What's Up, Doc?

Training Bodybuilding
21

Dr.Ryan
Hi Doc,
several years back i had the displeasure of having an osteotemy of my left patella. in that procedure they also raised the attachment of the tendon that the patella is part of. they used a bone graft and a screw to raise the attachment below the patella.

they also put a bolt through the patella for stabilization i think.

on the right knee i have had a couple of scope jobs done, but nothing major.

so that brings us up to now.
i would like to do squats and deadlifts, but even just doing body weight squats i have pain and of course crepitus. by the way there is crepitus all the time in both knees, but i dont think that in itself is that critical.

should i just stay away from doing weight work for my legs? i would rather be able to do something.

also cycling does not seem to bother me, as long as i dont push too big a gear. however going up and down stairs does get painfull. the pain is directly beneath my patellas.

what about any sups specifically for joint pain, glucosimine (sp) etc?
thanks for any advice.

22

I posted this on another thread but I wanted to get yor view on this.

I thrashed my left elbow on the inside (opposite of Tennis elbow). I can lift overhead etc. with no problems. If I do any kind of curl or pull/chin up, it feels like its going to rip in half. I went to the Dr. and she said there was nothing major wrong with it (tear, break etc.), but she didn’t really say anything about treating it ( she is a bike rider not a lifter). Would it do any good to wrap it or what can I do other than wait? I know the easiest thing is, if it hurts don’t do it, but I really don’t want to quit. Can I injure it farther (not an intended result) or will it heal whether or not if I keep working it.

23

zedhed,

Well I would definitely recommend the glucosamine, MSM and Fish oil.

What kind of treatment or therapy have you had as part of rehab?

24

HI doc, I have a question tonight relating to a lower back injury. I made an appointment with a chiropracter but its going to take two weeks to see him. I was hoping you might give me some insight until then

The injury really only pops up when i bend at the torso. It hurts just above my tailbone and to the left almost like a little knot. Could it be my siatic nerve i have from time to time had tingling in my left foot. The injury popped up about 3-4 days after a car accident i was in. I bent over and it felt like someone stapped me in the back. It hurt for quite a while and my doctor at the top just said it was a muscle issue and gave me some antinflammitories and muscle relaxers.

It was fine for a while but never great. If i stetch a lot and really watch my posture it feels ok but not great. I am slightly overweigth with about 18% bodyfat but i have always carried alot of muscle and lifting regurally before that point but i had put on some weight just before the incident i have lost most of the weight that i gained just before and after the car accident and back injury. I also have a longer torso then legs. Despite being 6’2 i only have a 29 each inseam. could that lead me prone to back injuries and what might i do or what might the cause of my injury be to the best of your abilities

25

RW,

Sorry to hear about the elbow. Did they do any diagnostic tests or just physical exam?

I’m guessing that she didn’t send you to physical therapy?

If you truly have no significant damage, then some myofascial (active) release would probably help. Depending on how long the injury has been present would be one factor in determining how much you can stress it with exercise.

Do hammer curls and reverse curls bother it or only curls with the wrist supinated? What about pull-ups (pronated grip)?

Obviously, I can’t feel the pain you have with these exercises, but if it is intense and recreates the the pain of the initial injury, then it could definitely make you worse. If the pain is more mild and doesn’t really recreate the pain of the injury, then you could try to work with it a little.

With any exercise, that stresses the area, start light with minimal volume and assess how you respond. Then increase slowly.

I would try to find a good sports med chiro or PT and see if they can’t provide you some treatment.

Take care,

Ryan

26

brotzfrog,

Well, pain with bending at the torso can be related to joint, ligamentous, musculotendinous or disc injury. Often once one of these tissues is injured, it creates a symptom complex involving the other tissues.

With numbness into the leg/foot, you would definitely want to rule out any disc injury creating nerve compression. The sciatic nerve is a large nerve that is formed through the conjoining of several lumbar spinal nerves. What part of the foot do you get symptoms in?

Two weeks is a long time to wait for an appointment. Have you been to this doc before? Make sure that they offer soft tissue therapy, stretching and rehab exercises as well as instruction on modifiying your daily activities to relieve stresses on your back.

Check out the Cool Tip archive for my Get on a Roll tip. That will help decrease lumbar stresses when you sit.

You may want to check out the book Treat Your Own Back, by Robin McKenzie. It explains the lumbar discs response to mechanical loading. Some of the exercises help significantly with conditions similar to what you describe. However, it should just be a part of a broader program.

