Tuesday, February 24, 2009

Physical Therapy and Product Review


I had my appointment this morning with the physical therapist to check out my right knee. I hate to admit it, but I was very anxious and afraid of what he was going to tell me. I spent some time giving him a little background information:
The pain started after a short 3 miler the first week of February, about a week and a half after a glorious pain free 7 mile run. The initial pain was mostly tightness and tracking issues, followed by pain going up and down the stairs. Then I laid of from running, only running about 2-3 miles 2 or 3 times per week. Then, the pain was only noticeable after 2 miles of running and was followed by tightness around the knee. At this point in time there was no concern with tracking or pain going up and down the stairs. The past week I didn't run a single mile, until this morning when I ran a little under a mile to "test out" the knee and all was pain free.

Then he did some exploring; bending my legs, playing with the kneecap, feeling the muscles and tendons around and behind the knee, rotating my feet, stretching my hips, etc. He had me do some strengthening exercises, and after all this, he noticed the following:
  • My hamstrings are okay, but could be stronger
  • My quadriceps, hips, and glutes are weak
  • My left glutes/hips are weaker than the right
  • My calves are extremely tight

He said I have one disadvantage that I can't do anything about: I am a female. With that, I am wide in the hips, narrow in the knees, and then go out again from there to the feet. He checked my feet and arches and was happy to see that they are pretty strong. No orthotics necessary.

He showed me a handful of strengthening exercises, with and without the bands, and gave me homework to complete prior to my return appointment next week. If your interested, and looking for some strengthening exercises to work similar muscle groups as I am, here are a handful:

  1. Leg lifts (on back, elbows, and sitting up): Start with laying on back, one knee bent, and other leg straight with toes pointed outward. Then raise the leg, stopping when it reaches the height of the other knee, hold for 2 seconds. Do 10 repetitions, 2 times. Repeat with other leg. Do this routine while 1. laying on the back, 2. propped up on the elbows, and 3. sitting up. They will, and should, be more difficult when sitting up. This should be done 2 times per day.
  2. Side Leg lifts: Lie on side with right leg on top. Bend lower leg slightly. Raise top leg straight up, without letting it come forward. Make sure to keep body in a straight line from shoulders, to hips, to feet. Hold for 2 seconds, and relax. Do 10 repetitions, 2 times, on both sides. This should be done 2 times per day.
  3. Knee Strengthening: Using a stretching band, create a loop at one end. Place one leg in the loop, and stick the other end in a closed door. Make sure the band is wrapped around the knee and step away from the door far enough to have some good tension. Begin with knee bent partway, then slowly straighten the knee (into locking position). Slowly bend knee again. Do 15 repetitions, 2 times, with both knees. Do this 2 times per day.
  4. Side-stepping: Use a stretch band with two ends tied together to create a loop. Place both feet inside and wrap it around the legs, halfway up the calves. Side step, keeping tension on the band, and shoulders level. Do NOT let the leg drag as you are stepping to the side. Do 3 sets to fatigue.
  5. IT Band Stretch: There are two different ways you can stretch the IT band. 1.) you can stand with the right leg behind the left, reaching over to the left. It may help to stand near a wall and use your left hand to support the body as your right hand stretches over your head. Hold 5-10 seconds and do 5-10 repetitions. Switch and do the same on the other side. 2.) Lie on your left side, the edge of your bed or a table, with your left knee slightly bent. Lift your right leg and let it hang over the side of the table/bed. You should be able to feel the band stretch in the right leg. Hold for 10 seconds and do 5-10 repetitions. Switch and do the same on the other side. One of these stretches should be done 2 times per day.
  6. Calf Stretch: Position body against the wall with one left foot behind. Point toes straight ahead and hold heal down. Lean into the wall so you feel a stretch in the left calf. Hold for 30 seconds, 1 repetition. Switch and do the other calf. This should be done 4 times per day.

If you are confused with any of these, let me know and I will try my best to clarify!

The PT recommended that I work to strengthen my muscles before really getting back into my half marathon training. He said that I need a good 5-6 weeks of strengthening. He didn't say I couldn't run, but if I do, he said to keep it minimal. He also said to be careful on the bike as well, as that can make knee issues worse, especially when on bikes that are not specifically set for me (ie. upright bikes). He was glad to see that I came in before it got worse and that I didn't continue to run through the pain. He says that with strengthening these muscles, I should be able to run with little to no pain in the future. I left my appointment on cloud nine and ready to strengthen some muscles!

Product Review:

Yesterday I tried my Yoga for Strong Knees video. The total run time is 50:00 and a lot of it is used to explain what kind of muscles do what and why it is important to strengthen those muscles. I thought that was very informative, but don't want to watch it every time I do the video. I think that if I do it a few more times with the video, I will be able to do it without the video in about 30 minutes. So far, I think it is a good video. They recommend doing it every other day, but with my strengthening exercises given by the PT, I will try to incorporate this yoga video a 2-3 times a week.

Today's Workout:
Run - .75 miles,
8:47, 11:42/mile avg.
Bike - 10.81, 31:00, 20.92mph

Today's Song:
Lady Gaga - Poker Face
(in sidebar)


Jess said...

Sounds like some of the exact same exercises my PTs had me do over the summer. I'm going to start the lifting routine again once some of the pain settles.

Marlene said...

I'm glad you got some answers and that you're on the road to recovery. Good luck with your homework!

Anonymous said...

You'll be just in time for the ND spring! And stronger than ever!

Unknown said...

I'm so glad you went. my knee issues were also related to muscle imbalances (but different on me). knowledge is power. you know what to strengthen and what to stretch and you should be good to go in a month and a half or so. great news!

Holly said...

I hope those exercises help!

IronGambit said...

Lady gaga ;) I love her!

Shannon said...

Isn't is great NOW that you actually saw someone and you have a plan? I hate the "not knowing" what it is.

BTW, I found a great mashup of Lady GaGa's just dance.

Just click on the link and scroll down to Just Dance. You can download for free too. :)


Carolina John said...

sounds like great advice from the pt. and i'm glad the yoga vid is going to work out, i'm going to have to look for that one.

Wes said...

First step, plan of attack! Time to sally forth :-)

Anonymous said...

Is it amazing to find out how many little things can add up to cause knee pain.

For knee problems I definitely agree it is crucial to also look at what is happening at the ankle/foot as well as what is happening at the knee.

Often the knee is what is caught in the middle when these two other joints aren't working properly.

Unknown said...

Glad you have a plan. Take care of yourself!

Marcy said...

YAY I'm glad you got checked out! Sounds like a good plan :-) GAH those child bearing hips always get in the way ;-)

Jess said...

Sounds like your PT appointment was helpful.

X-Country2 said...

Sounds like you got a lot of great info. You'll be back to full strength in no time!

BeachRunner said...

Sounds like a thorough diagnosis, great advice and a smart plan for the future. Hope that helps you.

I Run for Fun said...

Hope the exercises work and you are back to running without pain.

Michelle said...

Hi TW, wow you have a lot of work ahead of you but its all good stuff!!!

Your going to be just fine. DO THE EXERCISES!!!

Anonymous said...

Sounds like some good exercises, but your PT's comment about being disadvantaged because you're a woman - I'm sorry, but I truly believe that's a crock! But, I won't get into that! Get strong so you can get back to running soon.

Ritesh said...

YOGA THERAPY is the science of applying the various techniques of yoga in a
variety of illnesses and conditions, to facilitate optimal health, healing
and awakening. Classes are designed for the individual or group with a
therapeutic focus for a specific health condition e.g. cancer, heart,
prenatal, diabetes, multiple sclerosis.

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