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Weight Loss Forum / General Topics / March 2004First PT appointment for the knee problem
I finally found a physical therapist convienent enough to work that it won't cause problems with my working hours, and finally worked out all the HMO insurance crap and today had the first appointment. She went over the diagnosis of Chondromalacia, (aka Patella tracking disorder, runners knee, etc). and verified that is indeed what I have. Treatment: Cease all exercise (weights and cardio) for the time being. Well, I'd done that already. Allowed exercise - my recumbent bike, within reason. Elliptical, if it doesn't hurt - but the elliptical was hurting me alot when this first flared up, whereas the recumbent didn't. I didn't ask about my bicycling, now that the time is about to change, so I'll ask that tomorrow. Its not like I ride on any hills or anthign - flat ground, should be the same as a stationary bike. No squatting, no kneeling, no resting on the knees. Deep squats a BIG NO, NO... (hey, that's what *she* said...) I do have alot of pain in my left knee still and she could see/feel the problems and the swelling. We will be doing cortison massages 3 x per week. (well, its a drug like cortison, but its a rub that penitrates 2" down into the muscle, instead of the shot). I will be doing my own massages 2 times a day, to massage the outer tendon. Exercises to build the vastas medialis (inside quad muscle that runs down next to the knee. But at the same time does not engage the IT muscle (outer thigh muscle). (I hope I'm getting their names right). No weights for now with the exercises. We'll see how it goes over the next few weeks to eventually get me back into the gym and back to my regular routine... although I pressume running is out for quite a while until I get this done. Types of exercises. Ball squeeze thing. Squeeze a ball between my knees. Front leg lifts leg extensions from the knee down side leg extensions And stretches to relax the IT muscle I've probably missed something - but that's the jist of it. Oh, and an interesting note... My typical squat stance is a little wider than shoulder width - because I am female and there's the whole hip thing. She said while on one hand that is probably what has saved me all these years to where it hasn't bother me, because I took that precaution - on the other hand it means that interior quad muscle was not getting the activity to strengthen - and it was the exterior IT muscle that gets built up, and in feeling my thighs, she could certainly feel the strength and muscle of the outer thighs and the weakness (squishyness) of that interior muscle. So - there we are. 4 weeks, 3 times a week for visits, and PT on my own ever day. Now, to cut calories as low as possible to try to combat this 10lb gain I'm dealing with, since I can't make up the calories in exercise. > I finally found a physical therapist convienent enough to work that it > won't cause problems with my working hours, and finally worked out all > the HMO insurance crap and today had the first appointment. It's probably a relief just to get that part of it done. > Allowed exercise - my recumbent bike, within reason. Elliptical, if > it doesn't hurt - but the elliptical was hurting me alot when this > first flared up, whereas the recumbent didn't. I didn't ask about my > bicycling, now that the time is about to change, so I'll ask that > tomorrow. Its not like I ride on any hills or anthign - flat ground, > should be the same as a stationary bike. Actually it isn't because you are hauling the weight of the bike and yourself around whereas on an exercise bike you're stationary and not having to balance the bike between your legs so there's no stabilizing needed. > Oh, and an interesting note... My typical squat stance is a little > wider than shoulder width - because I am female and there's the whole [quoted text clipped - 5 lines] > certainly feel the strength and muscle of the outer thighs and the > weakness (squishyness) of that interior muscle. I was just asking my trainer about the thigh thing yesterday because my outer thighs are rather solid while my inner thigh muscles are barely existent. He had me try one legged assisted squats (unweighted) which were more like a lunge only the back leg is lifted and doesn't touch the floor. > So - there we are. 4 weeks, 3 times a week for visits, and PT on my > own ever day. > > Now, to cut calories as low as possible to try to combat this 10lb > gain I'm dealing with, since I can't make up the calories in exercise. Meat and salad diet - or meat salad diet? Jenn > > I finally found a physical therapist convienent enough to work that it > > won't cause problems with my working hours, and finally worked out all > > the HMO insurance crap and today had the first appointment. > > It's probably a relief just to get that part of it done. that part is done - now I'm in the battle w/ the doc/pharm/insurance over this stuff they want to use with the massage to get the kink out of the muscles. GGGGGGGGGRRRRRRRRRRRR.... A bunch of bumbling idiots! > Actually it isn't because you are hauling the weight of the bike and > yourself around whereas on an exercise bike you're stationary and not having > to balance the bike between your legs so there's no stabilizing needed. ah, stabilizing, that makes sense, although, I would think that mught help with that muscle thing. > I was just asking my trainer about the thigh thing yesterday because my > outer thighs are rather solid while my inner thigh muscles are barely > existent. He