Trails for Two

nkrichards wrote:Any idea when the PT is going to turn you loose to begin serious running again?  I can't wait to see how it goes when you get back to it!

She actually has released me to try running. I did a tiny bit on a trail and on the beach when we went to Yachats last Friday, and it didn't feel too bad. 

One problem is cropping up, though. My leg pain is flaring back up again. After those big sets Tuesday, I walked at lunch and then had a hard time walking that afternoon and most of Wednesday. Very frustrating. I corresponded with my PT today (it feels a little better today), and I speculated that the swiss curls were too much for my hamstrings and calves yet. So I did my exercises tonight subbing in simple (?) bridging on the ball instead.

1) Woodpeckers, steadying myself and moving slowly. 3 sets of 20.
2) Clamshells with therapy band, both sides, 3 sets, 40, 30, 30.
3) Lateral lunges, both sides. 2 sets of 20.
4) Bridge lifts on the therapy ball. 3 sets of 30.
5) Prone leg lift (working glute max), 1 set of 50, each side. 
6) Side leg lift. 3 sets of 30 each side.

I also walked 2.5 miles at lunch today. We'll see how my legs feel tomorrow. I swear even the uninjured part of my body hurt Wednesday. DOMS from PT! Crazy.

Mark B wrote:

nkrichards wrote:Any idea when the PT is going to turn you loose to begin serious running again?  I can't wait to see how it goes when you get back to it!

She actually has released me to try running. I did a tiny bit on a trail and on the beach when we went to Yachats last Friday, and it didn't feel too bad. 

One problem is cropping up, though. My leg pain is flaring back up again. After those big sets Tuesday, I walked at lunch and then had a hard time walking that afternoon and most of Wednesday. Very frustrating. I corresponded with my PT today (it feels a little better today), and I speculated that the swiss curls were too much for my hamstrings and calves yet. So I did my exercises tonight subbing in simple (?) bridging on the ball instead.

1) Woodpeckers, steadying myself and moving slowly. 3 sets of 20.
2) Clamshells with therapy band, both sides, 3 sets, 40, 30, 30.
3) Lateral lunges, both sides. 2 sets of 20.
4) Bridge lifts on the therapy ball. 3 sets of 30.
5) Prone leg lift (working glute max), 1 set of 50, each side. 
6) Side leg lift. 3 sets of 30 each side.

I also walked 2.5 miles at lunch today. We'll see how my legs feel tomorrow. I swear even the uninjured part of my body hurt Wednesday. DOMS from PT! Crazy.

Not surprised to hear that you're suffering from DOMS.  Even the "easier" workout is a tough workout!  Hope that you're on the right track and that it will remedy the issue eventually.

nkrichards wrote:

Mark B wrote:

nkrichards wrote:Any idea when the PT is going to turn you loose to begin serious running again?  I can't wait to see how it goes when you get back to it!

She actually has released me to try running. I did a tiny bit on a trail and on the beach when we went to Yachats last Friday, and it didn't feel too bad. 

One problem is cropping up, though. My leg pain is flaring back up again. After those big sets Tuesday, I walked at lunch and then had a hard time walking that afternoon and most of Wednesday. Very frustrating. I corresponded with my PT today (it feels a little better today), and I speculated that the swiss curls were too much for my hamstrings and calves yet. So I did my exercises tonight subbing in simple (?) bridging on the ball instead.

1) Woodpeckers, steadying myself and moving slowly. 3 sets of 20.
2) Clamshells with therapy band, both sides, 3 sets, 40, 30, 30.
3) Lateral lunges, both sides. 2 sets of 20.
4) Bridge lifts on the therapy ball. 3 sets of 30.
5) Prone leg lift (working glute max), 1 set of 50, each side. 
6) Side leg lift. 3 sets of 30 each side.

I also walked 2.5 miles at lunch today. We'll see how my legs feel tomorrow. I swear even the uninjured part of my body hurt Wednesday. DOMS from PT! Crazy.

Not surprised to hear that you're suffering from DOMS.  Even the "easier" workout is a tough workout!  Hope that you're on the right track and that it will remedy the issue eventually.

Me, too! This idleness is driving me nuts.

I had fewer issues after omitting the swiss curls, so I'll keep trying it that way until I see the PT again on Friday.

