Thursday, September 08, 2011

The knee post

As opposed to the hip posts of yore.

Sigh... yes... now knee problems.

And yes, my hip bone is connected to my thigh bone which is, in turn, connected to my knee bone. Hence, it's all connected.

More sighing.

As you know (and are no doubt tired of hearing at this point if you're friends with me on the Face Book) my right knee has been hurting, getting progressively more painful over the last few weeks. It started with some pain in my kneecap whenever I lunged during my workouts. So I backed-off for a bit, only to find that, without my regular PT workout (which includes lunges) my back began to hurt. The pain in my knee came back during certain lunges, however. Crap.

Then, all of a sudden, about a few weeks ago, it began to hurt walking up stairs also. Given I live in a 2 story home with an office and bedroom upstairs, this is a problem. Despite trying to stay away from aggravating activities, icing, and taking supplements like crazy, the pain progressed to a point where I had to crawl up the stairs yesterday.

Meanwhile, of course, my back is upset because it wants me to do my exercises that make IT happy.

Insolent little joints!

Today was my P.T. appointment. I'm not sure how many physical therapists this is for me now since 2005 but off the top of my head I can think of 5. I'd love to go back to my last PT who quite literally gave me my life back from S.I. joint and back pain, but the reality is that my insurance doesn't cover them and at $60 a time, I just can't do that right now.  Fortunately, I found another good therapist, Felicia, and she quickly put me through my paces.

The lamen's diagnosis is that my knee joint is a train that keeps veering off the tracks and, where it's crossing the line, there is friction and, therefore, pain. A more in-depth explanation is that my continued issues with a tight I.T. band (which extend back to before my hip surgery in '08), which connects from my glutes (which are, coinkidentally attached to my S.I. joint) mean my knee is being coaxed off the tracks. I also have a bit of a strained A.C.L., thankfully not torn but definitely causing destablization and exacerbating the problem. My knee, when I flex my quad muscle, is therefore being pulled up and out, to the side, causing the cartilage in the joint to rub and, potentially over time, degenerate.

Here's a pic to help those of you out who aren't big on anatomy (which I wasn't either until I started to hurt it.)

In the pic below you're seeing the front of the thigh. The tensor fascia lata on the left, connected to your glutes (butt muscles) at your hip and then turns into the I.T. band (Iliotibial tract) which then connects to the knee (patellar) and knee ligament. Fascinating, huh? (Or... not.)

In short: there's no doubt about it. I'm not making it to my grave able-bodied.

The good news is that she does not think I need surgery. Hallelujah because I really thought this was another kind of impingement that would require more people cutting into me, more recovery, more P.T. and back on that whole cycle again. No way. NO. WAY.

The bad news is that I have to add a whole new set of exercises to my P.T. repertoire to stretch my I.T. band, strengthen my glutes, and coax my knee back onto the tracks. Seriously, I could make doing my P.T. exercises a full time job at this point. There's the neck and shoulder exercises, the lower back and hip exercises, and now the knee exercises. All told, I can work out for 90 minutes just on this stuff alone. And many of the exercises should be done >1x a day!

Felicia also conceded that the hip surgery likely had something to do with all this. Since I had the surgery, whenever I lay down at night, my leg turns outward - I just can't stop it - and this is because my I.T. band is tight. It was tight before the surgery, likely pissed off by the traction during the surgery, and never really released after the surgery.

And so back to P.T. I go, 2x a week for 3 weeks. Because, you know, I have nothing better to do on my lunch hour.

I'll keep you posted. (I know, the suspense will kill you.)


e said...

Mmh. This is not uncommon. I had a similar issue many years ago. I solved it by doing exercises the strengthened by inner thigh muscles. Did your PT suggest such exercises? Point being that the muscles pull the patella evenly.

And, bummer, man!!

e said...

Och. So this week my right hip's been bothering me. I think I know why, there's one yoga pose that I can't do, and I did it. Bad move. Now I remember why I don't do it.

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