had me try one legged assisted squats (unweighted) which were > more like a lunge only the back leg is lifted and doesn't touch the floor. Ah, another thing on my "nono" list. Lunges are worse than squats (per the PT). But you are right - take the time to concentrate on that inner muscle. I'd be happy to share these exercises with anyone who cares, so that they too, can benifit One thing the PT mentioned is that the stair climber machines made this injury very common. But she said that ellipticals are usually pretty good at workign the muscles correctly - because they offer low impact as well as the feet are positioned at a more neutral position to evenly build the muscle. > Meat and salad diet - or meat salad diet? Probably more of a meat and salad as apposed to meat salad. I'm not much for mayo, so the meat salad things generally are limited. Today I had my sandwhich: 2 pieces of the Arnold, low carb bread. Mircle whip, mustard, 2 slices swiss cheese (packaged kind), and a healthy serving of liverworst. I love that stuff. Tonight's dinner - unknown. I'm in a really grumpy mood, nothing is thawed, but I have to come up with something to feed the child (little sh.t that skipped out of soccer practice tonight). Not sure - as I don't think we have any bread in the house, that I coulduse for the old copout of soup/grilled cheese sammiches. We are also out of salad greens, I could sit and eat carrots, tomatoes, cucumbers, celery, radishes and grapes and throw in some cottage cheese and some deli meats. hhhhmmmm... that's not sounding that bad. I'm too grumpy right now to go to the grocery to pick up those few necessities. "JayJay" > One thing the PT mentioned is that the stair climber machines made this > injury very common. But she said that ellipticals are usually pretty good > at workign the muscles correctly - because they offer low impact as well as > the feet are positioned at a more neutral position to evenly build the > muscle. I can see that.... I can't even climb real stairs w/out mild knee pain. However, the elliptical doesn't hurt hardly at all. I am going to try to start back at cardio next week... Glad to hear you've been able to find a PT that works into your schedule. I hate having to go to a specialist because they never have convenient hours for those of us who work. Hope you get this problem cleared up soon and can get back to regular exercise. Beverly > I finally found a physical therapist convienent enough to work that it > won't cause problems with my working hours, and finally worked out all [quoted text clipped - 62 lines] > Now, to cut calories as low as possible to try to combat this 10lb > gain I'm dealing with, since I can't make up the calories in exercise. > I finally found a physical therapist convienent enough to work that it > won't cause problems with my working hours, and finally worked out all [quoted text clipped - 30 lines] > Exercises to build the vastas medialis (inside quad muscle that runs > down next to the knee. But at the same time does not engage the IT My IT band is what Ahmed always works over in massage and it does give me some relief. I squat wide and do my cleans and snatches with a wide stance...that may not be a good idea, huh.? Did she give you any hints on what to do when you know that the patella is out of kilter? I've tried any number of things, but nothing seem to work consistently. Mostly I just wait it out and then...gritch...it slides back into place. I am waiting until after the competition before moving forward...mostly a time constraint thing. Hopefully, my knees will cooperate. Yesterday, I was in tons of pain...today nothing. I can't figure it out. Good luck...let us know if it works. Oh yes, one last question.....this no squatting thing is not permanent is it???? I could live with a moratorium on weights, but not complete banishment! Good luck.. Elise > muscle (outer thigh muscle). (I hope I'm getting their names right). > [quoted text clipped - 28 lines] > Now, to cut calories as low as possible to try to combat this 10lb > gain I'm dealing with, since I can't make up the calories in exercise. > My IT band is what Ahmed always works over in massage and it does give me > some relief. I squat wide and do my cleans and snatches with a wide [quoted text clipped - 8 lines] > permanent is it???? I could live with a moratorium on weights, but not > complete banishment! OK, from what I gathered from today's converstation. The wide stance is a good thing for keeping patella trackign disorder at bay. Afterall, cuz us women have hips, our legs have a tendency to veer inwards, and the normal stance of a squat would put undu pressure on the knees. The wide stance will help balance that. But, in the process, it tends to work the IT band (muscle, whatever) out more than it does that internal thigh/knee muscle. hence you build the IT, and the other goes slack. The goal in PT is to build the inner muscle, while not working the IT. Instead, work on stretching and relaxing the IT band. Right now I'm starting out with no weights for the PT sessions. I have to get my knee to the point where I don't have the swelling and pinching pains when I straighten it up, or the throbbing pains when baring weight on it. Once I get my knee to pain free, then we will add weights. I will have to certainly change my routine up. Eventually I'm sure I'll get back into squatting, but I'll have to be sure to counter the workout with something that will target that inner thigh muscle. I'm sure this is where leg extensions would come in, as well as some other exercises. That