So I'll just drop this in here...

Low HR Run/Walk: 3.1 miles

Weather: Mild, smoky. About 64° Gear: Topo road shoes, shorts, T.

My first real run attempt since June 17, when that marching band injury from May caught up with me while running 50K. 

I'm far from pain-free, even now, but it was time to test out the system and see what happens. We've both lost a ridiculous amount of fitness and really need to get going again. 

We started out with a 5-6 minute walk, transitioning into a slow run. The first mile was pretty creaky all over, with the key discomfort mostly at the very top of my calf area, where the hamstrings connect. Most of the other creakiness eased, but the injury area discomfort didn't really go away. It didn't get worse, either, so that's something. I have have noticed less discomfort going uphill, which was interesting. 

We're both out of shape now, and Alita's having challenges trying to figure out how to run with a slightly wider gait (her feet tend to cross over), so we walked a decent amount, too. The miles ended up averaging around 16 to 16:30 when you take the walking into account. When we ran, we were in the 11s and 12s. My HR was low overall, though it did creep up well into the 140s when we were running.

Walked first and last 5 minutes. Average HR for entire run: 113

---

After the run, I felt no lingering issues of significance, so after an hour or so, I did my PT work:

1) Woodpeckers, steadying myself and moving slowly. 3 sets of 20.
2) Lateral lunges, both sides. 2 sets of 20.
3) Clamshells with green (upgraded) therapy band, both sides, 3 sets, 40, 30, 30.
4) Prone leg lift (working glute max), 2 sets of 50, each side. 
5) Bridge lifts on the therapy ball. 3 sets of 30.
6) Side leg lift. 3 sets of 30 each side.

Mark B wrote:So I'll just drop this in here...

Low HR Run/Walk: 3.1 miles

Weather: Mild, smoky. About 64° Gear: Topo road shoes, shorts, T.

My first real run attempt since June 17, when that marching band injury from May caught up with me while running 50K. 

I'm far from pain-free, even now, but it was time to test out the system and see what happens. We've both lost a ridiculous amount of fitness and really need to get going again. 

We started out with a 5-6 minute walk, transitioning into a slow run. The first mile was pretty creaky all over, with the key discomfort mostly at the very top of my calf area, where the hamstrings connect. Most of the other creakiness eased, but the injury area discomfort didn't really go away. It didn't get worse, either, so that's something. I have have noticed less discomfort going uphill, which was interesting. 

We're both out of shape now, and Alita's having challenges trying to figure out how to run with a slightly wider gait (her feet tend to cross over), so we walked a decent amount, too. The miles ended up averaging around 16 to 16:30 when you take the walking into account. When we ran, we were in the 11s and 12s. My HR was low overall, though it did creep up well into the 140s when we were running.

Walked first and last 5 minutes. Average HR for entire run: 113

---

After the run, I felt no lingering issues of significance, so after an hour or so, I did my PT work:

1) Woodpeckers, steadying myself and moving slowly. 3 sets of 20.
2) Lateral lunges, both sides. 2 sets of 20.
3) Clamshells with green (upgraded) therapy band, both sides, 3 sets, 40, 30, 30.
4) Prone leg lift (working glute max), 2 sets of 50, each side. 
5) Bridge lifts on the therapy ball. 3 sets of 30.
6) Side leg lift. 3 sets of 30 each side.

Looks like a pretty productive day with a nice conservative run/walk and then your PT work.

Hope you aren't as impacted by the smoke as we are!

nkrichards wrote:Looks like a pretty productive day with a nice conservative run/walk and then your PT work.

Hope you aren't as impacted by the smoke as we are!

Thanks! I was feeling some soreness in the days afterward, but I was too busy to even attempt exercises, since some idiot kid set the Columbia River Gorge on fire last weekend.

A kid from Vancouver.

The smoke and ash have been pretty horrific here. Yesterday, it was like being in Satan's ashtray. Nasty.

I have a PT session tomorrow, so I did a set tonight for good measure, and ramped it up a little.

1) Woodpeckers, steadying myself and moving slowly. 3 sets of 20.
2) Clamshells with green (upgraded) therapy band, both sides, 3 sets, 50, 50, 50.
3) Lateral lunges, both sides. 3 sets of 20.
4) Prone leg lift (working glute max), 2 sets of 50, each side. 
5) Bridge lifts on the therapy ball. 3 sets of 30.
6) Side leg lift. 3 sets of 30 each side.

