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

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  1. Quote Originally Posted by bluehealer View Post
    See a foot doctor, you may require orthopedic boots.
    I agree, they are called orthotics, it could definitely help! Another thing that I have seen help lots of people with chronic foot, knee and low back problems are... Vibram FiveFingers : Barefoot Sports Shoes : Toe Shoes & Minimalist Shoes to be worn when not in your boots. In order to walk in these correctly you must walk on your toes and not heel strike when you walk, this builds up the gastroc muscles and the soleus muscles as well as limiting the amount of impact when you walk and strengthen all the muscles ligaments and tendons in your feet and legs, it is worth a shot, I have a pair and I love them!

    Dr. Albert Scott Representative for FINAFLEX
    www.finaflex.com
    Redefine Yourself..... REDEFINE EVERYTHING!


  2. Hey doc, I have this tendon, I assume, running horizontal across the outside of my kneecap.
    It's about 1/8" in diameter. It is very tendor/sore to the touch and when I bend my knee under a load (waking down stairs) my knee hurts.
    Taste the rainbow.
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  3. Quote Originally Posted by bluehealer View Post
    Hey doc, I have this tendon, I assume, running horizontal across the outside of my kneecap.
    It's about 1/8" in diameter. It is very tendor/sore to the touch and when I bend my knee under a load (waking down stairs) my knee hurts.
    Besides the anatomy, a little mobilization and a little rehab, I'm not the best with knees! I usually refer those patients out to a friend who refers his elbow and shoulder patients to me, where I am more proficient! Based on the anatomy, it sounds like your LCL (lateral collateral ligament), besides the basics of R.I.C.E. (Rest, Ice, Compression, & Elevation), I can't be of much help to you, but I bet BEZOE can, YO BEZOE... What do you think, some input!!!
    Dr. Albert Scott Representative for FINAFLEX
    www.finaflex.com
    Redefine Yourself..... REDEFINE EVERYTHING!

  4. Quote Originally Posted by bluehealer View Post
    Hey doc, I have this tendon, I assume, running horizontal across the outside of my kneecap.
    It's about 1/8" in diameter. It is very tendor/sore to the touch and when I bend my knee under a load (waking down stairs) my knee hurts.
    I wanna bang your avitar while Im eating a bag of skittles.

    When you say the outside of your kneecap, it makes me think of the area just laterally to the kneecap- not the side of your leg at the knee. Pain in this area, especially when weight bearing and moving the joint, indicates lateral meniscus damage.

    I cant be sure of that online, as I would need to do some special knee tests on you in person. That and imaging are the only ways to really diagnose such an issue.
    Suffer now.. and live like a champion later.

  5. [QUOTE=ScottyDoc;2900455]I agree, they are called orthotics, it could definitely help! Another thing that I have seen help lots of people with chronic foot, knee and low back problems are... to be worn when not in your boots. In order to walk in these correctly you must walk on your toes and not heel strike when you walk, this builds up the gastroc muscles and the soleus muscles as well as limiting the amount of impact when you walk and strengthen all the muscles ligaments and tendons in your feet and legs, it is worth a shot, I have a pair and I love them!QUOTE]

    I never even thought about those. Thanks for the help!
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  6. Quote Originally Posted by bezoe View Post
    I wanna bang your avitar while Im eating a bag of skittles.

    When you say the outside of your kneecap, it makes me think of the area just laterally to the kneecap- not the side of your leg at the knee. Pain in this area, especially when weight bearing and moving the joint, indicates lateral meniscus damage.

    I cant be sure of that online, as I would need to do some special knee tests on you in person. That and imaging are the only ways to really diagnose such an issue.
    Yo.. not disagreeing with you, but I always thought the meniscus (lateral or medial) were not painful? As in people can tear them and not even know they have done so, or am I thinking about something else, or is that only possible and not always the case, help me understand what I'm thinking of?
    Dr. Albert Scott Representative for FINAFLEX
    www.finaflex.com
    Redefine Yourself..... REDEFINE EVERYTHING!