old "aerobic" one of laying on the side, upper leg over the bottom, then lifting the bottom leg to work out the inner thigh. Or the other one she has me doing of sqeezing a ball between my thighs... Suzanne summers,... thigh master... :) Maybe discussing this w/ Ahmed will give you some insight. "JayJay" > I'm sure this is where leg extensions would come in, as well as some other > exercises. That old "aerobic" one of laying on the side, upper leg over > the bottom, then lifting the bottom leg to work out the inner thigh. Or > the other one she has me doing of sqeezing a ball between my thighs... > Suzanne summers,... thigh master... :) What about using the hip machines where you alternate pushing legs open and pulling them together (adductor or abductor machines I think, don't do a spell check!). The one that you use to close thight works IT muscles, right? > "JayJay" > [quoted text clipped - 8 lines] > spell check!). The one that you use to close thight works IT muscles, > right? You'll have to follow along down the road of my recovery. Right now, the goal is to get the swelling down and the grinding to stop. > No squatting, no kneeling, no resting on the knees. Deep squats a > BIG NO, NO... Welcome to my world. :-/  SignatureSmokey 425/225/2?? - Orwell and Roddenberry weren't just writers, they were prophets. - "A lie can go round the world before the truth has got its boots on." Terry Pratchett - "Nothing will benefit human health and increase the chances for survival of life on Earth as much as the evolution of a vegetarian diet." Albert Einstein > I finally found a physical therapist convienent enough to work that it > won't cause problems with my working hours, and finally worked out all [quoted text clipped - 7 lines] > Cease all exercise (weights and cardio) for the time being. Well, > I'd done that already. Argggh, how awful! Thank God you've already lost your weight. It probably makes a big difference in how aggressively they take your condition. Like with Jenn, I suspect you get a whole lot better treatment as a slender person. A fat person would just be told, "lost the fat and your knee will feel better." > Oh, and an interesting note... My typical squat stance is a little > wider than shoulder width - because I am female and there's the whole [quoted text clipped - 5 lines] > certainly feel the strength and muscle of the outer thighs and the > weakness (squishyness) of that interior muscle. So does she suggest you should have done adductor exercises? (Like the Nautilus one where you squeeze your legs together?) I didn't quite track the point of that - I've got wide-stance squats, too. In fact, the sumo deadlifts are hurting my knees more than the squats ever did. Should I add some exercise? > Now, to cut calories as low as possible to try to combat this 10lb > gain I'm dealing with, since I can't make up the calories in exercise. Isn't that off-topic? :-) Dally "Jayjay" > I finally found a physical therapist convienent enough to work that it > won't cause problems with my working hours, and finally worked out all > the HMO insurance crap and today had the first appointment. Great news! Did you like them?? Did they seem to want to work with you?? > Treatment: > > Cease all exercise (weights and cardio) for the time being. Well, > I'd done that already. That must be hard. > Allowed exercise - my recumbent bike, within reason. Elliptical, if > it doesn't hurt - but the elliptical was hurting me alot when this > first flared up, whereas the recumbent didn't. I didn't ask about my > bicycling, now that the time is about to change, so I'll ask that > tomorrow. Its not like I ride on any hills or anthign - flat ground, > should be the same as a stationary bike. I would think that bicycling would cause more knee strain then using the recumbent bike. You may not go over hills, but you could be on uneven pavement, which would be jarring. > We will be doing cortison massages 3 x per week. (well, its a drug > like cortison, but its a rub that penitrates 2" down into the muscle, > instead of the shot). Have you done this yet? Was it helpful? > Types of exercises. > [quoted text clipped - 3 lines] > side leg extensions > And stretches to relax the IT muscle Are you still able to work out upper body on weights?? > Oh, and an interesting note... My typical squat stance is a little > wider than shoulder width - because I am female and there's the whole [quoted text clipped - 5 lines] > certainly feel the strength and muscle of the outer thighs and the > weakness (squishyness) of that interior muscle. That is kinda interesting. I will have to monitor how I stand when I do ball squats, as I have big hips. > So - there we are. 4 weeks, 3 times a week for visits, and PT on my > own ever day. At least you've gotten a plan of action and a path on the road to recovery. That must be a big relief. > Now, to cut calories as low as possible to try to combat this 10lb > gain I'm dealing with, since I can't make up the calories in exercise. > Great news! Did you like them?? Did they seem to want to work with you?? I'm still kinda indifferent to her. It'll take time to form a good opinion > > We will be doing cortison massages 3 x per week. (well, its a drug > > like cortison, but its a rub that penitrates 2" down into the muscle, > > instead of the shot). > > Have you done this yet? Was it helpful? Oh, that is a whole nother story. The drug I need must be called in as a script from the referring physician. They called it into my pharm, who in turn, didn't understand which drug to get. i guess he called