Bill, my knees are hurting! Help! - JP Fitness Forums

RedWifey · 03-14-2006, 08:16 PM

Hi Bill,
I am having major knee pain and I am pretty sure that yesterday my right knee was on its way out of place. I was standing still in the bathroom and felt a short jolt of excruciating pain while my knee cap moved.

Squatting (at home and at the gym w/ weight) is terribly painful on both knees. Really the only way I get through the "Breaking In" workouts in New Rules is with time on the foam roll before-hand. Getting up/down is sometimes only endurable by putting my body weight on my hands and not really using my legs.

Every other night is my night to put our 3 year old down and EVERY time I kneel beside her bed, my right knee pops loudly.

Also, at the end of my pregnancy 9 months ago, I was in TERRIBLE pain at my SI joint and was involved in therapy to help me keep things in place. I only mention this because today as I was at a stop light, I did one of my therapy moves and my hips loudly shifted back into place.

Any guess on what's happening? Do you have any suggestions? Thanks!

FishrCutB8 · 03-15-2006, 06:25 AM

Suggestion: Go to a doctor.

If you're in pain and things are shifting around while you're just standing still, it could be more than just a PT issue. A doctor will be able to tell you what you're dealing with and what your options are.

Bill Hartman · 03-15-2006, 01:32 PM

Quote:

Originally Posted by RedWifey

Hi Bill,
I am having major knee pain and I am pretty sure that yesterday my right knee was on its way out of place. I was standing still in the bathroom and felt a short jolt of excruciating pain while my knee cap moved.

Squatting (at home and at the gym w/ weight) is terribly painful on both knees. Really the only way I get through the "Breaking In" workouts in New Rules is with time on the foam roll before-hand. Getting up/down is sometimes only endurable by putting my body weight on my hands and not really using my legs.

Every other night is my night to put our 3 year old down and EVERY time I kneel beside her bed, my right knee pops loudly.

Also, at the end of my pregnancy 9 months ago, I was in TERRIBLE pain at my SI joint and was involved in therapy to help me keep things in place. I only mention this because today as I was at a stop light, I did one of my therapy moves and my hips loudly shifted back into place.

Any guess on what's happening? Do you have any suggestions? Thanks!

Sounds like you've got a series of imbalances that are perpetuating down the kinetic chain (back to pelvis to knee to foot). Get to the doc and get a PT referral. They'll be able to help you.

Every woman who has given birth NEEDS rehab due to the adaptations that take place in your pelvic and adjacent areas.

Bill

RedWifey · 03-15-2006, 03:35 PM

Thanks, Bill! The midwives that deliverd our 9 pounder have no problem writing the script for the PT so they are mailing it to me today. It's interesting to me that nobody mentions the POST baby PT that women need.
Also, can I keep working out??????? It's gonna be a killer in motivation to stop, but if my knee is going to dislocate, I guess I'll stop for now.

Thanks again! Jamie

RedWifey · 03-27-2006, 10:02 AM

Alright, so I finally have an appointment for this wednesday. I'll let you know what they say. Do you have any recommendations for PT's in Houston, TX? I am going to the group at the Womens Hospital of Texas.

Thanks Bill! Jamie

RedWifey · 03-30-2006, 06:45 PM

Bill, I went to the PT yesterday and she said (a)my pelvis was WAY out of wack (b)my IT bands (and some adductor muscle the runs behind my knee on the inside) are VERY tight. So, she straightened out my pelvis and we are going to work on the soft tissue issues. That's great 'cause I can work on my IT Bands at home with our foam roll, but my problem is last evening I could feel that i was already back out of alignment. What's up with that? What do i need to do to strengthen those muscles/tendons/whatevers to keep my pelvis aligned?

Thanks!

Jamie

Bill Hartman · 03-31-2006, 05:23 AM

Okay, between you and me...the pelvis rarely "gets out of whack". As students we're taught ways to assess the pelvic alignment by palpating and visually comparing bony landmarks. We're then taught muscle energy techniques (you contract this muscle against my resistance to realign things) in an attemtp to realign the pelvis. the problem with this approach is that visual assessment of the pelvis has been shown to be highly unreliable and is not representative of changes in the joints of the pelvis especially the sacroiliac joints. The muscle energy stuff is really like contract/relax or PNF stretching, so the effect is temporary.

