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Chiropractic / Musculoskeletal / Joint pain Q & A...

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    Quote Originally Posted by celc5 View Post
    Ryan,
    the synvisc would be a reasonable option. I see mixed results with those injections as well. Some respond like Scotty's racquetball partner, others don't really get any lasting relief. At the same time, your insurance is one of many that doesn't cover it because of those mixed results.

    Cortisone, chiropractic, physical therapy, anti inflammatories are more reasonable options for your knee. Then it's time to at least try to get it/them scoped. With your aggressive history, maybe cleaning up some scar tissue and arthritis can get you some relief.

    Finally, have you had an MRI on your back?

    Scotty,
    you're right about relief percentage for the stim implant. I was totally guessing based on subjective reports that I've heard (I'd guess somewhere between 5-10 reports over the past few years).
    Ya cortisone, chiro, pt, and anti-inflammatories have been my life over the last couple of years, lol. They all provide transient relief, which is great while it lasts. The whole process gets old, and the longer this goes on the more pain I tend to feel from just doing even the simplest of things. Part of my problem is I have a high pain threshold, and if I am feeling decent one day I will go out and flip tires, or push a sled, or something else that is simply not a smart idea and usually lands me in bed. It's very hard for an athlete to realize they are no longer at their prime, but it's something altogether more difficult to accept at 30yrs old you can no longer do things that most people even in their 60's can do.
    I had my knee scoped last year and cleaned out a lot of crap which definitely helped, problem is the condition is constantly degrading, and the pain again is becoming more prominent. It doesn't help that I continue with strenuous activity. As far as my back I have had an MRI, but it was right after my injury, have only had x-rays since. The x-rays show degradation of the spine as far as arthritis, from what I understand osteoarthritis will present in previously injured areas, especially if the area is consistently stressed.


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    Quote Originally Posted by ryansm View Post
    Ya cortisone, chiro, pt, and anti-inflammatories have been my life over the last couple of years, lol. They all provide transient relief, which is great while it lasts. The whole process gets old, and the longer this goes on the more pain I tend to feel from just doing even the simplest of things. Part of my problem is I have a high pain threshold, and if I am feeling decent one day I will go out and flip tires, or push a sled, or something else that is simply not a smart idea and usually lands me in bed. It's very hard for an athlete to realize they are no longer at their prime, but it's something altogether more difficult to accept at 30yrs old you can no longer do things that most people even in their 60's can do.
    I had my knee scoped last year and cleaned out a lot of crap which definitely helped, problem is the condition is constantly degrading, and the pain again is becoming more prominent. It doesn't help that I continue with strenuous activity. As far as my back I have had an MRI, but it was right after my injury, have only had x-rays since. The x-rays show degradation of the spine as far as arthritis, from what I understand osteoarthritis will present in previously injured areas, especially if the area is consistently stressed.
    You kind of answered your question, in order to make a real recovery where you can even think about doing the things you want to do that you say someone in their 60's can do is if you actually do all those therapies while also giving your body the necessary time to heal. Not going to heal if you go flipping tires or relive the power-lifting glory days just because you are having a good day and not feeling pain. Think of pain like this... when an injury occurs over time it is the last thing to happen, as in it just gets a little worse and a little worse and all the while your tolerance for this pain builds as the pain progresses. Therefore, you get all these treatments & therapies and you get some relief, that does not mean the problem is gone, just means it is getting better/healing.

    I'm not saying this is you, but I will tell you I have a great many patients, both weight lifters and non-weight lifters alike who will come into my clinic get some treatment, go home take a pain pill, wake up the next morning feeling great and then go continue doing whatever it was that caused their injury in the first place and come back into my office complaining that it felt better, but now suddenly and for some unknown reason the pain is back and even worse??? I look at them and say "Really... Honestly... You don't know why the pain is back?" That is a problem of mine though, because as you know (psychologically) when we feel good, we feel healthy and when we feel healthy it is only in our nature to push our boundaries.
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    Oh you are absolutely right, and I'm not pushing myself to the point I was when competing. I guess what I have been doing is thinking that if I only lift x amount of weight, or flip a tire x amount of times then that will be enough. Basically downgrading the output, however I am coming to the realization that this is not working, and I need to make a serious change. But it's like you state "Psychologically" it is much easier said than done.

