Chiropractic / Musculoskeletal / Joint pain Q & A...
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ScottyDoc
Well-known member
Bran spanking new they are $1,800.00 with delivery, so if you found a local Chiro going out of business, you could definitely pick up a used one in the range of $700-$1,000 if not cheaper depending on how old it is and the condition it is in!
ScottyDoc
Well-known member
i'll have to keep an eye out
On the plus side, they are very simple machines that tend to last 20+ years with little to no maintenance, the padding and exterior covering is what wears out and needs to be changed every 5-10 years depending on the volume of use per day!
oogaly_boogal
Well-known member
I have a knee issue and my chiro cant figure out what it is, can you help me out sir?
ScottyDoc
Well-known member
I will do my best, but as I have stated before in past posts, Knees are not my specialty! There are two other guys that frequent this thread... BEZOE & CELC5 that could probably do a better job than I could, but regardless of where/who the help comes from, lets start with some basic information... Which knee (right or left)? Which leg is your dominent leg (right or left)? Is it anterior (front) or posterior (back) of your knee? Is it medial (inner) or Lateral (outer) knee? Please explain the different motions that aggravate your knee and which motions do not? Which orthopedic tests did your last CHIRO perform, if you don't remember the names of them, just describe what he did/had you do? Did he see anything on x-rays? How did this injury come about, suddenly (if so what happened) or slowly got worse over time? On a scale of 1-10 how bad is the pain, even if it is a zero at rest, describe it when it is at its worse or when you do something that aggravates it? Have you ever experienced this pain before? Is there anything you do that makes it better or worse (daily life things, position, walking or resting it a certain way, ice, heat, anything)? Lets start with answering those questions and by then hopefully BEZOE or CELC5 will chime in for the assist!
oogaly_boogal
Well-known member
Haha thank you, sorry I'm just getting annoyed with this damn knee I have had problems for 3 years after getting T-boned in a car accident.
Injury : Right knee, lateral, inability to stretch quadricep to the full extent. Lack of stability.
Some background history, I had a mensicectomy of the lateral meniscus removing 1/3 of it.
The cause of my most recent injury is uncertain in origin, but for around a year, when the leg is bent and the foot is moved upwards as if I were to cross my legs, there is always an intense pain and someone of a tearing feeling. Originally I could pop whatever the issue was back in by forcing my leg back into the other direction (it always felt like a slight fibular head dislocation, as it was also protruded a bit more every time this occurred).
It is my right knee, there is a band (I say band because it is a solid lump that flexes when i extend my leg) running from what appears to be my vastus lateralis, along the lateral side of my patella. It is above my patella, causing it to "catch" every time I attempt to stretch my quadricep. There was swelling but no bruising.
I suspect it could be my iliotibial band as I once did muay thai, and do like to run long distances. As well as the fact if I flex my quad it no longer has the form it used to.
My chiro did the usual crucial ligament tests, they aren't torn at least. He was more focused on aligning my hips and spine.
Initially the pain was an 8 in comparison my root canal after breaking a molar was a 5. The shin/fibula hurt the majority of the day, now just the fibular head is a bit tender. If I stand on it for some time or walk long distances it begins to hurt. When i attempt to stretch my quad the head of the vastus lateralis begins to hurt. I will post pictures the knee looks quite deformed.
To relieve the pain I tend to take hot baths while breaking down the Iliotibial band, as well as massaging the calve and using pressure to relieve the quad, and using my foam roller to work on my glutes and hamstrings. It has been helping but I would rather know the cause. I stopped using ice as swelling isn't really the issue.
Aggravated by this even a slight movement feels as if it dislocates the fibular head.
Invalid Link Removed
Here is the knee, stretched at the same length as the left knee, notice the absence of a knee cap and the odd form.
Invalid Link Removed
Injury : Right knee, lateral, inability to stretch quadricep to the full extent. Lack of stability.
Some background history, I had a mensicectomy of the lateral meniscus removing 1/3 of it.
The cause of my most recent injury is uncertain in origin, but for around a year, when the leg is bent and the foot is moved upwards as if I were to cross my legs, there is always an intense pain and someone of a tearing feeling. Originally I could pop whatever the issue was back in by forcing my leg back into the other direction (it always felt like a slight fibular head dislocation, as it was also protruded a bit more every time this occurred).