  7. Quote Originally Posted by ScottyDoc View Post
    I agree, they are called orthotics, it could definitely help! Another thing that I have seen help lots of people with chronic foot, knee and low back problems are... Vibram FiveFingers : Barefoot Sports Shoes : Toe Shoes & Minimalist Shoes to be worn when not in your boots. In order to walk in these correctly you must walk on your toes and not heel strike when you walk, this builds up the gastroc muscles and the soleus muscles as well as limiting the amount of impact when you walk and strengthen all the muscles ligaments and tendons in your feet and legs, it is worth a shot, I have a pair and I love them!


    Hell Yes! I have a pair as well Doc!

    I actually did a bunch of research and conducted an inservice on these "barefoot/minimalist" shoes. The few studies done since their conception show three main positive benefits in wearing them:

    1. Increases the intrinsic muscle strength of the feet

    2. Increases lower extremity proprioception- thus increasing balance, by allowing the foot to feel everything under it

    3. Decreases impact on ankle, knee, and hip joints by promoting the "shock setting mechanism" (the body's way of altering gait mechanics to decrease amount of force placed on lower extremity joints). Basically this means when you are wearing these shoes and have little cushion under the heel, it causes you to walk moreso on your forefoot to decrease impact. This, in turn places less stress on your knee and hip joints over time.

    HOWEVER, one should not jump right into these shoes! If youve been wearing high arch, stability shoes for years, your plantar aponeurosis is not acclimated to the amount of stress you will be putting on it by wearing these. Plantar fascsitis is a bitch. The studies I looked at recommended a 10% a week transition to these shoes.
    Suffer now.. and live like a champion later.

  8. Quote Originally Posted by ScottyDoc View Post
    Yo.. not disagreeing with you, but I always thought the meniscus (lateral or medial) were not painful? As in people can tear them and not even know they have done so, or am I thinking about something else, or is that only possible and not always the case, help me understand what I'm thinking of?
    Ummm I know there can be pain with meniscal tears.. but im not sure there can be asymptomatic damage. It is very well possible though. Come to think of it, I believe I have heard of cases of just decreased ROM where the knee cannot terminally extend because of cartilage pinched between the condyles and tibial plateaus.

    Most of the cases Ive seen have included symptoms of pain though Doc.
    Suffer now.. and live like a champion later.

  9. Quote Originally Posted by bezoe View Post
    Ummm I know there can be pain with meniscal tears.. but im not sure there can be asymptomatic damage. It is very well possible though. Come to think of it, I believe I have heard of cases of just decreased ROM where the knee cannot terminally extend because of cartilage pinched between the condyles and tibial plateaus.

    Most of the cases Ive seen have included symptoms of pain though Doc.
    OK, was just asking, just thought I remembered something like that from school, as I said previously, Knees are not my forte, only familiar with the anatomy really!
    Dr. Albert Scott Representative for FINAFLEX
    www.finaflex.com
    Redefine Yourself..... REDEFINE EVERYTHING!

  10. No problem bro! I just try to throw in the little bit I know when you call on me!
    Suffer now.. and live like a champion later.

  11. Quote Originally Posted by bezoe View Post
    I wanna bang your avitar while Im eating a bag of skittles.

    When you say the outside of your kneecap, it makes me think of the area just laterally to the kneecap- not the side of your leg at the knee. Pain in this area, especially when weight bearing and moving the joint, indicates lateral meniscus damage.

    I cant be sure of that online, as I would need to do some special knee tests on you in person. That and imaging are the only ways to really diagnose such an issue.
    When I say outside of kneecap, I mean between the skin and the cap, not under as in the joint area. If you were looking at my knee, it would be just below the horizontal centerline of my kneecap, running left to right. I can move the "ligament" up and down by rubbing my finger on my knee. If I kneel down on it, it hurts like a bi_ch. A sharp pain.
    Taste the rainbow.

