Injuries and RehabTell us where it hurts! Do a quick search before asking about your shoulder injury to make sure your question hasn't already been answered (about 50 times), and read the sticky post first.
1. When did the pain begin?
First noticed several months ago. Possible genesis from distance running about three years ago.
2. What were you doing at the time? Or did the pain come on gradually over time?
Gaining strength, gradual onset.
3. Where, anatomically, is the pain?
Left upper leg, lateral aspect, which would first seem like an IT band issue, but it actually got a little worse over the course of diligent SMR work.
4. What does the pain feel like? Sharp? Dull? Aching? Stabbing? Shooting?
Definitely aching when in a stretched position, shooting when putting weight on it.
5. Is the pain constant, or intermittent, or only on certain motions?
Door #3.
6. What motions make your pain worse?
A static hold of left ankle resting on right knee while sitting. Takes a good ten seconds after relaxation for pain to subside. Walking is nearly impossible immediately after relaxing the hold.
7. What, if anything, makes your pain better?
Not holding that position and/or walking it out.
8. Does your pain radiate to any other part of your body?
No.
9. What things could you do before, that you cannot do now because of your injury?
Slightly lesser ROM in that rotation, walking immediately after releasing the hold.
10. What is your main concern regarding the pain and its consequences?
Mobility limitations, especially considering strength imbalances and altered motor recruitment patterns.
11. Have you ever injured that part of your body before? If so, how?
Diagnosed by physical therapist with IT band tightness two years ago, began limited stretching but no mobility work.
12. Is your pain getting worse over time? And if so, how much worse over what time period?
Gradual but very slight worsening since first noticed. Nothing immediately debilitating but likely causing imbalance issues.
__________________ No Magic Pill (the log)
My Movember page (yes, I'm slacking on pictures)
At Lisa-squiggle's suggestion, here is more discussion on the issue:
Quote:
I've been trying to come up with some additional
possible precursors that might help explain it since I don't feel like
I did a good job of it in the thread I posted. So far:
--focused distance running, early 2005 to late 2007, varied from 5K
(often) to half-marathon (once), obviously a no-no for my biomechanics
(diagnosis noted in the thread, forgot to mention this came as a
result of another posted thread where I mentioned extreme loss of
function and feeling in the left anterior tibialis within a half-mile
of starting a run, this area still fatigues much more quickly than the
right side)
--right hamstring strain (grade 2, I think), April 2007, rehab only to
pain-free walking and full-ROM resistance movements, perhaps a motor
recruitment pattern imbalance developed from that, still a
strength/proprioception imbalance noticed in unilateral stability
tests (my own observations).
--stickshift transmission, November 2002 to present, posited before as
a possible issue but not really discussed to a conclusion,
pain/discomfort seems somewhat increased since getting a vehicle with
a heavier clutch a few months ago
--general warmth/tingling/pain, occurs when sitting on a hard seat
with feet off the ground, sometimes when on toilet (this can get
especially uncomfortable/painful, with complete leg numbness not
uncommon within a few minutes)
I'm probably missing something, but I really can't think of anything
else of any significance unless you count playing various sports for
several years while growing up overweight. I'm thinking specifically
of basketball in which, being right-handed, 99% of my layups came from
the left leg/right hand.
Further:
Quote:
No lumbar issues that I can recall; in fact, the fascia issue never
reaches the knee, but now that I think about it, it can radiate to the
hip if I try to walk immediately after relaxing the aforementioned
static hold. It stays lateral and doesn't go anterior or posterior.
Lateral flexion is a possibility, if for no other reason than I just
notice I tend to favor one side when standing for awhile. As an
example, when I'm casually squatting down to rest or look at something
on the ground, my left foot will lead and be flat on the ground; my
right foot is tucked more closely to my center of gravity and raised
in the heel (only the forefoot on the ground). I feel better balanced
there than in either a neutral position or especially in a mirrored
position.
Regarding squatting, I can't say I do any pure strength bilateral work
anymore with my semi-recent change in training philosophy. The only
bilateral lower-body work I do is with bodyweight (conditioning) or
single-arm power movements (one-arm clean-and-presses, snatches,
swings). I do perform power cleans once a month or so as a substitute
for a sandbag-based movement.
