Doc is in the House

You in front, next question please.

So what about my knee, doc?

Hey Doc,

If you could answer this on on the this thread I’d appreciate it!

http://www.t-nation.com/readTopic.do?id=633982

I just started a new thread with this question, but since you’re here: my girlfriends knee doesn’t track properly when she walks or squats. It sway’s inward during these activities and she now has pain in the knee (I’m guessing due to the tracking problem). This week she decided to not do knee bending excersises and to ice the area. Assuming that this releives the pain, what excersises should she do to correct the tracking problem?

After doc answers, can I chime in?

Stay strong
MR

[quote]TriGWU wrote:
Hey Doc,

If you could answer this on on the this thread I’d appreciate it!

http://www.t-nation.com/readTopic.do?id=633982

[/quote]

Mike feel free to chime in while I am answering the previous ?'s

Ryan

Rainjack,

If the pain is beneath the patella as you alluded on the other thread, then you may have possibly irritated the cartilage on the backside of the patella.

The more forceful the quad contraction the more compression of the patella into the groove between the femoral condyles. Obviously if you have irritated this area, continuing to repeatedly perform the same movements will continue to produce symptoms.

I don’t know if right now is the best time to be doing leg exercises 4 times a week as it won’t give it any time to heal.

You should work on quad/ham/ITB flexibility to help reduce any abnormal tracking issues and work on hamstring strength relative to quad strength as some research has shown that an imbalance can predispose you to increased patellofemoral compression forces throughout various movements.

Obviously in the acute phase make sure you ice the area with the knee in a flexed position.

If it continues to bother you for several more days, I would get it checked out, some therapy may help.

If you have any follow-up ?'s let me know.

Ryan

DR, I heard the Astros game on Sunday was amazing. Why didn’t you go? :slight_smile:

Real question here. I’ve been under a bit of stress for the past few months, and have develpoed a TMJ (jaw muscle) strain from grinding my teeth at night. This pretty much prevents me from eating anything solid that isn’t made by Little Debbie.

I recently heard about a sect (or possible faction) of dentistry that deals with manipulating your jaw to achieve body healing. Kinda like the “subluxation-fix is a cure all” mentality.

Have you heard of this? If so what are your thoughts?

Thanks!

TriGWU,

I assume that you mean sponylolysis and not spondylosis (arthritis).

If that is the case, then I would have to know what Grade she is and whether or not it is stable.

If it is minor and the vertebrae do not move much from flexion to extension, then she should not have any problem with the exercises you mentioned.

Many football players have been found to have these and they do not have low back pain to any greater degree than the other players.

I would suggest that she perform a good low back strength/endurance exercise program to promote further stability.

Does she currently have any symptoms or was it discovered as some sort of incidental finding?

Take care,

Ryan

Eewwwwww, I mis-read that, I thought you said spondylothesis. Anyway, a few questions:

  • What nutritional supps is she currently taking?
  • How far advanced is the spondylosis? What areas is it impacting? (Discs, facets, cervical, thoracic or lumbar vetebrae, etc.?)
  • What does her current exercise regimen look like?

A little more info and I’m sure we can help you out!

Stay strong
MR

[quote]TriGWU wrote:
Hey Doc,

If you could answer this on on the this thread I’d appreciate it!

http://www.t-nation.com/readTopic.do?id=633982

[/quote]

Soldierslim,

Knee tracking problems can be multifactoral. She should really be checked out to identify what all is contributing to the problem.

I’m not exactly sure what you mean by ‘her knee swaying inward’. On squats, do you mean that her knee kind of buckles inward at a certain portion of the ROM?

Really they need to check to see if her feet overpronate,check gastroc/TA tightness, assess the VMO compared to the lateral knee structures. Quad/Ham flex/strength is important. Also hip/pelvis mechanics need to be evaluated.

Where is her knee pain located?

Often the ITB/TFL need to be stretched and the VMO strengthened. Gastrocs stretched. Hamstring and quad flexibilty and strength imbalance addressed.

