half hour). Also use additional lumbar support on my chair.
14. What is your current workout routine for that bodypart? Do you play any sports? No sports. Just do starting strength at gym.
15. Any other information I should be aware of or that comes to mind that may help? Other than my back I am a fine physical specimen with no pain or other complaints
.
This seems like it could potentially be an SI joint issue, which you need to have adjusted by a good physical therapist or chiropractor.
That can cause all of the peripheral symptoms that you're having and you have pain on the marked red and yellow areas directly where the SI joint it.
If you have a leg length discrepancy or anything like that or feel like your pelvis a bit twisted those can be signs that you have an SI issue
If I'm correct you pretty much need to get this corrected before doing any rehab. Like I told some other people in this thread, if you try to rehab on top of a dysfunction that isn't corrected then you're just reinforcing bad habits that make it harder to break in the end.
On September 12 2012 19:53 rEiGN~ wrote: I decided to have my wrist checked up that's been bothering me for a quite a while (~3mo) now. The doctor was an orthopedist specialized in hand surgery and after a cursory examination he swiftly came to the conclusion that I have extensor carpi ulnaris instability and tendinopathy. He started talking about the possibility of surgery to fix it, but rather than that he said I should just get back to training and not do stuff that aggravates it -- and should it get worse, I should just rest and take anti-inflammatories until it gets better again.
The visit to the doctor has left me a bit confused. Last time I had a workout around 1½ months ago, I don’t remember noticing any acute pain, but regardless the next day the wrist felt like it had rolled back to the worst condition it had been to begin with. On the contrary to doctor’s orders to get back to training, I feel it’s probably better to wait maybe 1-2 more weeks and see if it gets asymptomatic or ameliorates in some way.
Currently there’s just one way left to induce pain on the wrist: pressing it against a table palm-side down where the hand begins. Another symptom is the occasional cracking.
In the meantime, is there something I can do that might be of help? Like soak it in hot water or perform wrist exercises with light weights.
On September 13 2012 18:02 rEiGN~ wrote: Went to a PT this morning. To summarize, she said the inflammation/tendinopathy and shit has weakened the muscles or something in my wrist and I should get back to training very slowly seeing which exercises I can perform. (for example last time I tried chinups I couldn't)
Also gave me to do 2 wrist exercises to strengthen the muscles that were lacking compared to the other arm.
This wrist strain injury has turned out to be quite expensive but it's better than sitting at home frustrated hoping rest to fix the issue by itself.
Does the wrist joint itself hurt... or is it just on the specific tendons that are giving you issues there?
What rehab exercises were you given? What type of exercises aggravate your injury?
On July 18 2012 07:19 Malinor wrote: Copied from the General Thread, since it belongs in here:
On July 18 2012 03:52 eshlow wrote:
On July 17 2012 02:17 Malinor wrote: My quadriceps sucks. I was in the middle of a training cycle to get me to a 200kg squat again, and after having all the volume in and moving to the intensity phase, I hurt myself doing jump robe. I am not really hurt badly, but from time to time while doing a wrong movement I can get a sharp pain through my quad, and it feels unstable in general. And basically when running above ~80% intensity, every step it hurts on the backside, outside of the right knee (so basically not the knee itself). Took 6 weeks off squatting and deadlifting, no difference. Went to the doctor and got electro and physiotherapy, plus stopped all running for 3 weeks, no difference, nor worse nor better. I would really like to kill some puppies now. I feel like a curl-bro when I go to the gym, keeping myself busy with so much upper body stuff. Anyway, today I just squatted again, 100kg 5x5. And of course, so since nothing that I do seems to make a difference, I just keep on squatting now. Just no weights where my technic could break down. And I'll just go to the doctor and try to get him to make a MRT. On the plusside, I broke 110kg bw for the first time (109,8), even though I had a gigantic day of feasting on saturday. 10,8kg to go. Unlikely that Phyre is gonna meet me there in time though, he does not know how to eat
How is your hip mobility?
A jacked up IT band can be compensating for other things.
What are you doing currently in therapy?
Both doctors I saw told me that the mobility in my right hip was worse than in my left one. They found it weird but didn't really drew any conclusions from it.
I mostly got massages for the connective tissue in my quad. I also did some balancing-work: balance on one foot on a pillow and catch a ball, and some form of balancing (walking) on two bands, like funambulation just on two cords.
