I Need a doctor

I feel like I’m taking crazy pills. Or this is sone sort of test and I’m being experimented on to see how much frustration a person can take. I can’t find a doctor able or willing to hlp within a day’s drive. I’m only three hours from NYC, Boston, Buffalo, and Albany is only 30 minutes away. I could even drive as far as Philadelphia.

Between doctors and PT’s I’ve seen probably 30-40 of them and none of them has helped AT ALL. Most barely listen. Most dismiss my concerns. Most send me away after failing with no suggestion for further treatment.

Maybe 5 have been any good, spending adequate time with me, not constantly talking over me, demonstrably a willingness to actually wrack their brains looking for an explanation I’ve been through PT program after PT program, all working on balance and glute stuff. Doesn’t matter. I tell them balance is bad and glutes don’t work because alignment is bad, not the other way around. Their “programs” do nothing, and they STILL don’t listen. They just shove me out the door with one of their shirts.

I need someone who will actually listen, consider that I actually have an alignment issue that superficial and minor PT tweaks can never fix, and stick with me until we figure it out and fix it instead of getting rid of patients who aren’t fixed by their cookie cutter regimes. Or do such people not exist?

This is ruining my quality of life, and there is no urgency whatsoever on the part of practioners to fix this before things get so bad they can never be fixed and serious permanent damage is done. It may already be too late. But no one seems all that concerned or helpful.

Help.

Being more specific may get you some actually helpful responses.

Leg alignment issues. Quads, calves, glutes don’t work right as a result, though PT’s consistently think it’s the other way around, even though their programs consistently fail to produce any results. Can’t be much more specific because I can’t get a detailed diagnosis. Hence the problem.

There is “something” wrong with my body somewhere between my lower back and the ground and I don’t know what it is. It had lead to knee pain, and now back pain and an injured butt and an all around feeling of awkwardness that I can only describe by saying it’s as if my right and left legs were switched.

It’s not a problem with movement. I can basically pass the FMS screens. My legs feel out of alignment 24/7 even if I’m not moving and every PT program seems to ignore that fact.

I need an accurate and precise diagnosis, thus I need a doctor who specializes in misalignments of lower body.

I found one doctor in NYC($300 out of pocket + travel expenses of driving 3 hours each way and parking in NYC) who used to be a team doc for the NY Jets, and he referred me to another who he said was the top guy when it came to patellar alignment issues. Drove 2.5 hours each way to THAT guy, and he was one of the worst doctors I ever saw. Talked over me constantly. Saw me for 10 minutes tops. Didn’t give me any recommendations. Gave me a brace which did nothing. The NYC doctor, the guy who referred me to him was WAY better in literally every way possible for a doctor to be better. He also referred me to a doctor in France, yes France, but I shouldn’t have to go halfway across the world to get a diagnosis and treatment plan.

You’re still not being clear and specific about your health problem. Not having a detailed diagnosis is an excuse, not a reason.

[quote]grippit wrote:
You’re still not being clear and specific about your health problem. Not having a detailed diagnosis is an excuse, not a reason.[/quote]

If you don’t know what is wrong you can’t intelligently devise a solution. Do you agree or disagree?

The problem is knee pain, leg discomfort. My quads feel really weird. The vastus lateralis feels numb. It works, but doesn’t work correctly. The VMO feels weird. It doesn’t contract fully. If I squat enough to get sore only the extreme interior of the VMO gets sore. None of the rest of the VMO and the VL feels like it got worked at all. I get pain between the upper and lower legs bones. I get pain above the patella. I can’t balance on one leg well. All single leg exercises feel awkward. Everything feels awkward. It feels like my upper and lower legs are out of alignment and my muscles don’t work right as a result. It feels like my legs are going to collapse inward any time I do anything on one leg. Doing anything like squatting I can’t feel my quads working. It feels like everything else is doing the work - back, hams, glutes. If I persist in squatting I get injured. Either it feels like I got another partial tear to the quad, or I hurt my back or my butt.