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    Quote Originally Posted by ryansm View Post
    but it's something altogether more difficult to accept at 30yrs old you can no longer do things that most people even in their 60's can do.
    .
    Unfortunately as bodybuilders/powerlifters there's a constant wear and tear from pushing our bodies to the limit everyday. The passion that we love is making our joints,cartilage,discs and tendons age alot quicker than your regular guy walking the streets. Our joints ect..ect.. are probably older than our actual age. IMO.
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    Quote Originally Posted by ryansm View Post
    But it's like you state "Psychologically" it is much easier said than done.
    I am not saying that just about you, I am saying we are all like that no matter what the sport and no matter who we are. If you are an athlete, which is about 99.99% of the people on this site, then pushing it to the limit is a mind-set (psychological) issue that is not easily broken. I will be the first to admit that I am personally 100% guilty of this!

    No worries bro, you'll figure this out, I can tell from our conversations you are a very intelligent guy, no need for me to beat a dead horse on this issue, LOL
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    I completely understand doc, and appreciate the help.

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    Quote Originally Posted by vidapreta View Post
    Unfortunately as bodybuilders/powerlifters there's a constant wear and tear from pushing our bodies to the limit everyday. The passion that we love is making our joints,cartilage,discs and tendons age alot quicker than your regular guy walking the streets. Our joints ect..ect.. are probably older than our actual age. IMO.
    I agree with what you are saying for the most part, I mean you are right, just wanna make sure that people know that just because we rode our bodies harder when we were younger with extreme sports/lifting doesn't mean we need to quit all together. It just means we need to listen to our bodies and switch gears in the way we lift and/or exercise. As I have stated before in my case it was to lose excess weight and start lifting lighter and for higher reps.
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    Quote Originally Posted by ScottyDoc View Post
    I agree with what you are saying for the most part, I mean you are right, just wanna make sure that people know that just because we rode our bodies harder when we were younger with extreme sports/lifting doesn't mean we need to quit all together. It just means we need to listen to our bodies and switch gears in the way we lift and/or exercise. As I have stated before in my case it was to lose excess weight and start lifting lighter and for higher reps.
    I'll never quit, but i do hate the idea of going lighter,it goes against everything that i started lifting weights for.
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    Quote Originally Posted by ryansm View Post
    I completely understand doc, and appreciate the help.
    Anytime bro, anytime! On a different note, when you were competing what exactly were you competing in? I ask because you originally stated you power lifted then mentioned flipping tires, were you entering strong man contests? I love watching that $hit on TV, my big head tells me.. "I can do that," but my logic knows I cannot, LOL. I remember from some of the older ones, the way they man handled.. and I mean MAN-HANDLED those full kegs... and I helped a buddy set up for a Christmas party and felt like a total weakling struggling to carry a full keg up a flight of stairs all alone. With that kind of stuff... the word cumbersome is the best way to describe it, because it wasn't all about the actual weight, but the size/weight that was the issue. I find the same thing is true whenever I have the joy of helping a friend move furniture, which unfortunately I am the first one they all call, this happen to you?
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    Diversity in life is a blessing, there is a reason moderation is advised in more than just the simple things. Athletes, especially professional, have or develop a perfectionist mindset. The key is to define yourself by many different things, and not hold your eggs in one basket. ^^^I'm trying to follow this outlook, lol.

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    Dr. Scott, I had arthoscopic surgery on my knee about 10 years ago due to a meniscus injury. They fixed it and cleaned up the cartilage a bit and ever since then, I have had an achy knee. I have tried everything and nothing works for it. I have just learned to live with it for the most part and lost all hope of it ever feeling better. I have tried ibuprofen, glucosamine chondroitin, fish oil, numerous joint support supplements and so on. Do you have any roccomendations as to what else I could do to eleviate the constant pain? I also was diagnosed with IT Band syndrom recently and think that may have been caused by my injury or atleast played a factor. Any thoughts would be greatly appreciated doc.
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    Who diagnosed IT band syndrome? What are you doing to address it? And where is your pain exactly?