Yes, I was sweaty and walking funny afterwards....

Barefoot Run: 2.08 miles

Weather: Partly cloudy, less smoke. Blue sky! 66° Gear: Bare feet, shorts, T

Squeezed in a 2-mile run after taking the kid to school to see how much time I have before I need to get ready for work, and to make sure my legs are stimulated and reacting when I go to the PT later this morning. Nothing like showing up and have nothing sore, right?

The first mile was pretty uncomfortable all over. Still have tightness behind the knee in the muscles, but it didn't really get worse. Two miles nonstop was pretty much for me right now, at my current level of fitness. Of course, I was running in the 10s, so there's that.

Average HR for entire run: 144

So. That PT session.

Didn't go the way I expected.

I'd been corresponding with my PT over the past couple of weeks, letting her know about the ups and downs of my leg. When I came in, expecting a new set of torturous exercises or at least a gait analysis, she had other plans. Lots of questions, lots of new poking and prodding and twisting and bending and grinding and... well, you get the idea.

The thing is, my injury doesn't make sense. If it's muscular, it should be getting better in a predictable, consistent arc. Instead, it's bouncing all over the place. Better, then not so much. Better, then backsliding once I add something to the mix. And the fact that I tend to get sore after sitting at work, or while driving, etc., doesn't fit either. It wouldn't even fit for tendonitis.

So she thinks it's maybe something else. Like, maybe, something involving the meniscus.

This is not what I want it to be, but I have to admit there are things that support that possibility. Like how I do not want to rotate on that leg while planted. Like how after sitting, it gets stiff, like it's swelling internally. Like how, when it's irritated, my knee wants to be in a hyperextended position rather than the normal straight-on, or slightly flexed position. Like how there was never any obvious swelling or bruising. There is no clicking or catching, however.

Remember how she said it'd be okay to try running? Yeah. That's out for now. As are further PT visits until we get it figured out.

The next step will be convincing my doctor to authorize an MRI and see what's going on in there. He didn't want to do one earlier -- he said that's only for when they're thinking about surgery -- but I think the weeks of PT without significant improvement is a pretty powerful argument to do it. So I think it'll be done, though I'm dreading what they might find.

I'll keep you all apprised.

The doc has steps to go through, probably, to justify the MRI.  If he has respect and prior dealings with your PT, that should help the case a little.  I wonder if he'd refer you to an ortho surgeon for the opinion or (dare I say it) a diagnosis.  The surgeon would probably knee-jerk (no pun intended) for an MRI.

If your doc can look good to the HMO by HIM not spending the money for an MRI, rather the specialist, he might just do the referral, even though it'll cost the HMO more money.

"Thank you for this challenging patient."

ounce wrote:The doc has steps to go through, probably, to justify the MRI.  If he has respect and prior dealings with your PT, that should help the case a little.  I wonder if he'd refer you to an ortho surgeon for the opinion or (dare I say it) a diagnosis.  The surgeon would probably knee-jerk (no pun intended) for an MRI.

If your doc can look good to the HMO by HIM not spending the money for an MRI, rather the specialist, he might just do the referral, even though it'll cost the HMO more money.

"Thank you for this challenging patient."

Great theories, and probably true. Though my primary care doctor did go ahead and order and MRI. I'm having it this afternoon.

Cross your fingers...

Mark B wrote:

ounce wrote:The doc has steps to go through, probably, to justify the MRI.  If he has respect and prior dealings with your PT, that should help the case a little.  I wonder if he'd refer you to an ortho surgeon for the opinion or (dare I say it) a diagnosis.  The surgeon would probably knee-jerk (no pun intended) for an MRI.

If your doc can look good to the HMO by HIM not spending the money for an MRI, rather the specialist, he might just do the referral, even though it'll cost the HMO more money.

"Thank you for this challenging patient."

Great theories, and probably true. Though my primary care doctor did go ahead and order and MRI. I'm having it this afternoon.

Cross your fingers...

