Knee pain returned

Post questions and tips on prevention, treatment, and rehabilitation of chronic injuries.

Knee pain returned

Postby pliskin » Sep 30, 2007 17:19

Damn! My left knee has started hurting me again.
It started when i did dynamic stretches, leg raises to the side. It hurts only when i am training for a side split. I can do any other sport activities and it does not hurt but the side split training is triggering the pain. As soon as i raise my left leg more than 45 degrees to the side my left knee hurts. I got rid of this problem a while ago and now it returned.I am angry like a bull now! :evil: Got to back off again of split training and go back to kindergarten doing squats and lunges. I lost 2 years of training for side split.
pliskin
 
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sartorius (tailor's muscle) or illiotibial band injury

Postby elskbrev » Oct 01, 2007 12:08

Pliskin,

I feel for you to have to wait for this to heal, but that sort of thing happens to the best of us once in a while. That’s how we learn. Take your time. There is no deadline. Life is long.

You did not specify whether the pain you feel is on the inside or outside of the knee, but I’ve followed enough of your posts to guess it could be either or both. A few months ago you dealt with an illiotibial band injury (pain on outside of knee) but just three days before this post, you commented ( http://stadion.com/phpBB2/viewtopic.php?t=957 ) on your experience with the following exercise: http://www.stadion.com/videos/patellofe ... tation.wmv . That exercise targets the hip extensor and strengthens/stabilizes the knee by way of the sartorius or “tailor’s muscle.” Did you overdo it, causing pain on the inside of the knee? Delayed onset pain can surface 2-3 days after injury of tendons.

~~~~~~~~~~~~~~
Pain on inside of knee: sartorius or “tailor’s muscle”

I didn’t find anything at http://www.med.umich.edu/1libr/sma/sma_index.htm about this, so let’s try Wikipedia.

Brace yourself. Per Wikipedia, at http://en.wikipedia.org/wiki/Sartorius_muscle , the sartorius “Assists in flexion, abduction and lateral rotation of hip, and flexion and medial rotation of knee. Looking at the bottom of your foot, like you are checking to see if you stepped in dog poop, demonstrates all 5 actions of sartorius.” (Ok, I laughed.) No offense intended, but that is exactly the sort of the action demonstrated in Kurz’ exercise for the hip extensor at: http://www.stadion.com/videos/patellofe ... tation.wmv . This movement targets the hip extensors, and stresses the sartorius. Overdo it, and you will probably experience pain on the inner side of your knee.

To rehab it? I would first wait, doing nothing until I felt comfortable to try that same hip extensor exercise with body weight only, light band band exercises for stabilization of the knee (see below), prone leg raises or whatever feels right and gradually get back into stretching it.

An instructor at my dojang suggested doing a deep lunge, like a modified runner’s stretch, to strengthen this muscle when it is healthy. We were practicing various hook kicks (front leg, back leg, step-behind, spinning) at the time.

~~~~~~~~~~~~~~
Pain on outside of knee: Illiotibial band (IT Band) [You know this well; just notes here for other readers]

From http://en.wikipedia.org/wiki/Iliotibial_band_syndrome , “Iliotibial Band Syndrome symptoms range from a stinging sensation just above the knee joint (on the outside of the knee or along the entire length of the iliotibial band) to swelling or thickening of the tissue at the point where the band moves over the femur.” I imagine the hip extensor exercise above could have aggravated your old injury. (?)

From Kurz:
For info on dealing with tight iliotibial band see http://www.stadion.com/injuries_kneecap.html . There you'll find videos of strength exercises, stretches, and massage.