It is my right knee, there is a band (I say band because it is a solid lump that flexes when i extend my leg) running from what appears to be my vastus lateralis, along the lateral side of my patella. It is above my patella, causing it to "catch" every time I attempt to stretch my quadricep. There was swelling but no bruising.
I suspect it could be my iliotibial band as I once did muay thai, and do like to run long distances. As well as the fact if I flex my quad it no longer has the form it used to.
My chiro did the usual crucial ligament tests, they aren't torn at least. He was more focused on aligning my hips and spine.
Initially the pain was an 8 in comparison my root canal after breaking a molar was a 5. The shin/fibula hurt the majority of the day, now just the fibular head is a bit tender. If I stand on it for some time or walk long distances it begins to hurt. When i attempt to stretch my quad the head of the vastus lateralis begins to hurt. I will post pictures the knee looks quite deformed.
To relieve the pain I tend to take hot baths while breaking down the Iliotibial band, as well as massaging the calve and using pressure to relieve the quad, and using my foam roller to work on my glutes and hamstrings. It has been helping but I would rather know the cause. I stopped using ice as swelling isn't really the issue.
Aggravated by this even a slight movement feels as if it dislocates the fibular head.
Invalid Link Removed
Here is the knee, stretched at the same length as the left knee, notice the absence of a knee cap and the odd form.
Invalid Link Removed
ScottyDoc
Well-known member
Man... minus getting my hands on that knee and feeling around and doing a little motion-palpation, it is really hard for me to say, definitely cannot pin-point a direct diagnosis with the information I have! I'll tel you what, it sounds like it needs a good adjustment to really set that bugger (fibular head) back into its normal juxtaposition!
oogaly_boogal
Well-known member
thanks, i updated with a pic, you can see the deformation haha
edit: that isn't swelling its solid
edit: that isn't swelling its solid
oogaly_boogal
Well-known member
Sad thing is my legs look tiny after only 3 weeks and I do squat/deadlift heavy.
I guess I should go and see my orthopedic surgeon again?
edit: reason I haven't gone to him is it's really expensive and im a broke college student.
EasyEJL
Never enough
isn't there some cheap health insurance plan through the school?
oogaly_boogal
Well-known member
I just got kaiser which should be activating soon, lots of loopholes to get through before they will send me for an MRI though. They suck, I grew up with them.
ScottyDoc
Well-known member
Kaiser does suck and they are one of the best insurance companies for denying claims due to loop-holes in their fine-print! Example: "Oh... your injury happened on a Thursday, well it clearly states on page 51, paragraph 7, line 32 that we do not accept responsibility for any injuries that occur on Thursdays, sorry, is there anything else we can help you with today? Do you mind staying online and participating in a quick survey to rate your quality of service today?"
EasyEJL
Never enough
well, how about working with me on what I should do with my chest + shoulder routines to minimize issues with my shoulder?
EasyEJL
Never enough
Overall, i've seen decent improvement with the ART + Graston, but I think we've hit maximum improvement there. Right now I do varied chest presses (really playing with elbow and hand spacing to avoid pain) and doing fairly little for direct shoulder work. My chiropractor has suggested that I do no shoulder exercises where my elbows go higher than my shoulders.
As an example for chest this week I did single arm db press, cable crossovers, incline bb press, machine flys
bezoe
Well-known member
Well.. the chiro is accurate in his suggestion to avoid shoulder abduction past 90 degrees. Because of the "impingement" findings via MRI, this precaution will help protect against reaggravating symptoms. So.. any movements that involve Invalid Link Removed past parallel with the ground should be avoided. If you want to perform an abduction movement like a shoulder lateral raise, do it with your thumb up towards the ceiling.
As far as the SLAP lesion goes.. theres really nothing that will eliminate symptoms. Avoid shoulder internal and external rotation to end range. If you wanna hit chest thoroughly without exaccerbating the shoulder pain.. perhaps try some partial range movements like DB presses to only 6-8 inches off chest for a few sets then 6-8 inches from completely locking out. So ultimately, you arent completeing a full blown range of motion each rep.