    Btw,No intent of stepping on your toes Scotty Just playing along
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    Quote Originally Posted by drinkyboy View Post
    Dr. Scott, I had arthoscopic surgery on my knee about 10 years ago due to a meniscus injury. They fixed it and cleaned up the cartilage a bit and ever since then, I have had an achy knee. I have tried everything and nothing works for it. I have just learned to live with it for the most part and lost all hope of it ever feeling better. I have tried ibuprofen, glucosamine chondroitin, fish oil, numerous joint support supplements and so on. Do you have any roccomendations as to what else I could do to eleviate the constant pain? I also was diagnosed with IT Band syndrom recently and think that may have been caused by my injury or atleast played a factor. Any thoughts would be greatly appreciated doc.
    Well, it is possible that the IT band played a role in your injury, and it is possible that it is continuing to play a role now, really hard to determine 100% to be honest. There are a few tests, but to be honest, they are not all that easy without someone who kind of knows what they are doing... I will list a few and you can look them up on the internet, will probably find a better explanation and possibly a picture of even a youtube video or something describing how to do them and what to look for, but here goes:
    1) Nobles Test
    2) Ober's Test
    3) Iliotibial Syndrome Test
    I would say if you pass all three of these tests, which are only slight variations of one another, then it would be fairly safe to say it is not currently your IT band at least. If it is your IT Band, again there are some really good stretches on youtube, but also I recommend some good deep muscle massage therapy, can't say you will enjoy it, will probably hurt like a MF, but will make a world of difference if that is indeed your problem.

    The only other recommendations I would have made, but you beat me to the punch as in you have already tried them is the Chondroitin, Glucosamine, & MSM along wish fish oils (omega 3-6-9, EFA's) I don't really know what else to say. Have you gone back and spoken to your surgeon about this? I mean, he has access to your x-rays, MRI's, he is the one who went in there and saw it all personally, I would love to hear his thoughts on this to help make a better conclusion. Sorry to say, but that is about all I have for ya, other than one more question... what do you do on a regular basis exercise-wise to improve it... strength, ROM, flexibility?
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    Thanks for addressing my problem. My doctor sent me to a physical therapist a few months back and thats when i was diagnosed with ITBS. I roll on my hard foam roller 2x a day for my hip flexors, IT band and quads and do RF/TFL stretches, lunge stretches and seated 90's. I can manage my IT band, its just the darn pain in my knee. Phys therapist said the meniscus injuries rarely return to normal after surgery. Its never really quite the same she says. I refuse to live on pain meds or anit-inflammatory meds by all means, so I guess I just have to talk to my doc again or suck it up. Thank you for your input doc.
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    And I forgot to mention that I went to phys therapy for my IT band when I addressed my knee problem. I did phys therapy after my surgery also but went into the military after that, and anyone who is currently serveing or a vet will tell you that the docs are nothing to brag about. That is why I took some years to get REAL help from REAL doctors.
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    Quote Originally Posted by drinkyboy View Post
    And I forgot to mention that I went to phys therapy for my IT band when I addressed my knee problem. I did phys therapy after my surgery also but went into the military after that, and anyone who is currently serveing or a vet will tell you that the docs are nothing to brag about. That is why I took some years to get REAL help from REAL doctors.
    Damn... Sorry to hear that, I have heard that about a lot of the doctors in the military... weird too, you think they would be really good, but I have heard a few butcher stories as well. I wish there was more I cold tell you or do for you, but minus the pain meds and anti-inflammatories, etc. PT is the best thing you can be doing for it to keep it from getting worse. As far as getting back to 100%, very true that is rare, but to live with constant aggravating pain for the rest of your life doesn't sound right either, so there must be something. I might not have the answer for you, but I would not give up and I will continue to do a little more research on meniscus injuries and recoveries, etc. on my own as well, see what I can't dig up for you!
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    Quote Originally Posted by celc5 View Post
    Who diagnosed IT band syndrome? What are you doing to address it? And where is your pain exactly?