I have a hypothesis for what’s causing all of this. Misalignment between the upper and lower legs possibly involving deformation of the upper or lower leg bones. This makes sense of my symptoms quite well. But doctors and pt’s don’t care. They just tell me I’m wrong and go on with treatments that have literally no effect.

The problem is I can’t get a diagnosis. That’s not an excuse. It’s a fact that objectively prevents effective treatment. I’m sick and tired of being blamed for the failures of the industry, which is what you have just hinted at.

If there is deformation of a bone, there is nothing I can do exercise-wise to fix this. And this is consistent with my experience. If exercises could help, I’d be fixed by now. There has never been a single exercise that resulted in detectable improvement and in 30+ practioners, not a single one has taken that to heart to lead to efforts to look for an alternative cause of my problems.

Also I’m twitchy. My legs from the bottom of my quads down twitch. My calves are the worst. I had a physiatrist do an EMG and there was nothing wrong though.

[quote]darsemnos wrote:

Either it feels like I got another partial tear to the quad, or I hurt my back or my butt.

[/quote]

So this is what I mean by not being clear and specific. Three posts in and now you’re all of a sudden mentioning a partial quad tear.

Can you elaborate on the timeline of these problems? When and how did you start to develop this? Were you injured or operated on or did things develop gradually? Etc.

Read this post to get an idea of what I mean by being clear and specific in your description of your health problem(s) http://tnation.T-Nation.com/hub/grippit#myForums/thread/6059604/

Btw, both knees?

[quote]grippit wrote:

[quote]darsemnos wrote:

Either it feels like I got another partial tear to the quad, or I hurt my back or my butt.

[/quote]

So this is what I mean by not being clear and specific. Three posts in and now you’re all of a sudden mentioning a partial quad tear.

Can you elaborate on the timeline of these problems? When and how did you start to develop this? Were you injured or operated on or did things develop gradually? Etc.

Read this post to get an idea of what I mean by being clear and specific in your description of your health problem(s) http://tnation.T-Nation.com/hub/grippit#myForums/thread/6059604/

Btw, both knees?

[/quote]

In all seriousness, the possible tear is not important. And I hurt my back and butt in addition to the possible tear. I just mean to say I basically can’t exercise anymore because I inevitably get injured because the orthopedic industry is mostly a joke, unless you have an obvious problem, like something is clearly fully torn. Even some doc’s have admitted to me that they basically have no idea what to do about patellofemoral pain.

I had a partial quad tear that was not diagnosed between 1 and 3 years. Don’t know when the tear occurred. But I was still highly functional. And the surgical fix benefited me literally in no way whatsoever. I just got a temporary feeling recently similar to that tear. At least I think. The known tear was a long time ago.

Everything has been degrading for 10 years. Very slowly, but inevitably,

But the bottom line is I can’t get a diagnosis online and am not looking for it. Numerous interactions online have proven to me that people are not willing to engage unless you simply accept what they say without question. When I ask perfectly reasonable clarifying questions they get irate for questioning them.

I’m not asking you for help diagnosing the problem. I need help from people online finding people in real life to diagnose the problem. So there’s no reason to explain everything except to say there is a misalignment somehow in the legs and all my perceived symptoms line up with this and I need an actual diagnosis as to what exactly the naure of this misalignment is and how it can be fixed. That’s all that matters.

No one online is going to give me the diagnosis and follow-up support necessary to make significant progress unless they’re willing to do on-going consultations. I’ve tried that and people are unnecessarily difficult and confrontational. Those who have made an effort have consistently accused me of being a hypochondriac when things don’t go their way rather than acknowledge I might have a problem that they didn’t immediately didn’t understand.

[quote]darsemnos wrote:

I’m not asking you for help diagnosing the problem. I need help from people online finding people in real life to diagnose the problem.

[/quote]

Ah, OK, I can’t help you with that. I hope you can find someone, good luck.