Give me some feedback on what you think of this
As far as the SLAP lesion goes.. theres really nothing that will eliminate symptoms. Avoid shoulder internal and external rotation to end range. If you wanna hit chest thoroughly without exaccerbating the shoulder pain.. perhaps try some partial range movements like DB presses to only 6-8 inches off chest for a few sets then 6-8 inches from completely locking out. So ultimately, you arent completeing a full blown range of motion each rep.
Give me some feedback on what you think of this
EasyEJL
Never enough
Thats an interesting strategy, i'll give it a whirl. I had been trying some other ideas, using reverse grip (to end up with lower working weight but same stimulation) and more reliance on the smith machine so I can more easily play with working out which angle of upper arm and what grip position works best.
bezoe
Well-known member
Sorry it took so long. I had to consult the literature on this one.
Here are reasons why I dont like either of these exercises: Reverse grip presses put your shoulder in an inefficient vulnerable externally rotated position. With a reverse grip press, the biceps brachii vigorously contracts to pull the humerus into Invalid Link Removed. The BB originates on an area of the scapula (superior glenoid fossa) that also connects to the glenoid labrum (which you have ruptured):
Therefore I suggest conventional grip over reverse. HOWEVER, I dont like smith machine as a primary exercise because of its lack of planes of movement. It only allows one plane out of 3 dimentionally possible planes. So no matter how you position your body and arms etc. you are still limited to a single, vetical plane of movement. This, over time, creates faulty proprioceptive feedback which will result in faulty joint movement and undesired joint stress. Its called "pattern overload". So contrary to what people think- smith and other machines are good for rehab, they are not optimal for anyone.
But, like I always say, listen to your body. If dumbbells irritate the shoulder dont do them. Im gonna try and compile a list of doable exercises for you.
Here are reasons why I dont like either of these exercises: Reverse grip presses put your shoulder in an inefficient vulnerable externally rotated position. With a reverse grip press, the biceps brachii vigorously contracts to pull the humerus into Invalid Link Removed. The BB originates on an area of the scapula (superior glenoid fossa) that also connects to the glenoid labrum (which you have ruptured):
Therefore I suggest conventional grip over reverse. HOWEVER, I dont like smith machine as a primary exercise because of its lack of planes of movement. It only allows one plane out of 3 dimentionally possible planes. So no matter how you position your body and arms etc. you are still limited to a single, vetical plane of movement. This, over time, creates faulty proprioceptive feedback which will result in faulty joint movement and undesired joint stress. Its called "pattern overload". So contrary to what people think- smith and other machines are good for rehab, they are not optimal for anyone.
But, like I always say, listen to your body. If dumbbells irritate the shoulder dont do them. Im gonna try and compile a list of doable exercises for you.
EasyEJL
Never enough
The dumbbells usually aren't too bad, but when I go heavy I sometimes end up in a situation where a slight bit of upper arm angle off causes enough momentary pain that I end up dropping the dbs rather than completing. Its not super frequent, and more when i'm doing 90+ lb dbs. This week I had tried doing one arm db presses, and that was a total bitch even with 70s 
but not painful in the shoulder.
but not painful in the shoulder.
bezoe
Well-known member
Yea im sure its a real bitch lol. That labral cartilage surrounds the humeral head so with any glenohumeral movement you risk aggravating that area. Unfortunately it may continue to bother you without surgery. That cartilage isnt real viable tissue so primary healing isnt likely. Good news is the MRI conclusions make it look pretty managable with surgery at this point.
bezoe
Well-known member
Well if funds are the only thing holding you back.. I would say save money and go for it. Ive never heard of an alternative resolution to surgery for this injury.. especially if youre gonna keep lifting. If your insurance is good and pays a large percentage of the cost, I'd do it.
ScottyDoc
Well-known member
EasyEJL... As much as I hate to ever recommend surgery to anyone, I will recommend it as a last resort and from what I have seen and read from what you are saying and how you feel etc. I have to agree with Bezoe, I mean if insurance is going to cover it or even a large percentage, it really sounds like the route to go as far as being able to continue lifting and solving the problem once and for all, I mean it will always be an area of predisposed weakness and you will always have to warm it up correctly and take care of it, but at least then if you do so, you will be lifting better and stronger and most importantly, with no PAIN!!!