    Btw,No intent of stepping on your toes Scotty Just playing along
    Don't worry bro, I don't mind at all. I have met quite a few people on here that are easily as knowledgable as myself, so by all means, chip in!
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    Drinky, do the TFL stretches give you any relief?
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    They do because my IT problem has caused me to have a tight hip flexor. My range of motion has improved and the throbbing in my thigh while seated has eased up quite a bit. It gets pretty bad if I dont do that stretch...it will tighted up all the way up to my buttox. It also helps to roll on a tennis ball on my butt cheek also to relieve the tension. Hurts like a mofo, but very effective in my experience. I use to not be able to squat for some time, but since doing some stretches and such, im back to squatting. I can def tell a difference. Liniment works wonders also, which I apply pre workout and post.
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    Quote Originally Posted by drinkyboy View Post
    They do because my IT problem has caused me to have a tight hip flexor. My range of motion has improved and the throbbing in my thigh while seated has eased up quite a bit. It gets pretty bad if I dont do that stretch...it will tighted up all the way up to my buttox. It also helps to roll on a tennis ball on my butt cheek also to relieve the tension. Hurts like a mofo, but very effective in my experience. I use to not be able to squat for some time, but since doing some stretches and such, im back to squatting. I can def tell a difference. Liniment works wonders also, which I apply pre workout and post.
    I would really look into some really good deep tissue massage on the TFL. Also, I've met a few really good massage therapists that will incorporate PNF stretching with their massage, that is really awesome!
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    The wife and I were just talking about getting massages...we are both well past due for one. Thanks doc for the insight.
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    Doctor Scott, this is really generous of you. Iíve been perusing AM for several months now and became a member a couple months ago but have never posted. Up until your offer I was just content soaking up all the info and learning as much as I can.

    Anyhow, maybe you might be able to help me with a minor issue I have with my shoulders. I first noticed it a few years ago when swimming under water. I feel and hear a crepitus-like sensation in both shoulders when Iím swimming under water. Up until recently this wasnít noticeable other than in the pool. And It is becoming more intense and annoying as time goes by. Now I can put my hand over my shoulder while I rotate the joint and feel some minor crackling and little popping. Thereís usually no pain and I canít hear anything. Itís only a sensation at this point. However I do have a habit of hurting one of my shoulders in the gym on occasion. It heals in a few days with rest. The shoulder injuries appear to correlate to intense shoulder isolation exercises either before or after inadequate rest between other upper body core workouts.

    Thanks so much for any suggestions or thoughts. Appreciated.
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    Quote Originally Posted by chunkymon View Post
    Doctor Scott, this is really generous of you. Iíve been perusing AM for several months now and became a member a couple months ago but have never posted. Up until your offer I was just content soaking up all the info and learning as much as I can.

    Anyhow, maybe you might be able to help me with a minor issue I have with my shoulders. I first noticed it a few years ago when swimming under water. I feel and hear a crepitus-like sensation in both shoulders when Iím swimming under water. Up until recently this wasnít noticeable other than in the pool. And It is becoming more intense and annoying as time goes by. Now I can put my hand over my shoulder while I rotate the joint and feel some minor crackling and little popping. Thereís usually no pain and I canít hear anything. Itís only a sensation at this point. However I do have a habit of hurting one of my shoulders in the gym on occasion. It heals in a few days with rest. The shoulder injuries appear to correlate to intense shoulder isolation exercises either before or after inadequate rest between other upper body core workouts.

    Thanks so much for any suggestions or thoughts. Appreciated.
    OK, just so you know you are not in front of me, I can't exactly get a full history, definitely can't see any x-rays or perform any necessary orthopedics tests, but I will do my best from what you are telling me.

    I need some more past history about sports you may have played, anything upper body intensive to explain what sounds to me like scar tissue that has built up in your shoulders. Almost all weight lifters, football players, baseball players, and other upper body dominant athletes that have been doing what they do for any extensive length of time (approx. 5-10yrs).

    If it is not causing any pain I would not be so worried that it is making a sound or that there is scar tissue in there (most common reason for crepitus sounds in a joint). I would just know that there has been some wear & tear in that area of your body and you need to warm it up properly, even before swimming, stretch it once it is warm, do strengthening exercises for your rotator cuff muscles, and if there is any soreness or you believe it has been sprained/strained then you want to ice immediately after.

    Answer my above Q (more about past history) and let me know if you are still feeling the crepitus as well as hearing it even after warming up properly, not during warm-up, will probably always hear it then (only surgery can get rid of scar tissue, which is what I believe it is).
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    Chunkymon,

    Hey bro, check out this other thread I had started a few months back it was specifically about shoulder injuries, the thread has kind of died, but there is quite a bit of information that is right up your alley if you read through it... Shoulder Injuries?
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    Thanks Dr. Scott. And I completely understand the limitations of this communication in regards to anything along the lines of diagnosis or treatment. What you have given is great and much appreciated.