To make a long story short, it takes a little time and effort to correct kinetic chain dysfunctions. You need to address the entire lower extremity from the ground up as well as adjustments in the trunk. Stay the course and give it some time.

You probably have some weakness in the hip which makes the ITB seem tight and causes the overrecruitment of the adductors. They're not necessarily "tight" but the are merely increasing their resting tone to compensate for the weakness in the hip.

If your pelvis is "out of whack" when she rechecks you, make sure she checks your psoas muscle for weakness.

Bill

RedWifey · 03-31-2006, 08:04 AM

How very disappointing! We spent the first 30 minutes on the visual assessment and muscle energy techniques (then we moved on to the ITB). And today I am in constant low grade pain in my right lower back.

I am all about the time and effort it takes to get this resolved, but I am not sure that I am getting anything that will really help. It NEVER helped during either of my pregnancies.

The kids and I are coming with RedLefty (Michael) to the summit next weekend, and plan to stop at JP's place before the 3 of us continue on to Michael's grandparents. If the moons align (unlike my pelvis

) and we are there when you're there, I would love to trade a donation to JP's summit fund for time on your table.

But until then, do you have any suggestions about the therapy I am receiving here?

You da man! Thanks a ton!

Jamie

Bill Hartman · 03-31-2006, 09:46 AM

Focus your efforts on the exercises you are provided and don't depend so much on "unwhacking" your pelvis.

That will take care of itself when normal movement patterns are reestablished. Make sure that each muscle of your hip has been muscle tested including psoas, TFL, gluteus medius, glute max. Your gait, squat, and lunge patterns should be assessed as well.

I'm in LR on Friday before the summit. Track me down...you may have to get in line.

Bill

RedWifey · 04-03-2006, 02:51 PM

Okey, Dokey, Smokey. I have another appointment this afternoon. I am printing out your instructions about what they should test and hopefully I'll come home with something different than...oh yeah, I got nothing before!!

Jamie

RedWifey · 04-03-2006, 08:16 PM

Well, that was a much better appointment. We discussed several things, did lots of exercises and stretching and she sent me home with 5 exercises that I am to do daily.

What we discussed:
I have essentially been pregnant since March 2002: (40 weeks of gestation + 1 year of nursing * 2 children) with a 6 month break in 2004. Which means that there's been signifanct trauma to my body AND relaxin has been free flowing for quite some time (I didn't know it continued while nursing and will continue until about 6 weeks after Jack is weened).

The squatting and deadlifting in the gym is overkill for the quads and hams as I do that A LOT being a stay at home mama for two small children.

I need good arch support for my feet (my feet have been aching when I get up in the morning). Is there a brand of shoe that is better at this, or is there a good store to visit?

What we did
We did some alignment stuff and finally after a few minutes she said, "Well, you are different today than last week" and everytime she adjusted something I moved out somewhere else. That good ol' relaxin!

She watched my knee as I tightened my leg muscle and she said that my knee cap is tracking to the outside instead of straight up. But she said she really felt like that was all about my hip instablility.

Here are the exercises:
1. Theraband wrapped around ankle, kick forward, extend out, kick back
2. Bridging (knees straight, knees in, knees out); this is like a "supine hip extension" I think
3. On hands and knees, squeezing abs to spine w/ kegels (I WAY feel this in muscles that are connected to my front hip bones!!! ouchie)
4. Sitting ham string stretch
5. ITB stretch on foam roll

An odd thing: We did a one rep max on leg extension and curl and my weight was equal (50lbs). Then my PT was sharing that with another PT and the other PT said "of course, women's quads are always weak after giving birth." What's up at that?

Ok, I am tired of typing. All of this to say, I am much more satsified. May not need to push anyone off your table this Friday! ha! ha!

Thanks for your input!

Jamie