ScottyDoc
Well-known member
That all depends on the technique they use when going in, the best I can give you is my own personal experience with having my chest ripped off the bone, which I would imagine is a longer healing process, but I could be wrong, Bezoe would be the best at answering this because he helps rehab people with these types of injury on a daily basis! Anyway, I would say the 1st week, I took off of work and was really babying the hell out of it, the 2nd week, I was functional, but as you said had to figure out ways to do things without really using my left arm, by the 3rd week, I was out of the sling and using it, but very little and very lightly, I still would not open doors with my left arm or try to lift anything heavier than like 3Lbs, by the 4th week, I was really starting to use it and only noticed things here and there, by the end of the 6th week, I would say I was pretty much back to normal as far as day to day use, minus lifting or pulling anything over 15Lbs, I was back in the gym by the end of my 8th week and spent 2 weeks only doing legs, core, & cardio, by the end of my 10th week, I was starting to do biceps & triceps real carefully, by the end of the 12th week I started doing shoulder presses, lat pulls and extremely light chest (more of just repetitive motion vs. weight). I would say by 18-20wks I was lifting everything the same except for chest, which I babied my chest for an additional 4 months at which time I contacted my doctor because I was 8mos post surgery and he said as long as I start increasing the weight very slowly and always keep my rep range around 15reps/set I should be fine and he was right, other than a left shoulder problem now, (which I believe is from compensation) I have no problems with my chest what-so-ever. Anyway, in a weird sort of way it was a good thing that happened to me, in the sense that it made me start lifting everything much lighter and I've made the best mass gains and fat-loss of my life since I made that switch in my workout style! Hope this helps Easy, no one person or one injury is ever going to be the exact same, but I hope this gives you an idea of what to expect!
EarthWormGym
New member
Hi i dont know if i can describe this very well, but will have a go
I currently have a hip issue (on the left side).
Feel pain when my left leg is raised upwards fast, meaning no jumping or sprinting. Squatting and deadlifting heavyish causes pain.
Also feel pain when i turn my foot up towards my body (knee facing outwards).
I regularly do kickboxing, jujitsu and mma so hip mobility is kinda useful to me lol
I am not exactly sure how i injured myself was either sprinting or kickboxing (probably a combination)
Any advice you can offer would be greatly appreciated,
Thanks
I currently have a hip issue (on the left side).
Feel pain when my left leg is raised upwards fast, meaning no jumping or sprinting. Squatting and deadlifting heavyish causes pain.
Also feel pain when i turn my foot up towards my body (knee facing outwards).
I regularly do kickboxing, jujitsu and mma so hip mobility is kinda useful to me lol
I am not exactly sure how i injured myself was either sprinting or kickboxing (probably a combination)
Any advice you can offer would be greatly appreciated,
Thanks
bezoe
Well-known member
Sorry it took so long Easy. Recovery will depend on many factors (as you probably guessed). These are:
1. Onset of instability- If the capsule/joint has been instable for much time and is atraumatic (this is your case, I believe) then more conservative postoperative managment is required.
2. Severity of associated lesions- Whatever the underlying pathology is (rotator cuff muscle weakness, neuropathy, etc.) the rehab time will depend upon this.
3. Previous failure of surgery- this doesnt apply to you
4. Direction of instability- Im not sure how "unstable" your GH joint is. Unless you have had subluxations and dislocations this wont exactly apply to you.
5. Type of surgical approach- all approaches yield quite similar healing times. Only difference is that arthroscopic is less painful
6. If electrothermally assisted capsularrhaphy is used, progression will be slower. If bony reconstruction is implemented, recovery will obviously be prolonged.
7. Patient variables- because you lift, your dynamic stabalizers (the muscles that surround the joint) will be stronger which will be a HUGE contributor to recover and rehab time.