Fingers crossed...although I'm not exactly sure what we're hoping for.  An answer I'm sure but what if it's not the answer you want to hear.  Oh well...I guess you can't fix it until you know what's broken.

nkrichards wrote:

Mark B wrote:

ounce wrote:The doc has steps to go through, probably, to justify the MRI.  If he has respect and prior dealings with your PT, that should help the case a little.  I wonder if he'd refer you to an ortho surgeon for the opinion or (dare I say it) a diagnosis.  The surgeon would probably knee-jerk (no pun intended) for an MRI.

If your doc can look good to the HMO by HIM not spending the money for an MRI, rather the specialist, he might just do the referral, even though it'll cost the HMO more money.

"Thank you for this challenging patient."

Great theories, and probably true. Though my primary care doctor did go ahead and order and MRI. I'm having it this afternoon.

Cross your fingers...

Fingers crossed...although I'm not exactly sure what we're hoping for.  An answer I'm sure but what if it's not the answer you want to hear.  Oh well...I guess you can't fix it until you know what's broken.

I'm hoping for no cartilage damage. I'm pretty sure the ligaments are fine, at least according to my PT. I guess the best case scenario would be a muscle injury that just keeps getting aggravated. That might mean lots of inconvenient things for me in the short term, but better prospects long term. I think.

Anyway, they told me I did a good job holding still for the MRI. A radiologist won't look at the images until early next week, but I went ahead and requested a CD of the images and brought them home with me. Just in case a second opinion is needed, and because they look really cool.



Here's a cross-section mid-knee, as best as I can tell. Note the white encircling that muscle just below and to the left of the bone. I'm wondering if that's fluid, or maybe a bursa? I think that muscle is the top of the gastroc. Maybe. 



A side view. Notice the light colored bands behind the knee. That's about where it hurts, so I wonder if that's something.



A different view that just looks cool.



Another view that shows the muscle tissue overlying the knee. Freaky!

I don't have a career as a radiologist, obviously. But it will be helpful to understand what they're saying when they're pointing anything out.

---

Later, more PT!

1) Woodpeckers, steadying myself and moving slowly. 3 sets of 20.
2) Clamshells with green (upgraded) therapy band, both sides, 3 sets, 50, 50, 50.
3) Lateral lunges, both sides. 3 sets of 30.
4) Bridge lifts on the therapy ball. 3 sets of 30.
5) Swiss curls on therapy ball. 3 sets of 10. (Trying to see what happens when I do them at a lower number of reps.)
6) Side leg lift. 3 sets of 30 each side.


I opted out of the prone leg lift after the bridge lifts and swiss curls. I could barely raise my leg after that! I may try some later.

I found a video online where a radiologist talks you through a normal knee MRI, identifying things that you can see, and I came away with a few impressions.

1) Radiologists have a hard job. It's like reading tea leaves while wearing dark sunglasses.
2) The free "lite" version of the MRI viewer I'm using doesn't have nearly the resolution of what the radiologists use. Of course, their version costs $699, so I'd hope so!
3) I've started learning how to identify some of the less obvious things in the images -- like my meniscus, for example, and some of the ligaments -- but I'm no closer to understanding what, if anything, is wrong in there.

Still, it's kind of fascinating. Maybe I'll watch some more videos and learn enough to be dangerous.

---

Also, my knee is a little off after my PT work, but not horribly so. I'll do more PT tonight.

Mark B wrote:

nkrichards wrote:

Mark B wrote:

ounce wrote:The doc has steps to go through, probably, to justify the MRI.  If he has respect and prior dealings with your PT, that should help the case a little.  I wonder if he'd refer you to an ortho surgeon for the opinion or (dare I say it) a diagnosis.  The surgeon would probably knee-jerk (no pun intended) for an MRI.

If your doc can look good to the HMO by HIM not spending the money for an MRI, rather the specialist, he might just do the referral, even though it'll cost the HMO more money.

"Thank you for this challenging patient."

Great theories, and probably true. Though my primary care doctor did go ahead and order and MRI. I'm having it this afternoon.

Cross your fingers...

Fingers crossed...although I'm not exactly sure what we're hoping for.  An answer I'm sure but what if it's not the answer you want to hear.  Oh well...I guess you can't fix it until you know what's broken.