I also experience some discomfort on my back, not only in my quad, the problem really is that it is a different spot everyday that hurts. Since you asked here, I will just use this thread instead of the injury thread:
(The points on the outside are marked from both directions, so it is 4 spots in total)
These are basically the points were I am hurting. The problematic one is the one right above the knee, this one causes instability during all movements, especially when running at intervalls at a higher speed (80-90%). Generally the pain is located on the outside of the hip/leg. The pain on my back is more a discomfort, it doesn't really cause any problems.
So I don't really know what to make of it, help would be very welcome at this point.
edit: the origin of the injury was sprinting. It got worse later after I twisted my leg during jump robe one time.
edit2: So I just did some jump robe and just landed out of place once, and I directly a sharp pain as a result: Felt totally just like quadriceps, but I don't know how these things are related. In general, a lot of explosive movements like jumps (but not all, depends on how I jump) cause me sharp pain.
edit3: just called my doctor today again for consoltation, and the nurse told me over the phone that the 'official' diagnosis was 'muscle fiber tear' / torn muscle. Though the doctor did not see anything when looking at the Ultrasound. So he did not think it was very severe. Either way, they did not tell me to stop training really, just to avoid high intensity stuff like sprinting or running. So during the last three weeks I only did cross-trainer (squatted once with 80kg, so very very light). Do you think I should stop everything all together, or is movements where I don't feel any pain fine? For example, normal jump robe is always risky, but when I just run/sprint with the robe, I don't feel anything. Would icing / foam rolling do anything here?
Sorry I didn't get back to you before I went out of town.
Check your internal and external range of motion in your hip. Most people have significantly more ER which can typically cause some issues as certain muscles get tight and the hip gets a bit gummed up.
I'm a bit confused by the fact that you're having an issue in so many places. It might not be a bad idea to get a chiro or physio to check out your SI joint and/or pelvis just in case.
Access to a good sports orthopedic doc or physical therapist would be your best bet IMO... but if you can see if improving your hip ROM on the right starts helping that may be possibly something we can figure out potentially.
Very poor doc to just recommend not doing exercises. Good professionals should be able ot work with you to get you back to what you want to do.
Can you advice me some exercises to increase internal hip rotation? I looked around a bit but to be honest did not find much that I thought made sense. Was way easier to find stuff for external rotation.
And yes, there's a lot of incorrect pictures there too
Alright, I am freaking out a little bit right now. First of all, my behaviour seems to have little to absolutely no effect on my injury. 3weeks of rest didn't help at all. And given that 2 weeks before I only used the elliptical and the two weeks afterwards I have only used a stationary bike, I really don't know what to do.
What worries me way more though is that I measured my legs 2-3 inches above my knee (basically where the quadriceps is fully developed, and there is like a 4cm difference between both legs (my latest measurement is ~63cm vs 59cm). It is actually visible while looking from the front that my left quad is just way bigger. Now my left biceps is also like 1cm bigger than the right one (like 44cm:43cm), but 4cm? I suspect that there is some local atrophy going on... I mean it feels like a fucking strain and I am not even thirty years old, somehow it should have healed itself by now, it cannot be that this thing needs like 2 months of no movement to heal (and noone even has recommended that to me, but the light exercises don't help anything at all either). I don't know what to think anymore.
Pure rest does not usually help injuries that have kind of festered for a bit.
Would very strongly suggest going to see a physical therapist about this.
Doctor doing physiotherapy (as in modalities) is not that great.
I don't have enough details but it seems like something is probably going on up in your pelvis making it unstable and it's showing up moreso in your thigh/knee area. That is what tends to happen if things don't resolve down in the thigh/knee with rest since it can't be overuse since you've rested, and you're thrown a ton of soft tissue work at it and it's still not resolving. Thus, likely culprit is up higher somewhere not at the point(s) of pain.
You need a professional to figure it out.
Alright here is a little update, I'd just like another opinion on that.
For the last two physical therapy sessions, the owner of the place came to see me to figure out what was wrong. Basically he is sure that this is just scar tissue and pretty deep agglutination. What he did is first to use some kind of vacuum bell (basically put it on the spot where the pain is located, then creating a vacuum via a reverse air pump and let me exercise through it (leg extensions) while this thing was sucked onto my quad (really hard to explain in english...). And second he massaged the muscle strands from bottom to top, but not using his thumbs as before, but with some kind of device to basically establish way more pressure. I was also not lying, but stand up, so that the muscle is under some pressure.