__________________ No Magic Pill (the log)
My Movember page (yes, I'm slacking on pictures)
Hmmmm ... do you have trigger points in glute medius and minimus? How about tensor fascia lata? And what about quadratus lumborum?
What happens when you do a pigeon stretch?
How is your gluteal activation on that side?
No trigger points to speak of in the areas you mentioned, at least from what I can tell offhand.
An interesting note with the pigeon stretch: no pain or limited range. It seems that there's only pain when the knee is unsupported, meaning ankle-on-opposite-knee stretches and standing cradle holds trigger tightness and pain.
Left glute activation is likely inhibited relative to the right side, something I noticed when dealing with the hamstring issue. I can literally feel a difference in hamstring recruitment (more left, less right) when balancing on one leg at a time.
Quote:
Originally Posted by optimum performance
Just a long shot - check SI joint function. Sometimes this can radiate pain to that lateral, anterior hip.
SI joint function seems okay, but I'd need a more trained eye than mine to say that with complete confidence.
__________________ No Magic Pill (the log)
My Movember page (yes, I'm slacking on pictures)
Lie on your side with the involved leg up.
Bend the top knee and place the foot flat on the ground in front of your pelvis. (You may need to bend the bottom knee slightly to keep stable.)
Put your top hand on the raised knee and push it out (you may have to put your bottom hand on the foot to keep it from sliding).
What does that feel like?
(If it doesn't make sense, let me know and I'll take a photo.)
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Sounds like a side-lying cradle position of sorts, but yes, it makes sense.
Now THIS causes the same pain as the seated ankle-across-knee hold. Significant pain in the hold and shortly after relaxation, and it's a bit of a pull to get the left foot up to the pelvis (and out from the body a couple inches so the lower leg is perpendicular to both my body and the floor). No problem with the right leg (same ROM). As I sit here in a typical seated position, I'm rotating my upper leg (lower leg swinging left and right), and there's a little tightness and soreness in the lateral aspect when internally rotating.
__________________ No Magic Pill (the log)
My Movember page (yes, I'm slacking on pictures)
Do that stretch ... be gentle though ... aim for stretch feeling and not pain feeling.
Do the pigeon stretch, aiming to get your left foot as close to your right hand as possible and keep your hips square to the front and your hips pressing into the ground.
Do a half-kneeling hip flexor stretch. (Really pull into a posterior pelvic tilt, and shift weight to stick the left hip out. Also pull chin down into chest to target the femoral nerve a bit.)
And before stretching, roll a lacrosse ball along the TFL ...best done vertically against a wall.
Stretch twice daily ... but not before lifting.
Hold each stretch for 30 seconds. Twice on the left, once on the right.
See how it is in two weeks and report back ...
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Life's a Journey ... Enjoy the Ride!
I'm going to give this an extra week (almost been two by now). So far, I'm not noticing a positive difference; if anything, discomfort is more common with no change in pain or immobility issues, but then, I haven't been as compliant with the routine as I should be. I've gotten better with the stretches and can tweak this or that to make sure I'm targeting the right places, but proprioception only goes so far.
One thing I've noticed for a long time (this whole thing reminded me) is that my left leg is constantly tense. I'll just be sitting in a chair, and while my right leg is completely relaxed, my left leg is contracted (usually just the upper-leg but sometimes the whole thing). I have to really concentrate to get it to relax, which it does after a few seconds, but as soon as I take my full attention away, it'll gradually tense back up. Perhaps a neural issue underlying all this? Weirdness, but first, coffee.
__________________ No Magic Pill (the log)
My Movember page (yes, I'm slacking on pictures)
Nah, we'll see. Right now, supposedly there's to be some experimentation involving homemade videos being shared online. I agreed on the condition that I get at least 50% of any revenues they may generate
__________________ No Magic Pill (the log)
My Movember page (yes, I'm slacking on pictures)
Left upper-leg lateral fascia pain (not IT band)
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