I'm hoping for no cartilage damage. I'm pretty sure the ligaments are fine, at least according to my PT. I guess the best case scenario would be a muscle injury that just keeps getting aggravated. That might mean lots of inconvenient things for me in the short term, but better prospects long term. I think.

Anyway, they told me I did a good job holding still for the MRI. A radiologist won't look at the images until early next week, but I went ahead and requested a CD of the images and brought them home with me. Just in case a second opinion is needed, and because they look really cool.



Here's a cross-section mid-knee, as best as I can tell. Note the white encircling that muscle just below and to the left of the bone. I'm wondering if that's fluid, or maybe a bursa? I think that muscle is the top of the gastroc. Maybe. 



A side view. Notice the light colored bands behind the knee. That's about where it hurts, so I wonder if that's something.



A different view that just looks cool.



Another view that shows the muscle tissue overlying the knee. Freaky!

I don't have a career as a radiologist, obviously. But it will be helpful to understand what they're saying when they're pointing anything out.

---

Later, more PT!

1) Woodpeckers, steadying myself and moving slowly. 3 sets of 20.
2) Clamshells with green (upgraded) therapy band, both sides, 3 sets, 50, 50, 50.
3) Lateral lunges, both sides. 3 sets of 30.
4) Bridge lifts on the therapy ball. 3 sets of 30.
5) Swiss curls on therapy ball. 3 sets of 10. (Trying to see what happens when I do them at a lower number of reps.)
6) Side leg lift. 3 sets of 30 each side.


I opted out of the prone leg lift after the bridge lifts and swiss curls. I could barely raise my leg after that! I may try some later.

The first image looks like The Grinch with goggles.

Hopefully, the closet doctor (that's what a radiologist is called in the medical profession) can figure something out, other than 'unremarkable.'  Just get your dictionary out to put into English what he's saying.  And make a copy of the report for the PT, so she can explain it to you where a dictionary can't.

Good luck, but I think crossed fingers wouldn't help.  Crossed KNEES would, however.

How has your bride's 2nd surgery shaken out?

ounce wrote:The first image looks like The Grinch with goggles.

Hopefully, the closet doctor (that's what a radiologist is called in the medical profession) can figure something out, other than 'unremarkable.'  Just get your dictionary out to put into English what he's saying.  And make a copy of the report for the PT, so she can explain it to you where a dictionary can't.

Good luck, but I think crossed fingers wouldn't help.  Crossed KNEES would, however.

How has your bride's 2nd surgery shaken out?

My bride though some of the images looked like an angry owl, so I think you're on to something there.

Definitely hoping to hear back soon, though they said it may take a couple of days. I'll make sure to ask for the report -- and a medical dictionary.

Alita's surgery is inconclusive at this point. It can take months for hearing to improve, unfortunately. She'll have a hearing test in October, I think. It'll all depend on whether her body generates too much scar tissue in that area, which seems to have been part of the reason the first try failed.

So, here's the report:
 
FINDINGS:  
 
Cruciate ligaments: The anterior and posterior cruciate ligaments are
normal.
  
Collateral ligaments: The medial collateral ligament is normal.  The
components of the lateral collateral ligamentous complex (including the
fibular collateral ligament, biceps femoris tendon, popliteus tendon, and
iliotibial band) are normal.
 
Medial compartment: There is irregular intermediate signal in the
posterior root of the medial meniscus, likely a combination of
degeneration and partial tearing. There is no meniscal extrusion. The
articular cartilage is maintained.
 
Lateral compartment: The lateral meniscus is normal.  Mild partial
thickness cartilage thinning and probable fissuring are noted in the
posterior half of the lateral tibial plateau.
 
Patellofemoral compartment and extensor mechanism: The quadriceps and
patellar tendons are normal.  The medial and lateral retinacular complexes
are normal.   Mild patellar articular cartilage degenerative surface
fraying is noted.
 
Bone marrow: Bone marrow signal is normal.
 
Other: There is no joint effusion. A tiny Baker's cyst is present. The
muscles are normal in bulk and signal intensity.
 
IMPRESSION:
 
Degeneration and probable partial tearing of the posterior root of the
medial meniscus.
 
Minimal lateral tibial plateau and patellar chondromalacia.
 
Tiny Baker's cyst.
 