If her knee buckles in during squats, she needs to increase hip abductor strength. She can wrap a resistance band around the knees when squatting to work on engaging the hips ,etc.

I saw a link to an Ian King article regarding Ending Needless Knee Pain, but I haven’t had the chance to read through it yet.

You may want to ask Mike or Eric if they have any articles on the site that address the issue. There’s no sense reinventing the wheel if they have one.

If you have any follow up ?'s let me know.

Take care,

Ryan

If I could get an opinion on this topic I’d appreciate it:

http://www.t-nation.com/readTopic.do?id=635178

Thanks.

Greg

Dave,

Yea the Astros won 9-0. I was planning on going but some asshole that I was going with got stuck in a ‘traffic jam’.

What kind of TMJ symptoms are you having? If you are grinding at night, consider getting one of those football mouth pieces and using that. If you bite down hard when you lift, the mouth piece would help as well. Also, if you are taking any kind of stimulant products, that can make you more prone to the muscle tightness/tension. Try some ZMA at night, that may help.

You may want to try some trigger point work over the masseter and pterygoid muscles.

There is some manipulation that can be done for the joint, sometimes it helps, sometimes it doesn’t.

If you can make it to Houston, without getting stuck in a traffic jam, I’ll check it out for you.

It really must be putting a crimp on your social life :slight_smile:

Ryan

Greg,

First of all, what fingers do you get symptoms in? What postion(s) are you in when you have the symptoms and do they go away with any certain movements/positions?

More info would be helpful.

Take care,

Ryan

Thanks doc.

I’m gonna look like CT’s “light bulb” by the time I get off this cycle.

Rainjack,

Not saying that you can’t work legs, just not every two days.

What symptoms do you have currently?

Do you get pain going up and down stairs as well?

Do you warm up and stretch prior to performing your leg exercises?

[quote]Dr. Ryan wrote:
Rainjack,

Not saying that you can’t work legs, just not every two days.

What symptoms do you have currently?

Do you get pain going up and down stairs as well?

Do you warm up and stretch prior to performing your leg exercises?
[/quote]

Check your PM, doc.

No pain on the stairs, and I try and stretch everything real good before I start every workout.

Today was QD’s 2X25 day and I squatted with very light weight (70 pounds). I got to 15 reps on the first set and felt a very slight pain, so I stopped. Being the dumbass I’ve become famous for - I did a second set as well, slightly more pain than the first set, but hardly of the magnitude that it has been lately.

After sitting on my ass here at home for an hour, or so - It feels real tight all the way around the joint. No swelling. No pain. It feels like my knee is pumped, if that makes any sense.

When I wake up in the morning my upper-chest feels tight around my collar bones. And right after I stand up out of bed the muscles around them are sore. If I press my arms down I can make them both pop. This loosens them up and I don’t feel any more pain after about 10 to 15 minutes and can funtion normally throughout the rest of the day. What’s up with this???

This is an everyday occurrence since about a month ago.

OD

There were a few minor symptoms that I almost overlooked.

On one of my sets on the 2nd rep I felt quick tingle in my right pinky finger as I pushed the weight up. I completed the rest of the set of 3 reps and several more sets without any other sympotoms.

Then there was a slight tingling in my little finger on my left hand when I woke up the night after doing my benchpress. I was sleeping on my back. I just lifted my hand and wiggled my fingers and it went away.

There was also a little pain or tightness just inside my shoulder blades that I notice every once in a while during the day. Last time it happened it went away after a day and I had no symptoms until I bench pressed again which I do once a week.

I forgot to mention that when I changed my form I dropped the weight from 205 to 185 to get used to the new movement. I had no problems with 205 using my old form.

The last time this happened I was squatting 245 2 days after (bar high on back) and had no pain in my back.

Thanks for the reply Doc. Her left knee does buckle inward when she squats. Most notably during the concentric portion. Her pain is in the lower/ medial portion of the knee. She says that she cant quite pinpoint it though. Thanks for the King article suggestion.

SS