  12. Quote Originally Posted by bluehealer View Post
    When I say outside of kneecap, I mean between the skin and the cap, not under as in the joint area. If you were looking at my knee, it would be just below the horizontal centerline of my kneecap, running left to right. I can move the "ligament" up and down by rubbing my finger on my knee. If I kneel down on it, it hurts like a bi_ch. A sharp pain.
    As soon as I read that I thought of the Patellar Tendon and here is what I found on it:

    Patellar Tendonitis:

    The patellar tendon connects the kneecap (the patella) to the shin bone. This is part of the 'extensor mechanism' of the knee, and together with the quadriceps muscle and the quadriceps tendon, these structures allow your knee to straighten out, and provide strength for this motion. The patellar tendon, like other tendons, is made of tough string-like bands. These bands are surrounded by a vascular tissue lining that provides nutrition to the tendon.

    What causes patellar tendonitis?
    Patellar tendonitis is the condition that arises when the tendon and the tissues that surround it, become inflamed and irritated. This is usually due to overuse, especially from jumping activities. This is the reason patellar tendonitis is often called "jumper's knee."

    When overuse is the cause of patellar tendonitis, patients are usually active participants of jumping-types of sports such as basketball or volleyball. Patellar tendonitis may also be seen with sports such as running and soccer. Also, some patients develop patellar tendonitis after sustaining an acute injury to the tendon, and not allowing adequate healing. This type of traumatic patellar tendonitis is much less common than overuse syndromes.

    What are the symptoms of patellar tendonitis?
    Patellar tendonitis usually causes pain directly over the patellar tendon. Your doctor should be able to recreate your symptoms by placing pressure directly on the inflamed tendon. The other common symptom of patellar tendonitis is pain with activities, especially jumping or kneeling. Less common, but not unusual, is swelling around the tendon itself.

    X-ray tests are usually performed to confirm there is no problem with the bones around the knee. Occasionally, a bone spur is seen that can be related to patellar tendonitis. A MRI is useful in patients with chronic patellar tendonitis to look for areas of degenerative tendon.

    Reference: http://orthopedics.about.com/cs/pate...llartendon.htm
    Dr. Albert Scott Representative for FINAFLEX
    www.finaflex.com
    Redefine Yourself..... REDEFINE EVERYTHING!

  13. Quote Originally Posted by ScottyDoc View Post
    As soon as I read that I thought of the Patellar Tendon and here is what I found on it:

    Patellar Tendonitis:

    The patellar tendon connects the kneecap (the patella) to the shin bone. This is part of the 'extensor mechanism' of the knee, and together with the quadriceps muscle and the quadriceps tendon, these structures allow your knee to straighten out, and provide strength for this motion. The patellar tendon, like other tendons, is made of tough string-like bands. These bands are surrounded by a vascular tissue lining that provides nutrition to the tendon.

    What causes patellar tendonitis?
    Patellar tendonitis is the condition that arises when the tendon and the tissues that surround it, become inflamed and irritated. This is usually due to overuse, especially from jumping activities. This is the reason patellar tendonitis is often called "jumper's knee."

    When overuse is the cause of patellar tendonitis, patients are usually active participants of jumping-types of sports such as basketball or volleyball. Patellar tendonitis may also be seen with sports such as running and soccer. Also, some patients develop patellar tendonitis after sustaining an acute injury to the tendon, and not allowing adequate healing. This type of traumatic patellar tendonitis is much less common than overuse syndromes.

    What are the symptoms of patellar tendonitis?
    Patellar tendonitis usually causes pain directly over the patellar tendon. Your doctor should be able to recreate your symptoms by placing pressure directly on the inflamed tendon. The other common symptom of patellar tendonitis is pain with activities, especially jumping or kneeling. Less common, but not unusual, is swelling around the tendon itself.