Long story short, it felt better instantly, though the second session did not really replicate that succes (but it was not him treating me then, and the girl may just have been too weak to establish enough pressure) and the effect by now has worn off and everything is as it was before. Anyway, I went to the doctor today trying to get a new recipe, but he wouldn't give me one and said he believed this was the final stage and it probably could get better over time. But phyiscal therapy won't help me. Since the injury occured that far back, he thinks it was initially a muscle tear. My reply, that the pain has never been severe but always like this and it never really was worse, did not have any effect on him.
So I have to pay privately for more therapy sessions. The doctor doesn't think it will do anything but the physical therapist does. I am probably gonna do it anyway, but maybe you have something useful to say about this story -.-
If you were getting results from the main guy I would request him. Not all therapists are created equal.
Generally speaking, if everyone thinks it's a strain with lots of scar tissue then I guess it is a strain... hmm... I don't know something doesn't really smell right to me about that though based on everything you've said.
If it was just a strain you should be able to rehab it with eccentrics. But first thing you should do if there's no swelling or significant inflammation is try to get it from cramping up with heat and non-painful mobility work. Then after it calms down then begin strengthening exercise.
> 2. What exercises hurt? Which shoulder articulations hurt? Make sure you > check both with passive motion and resistive/active motion. > http://www.exrx.net/Articulations/Shoulder.html >coming out of the hole on snatches and cleans, sometimes squats when i'm bouncing out of the hole, especially hurts when missing lifts in the front
> 3. What type of pain is it? Burning? Ache? Tingling? Sharp? >deep ache/weakness
> 4. What would you rate the pain at on a 0/10 scale? 0 being no pain, 10 > being go to the emergency room. >5-6, enough to prevent training
> 5. Acute or chronic (chronic more than ~6-8 weeks)? What date was onset? How > has the pain improved since the initial injury? >acute, started on sept 3rd(first day the power gym re-opened), gets better after a few days of rest then gets re-injured again
> 6. Have you been training through pain? If so, how long? >yes, since the beginning of september
> 7. How deep is the pain? Is it more superficial tissues? Or does it seem to > be more inside or around the joint? Describe it. >feels deep, almost at the bone,
> 8. What have you been doing for recovery purposes? > tiger balm, calf compression sleeves, foam rolling, stretching
> 9. What seems to help? What seems to make it worse? Is it constant? Does it > increase/decrease with certain activities? >olympic lifting makes it worse
> 10. Check the tissue quality of the surrounding muscles. Which ones are > tight? Which ones are tender? Is there any swelling? > quads seem tender during foam rolling, right hip is sore, left achilles tendon aches a bit when i stretch the calves
> 11. How does it feel after exercise (if any)? How does it feel at the > beginning of the day? How about the end of the day? > doesn't really hurt during the day, but I feel it sometimes climbing the stairs. Feels very bad after training, but seems to go away fast after training is over.
> 12. Any previous injury history? >On and off knee pain
> 13. How's your posture? >decent
> 14. What is your current workout routine for that bodypart? Do you play any > sports? >olympic weightlifting, no real emphasis on calf work
> 15. Any other information I should be aware of or that comes to mind that > may help? >elite level CNS
So it's more on the fibula and not on the gastroc/soleus area?
Is there a video of the technique he is currently using and the specific time during that technique that causes pain?
Coming out of the hole means at the bottom of the hole or where the thighs are parallel with the ground? Is weight on the front of the foot, etc?
> 2. What exercises hurt? Which shoulder articulations hurt? Make sure you > check both with passive motion and resistive/active motion. > http://www.exrx.net/Articulations/Shoulder.html >coming out of the hole on snatches and cleans, sometimes squats when i'm bouncing out of the hole, especially hurts when missing lifts in the front
> 3. What type of pain is it? Burning? Ache? Tingling? Sharp? >deep ache/weakness
> 4. What would you rate the pain at on a 0/10 scale? 0 being no pain, 10 > being go to the emergency room. >5-6, enough to prevent training
> 5. Acute or chronic (chronic more than ~6-8 weeks)? What date was onset? How > has the pain improved since the initial injury? >acute, started on sept 3rd(first day the power gym re-opened), gets better after a few days of rest then gets re-injured again
> 6. Have you been training through pain? If so, how long? >yes, since the beginning of september
> 7. How deep is the pain? Is it more superficial tissues? Or does it seem to > be more inside or around the joint? Describe it. >feels deep, almost at the bone,
> 8. What have you been doing for recovery purposes? > tiger balm, calf compression sleeves, foam rolling, stretching
> 9. What seems to help? What seems to make it worse? Is it constant? Does it > increase/decrease with certain activities? >olympic lifting makes it worse
> 10. Check the tissue quality of the surrounding muscles. Which ones are > tight? Which ones are tender? Is there any swelling? > quads seem tender during foam rolling, right hip is sore, left achilles tendon aches a bit when i stretch the calves
> 11. How does it feel after exercise (if any)? How does it feel at the > beginning of the day? How about the end of the day? > doesn't really hurt during the day, but I feel it sometimes climbing the stairs. Feels very bad after training, but seems to go away fast after training is over.