What specialists have you seen? Have you had x-rays on your legs that appear abnormal? How are you so sure that it is an alignment issue and not a neurological issue?

give these people a call. my family has used MUSC for everything from cancer to MS to retinal reattachment.

http://clinicaldepartments.musc.edu/ortho/

Medical Team

[quote]tedro wrote:
What specialists have you seen? Have you had x-rays on your legs that appear abnormal? How are you so sure that it is an alignment issue and not a neurological issue?[/quote]

I’ve seen sports medicine doctors. Orthopedic surgeons. Physiatrists. Chiropractors.

Nothing major on x-rays or MRI’s. But I’ve learned to be skeptical of doctors. A dermatologist told me in high school food doesn’t affect acne. I should have listened to my much more intelligent father who’s a mere engineer. Another doctor chopped off part of my body without consent and without medical need. Doctors are not immune to fantastic stupidity.

I’ve had an EMG twice. I have a TON of twitching in my calves but it’s benign as far as the EMG is concerned. It looks like there’s a creature swimming around in there, but the physiatrist said it’s common and unless the EMG shows anything it’s nothing to be worried about. I have my own theories.

I know it’s an alignment issue becuase I can feel directly that the alignment is wrong. My legs literally look different than they used to, and it’s not just due to loss of muscle mass. They feel different too. How my knees touch when I sleep on my side has changed as well. Misalignment makes sense of all of my symptoms but I can’t get anyone to take it seriously.

And I’ve even had one doctor, but who is unfortunately almost 2,000 miles tell me this after I emailed him. He said most doctors are unable to properly diagnose this problem. See below:

Dear Mr. xxxxxxxx,

This certainly seems like a rotational malignment. Most of these patients have already been through the medical â??millâ?? after years of useless PT, through useless arthroscopic and other â??minimally invasiveâ?? procedures, and finally narcotic addiction at the hands of the â??pain managementâ?? doctors.

You need to find a competent doctor to do the correct physical examination, order the correct imaging, and then have the guts to act on his/her findings. Unfortunately, there arenâ??t so many of these people as the work is hard, and the remuneration is low. I am sorry, but I donâ??t know anyone in your part of the world that regularly takes these cases on.

Perhaps you should visit me for a day or two, and you will return home with all the answers you seek.

With best regards,

[quote]silverblood wrote:
give these people a call. my family has used MUSC for everything from cancer to MS to retinal reattachment.

http://clinicaldepartments.musc.edu/ortho/

Medical Team

Why? What’s special about them? I’m 1500 miles away. I can’t visit every place people recommend within 2000 miles. I have a normal job and I’m not made of money. There is already a place in Houston I want to check out, but that’s probably a minimum $1000 and 2 vacation day investment for the POSSIBIITY of an accurate diagnosis. I haven’t yet given up on finding something I can drive to in a day.

[quote]darsemnos wrote:
Perhaps you should visit me for a day or two, and you will return home with all the answers you seek.

With best regards,
[/quote]

I don’t seek the answers for you. Just trying to help you out. I read your first post and immediately thought it sounded like something was amiss in your nervous system. I’m no doctor and have no desire to be one. I can promise you I am at a minimum every bit as skeptical of doctors as you are. I believe for the vast majority of doctors their only accomplishment is the dedication to stay in school long enough to get licensed. Finding a doctor that is also in the top .1 or .01 percentile of general intelligence is a rarity, which is a shame because in the grand scheme of things 1/1000 or 1/10,000 should not really be rare, with nearly 1,000,000 physicians in the country. Unfortunately the current state of medicine and the current state of education in general does not encourage the best and brightest to enter the field, but merely those that wish to follow the line of regurgitating popular opinion.

[quote]
I know it’s an alignment issue becuase I can feel directly that the alignment is wrong. My legs literally look different than they used to, and it’s not just due to loss of muscle mass. They feel different too. How my knees touch when I sleep on my side has changed as well. Misalignment makes sense of all of my symptoms but I can’t get anyone to take it seriously. [/quote]

What came first, the chicken or the egg? Is it possible an undiagnosed issue with your nervous system has lead to the misalignment issue? I would not at all be surprised to see numerous orthopedic surgeons view you as nothing more than an unathletic adult and send you on your way murmuring under their breath that you are a hypochondriac.