    X-ray tests are usually performed to confirm there is no problem with the bones around the knee. Occasionally, a bone spur is seen that can be related to patellar tendonitis. A MRI is useful in patients with chronic patellar tendonitis to look for areas of degenerative tendon.

    Reference: http://orthopedics.about.com/cs/pate...llartendon.htm
    You da man doc. Probably due to leg extensions. Doesn't sound too serious but will def see a doctor about it just to be sure..
    Taste the rainbow.

  14. Quote Originally Posted by bluehealer View Post
    You da man doc. Probably due to leg extensions. Doesn't sound too serious but will def see a doctor about it just to be sure..
    Whenever possible, seeing a professional in person is always your best bet! If you have the resources, I would ask around and see if you can make an appointment with someone who specializes in knees and works with athletes, athletic specialists are usually the best because it is their job to advise the Athletes get them to or as close to 100% as possible, as their careers and sometimes millions of dollars are on the line! Trust me, word gets around as to who is best in your area, you could probably even Google it! I'm just saying I wouldn't just go to anyone, for example, if you came to me, I would probably only be able to identify what is injured and not give you the best advice on what to do/rehab etc. This is why I refer out, but some will just try anyway to make the $-Money-$, while not getting you any better than when you started because of their lack of knowledge in that area... (Blood-Sucking-A$$holes). So be careful, there are a lot of those out there!
    Dr. Albert Scott Representative for FINAFLEX
    www.finaflex.com
    Redefine Yourself..... REDEFINE EVERYTHING!

  15. Yup. Patellar tendonitis. I have a chronic case in my left knee.

    If you were an adolescent, we would have to consider Osgood Schlatter's and Patellofemoral syndrome as well but I doubt you are still growing, so those can be ruled out.

    EMG studies prove that open chain quadriceps exercises such as leg extensions place more strain on the patellar tendon than closed chained movements such as squats... UNLESS the open chain movement is performed with extremely heavy weight without completing terminal extension or with extremely light weight, and reaching terminal ext. if desired.

    There was a nice article on T-nation about it.. i will try to find it.
    Suffer now.. and live like a champion later.

  16. From your subjective statements, I can pretty much guarantee its some tendonitis. Ice it after workouts, warm it up good before working legs, and dont go to terminal (full) extension on leg extensions.

    There could always be a possibility of medial or lateral shifting of the patella due to increased or decreased Q angle- which would cause pain, but thats an entirely different beast.

    And whats up with the flowery looing colors they gave us?? Does everybody else have a bright colored screen now?

    Here it is: http://www.t-nation.com/free_online_...81-mcd02.hydra
    Suffer now.. and live like a champion later.

  17. just FYI, i'm going to go get my shoulder MRI'd on friday, just so we can see for sure if there is anything seriously damaged.

  18. That'll be interesting to see. I hope everything looks ok of course. Then again, im sure it would be nice to see some conclusive indication of why you are having issues.
    Suffer now.. and live like a champion later.

  19. Quote Originally Posted by bezoe View Post
    From your subjective statements, I can pretty much guarantee its some tendonitis. Ice it after workouts, warm it up good before working legs, and dont go to terminal (full) extension on leg extensions.

    There could always be a possibility of medial or lateral shifting of the patella due to increased or decreased Q angle- which would cause pain, but thats an entirely different beast.

    And whats up with the flowery looing colors they gave us?? Does everybody else have a bright colored screen now?

    Here it is: http://www.t-nation.com/free_online_...81-mcd02.hydra
    lol, ok thanks for the link but there are some big words in there. Basically what I got out of it was, do not do leg extensions. Lunges a better alternative?
    Taste the rainbow.

  20. I took A&P last year but my prof was horrible and I got lazy too so I failed the class. Any recommendations on where to look to help prepare for the A&P needed for Personal Trainer degree?

  21. Yes it recommends doing leg exts heavy with fast movement opposed to slow or medium speed- Thats where the damage happens. Yes, according to this article, lunges would be a better alternative because they are "closed chain"- the femur (thigh bone) rotates on the tibia (shin bone) instead of visa versa.
    Suffer now.. and live like a champion later.

