Another round of PT, no progress whatsoever in 8 years

[Bradley]

I've been through a dozen or more bouts of PT for my knees over the past 8 years and have literally nothing to show for it. I don't know what I'm supposed to do now. They either give up or tell me nothing is wrong, when I know for a fact that that is not true.

I'm two weeks into another round. Just saw them today, and tomorrow I'm going to tell them if they can't show me anything new that actually helps or come up with some theory about what's wrong that makes any sense that I'm not going to complete the PT. So far it's the same old same old.

I suspect there might be something else wrong, like bowed legs or some other deformity that has developed over time that makes things feel the way they do but I have no idea how to get this checked out. All the doctors I see truly seem clueless. They either suggest to stop doing anything remotely strenuous or to just deal with it. It's pathetic actually. I can't get anyone to even take seriously my complaints it seems. They just lump it into generic knee pain category.

I have no idea what to do. What kind of doctor to see, what kind of PT to see.

 

[Bradley]

Might be time for a radical diet change.

Why is that?

 

[rammpeth]

well it all depends. since when do you have these problems? how old are you? how much do you weight and whats your body composition? do you have problems in any other joints? male or female? etc etc.

Any one of those or any combination of those could be the problem. You might even have something that just hurts but isnt a "real" problem (i had/have osteocondritis but dont feel it anymore)

 

[ad5ly]

I sense your frustration. You say the docs find nothing wrong. Or they just don't know.

things to consider:
1. Injury history.
2. What activities cause the pain?
3. Is the pain constant?
4. Can you do perform a bw squat without pain?
5. Does walking or running hurt?
6. Does prolonged standing hurt?

It could be that you are doing too much in your program. You gave no details in what you are actually doing program-wise. Too many reps, too much volume, too much weight? Maybe CC would be something to work with.

Inspect your shoes. Maybe worn or bad fitting shoes are making things worse.

It could maybe be nerve damage?

Hope you figure this out. Good Luck..Dennis

 

[Bradley]

well it all depends. since when do you have these problems? how old are you? how much do you weight and whats your body composition? do you have problems in any other joints? male or female? etc etc.

Any one of those or any combination of those could be the problem. You might even have something that just hurts but isnt a "real" problem (i had/have osteocondritis but dont feel it anymore)

My problem is the opposite. It's something that doesn't always hurt but that is a real problem.

 

[Bradley]

I sense your frustration. You say the docs find nothing wrong. Or they just don't know.

things to consider:
1. Injury history.
2. What activities cause the pain?
3. Is the pain constant?
4. Can you do perform a bw squat without pain?
5. Does walking or running hurt?
6. Does prolonged standing hurt?

It could be that you are doing too much in your program. You gave no details in what you are actually doing program-wise. Too many reps, too much volume, too much weight? Maybe CC would be something to work with.

Inspect your shoes. Maybe worn or bad fitting shoes are making things worse.

It could maybe be nerve damage?

Hope you figure this out. Good Luck..Dennis

I'm not doing too much. I'm barely doing anything. Aside from PT all I'm doing for my legs is trying to squat occasionally with relatively light weight, and legs extensions, mostly just as a test. But the PT's not working and it's never worked, regardless of how much other stuff I was doing.

Pain is not the problem. I can't get the PT's to understand this, apparently. They ask me about pain, and while pain is a problem, it's not the problem. Even when I don't have pain I can feel that my legs are messed up and not working properly. So it's almost a worthless means of determining if I'm making progress, though right now, my legs are worse since starting this bout of PT.

 

[fatman]

Are you injured, or have an inborn defect?

What is your training history?

What sort of PT are you going through now?

How do you feel that your legs are not working properly? A PT who 'understood' that "pain is not the problem" would not really be a PT, but a quack.

 

[Bradley]

Are you injured, or have an inborn defect?

What is your training history?

What sort of PT are you going through now?

How do you feel that your legs are not working properly? A PT who 'understood' that "pain is not the problem" would not really be a PT, but a quack.

Sorry, but your last statement is nonsense. I DO have pain, but even when I don't have pain my legs feel terrible - awkward, out of alignment, and the muscles feel funny. If they don't recognize this as a problem, regardless of whether or not I'm feeling pain, THEN they area quack.

 

[ad5ly]

Can you recall what happened 8 years ago? Car accident, electrical shock, training mishap? This sounds more and more like a neurological problem. But I am no doc just guessing. Step #1 is to identify what you are dealing with. Until that happens people will just br pulling stuff out of their butt ( all with good intentions) to help you. I do hope you find a doc that is helpfull..Dennis

 

[fatman]

Sorry, but your last statement is nonsense. I DO have pain, but even when I don't have pain my legs feel terrible - awkward, out of alignment, and the muscles feel funny. If they don't recognize this as a problem, regardless of whether or not I'm feeling pain, THEN they area quack.