Illustration: http://www.med.umich.edu/1libr/sma/sma_knee-ili_art.htm
Rehabilitation: http://www.med.umich.edu/1libr/sma/sma_xknee-il_art.htm
~~~~~~~~~~~~~~~~~

Kurz seems to be a big proponent of waiting until muscle tears have healed and you have no more significant pain before you resume exercise or stretching. Instructors at my dojang and my kinesiologist (a.k.a. chiropractor) have suggested light progressive static or assisted PNF stretching on the sore muscle so that it does not heal short. The latter was new to me and I can’t say I like it. Very risky, unless you know what you are doing or have a great coach. I have always just waited it out and started “in kindergarten” again, as you so aptly put it, beginning again wherever I was.

I had an IT Band injury accompanied by misalignment of my hip a year ago (due to a practice spin crescent I shouldn’t have tried in the first place having had only a few weeks knowledge of martial arts at the time). A kinesiologist gave me lots of band work for the hip and for knee stabilization similar to the exercises shown in the lower right of the IT Band rehabilitation illustrations page referenced above. As you get well, you can raise the leg higher in the side raise and knee-up as you bring the leg in and set it down; do the opposite motion as well.

I still do exercises with bands 3-4 times per week to this day as I regard them a matter of survival. I was sidelined for six months for rehab of the hip and IT band and I will not go through that again. On the plus side, the maintenance (f.k.a. rehabilitative) exercises continue to do great things for the power and control of my kicks, and for my sense of balance. They also stabilize knees and ankles. I was told to do 10 reps each of four specific exercises and today, unless fatigued, I can often do all 40 in good form without stepping down. No, I did not have such keen balance before learning to do this. Yes, I am great at kata. Sometimes I add to these four “pillars” movements to mimic whatever kick we are practicing in class, for example, hip flexion for hook kicks.

On a closing note, you and I can commiserate today. I was out last week for overdoing something in class. The instructor asked for a flutter round. I had never done that, so I asked him to show me. Next combination was step-behind hook, flutter-roundhouse, from one end of the floor to the other. Do you know if you pump a little height into the flutter and snap a high front you can get off an aerial roundhouse just before your other toe touches the floor? Beauty. I won’t be trying that again until my hamstring is in better shape.

Take care of yourself, and remember: Take your time. Nobody’s watching. You compete with yourself first.

Cindy
elskbrev
 
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Postby pliskin » Oct 01, 2007 15:40

Hi elskbrev,

I am so happy that you dedicated a whole day to write me a reply. :P I really appreciate it.
I am so sorry that i did not specified that i have the pain only on the outside of my left knee, exactly where the itb is rubbing on the bone and a little bit lower so you had lost plenty of time i guess on this part of explaining. Anyway thank you about the sartorius or “tailor’s muscle” infos, i studied it in details for the times when i will got that injury :lol: .
So my problem is on outside of knee. I had a problem with my itb band earlier, so i guess it is all connected now with that problem. I suppose i have aggravated my old injury. I have learned a lot about itb band in the last year, exercises, strenghtening, rehab and stretching, and i studied all the exercises that Kurz is demonstrating on his video clips.

http://www.med.umich.edu/1libr/sma/sma_knee-ili_art.htm

The spot that hurts when i lift my left leg to side is exactly the spot that is shown on the above illustration as “area of pain” , plus i have pain a little bit lower where the band is ending, and sometimes but it is really rarely under my kneecap. None of these are sharp pains, they just really annoy me, as a matter of fact when i warm up i can clearly ignore the pain and do my side leg swings, a little bit more than 90 degrees to the side, and i can do kicks on the bag in my hip height and go through the motions if i really want to, but the day after when i am cold my left knee aches like hell. I think that all this is caused by the illiotibial band, however i am a little bit afraid that the pain that is lower than the itb band rubbing area is a result of something else, some other injury, something that is torn, or ripped, or i guess that it would be a much worse pain :?:
Anyway i will be off now from side split training for a while. :cry:

Glad to hear that you are on with your trainings and that you are advancing, and sorry to hear about the overdone hamstring. I hope it is nothing serious. A torn hamstring muscle will do you trouble till the end of your life, is what they told me. :shock:

Thank you for your time and your help, i really appreciate it, i will report in later about my next events, will I worsen up things or will I heal my wounds.

Many thanx, and good luck...
:wink:
pliskin
 
Posts: 37
Joined: Jul 09, 2006 05:48
Location: Serbia

Postby elskbrev » Oct 01, 2007 18:52

Yep, took the whole day to write that and what do you know, I should be asking questions first. glad you got a laugh out of it. can't be tooooo mad like bull today. :lol: gottagetbacktothegym,waytoomuchtimeonmyhandstoday....

pliskin, I am afraid you could be in big trouble this time. The tendon that connects the IT band to the bone is the problem, all right. Typical of tendon strain is that you feel fine once you are warmed up, but the pain returns like crazy when you cool down. Better let it heal. Stop working it for a while. Take up knitting or something. (Just messing with you.)

I may not know much, but I know all about tendon injury. In 2003, I injured the tendons in both my lower legs (sudden overuse) but didn't stop working out on them for six weeks. I experienced the same thing as you--as soon as I warmed up, my legs felt fine; cool down and pain like charlie horse cramp 24/7. It was crazy that I didn't have a clue what was wrong. Six weeks later, I figured out the only thing that stopped the pain was stillness. A full year later, I could amble and stroll without undue pain. (some athlete, huh?). Two years later, the only remnants of the injury were unstable ankles and achilles pain. Talk about starting over.

That was four years ago. You could say I've learned a little since then. If someone hadn't talked me into trying tae kwon do about a year ago, I would still be sitting around worried about my ankles. These days, the parts I was worried about are holding up just fine; I'm finding all my other weak links.

Wouldn't mess with a tendon injury. Better 2-6 weeks out than...years. That's just plain scarey.

Cindy
elskbrev
 
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Location: Wisconsin, USA

Postby pliskin » Oct 02, 2007 06:12

elskbrev wrote:pliskin, I am afraid you could be in big trouble this time. The tendon that connects the IT band to the bone is the problem, all right. Typical of tendon strain is that you feel fine once you are warmed up, but the pain returns like crazy when you cool down. Better let it heal. Stop working it for a while.

Wouldn't mess with a tendon injury. Better 2-6 weeks out than...years. That's just plain scarey.


Oh no! I got sweat all over me when i was reading this. I guess it is a tendon problem already. The worse thing is that i have been dealing with this problem maybe a year or maybe more,i did not stop training i was just forcing it more and more, maybe i am late already to heal it right. Huh, shuh, i got to think clearly now what am i gonna do further. Thanx for your support, the advices and tips, you helped me greatly. I am at your service anytime.
pliskin
 
Posts: 37
Joined: Jul 09, 2006 05:48
Location: Serbia

knitting

Postby elskbrev » Oct 03, 2007 21:04

Hey, pliskin, guess who gets to take up "knitting?" None other than yours truly. 4-6 weeks, the doctor said. :(

Pain on inside of knee due to tear in tendons that connect two of the hamstrings to the tibia. Caught it early, so am optimistic. Happened after an evening practicing hook kicks. I thought I was favoring my recovering hamstring, but didn't factor in the effect of snapping that hook. Now I know.

I really mean to apologize for being so flip earlier. I mean, you gotta have a sense of humor about this stuff sometimes; can't walk around with a long face just because your favorite sport is on hold and you're doing physical therapy...

Injury comes with the territory. If I had known all this was ahead I would have signed on anyway. Martial arts is tons of fun when things are working right.

Take care of yourself.

Cindy
elskbrev
 
Posts: 79
Joined: Aug 08, 2007 07:08
Location: Wisconsin, USA

Postby pliskin » Oct 04, 2007 03:54

Sad to hear about your tendon tears. You re right, it is hard to walk with a smile on your face when your favorit sport is on hold. One of the worse thing is in life when you cannot do what you want and love to do. Anyway we need to cheer up, 4-6 weeks is not so much, you can do upper body exercises at double till your leg recover, maybe some static holds, they give extreme strenght. "Injury comes with the territory" - very nicely said.

Please, if you have time visit this link:

http://www.martialartsplanet.com/forums ... ight=knees

it is about legs/knees, very interesting thread, there is some things that is new to me and that i do not understand, for example :

"make sure when you stretch that you don't feel the stretch at the back of the knees... just in the muscles... if you are bend your leg a little - otherwise you stretch the ligaments and tendons... which you don't want to do!"

maybe i did not understand this well, but how the hell should i stretch my front split/hamstrings when i am bending my leg and how can i not stretch the back of my knee? :shock:

Back to topic, i hope you will get well soon, i wish you lots of fun by the TV :wink:
Wish you all the best, and inform us how you are advancing with your recovery.
BytheWay knitting is a little bit boring :D
pliskin
 
Posts: 37
Joined: Jul 09, 2006 05:48
Location: Serbia

Postby pliskin » Oct 08, 2007 08:31

October 2007:
Started doing weighted deep squats, with 20/25 kg barbell.3 or 4 series 12 repetitions, every second day.My knee pain started diminishing slowly. I do not dare to try any side leg raises yet.
pliskin
 
Posts: 37
Joined: Jul 09, 2006 05:48
Location: Serbia

Postby pliskin » Oct 17, 2007 15:51

Stopped all weight training, due to high blood pressure. Now doing just aerobic exercises, and every day deep, wide bodyweight squats, 3series, 30 repetitions, + cycling everyday 10 km's. Knee pain totally disappeared. Still afraid to start side split training, side leg raises cause that is what triggered the pain earlier.
pliskin
 
Posts: 37
Joined: Jul 09, 2006 05:48
Location: Serbia

Postby pliskin » Nov 11, 2007 17:26

11.11.07
As I said my left knee pain has gone, and now I started to train for the side split again. I did dynamic leg raises this week, everything is fine, however I think that my posture is not right when I am doing side leg swings with my left leg. At hip level i kinda feel like the pain is activating outside of my leg under my knee, and runs along with the itb band. I have to work on my stance.
I did adductor flyes this week without weights and i managed to do 100 rep without problem. I surprised myself. I did not have any muscle soreness the day after. Nice
I did leg raises every second day. I did som low kicks and kicks in hip level on the heavy bag. No muscle and joint bothers. I am very satisfied.
Yesterday i did adductor pulldowns with 15kg (33lbs) and today I can hardly walk from my adductor muscle delayed onset muscle soreness. I guess i am not ready for this yet. I did some isometrics for the front split yesterday, and there I have no soreness today. Bottom line I am satisfied till now case I think I managed to eliminate my knee pain finally.
pliskin
 
Posts: 37
Joined: Jul 09, 2006 05:48
Location: Serbia

Postby pliskin » Nov 12, 2007 15:19

Abnormal soreness in adductor muscles today, and the worst thing i think the third day after the trainig will be the worst, that is tomorrow. I really overdone it this time. I do not exaggerating but I really hardly can walk, I look like a 70 year old guy without his wheelchair on the street.
pliskin
 
Posts: 37
Joined: Jul 09, 2006 05:48
Location: Serbia

Re: Knee pain returned

Postby pliskin » Sep 21, 2008 15:19

18 September 2008:
Finally decided to do a Magnetic Resonance Imaging of my left knee, after two years of pain.
The test was real expensive, and the results are not so good, I have found out that I have a some meniscus and ligament problem in my left knee, so the doctor had forbidden every sport activity for now, and I have to wear a knee bandage. I do not know what will happen further...
pliskin
 
Posts: 37
Joined: Jul 09, 2006 05:48
Location: Serbia

Re: Knee pain returned

Postby elskbrev » Oct 01, 2008 06:03

Hey, pliskin, me again.

I wish I could say just the right thing, but I have no words. You are in for a challenge. This will mend. It will take time.

Can you keep up your aerobic activity? Are you still biking 10km daily? Are you allowed to swim?

Cindy
elskbrev
 
Posts: 79
Joined: Aug 08, 2007 07:08
Location: Wisconsin, USA

Re: Knee pain returned

Postby pliskin » Oct 01, 2008 15:13

Hi Cindy, I am so glad that you are still here, I am in the middle of some exams, and I am not sure yet, what can I do and what cannot from sport activities, and will I have a knee surgery or will I not.
I will post here for sure as soon as I find out something new.
pliskin
 
Posts: 37
Joined: Jul 09, 2006 05:48
Location: Serbia

Re: Knee pain returned

Postby elskbrev » Oct 01, 2008 15:42

Best of luck with it all. I'd rather you keep doing something before all those little explosives they planted in your veins start acting up.
This past summer I found out how it is that even elite athletes can blow a hamstring. I was in excellent shape (ok, excellent for ms. average athlete) yet I made a mess of mine.
Two weeks ago, and about eight weeks into recovery, I signed up for swimming lessons. Long story short, I didn't have access to water when I was a kid, so I didn't learn to swim. In college, I signed up for a water survival course wherein I learned that I could float, and so lost my previously healthy fear of water, but I still could not swim. So, I've been in the water for two lessons and three practices so far and am starting to get the hang of it...You watch, in three months, maybe I look just like Dara Torres! She uses stretch and strength methods akin to Kurz' practices, by the way, though she lists Bob Cooley in the credits.
Take care of yourself, and
never, never, never give up.
Cindy
elskbrev
 
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