> 12. Any previous injury history? >On and off knee pain
> 13. How's your posture? >decent
> 14. What is your current workout routine for that bodypart? Do you play any > sports? >olympic weightlifting, no real emphasis on calf work
> 15. Any other information I should be aware of or that comes to mind that > may help? >elite level CNS
So it's more on the fibula and not on the gastroc/soleus area?
Is there a video of the technique he is currently using and the specific time during that technique that causes pain?
Coming out of the hole means at the bottom of the hole or where the thighs are parallel with the ground? Is weight on the front of the foot, etc?
Need some more details.
Does this help?
also "I'm kind of high on painkillers right now from wisdom tooth surgery, I'll get back to you on that"
On September 12 2012 19:53 rEiGN~ wrote: I decided to have my wrist checked up that's been bothering me for a quite a while (~3mo) now. The doctor was an orthopedist specialized in hand surgery and after a cursory examination he swiftly came to the conclusion that I have extensor carpi ulnaris instability and tendinopathy. He started talking about the possibility of surgery to fix it, but rather than that he said I should just get back to training and not do stuff that aggravates it -- and should it get worse, I should just rest and take anti-inflammatories until it gets better again.
The visit to the doctor has left me a bit confused. Last time I had a workout around 1½ months ago, I don’t remember noticing any acute pain, but regardless the next day the wrist felt like it had rolled back to the worst condition it had been to begin with. On the contrary to doctor’s orders to get back to training, I feel it’s probably better to wait maybe 1-2 more weeks and see if it gets asymptomatic or ameliorates in some way.
Currently there’s just one way left to induce pain on the wrist: pressing it against a table palm-side down where the hand begins. Another symptom is the occasional cracking.
In the meantime, is there something I can do that might be of help? Like soak it in hot water or perform wrist exercises with light weights.
On September 13 2012 18:02 rEiGN~ wrote: Went to a PT this morning. To summarize, she said the inflammation/tendinopathy and shit has weakened the muscles or something in my wrist and I should get back to training very slowly seeing which exercises I can perform. (for example last time I tried chinups I couldn't)
Also gave me to do 2 wrist exercises to strengthen the muscles that were lacking compared to the other arm.
This wrist strain injury has turned out to be quite expensive but it's better than sitting at home frustrated hoping rest to fix the issue by itself.
Does the wrist joint itself hurt... or is it just on the specific tendons that are giving you issues there?
What rehab exercises were you given? What type of exercises aggravate your injury?
I think it's tendon related.
The two exercises are rotation of the wrist, and then with hand hanging off the edge of table lift it while focusing on that the wrist is completely straight. Both with a light dumbbell.
I'll be able to tell more about bad exercises after I get back to the gym next week but chinups at least.
On September 12 2012 19:53 rEiGN~ wrote: I decided to have my wrist checked up that's been bothering me for a quite a while (~3mo) now. The doctor was an orthopedist specialized in hand surgery and after a cursory examination he swiftly came to the conclusion that I have extensor carpi ulnaris instability and tendinopathy. He started talking about the possibility of surgery to fix it, but rather than that he said I should just get back to training and not do stuff that aggravates it -- and should it get worse, I should just rest and take anti-inflammatories until it gets better again.
The visit to the doctor has left me a bit confused. Last time I had a workout around 1½ months ago, I don’t remember noticing any acute pain, but regardless the next day the wrist felt like it had rolled back to the worst condition it had been to begin with. On the contrary to doctor’s orders to get back to training, I feel it’s probably better to wait maybe 1-2 more weeks and see if it gets asymptomatic or ameliorates in some way.
Currently there’s just one way left to induce pain on the wrist: pressing it against a table palm-side down where the hand begins. Another symptom is the occasional cracking.
In the meantime, is there something I can do that might be of help? Like soak it in hot water or perform wrist exercises with light weights.