You claim you haven’t always felt this clumsy. To one that doesn’t know your history, you simply ARE clumsy and that’s the end of it. As reported by you, no one wants to dig into the problem and find the cause. I’m just throwing out the first thing that came to my mind, and suggesting maybe you take a chance on something that you hadn’t yet considered.

Good luck. I’m not going to pretend I’ve been in a situation like yours, but I very much know what it’s like to go years without a diagnosis for a legitimate issue due solely to ineptitude on the part of multiple physicians.

[quote]tedro wrote:

[quote]darsemnos wrote:
Perhaps you should visit me for a day or two, and you will return home with all the answers you seek.

With best regards,
[/quote]

I don’t seek the answers for you. Just trying to help you out. I read your first post and immediately thought it sounded like something was amiss in your nervous system. I’m no doctor and have no desire to be one. I can promise you I am at a minimum every bit as skeptical of doctors as you are. I believe for the vast majority of doctors their only accomplishment is the dedication to stay in school long enough to get licensed. Finding a doctor that is also in the top .1 or .01 percentile of general intelligence is a rarity, which is a shame because in the grand scheme of things 1/1000 or 1/10,000 should not really be rare, with nearly 1,000,000 physicians in the country. Unfortunately the current state of medicine and the current state of education in general does not encourage the best and brightest to enter the field, but merely those that wish to follow the line of regurgitating popular opinion.

[quote]
I know it’s an alignment issue becuase I can feel directly that the alignment is wrong. My legs literally look different than they used to, and it’s not just due to loss of muscle mass. They feel different too. How my knees touch when I sleep on my side has changed as well. Misalignment makes sense of all of my symptoms but I can’t get anyone to take it seriously. [/quote]

What came first, the chicken or the egg? Is it possible an undiagnosed issue with your nervous system has lead to the misalignment issue? I would not at all be surprised to see numerous orthopedic surgeons view you as nothing more than an unathletic adult and send you on your way murmuring under their breath that you are a hypochondriac.

You claim you haven’t always felt this clumsy. To one that doesn’t know your history, you simply ARE clumsy and that’s the end of it. As reported by you, no one wants to dig into the problem and find the cause. I’m just throwing out the first thing that came to my mind, and suggesting maybe you take a chance on something that you hadn’t yet considered.

Good luck. I’m not going to pretend I’ve been in a situation like yours, but I very much know what it’s like to go years without a diagnosis for a legitimate issue due solely to ineptitude on the part of multiple physicians.[/quote]

I’m actually not clumsy at all. My hand-eye coordination is fine and my balance is fine. In the midst of athletic movement I’m plenty agile. It just feels all wrong. I can force just about any movement. It just feels dangerous.

And speaking of unathleticism, 90% or way more of the fellow patients I see at physical therapy clinics are old people. Seeing another athletic person is rare. That’s bad.

[quote]darsemnos wrote:

[quote]silverblood wrote:
give these people a call. my family has used MUSC for everything from cancer to MS to retinal reattachment.

http://clinicaldepartments.musc.edu/ortho/

Medical Team

Why? What’s special about them? I’m 1500 miles away. I can’t visit every place people recommend within 2000 miles. I have a normal job and I’m not made of money. There is already a place in Houston I want to check out, but that’s probably a minimum $1000 and 2 vacation day investment for the POSSIBIITY of an accurate diagnosis. I haven’t yet given up on finding something I can drive to in a day. [/quote]

they are an outstanding hospital with a great record. you didn’t give a distance you would travel. you wanted a doctor. I said to call them. I was trying to help so quit acting like a dick!

There’s a grave danger of me launching off onto a 20 page rant - but I’ll try to keep it short!!