  22. By degree, to you mean certification? Ive never heard of a university offering a degree in personal training, but that would be cool. I would think you could buy a study program online. You could probably buy an A and P book and take the tests off the CD in the back. ORRRRRRRR you could just tune in to this thread often
    Suffer now.. and live like a champion later.

  23. Quote Originally Posted by bezoe View Post
    By degree, to you mean certification? Ive never heard of a university offering a degree in personal training, but that would be cool. I would think you could buy a study program online. You could probably buy an A and P book and take the tests off the CD in the back. ORRRRRRRR you could just tune in to this thread often
    When I was in Austin Community College I was working on an associates degree in Personal Fitness Training. It was only an Associates at a community college, and the only difference in it and the certification course was that it included normal college basics, but I thought it would be more beneficial than just the certificate. Now I'm planning on just taking the certification course.
  24. AnabolicMinds Site Rep
    MidwestBeast's Avatar

    I don't know how I missed this thread before, Doc! I've actually got a couple questions for ya. My right leg is ever so slightly longer than the left (you can see the bottom of my right knee is just barely lower than the left). Is there anything to do to remedy that? I'm gonna try wearing an insert in the left shoe, but I don't know that it'lll help. And more importantly, my right lat comes down lower than my left, which I'm pretty sure is because my left shoulder seems to be slightly rolled forward. It is very noticeable (to me) when I do a shrugging motion upward - I can feel my left shoulder moving straight up and my right one pulling back a bit. I noticed, too, in pictures from Hawaii, when I was standing with my hands at my sides, that my left arm tends to be more in front of my body that straight to the side. Is this something that a chiropractor can help with? In terms of realignment.

  25. Quote Originally Posted by MidwestBeast View Post
    I don't know how I missed this thread before, Doc! I've actually got a couple questions for ya. My right leg is ever so slightly longer than the left (you can see the bottom of my right knee is just barely lower than the left). Is there anything to do to remedy that? I'm gonna try wearing an insert in the left shoe, but I don't know that it'lll help. And more importantly, my right lat comes down lower than my left, which I'm pretty sure is because my left shoulder seems to be slightly rolled forward. It is very noticeable (to me) when I do a shrugging motion upward - I can feel my left shoulder moving straight up and my right one pulling back a bit. I noticed, too, in pictures from Hawaii, when I was standing with my hands at my sides, that my left arm tends to be more in front of my body that straight to the side. Is this something that a chiropractor can help with? In terms of realignment.
    MWB - Yep, Bezoe, Celc, & I have been doing our best to give people Musculoskeletal and sport's related injury advice as we can, I must say we have a pretty good team and it is always good to get more than just one or even two opinions!

    Now to business... I have found in my practice that a person having one leg longer than the other by a significant amount (as in enough to make a difference) is very rare and is called an anatomical short leg. Usually what it is, is an imbalance in the hips which causes one leg to apear longer than the other, which is also why chiropractors do leg length checks to determine which side of the hips are misaligned. As far as one shoulder being rolled back or a scapula winging, stuff like that is common and can be corrected in a few different, but similar ways, Chiropractors typically will realign the structure (structure affects function) and typically the muscles will relax and follow suit, if not then they will advise a massage to loosen the muscles, they will also, very similar to a PT advise postural correcting and strengthening stretches and exercises! If you want to determine if you truly have one leg longer than the other, and not just a misalignment of the hips, you will have to measure your legs and compare their lengths. The way to do this is to measure from the ASIS (Anterior Superior Iliac Spine) down to the center of your Medial Malleolus. In English your ASIS is the very front part of your hip that sticks out on the ventral (belly) side of your body you have one on either side of your body and your medial malleolus is your inside ankle bone. Measure those on both sides and compare, I usually measure in centimeters and anything less than two centimeters is insignificant and the bigger the difference from 2cm and up the more significant it can be and would require special orthotics (sole inserts) in order to compensate for it so your body doesn't have to compensate for it, which is what you are noticing whether the short leg is being caused by an anatomical short leg or a misalignment of the hips is what I'm trying to help you determine! Get back to me on your Anatomical leg lengths by doing the measurement I suggested above. Also, Bezoe is the our resident PT guru, so I'm sure he would be the best at giving you some functional stretches and exercises to help with your situation/condition.
    Dr. Albert Scott Representative for FINAFLEX
    www.finaflex.com
    Redefine Yourself..... REDEFINE EVERYTHING!
  26. Dr. Albert Scott Representative for FINAFLEX
    www.finaflex.com
    Redefine Yourself..... REDEFINE EVERYTHING!