First 2 Weeks
Initially you will be "immobilized" with a sling. This will stay on without ANY movement for 1-3 days. After that you will be allowed to temporarily remove the arm from the sling to perform Passive Range of Motion exercises (done by someone else of course) and "Pendulum" exercises. Because you will most likely undergo rotator cuff repair also, rehab interventions will be dictated by your surgeon (such as how much range you can move and how often you can remove the sling). You should recieve a "report" with these directions on it. You may even start exercises as soon as the day after surgery depending on whether the biceps tendon has to be repaired. During the first phase of rehab you will control inflammation (with ice and antiinflammatories), maintain correct posture (with trunk/spine extensions and scaplular retractions), and maintain mobility of structures proximal and distal to the shoulder (wrist/forearm and elbow ROM and scapular ROM). You may progress to self assisted ROM using "wand exercises" at the end of 2 weeks.
Weeks 3-6
"Muscle Setting" exercises can be initiated. (These are just isometric contractions of muscles around the shoulder). VERY LIGHT grade band exercises may be initiated for muscles below shoulder level. All band exercises should be open chain to prevent weight bearing on operated structures.
Weeks 6-12
Full active Range Of Motion exercises will be performed. Stabalization of the GH joint will be emphasized. Light stretching and grade III joint mobilizations (that do not sacrifice stability) will be performed. "Alternating isometrics" and dynamic resistance exercises with bands and weights for GH stabalizer muscles (rotator cuff and scapular stabalizers) will be started next. Your surgeon should provide info on "anteior" or "posterior" stabalization and what specific movements to avoid- it gets pretty in depth so I'd have to know what the procedure was.
Weeks 12-16
You should be "returning to function" at this point. Stretching needs to continue to attain preoperative ROM. (collagen synthesis will continue for 12 months so ROM can be achieved within this time range). Plyometric exercises and actual exercises you do at the gym can be started. 6 months is usually required to regain COMPLETE function.
So, not a simple endeavor here. But as Doc and I explained, the surgery is the only option that we have available to regain function and eliminate pain. These surgeries, IME, have been overall successful and if you get a good orthopedic surgeon who does these every day you should be in good shape my man. If you have any questions about anything i put in this post, including exercises and terminology, I will be glad to elaborate.
bezoe
Well-known member
How old are you bro? How long has this been going on? Where exactly is the pain? Tell me where on the illustration
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EarthWormGym
New member
Im 20, its only been going on for a little over a week. I feel pain in the very top of my leg, seems to be around the socket.
thanks for your time man
ScottyDoc
Well-known member
For ease of this, can you find a skeleton, or some kind of anatomical picture and put and X marks the spot where it hurts? Different people consider many different areas their hip and the hip itself is large with an anterior, posterior and lateral aspect all changing which muscles &/or tendons are involved!
EarthWormGym
New member
Invalid Link Removed
seems to be around the joint, on the leg side (if that makes sense).
pain felt in both front and outside of very to of leg depending on which way i move my leg.
thanks
seems to be around the joint, on the leg side (if that makes sense).
pain felt in both front and outside of very to of leg depending on which way i move my leg.
thanks
EarthWormGym
New member
Invalid Link Removed
not sure if this image is more useful,
cheers for your time
not sure if this image is more useful,
cheers for your time
ScottyDoc
Well-known member
Nice, now we are cooking with Gas, as in now I know where you are talking about! Hmmm, so it just came on suddenly or slowly started to ache? On a scale of 1-10 (10 being the worse pain you have ever felt in your life) how would you rate the pain? Would you consider the pain sharp, electric like, burning, dull, achey, stiff, sore (you can use more than one adjective to describe your pain)? I've already got the time frame, approx. 1 week. OK, so far, unless you were doing something or experienced a trauma (car accident, fall, blow to the area), I would suspect it is just a sprain/strain of the area. Something like this can take as short as a week or two or as long as 3-6 mos. to heal and feel better, with your age I'm hoping in just a matter of a few weeks. First off, I would start doing contrast baths of heat and ice as often as you can during the day, always heat first and ice after heating, if given the choice, it is always better to just ice if you can't ice after heating. Next, unless it causes sharp or severe pain, it is a good idea to stretch the area as much as possible while heating the area and just let it relax when you are icing, another good thing is compress the ice down, use suran-wrap if necessary, and I would avoid your MMA training and or any lower body weight lifting for at least two weeks and see how you are feeling at that point before deciding to start back at that time. I'm sure my buddy Bezoe will chime in and give you some more helpful advice, tips, & hints, he's a very knowledgable PT, when he speaks, I listen!