I’ve had similar experiences. I practiced martial arts for 20 years and was very fit, strong and flexible. Then one day my hip seized up overnight (in retrospect I can see that the problem had been developing for a decade or more). Physios couldn’t figure it out and I was eventually sent for an x-ray which came back saying “degenerative changes in both hips”. Perfectly common in symptom free 42 year olds, but from that day on I was labelled as having hip OA and told to stop training and come back when I needed a hip replacement. I’m not going to launch onto my normal rant about my experiences of health professionals - I’d be preaching to the converted anyway!! :O)

I knew it was nonsense. I felt that it was a rotated pelvis knocking everything out of alignment. The problems rippled through my whole body. I have spent thousands on various experts and had similar experiences to you. They often start out promising the earth, but after a few failed treatments they loose interest and change their diagnosis to hip OA. Which just doesn’t fit by any stretch of the imagination. They don’t want to hear your ideas, experiences thus far - the just want to go through their preferred routine without thinking.

I ended up having to figure it out for myself. Your symptoms aren’t the same as mine mine, but some of the things you’re saying match. It’s quite possible the mechanisms are similar - so basically muscle imbalance (I know you’ve kind of ruled that out, but stick with me…).

Have you had anyone check for sacral torsion? I’ve attached a video animation of what happens to the sacrum (base of spine) and innominates (wings of pelvis) during normal gait. This is exaggerated - the movement is subtle. The sacram is very significant as movement of the whole body is closely tied in with it. So for example, when the sacrum tilts right and rotates right the lumber spine does the opposite (rotates left and tilts left); the thoracic does the opposite to that (rotates right and tilts right). All sorts of things happen down the way too. So when sacrum tilts right and rotates right the right innominate goes into posterior rotation and inflare (and maybe downslip). I don’t remember the details, but the pattern ripples down the legs too. A predictable pattern - you get a clue of what’s happening all over the body based upon where the sacrum is positioned. It’s just the way the body works.

The sacrum (and therefore the whole body) can get ‘stuck’ at any point in the normal cycle. Not necessarily stuck even - sometimes it’s just more mobile one way than the other. Visualize how it’d feel to move with the structure jammed at any one point in the cycle shown in that video. That’s what it turned out to be with me - right on right sacral torsion. Because all of the boney landmarks are out of place muscle attachments are in the wrong place. Some muscles are in a disadvantaged position and can’t fire. Others try to take up the slack but aren’t suitably positioned to do the job properly. Everything just feels wrong and works wrong.

There are lots of positions that the sacrum can ‘stick’ in. So symptoms would vary. Also, knowing you have a stuck sacrum isn’t really a solution as you still need to figure out why. It’s a chicken and egg thing - are the muscles tight because of the stuck sacrum or is the sacrum stuck because of tight muscles. Tight thoracic could be knocking the sacrum out of place which in turn jams the knee into a bad position. It’s complex. Essentially I think it’s always down to muscle imbalance but these can be impossible to untangle. The physios didn’t pick up on my sacral torsion. The chiros and osteos did but had no clue how to fix it. The surgeons just wanted to operate!!

Sources of information that have been very helpful to me include:

The Postural Restoration Institute.
http://www.posturalrestoration.com/

Look through their articles and see if anything matches up with what you’re experiencing. They could put you in touch with someone trained in their methods if you think it sounds promising. I’m in the UK - if you’re in the US I think you’ve got a much better chance of having someone near you.

Neuro-Kinetic Therapy.
They have a webiste but if you’re on FB follow them there:

They post up regular case studies and little scenarios that just make you think “Of course - it’s so obvious!”. They too could put you in touch with someone trained in their methods if you think it seems promising. I think this is the one that best explains what’s going on with stubborn muscle imbalances, and how to fix them. This one could be of great help even if your problem is nothing to do with twisted pelvis/stuck sacrum. So have a good look at this one.

I managed to figure mine out on my own, but it’s taken 8 years! Like you, I tried lots of physio/exercise with ZERO impact. But when you find the route of the problem and do the right things you can get results. So don’t rule out the possibility of muscle imbalance. Really open your mind to the Neuro Kinetic Therapy ideas and see if it starts to make any sense.

I totally get what you’re saying about paying out for endless ‘experts’ that are worse than useless. How do you find a good one without paying 100 useless ones en-route?

I hope that this can help in some way. I know how frustrating it is!!