    In regards to my hx. I have been involved in athletics most of my life but this involvement was primarily lower body movements and nothing really upper body intensive. I played soccer for about 25 years continuously and did things like long distant running. I did play a lot of basketball and a year of football but that was all in my teens. And I golf and will play any sport I have a chance to do like racquetball or water polo. I just like sports but Iíve never really done anything upper body intensive, just mess around. Iím 36 now. My intuition tells me this shoulder ďweirdnessĒ is related to lifting which I began seriously about ten years ago albeit I went through significant periods without visiting the gym d/t school, fam, life stuff. But I have been hitting the gym hard for the last 8 months and this seems to correlate.

    I should say that I never lift cold and always do cardio until I have a good sweat going which is anywhere between 30 and 40 minutes and I try to involve upper body movement during this warm up period. I love to row for example. Then Iíll lift for about 40 minutes and cool down in steam room. But I hadnít thought to warm up before swimming. My swimming usually involves taking my little daughter to various hot springs pools around where I live so Iíve never really thought about warming up since Iím just soaking or playing with kid.

    After warmup. I wonít visit the gym again until tomorrow but Iíve decided to take a week off of upper body movements to rest up before a new training program. Iíll just be doing cardio. But from recollection, the crepitus and sensation is still present after warm up.

    I just noticed your other post with the link. Iíll check it out now. Just wanted to respond to your info and question. Thanks again for your time.
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    Quote Originally Posted by chunkymon View Post
    Thanks Dr. Scott. And I completely understand the limitations of this communication in regards to anything along the lines of diagnosis or treatment. What you have given is great and much appreciated.
    Anytime Bro, this is why I posted this to help people the best way I can. I can't heal/fix people's problems from my laptop, but I can definitely give sound, non-biased advice that can help individuals on their way to recovery. Besides, helping others is what I love to do, it makes me happy and I'm good at it (not conceited, just saying it is easy to be good at something you love and are passionate about). My passion is knowledge on the human body and using that knowledge to help people!
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    Quote Originally Posted by ScottyDoc View Post
    helping others is what I love to do, it makes me happy and I'm good at it (not conceited, just saying it is easy to be good at something you love and are passionate about). My passion is knowledge on the human body and using that knowledge to help people!
    I understand completely. You get instant gratification every day. Most jobs aren't like that.
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    Wakey... wakey... Hands off the Snakey!!! Where are my Questions?
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    Haha! Thanks for bumping this!

    rib subluxation- any tips on getting these ****ers back into place on your own? The ribs near my shoulder blade pop out of place all the time and for the most part I can just roll on a dumbbell and they pop back in. Some times I need to go see my chiropractor... This last time I had to go see my chiro and he got good adjustment but as soon as I got home they popped out.

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    Quote Originally Posted by StakedCop View Post
    Haha! Thanks for bumping this!

    rib subluxation- any tips on getting these ****ers back into place on your own? The ribs near my shoulder blade pop out of place all the time and for the most part I can just roll on a dumbbell and they pop back in. Some times I need to go see my chiropractor... This last time I had to go see my chiro and he got good adjustment but as soon as I got home they popped out.
    That is a good question, hard to answer though! See the adjustment is like 2nd nature to me, so easy, but not something I could really explain over the computer. My personal suggestion is to continue seeing your chiro, safest bet. If you are desperate to not continue using your chiro, there are some pretty good how to videos on YouTube, type in "rib adjustment" just remember it looks easier to do than it really is when you are not use to doing them.
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    Quote Originally Posted by ScottyDoc View Post
    That is a good question, hard to answer though! See the adjustment is like 2nd nature to me, so easy, but not something I could really explain over the computer. My personal suggestion is to continue seeing your chiro, safest bet. If you are desperate to not continue using your chiro, there are some pretty good how to videos on YouTube, type in "rib adjustment" just remember it looks easier to do than it really is when you are not use to doing them.
    My chiro showed me some moves and they ALMOST always work. Last week I swear I must have popped out every rib on my right side. Went for an adjustment since the pain was so god awful and like I said he fixed me up but the popped right back out.

    I'll check out the YouTube vids though

    My shoulders crack... I mean they crack loud and a lot. I'm sure this is common among weight litters but is there any exercises / stretches I can do so I'm not completely fuc*ed as I get older (23 now) or is the damage done? I take joint support and 10 grams fish oil a day. So far the fish oil is the only supp that seemed to help.