EarthWormGym
New member
its not too painful, i would only rate it a 4-5. But it instantly removes all strength around the area.
the pain is sharp, but goes soon afterwards (not as fast as it comes though)
there was no major trauma/experience. I first noticed it when sprinting (haven't got a great technique) although there was no 'pain' as such, it just felt wrong/discomfort. a few days later after multiple sets of squats, deads and possibly sled work (i can't quite remember), i started to experience a little bit of pain in the same area (but this time the sharp pain i get now).
i will start icing it, and performing some light stretching.
Thanks for the advice
the pain is sharp, but goes soon afterwards (not as fast as it comes though)
there was no major trauma/experience. I first noticed it when sprinting (haven't got a great technique) although there was no 'pain' as such, it just felt wrong/discomfort. a few days later after multiple sets of squats, deads and possibly sled work (i can't quite remember), i started to experience a little bit of pain in the same area (but this time the sharp pain i get now).
i will start icing it, and performing some light stretching.
Thanks for the advice
ScottyDoc
Well-known member
No problem, anytime my friend, I would take a week or so off for sure, and while taking the time resting from the gym and MMA, etc. I would be stretching it while you heat it, then end with ice, you can even massage it while icing it (ice-massage) all these things help losen up and stretch out the tendons and ligaments, as well as pumping healing oxygenated blood to the area and then pumping out any edema and inflammation, so all very good, but please make sure you rest it, or you will just continue to irritate the area!
bezoe
Well-known member
This exactly
Follow all the recommendations Doc gave and you should be G2G in due time
bezoe
Well-known member
LOL im in the zone> this "strain" happens in the propulsive phase of gait, that is, when your back (extended) leg that is off the ground begins to forcefully swing forward to complete the next stride. These stretched hip flexor muscles vigorously contract and create "macrotears" within the fibers, usually around the musculotendenous area.
To help prevent these in the future just be sure to warm up properly and gradually work up to sprinting.
To help prevent these in the future just be sure to warm up properly and gradually work up to sprinting.
CJ_Xfit89
Board Sponsor
I hope someone may be able to help me with this:
Quads get sore and tender after my running training and intervals etc
My glutes get a tad tight but i can't feel my hamstring firing while running
What could i possibly do to try and help increase the hamstring firing so i get a reduction of hammering to my quads.
P.S I have sprinters looking quads but smaller hamstrings.
Such a burden on long distance training
Thanks
Quads get sore and tender after my running training and intervals etc
My glutes get a tad tight but i can't feel my hamstring firing while running
What could i possibly do to try and help increase the hamstring firing so i get a reduction of hammering to my quads.
P.S I have sprinters looking quads but smaller hamstrings.
Such a burden on long distance training
Thanks
ScottyDoc
Well-known member
Minus personally/physically checking you out and ruling out a possible nerve impingement, I would just based on what you told me, suggest on non-running days to get into a gym and do leg curls for the hamstrings, don't do any extensions, just leg curls and try very hard to make that mind/body connection with your muscle and mentally focus on only using your hamstrings to curl the weight, this will build strength in your lacking hamstrings as well as help you make the mind/body connection so you can control them better and get those buggers firing, like I said, this is the way to do it if there is not a true physical problem causing this lack of firing, which I could only determine if I was able to examine you in person! So I hope this helps you, if you have any further questions or comments, please feel free to post them and I'll always do my best to answer as quickly and as accurately as possible!
bezoe
Well-known member
Good advice from Doc.
Stretch the hip flexors, strengthen hip extensors (glutes and hamstrings). No need for any extravagant stuff. Perhaps have your gait analyzed during running.. incorrect mechanics can cause issues like you are describing. You mentioned tightness in your back in the other thread, i believe. Improper mechanics can radiate problems all the way up and down the body.
How long have you been running?
ScottyDoc
Well-known member
I wish I could say something that would help you more, but my honest opinion is, maybe try going and seeing a sports specific Chiropractor in your local area, can definitely help with gait and alignment issues you may be experiencing besides the exercises I suggested and the stretching that Bezoe suggested!