On September 13 2012 18:02 rEiGN~ wrote: Went to a PT this morning. To summarize, she said the inflammation/tendinopathy and shit has weakened the muscles or something in my wrist and I should get back to training very slowly seeing which exercises I can perform. (for example last time I tried chinups I couldn't)
Also gave me to do 2 wrist exercises to strengthen the muscles that were lacking compared to the other arm.
This wrist strain injury has turned out to be quite expensive but it's better than sitting at home frustrated hoping rest to fix the issue by itself.
Does the wrist joint itself hurt... or is it just on the specific tendons that are giving you issues there?
What rehab exercises were you given? What type of exercises aggravate your injury?
I think it's tendon related.
The two exercises are rotation of the wrist, and then with hand hanging off the edge of table lift it while focusing on that the wrist is completely straight. Both with a light dumbbell.
I'll be able to tell more about bad exercises after I get back to the gym next week but chinups at least.
I developed a nagging pain in my kneecap. I'm sure the culprit is somekind of overuse injury, stemming from me not pushing out my knees enough while squatting, combined with me doing some kind of activity (running, climbing) that involves the knee every day.
Currently, I'm resting my knee completely - walking as little as possible, and not doing any lifts that involve my legs.
Do I need to do anything other than rest until the pain goes away? If it doesn't go away, should I see a doctor in a week? Two weeks? What upper-body exercises should I be doing? I've been doing presses, deadlifts and squats as well as running. Presses are obviously still in, and I added barbell rows, lat pulldowns, curls and chin-ups to have something to do while waiting. Is there anything you could suggest I add in?
On September 19 2012 22:03 kmh wrote: I developed a nagging pain in my kneecap. I'm sure the culprit is somekind of overuse injury, stemming from me not pushing out my knees enough while squatting, combined with me doing some kind of activity (running, climbing) that involves the knee every day.
Currently, I'm resting my knee completely - walking as little as possible, and not doing any lifts that involve my legs.
Do I need to do anything other than rest until the pain goes away? If it doesn't go away, should I see a doctor in a week? Two weeks? What upper-body exercises should I be doing? I've been doing presses, deadlifts and squats as well as running. Presses are obviously still in, and I added barbell rows, lat pulldowns, curls and chin-ups to have something to do while waiting. Is there anything you could suggest I add in?
Can you answer the questions in the spoiler in the OP so I can better get an idea of what this might potentially be.
Can you answer the questions in the spoiler in the OP so I can better get an idea of what this might potentially be.
Oh sorry.
1. The pain is immediately around the kneecap. Slightly below it, and slightly to the inside.
2. The pain is mostly present when locking out my knee or bending it while sitting. Keep it bent in a relaxed state makes the pain all but disappear.
3. Burning, I'd say. It's very dull.
4. 3/10, maybe? I could easily ignore it and go through it, I don't need pain medication to push through. Then it first flared up, it was closer to a 6/10 - enough to make me immediately stop what I was doing, wait for the worst to subside, and go home without delay.
5. Acute. It was onset walking down a set of stairs away from the rock climbing gym. 10th of September.
6. I tried training through it for a week. I was trying to be careful but still kept doing the same exercises. The pain did not go away, thus I am now giving it as complete a rest as I reasonably can without a brace. It also did not get any worse.
7. Hard to say. My knee pops and cracks more than usual and hurts a bit when it does, but mostly it feels like soreness around the kneecap. The tissue doesn't feel tender if I try to massage it, but if I put pressure on the joints (kneecap, bones) it definitively hurts.
8. Resting as much as I can. I have a sedentary job, which is not really helping, but I've been trying to avoid excessive walking or motion.
9. Putting weight on it makes it worse the day after. It does not flare up immediately.
10. I honestly can not say what feels tight and what not. There's no discernable swelling. Nothing seems tender when I massage it. Massaging the kneecap itself feels slightly painful.
11. Some mornings I've slept mostly on my back and it feels fine. Other mornings I've slept in a fetal position and it feels worse. It's mostly the same throughout the day. I have a desk job, and it gets a bit worse towards the end of the day. Once I get home, it gets better.
12. None whatsoever, I've been lucky.
13. A bit of a nerd hunch (APT), but it's not excessive.
14. My routine before the injury would be to squat 3x a week, run 2 miles 3x a week, cilmb 1x a week as well as doing bodyweight leg exercises (lunges etc) once a week - so my knee was definitively put under some stress. Right now the only things I do are standing exercises (barbell rows for instance), as well as sitting down.