Let me know if you have any follow-up questions.

27

thanks alot for your input i really appreciate it. The tingling happens very seldom when it does its mostly in the toes. not to the point of numbness put it is noticeable. the pain and discomfort is mostly located in the lower left area of my back just above my hip it feels like there are two corresponding bones on either side of my spine at this point like little knobs(i am not very skilled in anatomy) the left one can really feel tender at times even to the touch.

I have waited probably to long to take care of it but i desperately wanted to work out as much as possible the initially injury was about two years ago.

28

brotzfrog,

The ‘bumps’ you are referring to are your PSIS’s (posterior superior iliac spines). The area right around the PSIS’s is a hot bed for LBP. There are many pain generating structures in that area.

Since it has been so long since the accident and you still have symptoms, you should definitely have it evaluated. An MRI would be the best diagnostic test to give you info. regarding the discs, joints, nerves, etc.

With the symptoms you describe, it doesn’t sound like a severe problem, I would think that even if the disc is involved, by doing some treamtents and getting on a good lumbar stabilization program, you should do just fine.

It will be important for you to maintain the normal lumbar lordosis during any kind of squatting or deadlifting motions as well as rows or any movement that could result in loading of the spine in flexion.

If you have any questions let me know. Definitely keep me posted.

Take care,

Ryan

29

Dr. Ryan
ok this is from a long time back.
i think pretty much the standard. supervised stretching-breaking the adheasions, muscle strengthening and toning and cold whirlpool to reduce swelling afterwords.
(at this time my range of motion was less than 90%).
then when the structured therapy was over, on my own after 6 months to a year of just day to day living i got into martial arts to improve my range of motion and overall health. and then i got into cycling. i got up to 40-50 miles/day.
during all of this time i have been breaking the adheasions myself and then icing and elevating for the resulting swelling.
during the time that i was cycling i was doing half squats 10x10 with 180-200 Lbs. i dont remember having the pain that i do have now though. i mean there was some as would be expected but now there seems to be considerably more particularly going down.(with just 130 Lbs)
for the last couple of years i have been using the treadmill. at first i was not ablt to jog or run at all. now i am to the point that i can run (softly). when i get off the tread, i do stretching and then move on to weights.
right now my range of motion is probably close to 90-93%. i take gloucosimine 1500 mg once a day, borage, fish and flaxseed oil, 1500 mg per day.

30

Here are my problems:

1.In the squat position theres this blood vessel in right knee.I cant feel it when I`m standing.
I feel it only in the bottom position of the squat.No such thing in my left.

2.Right part of the body is tighter than left.

3.Right obliques are stronger than left.

4.During leg curls -Right hams are stronger than left.

5.The arch of my right foot has kindda flattened out-I think thats cause of barefoot squatting.

6.I suffer from a pelvic/lower back twist.

7.The part of my Right Knee which is on my left(hope you understand this) hurts me like hell.

When I exercise:

SQUATS:

1.My biggest prob-The part of my Right Knee which is on my left(hope you understand this) hurts me like hell when

I squat.It hurts me even when I do Hindu squats.

2.My R glute/hip muscles feel like they`ve been ripped off my body. Odd choice of words-but thats the way it is. Its not very painful but it feels like the R leg is not a part of my body.

  1. I tried going into a Horse stance -same bloody problem.

I thought I was facing this only when I exercised. Not True. All these pains and aches I face even when I`m not exercising. I went for this long walk yesterday-not even at a brisk pace-and my knee and glute area started hurting me.

I started having these problems something like 3 months ago-or so I thought…

When the pain became too much to bear I stopped lifting.This was one month ago. Then I started going through my journal. Imagine my horror when I noticed that Ive been going through this for the past year or so(maybe more-Ive just gone through a years worth of work-outs). The only thing that has changed is the intensity of the pain. Last year Ive documented it as something irritating my Right knee-today Im documenting it as excruciating and drop-dead.

During ALL my squat wk-outs since last year this is what I`ve documented:

1.Knees screwd up.Knees keep coming in(cause of weak adductors.Knock knees…)

2.Squatting pressure more on 1 leg rather than equal-somtimes left-sometimes right.

3.Abs “need to be stronger”

4.Right glutes more stimulated than Left.

5.Limited flexibility…

I was planning to go see a Physio about this- but kept procrastinating it.I`m seeing one this week.
But shes not a lifter. Anything you can recommend would be very helpful. Any exercise, nutrition…