  27. Quote Originally Posted by bezoe View Post
    Yes it recommends doing leg exts heavy with fast movement opposed to slow or medium speed- Thats where the damage happens. Yes, according to this article, lunges would be a better alternative because they are "closed chain"- the femur (thigh bone) rotates on the tibia (shin bone) instead of visa versa.
    Thanks a lot Bezoe. I found that walking down the steps sideways helps with the pain, lol.
    Taste the rainbow.

  28. Doc,

    I hurt my lower back doing a deadlift about 2 weeks ago. I didn't know it at the time, but I was at the onset of a cold when it happened. I was struggling with my workout that day but decided to press on and in the process of pulling 375 lb, I lifted my hips too early and hurt something at the base of my lower back. It is in the middle of my back, slightly to the left of side at the top of the tail bone. Now, everytime I bend down, there is a feeling of building pressure in that area. It is not really a sharp pain but more like hard downward pressure on the area. Any idea what this could be? And if so, is this something that I can just continue to push through with my workouts, or do I need to shut it down for a while to give it time to heal. I feel it when I do certain back and leg routines like deadlifts, squats, bent over rows, etc, but the pressure is not so intense that it prohibits me from doing these exercises.

  29. Quote Originally Posted by TerpVTX View Post
    Doc,

    I hurt my lower back doing a deadlift about 2 weeks ago. I didn't know it at the time, but I was at the onset of a cold when it happened. I was struggling with my workout that day but decided to press on and in the process of pulling 375 lb, I lifted my hips too early and hurt something at the base of my lower back. It is in the middle of my back, slightly to the left of side at the top of the tail bone. Now, everytime I bend down, there is a feeling of building pressure in that area. It is not really a sharp pain but more like hard downward pressure on the area. Any idea what this could be? And if so, is this something that I can just continue to push through with my workouts, or do I need to shut it down for a while to give it time to heal. I feel it when I do certain back and leg routines like deadlifts, squats, bent over rows, etc, but the pressure is not so intense that it prohibits me from doing these exercises.
    OK, I will start by saying that I can't be certain without actually examining you personally, but from your explanation... it sounds like what us Chiro-Quackers call a text-book subluxation (mis-alignment) of your Sacro-iliac joint on your left side, which is putting pressure on a nerve and causing possible muscle spasm and general pain and when/if you move the wrong way and it puts more pressure on the nerve/s it can cause sharp even shock-like pain! The best advice to you is to ask around and seek out the services of a local Chiropractor, the sooner the better, as in the sooner you go, the fewer visits it will require to put in place and stay there! I am not saying the joint cannot and will not move back into it's normal juxtaposition, but that may take a lot of time and pain, so why chance it! I do advise to ask around though and try and find one that specializes in sports related injuries! Good luck my friend and if you have any more questions, please feel free to ask and I will do my best to help you, injuries suck for a lack of better words!
    Dr. Albert Scott Representative for FINAFLEX
    www.finaflex.com
    Redefine Yourself..... REDEFINE EVERYTHING!

  30. Thanks Doc. I appreciate the advice. I will try and find a local Chiropractor to get this thing fixed.
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