Not really. If your communication with the doctors is equally articulate and open as your posts in this thread, pain might be the only information they have to work with. "My muscles feel funny" isn't exactly conducive to a diagnosis...

 

[AWAQ]

It's probably your hips

* When standing relaxed, do both your knees point straight ahead?
* Do your knees and feet point in the same direction?
* If you do 1 leg deep knee bend, can you keep your foot pointing straight ahead. Are your hips level?

Most simply put, the knee is a hinge joint and is not made for twisting which can happen if your hips are off. I would check this out first.

 

[terich]

Do you know this clever little book "Treat your own knees"? Look on Amazon, it may give you some answers, good luck.

 

[schnieder]

Bradley - email me sean@strengthproductionsllc.com

I have some simple stuff to try. It might work and it might not.

 

[ChrisSpring]

Are you injured, or have an inborn defect?

How do you feel that your legs are not working properly? A PT who 'understood' that "pain is not the problem" would not really be a PT, but a quack.

Then call me a quack!

You want to know what a bad PT does? They chase the pain. You got knee pain, they'd examine the knee, treat the knee, and strengthen structures around the knee. But 99% percent of the time, the knee is not the problem with non-traumatic injuries! There's a dysfunction elsewhere (usually immobility of the hip and/or ankle) that causes excess stress on the knee. Does having a stiff hip mean you'll have knee pain? Of course not, but it doesn't mean that a stiff hip isn't going to make you move dysfunctional elsewhere.

Different people and cultures describe pain and problems differently - and that is why PTs use objective and functional exams. The FMS is a functional screen that DD was associated with, which looks at movement patterns for individuals without pain. There's a sister screen for us medical professionals called the SFMA which looks at movement patterns with people with pain. Even though he sometimes does not have pain and pain is not an issue, he still has a significant history of pain and he would be a great candidate for this screen. The screen looks at and breaks down full body movement patterns and divides them into functional/dysfunctional and painful/non-painful. And the real genius of it is according to the assessment you treat/correct the most dysfunctional NON-PAINFUL pattern first - and then the painful area magically sees improvement.

90 out of 100 of people who get injured do not know what's wrong with them, and of the 10 who think they do know, 9 of them are wrong. There's nothing wrong with someone not knowing how to describe what's wrong with them, that's my job to figure it out.

 

[SScullin]

Hi Bradley,

May I ask, where are you located? And have you tried seeing an FMS (Functional Movement Screen) certified trainer? The FMS trainer will be able to screen you and give you corrective exercises that may help to alleviate your problem...

I train a client who has had constant knee pain for almost 5 years. She recently went in for an arthroscopy on both knees and was looking at more serious surgery further down the track. After running her through an FMS screen and performing specific corrective exercises the pain in her knees has started to alleviate and on her last visit to her specialist was advised "whatever it is you are doing, keep doing it"!

I am not saying that you have the same ailment as her but I highly recommend getting a screen. You can find a list of certified specialists closest to you in the following link:

www.functionalmovement.com

I hope this helps. Let me know how you progress.

 

[SScullin]

Oh... I forgot to mention..... If your knees are bad, stay away from the leg extensions. They will only be making the problem worse!

 

[GeoffreyLevens]

Been putting off adding this comment because it isn't in line w/ common thinking and of course, I am a quack of sorts, having been an acupuncturist of 25 years.

I have had lots of problems w/ left hip, leg, knee, ankle. Sciatica, back "out" badly sprained ankle several times, 2 knee surgeries for cartilage damage. Fortunately the first surgery they stapled it in place rather than removing and the second, a month later, was only to repair massive scar tissue formation. Tons of my own PT for a couple years and it was good as the right knee.

Bottom line is that working w/ some brilliant quacks, a Pilates specializing PT and a woman who combined 5 Element Acupuncture, Polarity Therapy, Hanna Somatics, Levine's trauma reintegration, and very refined craniosacral work, I/we uncovered a deep neurological-musculo-skeletal pattern that most likely originated prenatally or during birth. That pattern tends to turn off leg/hip external rotation and cause severe pronation issues in my gait. Once we found that, I could work on retraining OUT of that pattern. This involved primarily awareness in movement work and very very subtle realignments in function by working on very specific muscles to overcome neuromuscular amnesia. Now pretty much no issues except very thin knee cartilage from all the previous stress as a "sensitive" low back/sciatic nerve from all the damage done there. I am good to go on any and all movement and training and have been now for years.

But it was a learning and long training process to groove in new "reflex" patterns so that now my default is proper alignment rather than misalignment.

Quack quack!!! I totally agree, pain is an issue but NOT the problem!!!!