15. Like I said, I feel inclined to think that this is mostly related to my knees not pushing out towards the side enough when doing barbell squats. The injury didn't feel like much at all, before stepping down a flight of stairs suddenly hurt a lot. After that, there's been low-level pain that hasn't gone away. To remedy this, I have ceased all leg-focused activities in order to allow my knee to rest.
Thank you so much for taking the time to help me out. I don't think there's much to worry about - I just feel inclined to ask how long I should wait before heading to a doctor, and if there's any upper-body exercises I could be doing while I heal up that I'm neglecting.
4. 3/10, maybe? I could easily ignore it and go through it, I don't need pain medication to push through. Then it first flared up, it was closer to a 6/10 - enough to make me immediately stop what I was doing, wait for the worst to subside, and go home without delay.
5. Acute. It was onset walking down a set of stairs away from the rock climbing gym. 10th of September.
6. I tried training through it for a week. I was trying to be careful but still kept doing the same exercises. The pain did not go away, thus I am now giving it as complete a rest as I reasonably can without a brace. It also did not get any worse.
7. Hard to say. My knee pops and cracks more than usual and hurts a bit when it does, but mostly it feels like soreness around the kneecap. The tissue doesn't feel tender if I try to massage it, but if I put pressure on the joints (kneecap, bones) it definitively hurts.
8. Resting as much as I can. I have a sedentary job, which is not really helping, but I've been trying to avoid excessive walking or motion.
9. Putting weight on it makes it worse the day after. It does not flare up immediately.
10. I honestly can not say what feels tight and what not. There's no discernable swelling. Nothing seems tender when I massage it. Massaging the kneecap itself feels slightly painful.
11. Some mornings I've slept mostly on my back and it feels fine. Other mornings I've slept in a fetal position and it feels worse. It's mostly the same throughout the day. I have a desk job, and it gets a bit worse towards the end of the day. Once I get home, it gets better.
12. None whatsoever, I've been lucky.
13. A bit of a nerd hunch (APT), but it's not excessive.
14. My routine before the injury would be to squat 3x a week, run 2 miles 3x a week, cilmb 1x a week as well as doing bodyweight leg exercises (lunges etc) once a week - so my knee was definitively put under some stress. Right now the only things I do are standing exercises (barbell rows for instance), as well as sitting down.
15. Like I said, I feel inclined to think that this is mostly related to my knees not pushing out towards the side enough when doing barbell squats. The injury didn't feel like much at all, before stepping down a flight of stairs suddenly hurt a lot. After that, there's been low-level pain that hasn't gone away. To remedy this, I have ceased all leg-focused activities in order to allow my knee to rest.
Thank you so much for taking the time to help me out. I don't think there's much to worry about - I just feel inclined to ask how long I should wait before heading to a doctor, and if there's any upper-body exercises I could be doing while I heal up that I'm neglecting.
I think your general hunch seems to be correct that you're having some mechanics issues. Also potentially some plica syndrome which may respond well to some ice or heat... take your pick if there's no swelling and see how it does.
Keeping the knees out over the toes during squats does not just apply to squats though... it applies to ALL of the exercises during the day including walking up and down stairs etc.
If you let the leg collapse in leg that it may eventually become knock kneed and you can have tons of issues including increased potential for ligament tears and whatnot. Also puts you at risk for meniscus issues which I would not rule out with it hurting at end range and then very deep flexion.
You can continue your normal exercise routine, albeit avoid any exercises that tend to aggravate it. So all of the upper body work you can still do. I don't know if you do any lower body work that doesn't hurt though. Make sure when you climb you don't allow that to happen because the knees can go everywhich way especially during tougher climbs.
I would make a docs appointment NOW because it usually takes a week or two to get in. If it's not significant better by then you'd want to see a doc anyway. If it is better then you can cancel the appointment -- but be couteous if you think you're gonna cancel then try to do it ASAP so they know and can schedule someone else in the slot.
Thanks. I was actually able to get a doctor's appointment in today, and he came to the exact conclusion you did. When he tested extreme flexion it did no longer hurt. The diagnosis was a case of patellar chondromalacia, caused by mechanical issues (knee collapsing).
To help fix the mechanics, I was asked to continue exercising, but obviously stop if there's any sharp pain. In particular, I should do hamstring stretches, sprints, and knee extensions to help remedy the mechanical issues. I was also prescribed anti-inflammatory painkillers that are to be taken as needed.