-30-

My doctor in a separate message described as a "wear and tear types of changes to the meniscus." He said sometimes surgery is required, but it's often avoided with a knee (cortisone, I assume) injection. He said I should come in and let him inject my knee. Sounds moderately terrifying, but okay....

The upside is pretty much everything else in my knee is solid.

I have no experience with cortisone shots, but I've heard stories.  Excellent that the knee structure has been ruled out, for the exceedingly large part.   Good news, so get back to doing those PT things and wake up those muscles!

So you're getting old. Well, I'll buy you a cane.

Did the doc say you should run barefoot all the time, even on trails?   

(one more) Well, can't think of a third one.  Must be getting old.

ounce wrote:I have no experience with cortisone shots, but I've heard stories.  Excellent that the knee structure has been ruled out, for the exceedingly large part.   Good news, so get back to doing those PT things and wake up those muscles!

So you're getting old. Well, I'll buy you a cane.

Did the doc say you should run barefoot all the time, even on trails?   

(one more) Well, can't think of a third one.  Must be getting old.

Irony alert! One article I read (on Runner's World, even) suggested softer surfaces (trails) AND barefoot or barefoot-like running to minimize impact on the knees. So yeah... maybe. Who needs straight toes?

So now you have a diagnosis...sort of...what happens next?  What do you change after you have the shot (assuming you go ahead with it)?  You're already doing the things they recommend.

I'd do your research and ask questions before you get a cortisone shot.  My understanding is that it does make it feel better but it does it by softening the cartilage which causes it to wear more quickly...short term gain for long term loss maybe. 

I had trouble with my wrist during track season my Senior year...I was a shot putter.  My coach finally sent me to a specialist (Dr. Harry Growth).  He gave me a cortisone shot...not sure it made much difference and I still have trouble with my wrist when I use it to much.  Cutting corn off the cobs for canning makes it sore for a few days.

Enjoying the fresh air...

nkrichards wrote:So now you have a diagnosis...sort of...what happens next?  What do you change after you have the shot (assuming you go ahead with it)?  You're already doing the things they recommend.

I'd do your research and ask questions before you get a cortisone shot.  My understanding is that it does make it feel better but it does it by softening the cartilage which causes it to wear more quickly...short term gain for long term loss maybe. 

I had trouble with my wrist during track season my Senior year...I was a shot putter.  My coach finally sent me to a specialist (Dr. Harry Growth).  He gave me a cortisone shot...not sure it made much difference and I still have trouble with my wrist when I use it to much.  Cutting corn off the cobs for canning makes it sore for a few days.

Enjoying the fresh air...

I've read that about cortisone, too. I have mixed feelings.

Beyond the call to come in for an injection, I've heard nothing else about what I can/should/shouldn't do. I'm hoping to get some answers -- including an explanation as to how damage to the medial cartilage can cause what feels like muscular pain in the lateral calf and hamstrings. Part of me wonders if the knee issue is something unrelated that had been there a while. But I don't know.

To that point, I just sent the following email to my doctor: "I have made an appointment to see you next week regarding my knee and possibly get an injection. I'm curious, though, how the damage seen on the MRI (probable partial tear of posterior horn of medial meniscus) would cause the primary symptoms I've been having -- the muscular pain in the calf and hamstring on the lateral, posterior side of my left leg. I want to make sure we're treating the right thing. For all we know, that meniscal damage could have been there for a long time. I look forward to discussing this with you."

And this email to my PT: 
After processing what the MRI results said, I'm still puzzled as to how damage to the posterior horn of the medial meniscus would cause my primary symptoms -- the pain in the lateral calf and hamstring reaching up into my backside. (I don't doubt there's some meniscal damage, but I think it may have been there for years, and I wonder if it's a issue, but unrelated.) That pathway of pain appears close to the path of the sciatic nerve, so I'm trying some gluteus medius and piriformis stretches to see if that has any impact on my symptoms. I did a set  just now and I was surprised at how tight and tender it was. I have noticed that my wallet is digging in a bit while sitting at work, so there's that, too." I asked for thoughts and suggestions. 

I wonder what they'll say....

I stand corrected.

From my PT: "The symptoms in the back of the leg can certainly be caused by the meniscal tear. Your hamstring insertion has fibers connected to the meniscus and could radiate pain in the hamstring/calf distribution."

Oh. Well. Learned something new!