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    Quote Originally Posted by StakedCop View Post
    My chiro showed me some moves and they ALMOST always work. Last week I swear I must have popped out every rib on my right side. Went for an adjustment since the pain was so god awful and like I said he fixed me up but the popped right back out.

    I'll check out the YouTube vids though

    My shoulders crack... I mean they crack loud and a lot. I'm sure this is common among weight litters but is there any exercises / stretches I can do so I'm not completely fuc*ed as I get older (23 now) or is the damage done? I take joint support and 10 grams fish oil a day. So far the fish oil is the only supp that seemed to help.
    Go see my other post on Shoulder injuries, read through this and you will see all kinds of help to different shoulder problems including many different exercises, etc.

    Shoulder Injuries?
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    I don't know if you're a fan of foam rolling to loosen muscles. *But maybe you could answer this

    Should foam rolling be done before or after lifting, if I only have time to do it once? *I'm doing squats today and my hips and hams are tight so I was gonna do some rolling before the gym

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    Good info in here. I'm battling back problems right now and the chiropractor is working on me. Sucks big time and I go through this about once per year
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    Quote Originally Posted by StakedCop View Post
    I don't know if you're a fan of foam rolling to loosen muscles. *But maybe you could answer this

    Should foam rolling be done before or after lifting, if I only have time to do it once? *I'm doing squats today and my hips and hams are tight so I was gonna do some rolling before the gym
    First off, excellent question, foam rolling for tight and/or cramping muscles is awesome! I personally think that foam rolling serves it purpose best as a post workout therapy to loosen tight muscles. Pre-workout therapies would be some type of physical activity to raise the body's core temperature and specifically pump more blood to the area/body part preparing to exercise!
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    Quote Originally Posted by ScottyDoc View Post
    First off, excellent question, foam rolling for tight and/or cramping muscles is awesome! I personally think that foam rolling serves it purpose best as a post workout therapy to loosen tight muscles. Pre-workout therapies would be some type of physical activity to raise the body's core temperature and specifically pump more blood to the area/body part preparing to exercise!
    Great advice, as always!

    I normally do 5-10 min warm up on stationary bike but yesterday my hams and hips were so tight I decided to a few mins of foam rolling. I was worried the tightness was going to ruin my leg workout and I wanted to insure a good workout. because we all live for leg day, right?!!! Lol anyway, had a good workout and didn't feel as tight but I got 2 reps less on most my squats... Do you think the loss of strength is directly related to the pre workout foam rolling?

    My personal chiro says do NOT stretch immediately before lifting. Would you agree? And if so why?

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    Quote Originally Posted by StakedCop View Post
    Great advice, as always!

    I normally do 5-10 min warm up on stationary bike but yesterday my hams and hips were so tight I decided to a few mins of foam rolling. I was worried the tightness was going to ruin my leg workout and I wanted to insure a good workout. because we all live for leg day, right?!!! Lol anyway, had a good workout and didn't feel as tight but I got 2 reps less on most my squats... Do you think the loss of strength is directly related to the pre workout foam rolling?

    My personal chiro says do NOT stretch immediately before lifting. Would you agree? And if so why?
    It is possible, but I would blame it on your unusual tightness and/or whatever may have caused you to be abnormally tight to begin with.

    Ahaaa... Ahaaa!!!
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    Quote Originally Posted by ScottyDoc View Post
    It is possible, but I would blame it on your unusual tightness and/or whatever may have caused you to be abnormally tight to begin with.
    Holy fast response batman!!

    My hams are always tight I just learned about foam rolling and I'm addicted to it! It has loosened up my hams a good amount but they get tight again just as fast. Since I started my SI joint hasn't bothered me nearly as much. I just have to stay on top of this...

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    Quote Originally Posted by ScottyDoc View Post
    First off, excellent question, foam rolling for tight and/or cramping muscles is awesome! I personally think that foam rolling serves it purpose best as a post workout therapy to loosen tight muscles. Pre-workout therapies would be some type of physical activity to raise the body's core temperature and specifically pump more blood to the area/body part preparing to exercise!
    Completely agree here^^^

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    Quote Originally Posted by ryansm View Post
    Completely agree here^^^
    Thank you sir... You are both a gentleman and a scholar, LOL!
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