If there's any sharp pain or reduced ROM, I should book another appointment. The doctor pointed out that the healing will take time and I can expect soreness to last for up to a month as part of that.
On September 21 2012 20:52 kmh wrote: Thanks. I was actually able to get a doctor's appointment in today, and he came to the exact conclusion you did. When he tested extreme flexion it did no longer hurt. The diagnosis was a case of patellar chondromalacia, caused by mechanical issues (knee collapsing).
To help fix the mechanics, I was asked to continue exercising, but obviously stop if there's any sharp pain. In particular, I should do hamstring stretches, sprints, and knee extensions to help remedy the mechanical issues. I was also prescribed anti-inflammatory painkillers that are to be taken as needed.
If there's any sharp pain or reduced ROM, I should book another appointment. The doctor pointed out that the healing will take time and I can expect soreness to last for up to a month as part of that.
Hmmm, chondromalacia patella generally affects the lateral aspect of the patella, but it can affect the medial to some extent.
For patellofemoral syndrome you want to focus on correcting mechanics, especially sitting back in squatting to get more glute activation and keeping the knee out.
Studies have shown that you need to be doing both hip external rotation control (sidelying clams are a good initial step before going to squats) and more glute activation type work along with squat technique. Then strengthen the quad/hams up too.
2. What exercises hurt? Which shoulder articulations hurt? Make sure you check both with passive motion and resistive/active motion. After running, sometimes during running it hurts when I stand on my toes. Lately it has been hurting even the day after.
3. What type of pain is it? Burning? Ache? Tingling? Sharp? Incredibly hard to explain... Feels like my bones are scraping up against eachother.
4. What would you rate the pain at on a 0/10 scale? 0 being no pain, 10 being go to the emergency room. 2, its not painful at all and I can easily walk/run thru the pain.
5. Acute or chronic (chronic more than ~6-8 weeks)? What date was onset? How has the pain improved since the initial injury? Been around for 3-4 weeks, but hasnt been bothering me too much. This week it has been a little worse than usual tho.
6. Have you been training through pain? If so, how long? There is only a little bit of pain after i take off my running shoes or when i do sprints.
7. How deep is the pain? Is it more superficial tissues? Or does it seem to be more inside or around the joint? Describe it. Around the joint, like there is something between the bones being annoying or the bones are hitting and scraping eachother.
8. What have you been doing for recovery purposes? Nothing, I cant really stretch it or anything.
9. What seems to help? What seems to make it worse? Is it constant? Does it increase/decrease with certain activities? Pain goes away quite quickly. Running and sprinting esspecially makes it worse. Also cycling for long periods of time on a racerbike with feet locked to the pedal makes it bad, but only right after taking the cyclingshoes off.
10. Check the tissue quality of the surrounding muscles. Which ones are tight? Which ones are tender? Is there any swelling? I honestly don't really know much about how my foot is supposed to feel. There is callus everywhere down there since have done a couple of barefeet runs on asphalt.. My toe is not near as flexible as this + Show Spoiler +
11. How does it feel after exercise (if any)? How does it feel at the beginning of the day? How about the end of the day? Usually no pain in the beginning of the day. And pain after the excercise when i am stepping on top of my toes (dorsiflexion? I thinks thats what its called when you extend your toe upwards.)
12. Any previous injury history? Nothing in the feet, little bit of trouble with the patella a long time ago, which Eshlow fixed
13. How's your posture? Trying to correct my slouchy shoulders and anterior pelvic tilt. Not much progress here tho..
14. What is your current workout routine for that bodypart? Do you play any sports? I lift weights 3-4 times a week and run about 4 times a week. Not many lifts have me on my toes tho, only like push presses.
15. Any other information I should be aware of or that comes to mind that may help? My dad has a lot of arthritis in his toes? Not sure is this is something that is genetical, and im only 19 anyway so im way too young to get arthritis, I hope
2. What exercises hurt? Which shoulder articulations hurt? Make sure you check both with passive motion and resistive/active motion. After running, sometimes during running it hurts when I stand on my toes. Lately it has been hurting even the day after.
3. What type of pain is it? Burning? Ache? Tingling? Sharp? Incredibly hard to explain... Feels like my bones are scraping up against eachother.
4. What would you rate the pain at on a 0/10 scale? 0 being no pain, 10 being go to the emergency room. 2, its not painful at all and I can easily walk/run thru the pain.