She wants me to come back for more soft-tissue poking and prodding, though. Presumably to ensure I don't have a second thing going on.

At the risk of harping, I still think that a TENS unit will be of great intermediate benefit to you, Nancy, Mike, and Miche1e.  I can't thank my PT enough for writing a script for that thing a few years back.  It is just a phenomenal device for niggles and nipping stuff in the bud.  That plus rechargeable 9 volt batteries and you're golden.

Just keep a copy of the script because if you take the thing on a plane, TSA will want to see the script, I was told by the PT.

Keep learning, Mark, and teach us.  That wagon injury could have jumbled up things in the back of the knee.  (I'm working on the AMA to have 'jumbled up' as a legitimate medical term.)

ounce wrote:At the risk of harping, I still think that a TENS unit will be of great intermediate benefit to you, Nancy, Mike, and Miche1e.  I can't thank my PT enough for writing a script for that thing a few years back.  It is just a phenomenal device for niggles and nipping stuff in the bud.  That plus rechargeable 9 volt batteries and you're golden.

Just keep a copy of the script because if you take the thing on a plane, TSA will want to see the script, I was told by the PT.

Keep learning, Mark, and teach us.  That wagon injury could have jumbled up things in the back of the knee.  (I'm working on the AMA to have 'jumbled up' as a legitimate medical term.)

I will do my best, Ounce.

As far as learning goes, I did some more of it today.

I got a call just as I arrived at work that my PT had an opening at 10:40. I immediately accepted but cursed myself that I forgot to bring a pair of shorts with me just in case. So I left a little early, drove home and got shorts, then drove to the appointment on the other side of town. I was almost on time!

To say it was an interesting session would be an understatment. My PT verified to her satisfaction that the pain in my knee area when she works it is almost certainly from my knee injury -- even if it's an old injury that just got aggravated. She says an injection often helps clear it up and get it happier and allow me to return to activity. I could live with that.

She said the other pain above and below could be caused by my body trying to avoid putting pressure on the aggravated part of the knee (a process known as "compensation") though that's not 100% sure. It could be directly related to the knee injury, as well. The injection will help determine that. If the pain goes away everywhere, that's pretty much the answer.

She also did a thorough checking of my spine to make sure it's not a nerve thing, and that all was negative. Good.

Less good was the condition of the soft tissue on the outside of my calf. She found spots that were so painful I yelped. I had thought it was just tight muscles, but no! It's the myofascial tissue around the gastrocnemius in there binding things up. She said it felt noticeably "gritty" under her fingers. (How it got that way? Dunno. Maybe more of the compensation?) She worked it for a good 20 minutes with her hands and even cupped it. It was surprisingly painful, but it was the type of pain that part of me wanted to lean into at some point.

After the session, my calf almost went into a massive charley horse as I put my pants on, but I noticed that my walking felt more natural (even though the calf still hurt). She said to let me know how it reacts over the next couple of days to see if it helps.

It must have helped a little, because I was able to walk 3 miles at lunch. It's a little tender now, especially where she did the work, but I think it's still better. We'll see how the whole thing reacts later today and tomorrow.

Okay, today was test the leg day.

1) Woodpeckers, steadying myself and moving slowly. 3 sets of 20.
2) Clamshells with green (upgraded) therapy band, both sides, 3 sets, 50, 50, 50.
3) Lateral lunges, both sides. 3 sets of 30.
4) Prone leg lifts, both sides, 3 sets of 50. 
5) Swiss curls on therapy ball. 3 sets, 20, 15, 15. BOY do those things activate EVERY freaking muscle!
6) Side leg lift. 3 sets of 30 each side.


Iced for 15 minutes afterward. Let's see how my body reacts!

My body reacted pretty well on Friday, which was nice. But my knee got sore today. 

It's weird. Before, all the pain was above or below the knee, usually. When I felt pain in my "knee pit" before, I thought it was a muscle or tendon. Now I know better. It's either pain from the partial meniscal tear, or from the fissures on the lateral tibial plateau. (Which sounds horrific but is actually just a softening of the cartilage.) 

To make it even more weird, with the soft tissue work and better stance, my gait is more natural and my calf and hamstring aren't so edgy. So all my attention is focused on my knee. Hoping it'll feel better tomorrow.