the GP back, but got the machine, and never got a return call last night. Therefore, the script isn't available, so I won't have it for today's session either. I guess I'll have to wait until next week for that to start being used. > Are you still able to work out upper body on weights?? I don't see why not. As long as I'm not squatting down to pick up the weight. "JayJay" > > Are you still able to work out upper body on weights?? > > I don't see why not. As long as I'm not squatting down to pick up the > weight. That is good news. You can work on your arms and back at least. >"JayJay" > [quoted text clipped - 4 lines] >> >That is good news. You can work on your arms and back at least. Yup - now to find the time to get my a.s back into the gym. Being a soccer mom and work, takes up alot of time. Trying to find that motivation I had to get up at 4:30am when I was doing bootcamp last fall. :-) I would probably be better off for the injury risk sake - if I used the machines at the gym, as opposed to the dumbells and free weights at home. Although at home I can position bench in front of weight rack and lift from the sitting position. I think you would be ok if you are sitting while using the free weights at home. You won't strain your legs that way and you won't have to hobble around the gym. "Jayjay" > I would probably be better off for the injury risk sake - if I used > the machines at the gym, as opposed to the dumbells and free weights > at home. Although at home I can position bench in front of weight > rack and lift from the sitting position. >I think you would be ok if you are sitting while using the free weights at >home. You won't strain your legs that way and you won't have to hobble >around the gym. Well, the plus side to the gym would be to try the elliptical again, once the swellign goes down. And of course, once I get back to the weight stuff, I'll be able to use the equipment for the leg extensions, hip extensions and the other things that she may allow me to do. :) Right now the tuff part is once again, scheduling. Here I was thinking I'd lucked out again. DS signed up for soccer for the spring, and the way the Y is working it, its more like a "clinic" than they usual team sport thing. They offer practice 3 nights a week. T-W-T. 5:30 - 7pm. And when it started they were using the fields right behind the Y. So it was going to be wonderful - I could get him there, drop him off, go inside and get a good workout, then go outside and pick him up. And the way the gym is setup w/ the windows, you can see the fields. But, then they decided to move the practices down to the middle school fields for some reason. The MS is about 4 miles from the gym, w/ traffic and all its a PITA to do all the running around. But the MS has their track area that I could get exercise on... But w/ the "no running" thing, that idea is out. But, the cool thing is - DS is now old enough to join the Y's "pre-teen fitness" program. Next start date for the program is in April sometime. its a 12 week program where they go thru all the gym equipment and facilities to show the "pre-teens" how to use it. (10 - 12yr olds). Once the finish the 12 week program then they allow the kids in the weight room when supervised with an adult. This means that if i want to go to the gym in the evenings, I can bring him with me without the whole "kid care" issue. "Jayjay" > Well, the plus side to the gym would be to try the elliptical again, > once the swellign goes down. And of course, once I get back to the > weight stuff, I'll be able to use the equipment for the leg > extensions, hip extensions and the other things that she may allow me > to do. :) Yes, but in the mean time, you can work out at home until the swelling, etc gets better. It is nice to know you have that option. > Right now the tuff part is once again, scheduling. Here I was > thinking I'd lucked out again. DS signed up for soccer for the [quoted text clipped - 5 lines] > outside and pick him up. And the way the gym is setup w/ the > windows, you can see the fields. That sounds like the perfect arrangement. It is a shame they couldn't maintain that for you. > But, the cool thing is - DS is now old enough to join the Y's > "pre-teen fitness" program. Next start date for the program is in [quoted text clipped - 4 lines] > that if i want to go to the gym in the evenings, I can bring him with > me without the whole "kid care" issue. Hopefully, you will be well enough to use gym by then. It is a good idea AND is a mother/son bonding experience. > Oh, and an interesting note... My typical squat stance is a > little wider than shoulder width - because I am female and [quoted text clipped - 7 lines] > thighs and the weakness (squishyness) of that interior > muscle. Aside from some of the other things she apparently told you, this in particular sounds like nonsense. Elzi, Lyle? Signature-Wayne >>Oh, and an interesting note... My typical squat stance is a >>little wider than shoulder width - because I am female and [quoted text clipped - 10 lines] > Aside from some of the other things she apparently told you, this > in particular sounds like nonsense. Elzi, Lyle? I can't recall seeing anything where width of stance really affected recruitment this way (bodybuilding nonsense about buiding the sweep and sh.t notwithstanding). I could see it being a depth issue with wide stance limiting depth comopared to a narrower stance. Tho slightly wider than shoulder width isn't that wide. To the OP, how deep do you normally squat? Lyle |
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