5. Acute or chronic (chronic more than ~6-8 weeks)? What date was onset? How has the pain improved since the initial injury? Been around for 3-4 weeks, but hasnt been bothering me too much. This week it has been a little worse than usual tho.
6. Have you been training through pain? If so, how long? There is only a little bit of pain after i take off my running shoes or when i do sprints.
7. How deep is the pain? Is it more superficial tissues? Or does it seem to be more inside or around the joint? Describe it. Around the joint, like there is something between the bones being annoying or the bones are hitting and scraping eachother.
8. What have you been doing for recovery purposes? Nothing, I cant really stretch it or anything.
9. What seems to help? What seems to make it worse? Is it constant? Does it increase/decrease with certain activities? Pain goes away quite quickly. Running and sprinting esspecially makes it worse. Also cycling for long periods of time on a racerbike with feet locked to the pedal makes it bad, but only right after taking the cyclingshoes off.
10. Check the tissue quality of the surrounding muscles. Which ones are tight? Which ones are tender? Is there any swelling? I honestly don't really know much about how my foot is supposed to feel. There is callus everywhere down there since have done a couple of barefeet runs on asphalt.. My toe is not near as flexible as this + Show Spoiler +
11. How does it feel after exercise (if any)? How does it feel at the beginning of the day? How about the end of the day? Usually no pain in the beginning of the day. And pain after the excercise when i am stepping on top of my toes (dorsiflexion? I thinks thats what its called when you extend your toe upwards.)
12. Any previous injury history? Nothing in the feet, little bit of trouble with the patella a long time ago, which Eshlow fixed
13. How's your posture? Trying to correct my slouchy shoulders and anterior pelvic tilt. Not much progress here tho..
14. What is your current workout routine for that bodypart? Do you play any sports? I lift weights 3-4 times a week and run about 4 times a week. Not many lifts have me on my toes tho, only like push presses.
15. Any other information I should be aware of or that comes to mind that may help? My dad has a lot of arthritis in his toes? Not sure is this is something that is genetical, and im only 19 anyway so im way too young to get arthritis, I hope
Honestly. it sounds like some turf toe or something very similar.
I would suggest laying off of those activities that are making it worse.
There is some funky weird mechanics going on in that snatch but nothing like blatantly out of line.
Does any type of end range of motion knee, ankle or anything like that type of movement hurt?
I'm thinking potentially he needs a fibular head or ankle mobilization.
Any big impacts or anything like that in the past few weeks or so?
I'll send these questions to him now. Sorry i forgot to update this before.
So it's more on the fibula and not on the gastroc/soleus area? I don't think its bone pain, I would definitely say its in the muscle
Coming out of the hole means at the bottom of the hole or where the thighs are parallel with the ground? Is weight on the front of the foot, etc? It hurts the most at the point when I'm breaking parallel on the way up. I feel pretty stable, so I think the weight is on my heels
----- Any big impacts or anything like that in the past few weeks or so? no end ROM pain, no impacts
There is some funky weird mechanics going on in that snatch but nothing like blatantly out of line.
Does any type of end range of motion knee, ankle or anything like that type of movement hurt?
I'm thinking potentially he needs a fibular head or ankle mobilization.
Any big impacts or anything like that in the past few weeks or so?
I'll send these questions to him now. Sorry i forgot to update this before.
So it's more on the fibula and not on the gastroc/soleus area? I don't think its bone pain, I would definitely say its in the muscle
Coming out of the hole means at the bottom of the hole or where the thighs are parallel with the ground? Is weight on the front of the foot, etc? It hurts the most at the point when I'm breaking parallel on the way up. I feel pretty stable, so I think the weight is on my heels
----- Any big impacts or anything like that in the past few weeks or so? no end ROM pain, no impacts
I'm thinking that some fibular head mobilizations would probably help:
Also, before you do these (although you may want someone experienced to do them) you should focus on massage and potentially foam rolling to loosen up the muscles a bit.
EPT![[image loading]](http://img198.imageshack.us/img198/7798/lowerbackpain.jpg)
![[image loading]](http://media.summitmedicalgroup.com/media/db/relayhealth-images/xlbpm.jpg)
![[image loading]](http://i.imgur.com/srOSz.png)
![[image loading]](http://i.imgur.com/KGxF6.png)
![[image loading]](http://i.imgur.com/Sggvj.png)
![[image loading]](http://www.footankleinstitute.com/Portals/14171/images/BigtoeROM2.jpg)
