Archive for the ‘Physical Therapy’ Category

Solid Week of Training

August 15, 2010 Leave a comment

Ended up with 22 miles running, 18 miles biking this week, with one day in weight room.

Did the 22 miles on 4 days of running, next week I will add one more day of running and possibly another strength workout in the gym.

Achilles is still a little tight in the morning but seems to be improving.  I am icing about 3-4 times a day and doing some stretching.  I should have been massaging it with the trigger point therapy tools, but I haven’t…That will start next week.


International Soccer Game in Vienna

July 17, 2010 Leave a comment

I’m writing to you all from Vienna, Austria, actually just outside in a small town called Tulln.  We (my fiance and I) are here for her cousin’s wedding.  As part of the pre-wedding festivities there was a soccer game.  Poland vs Croatia (her cousin is Polish, and his fiance is Croatian).  I played for the Polish team.  I haven’t played soccer since I was little, and this game was very informal, most of the Polish players took regular cigarette breaks 🙂

Soccer Time!

We got dominated in the game, but afterward I found out that the Croation team had 4 guys who are currently playing in semi pro leagues, so I don’t feel so bad.  I did OK, for being a little rusty. I had 2 perfect headers and handled and passed the ball like a champ.  No goals though.  We lost 8 to 3.   The team called me the “marathon man”, being a runner and all.  I finished the game almost unscathed, I did have a small shin to shin clash which left a mark.  And my achilles tendon wasn’t too happy with my soccer game.  Oops.  The original achilles strain came from my venture with the Five Finger shoes a few weeks ago.  I guess it wasn’t all the way healed, but it is definetely sore today.  A slight case of achilles tendonitis.  I have a wedding to attend tonight, so there will be some dancing.  No break-dancing tonight I guess 🙂

Here is a couple good sites on treating achilles tendonitis.

Time-To-Run Site about Treatment

I’ve been icing every couple hours with an ice cube directly on the sore area and didn’t run today.

I will be doing more biking and swimming when I get back to the US to let this heal before it becomes chronic.  I’m not worried though.  I’ve had this before, it just takes rest and attention.  A lot of ice, anti inflammatory meds and don’t do anything crazy, like play soccer.

Saw the Orthopedic doctor

February 16, 2010 2 comments

Finally made it to bring my MRI film to the orthopedic doctor.  Apparently the MRI office didn’t include all of the usual film sheets that this doctor is used to.  He inspected the ones they did provide and pointed out the very small horizontal tear that showed up.  The doctor however was “unimpressed” with the cyst.  He mentioned cysts were common in meniscus tears and he wasn’t concerned. He also explained a horizontal tear is a way I could picture.  It is not like a tear on a piece of paper but it is more like a tear as if you were slicing a bagel.  So to scope it and “trim” the tear would essentially make the meniscus more thin in that area.

He did a bunch of leg twists to see how stable my knee was and to check for any pain.  There was no pain or tenderness.  And there really hasn’t been pain or swelling in the last few weeks.  He said he would not reccommend surgery at this time.

He said to resume normal running activity and monitor the knee.  If it starts to swell again or becomes painful, surgery may be necessary but for now back to the streets 🙂

Maybe it will actually heal.  I am doing some ultrasound on it, also making sure I’m keeping my hamstrings stretched.  I am also applying MSM cream nightly, which is supposed to restore collagen tissue.  Meniscus are composed of some collagen fibers, so it’s worth a try….

How to Prepare for Knee Surgery

February 9, 2010 2 comments

Got this online from eHow member “painfuljoints”  🙂

I feel like this is a VERY important step that is often overlooked.  This preparation is the key to having a chance at a quick and full recovery.

How to Prepare for Knee Surgery

Things You’ll Need:

  • Copies of your MRI and x-rays
  • Second opinion from another knee surgeon
  • Consultation with a physical therapist (interview several)
  • Examples of knee “prehab” exercises
  1. Step 1

    // Once your surgeon suggest you need knee surgery, research the type of surgery he suggests, even if it’s a seemingly simple arthoscopy. Take it from a veteran of seventeen knee surgeries on one knee who is still disabled in that joint.

  2. Step 2

    Your quadriceps, which are vital to proper knee function, are some of the fastest to atrophy when not used regularly and are some of the slowest to come back after atrophy has occurred. Thus it is critical to do at least four weeks of “prehab”, specialized knee exercises that strengthen the quadriceps, especially the VMO (or front inside part of the quad).

  3. Step 3

    As a veteran of seventeen knee surgeries, I can give you a list of excellent exercises, but it’s best to get this information from a trained physical therapist. If you do not want to seek out your physical therapist prior to surgery, something I strongly recommend, keep up a workout at the gym at least three days per week with your physician’s blessing, since you may have concomitant illnesses that make workouts dangerous.

  4. Step 4

    One less dangerous to the heart exercise that may help you prepare is what’s called the “quad set.” The quad set consists of lying flat on your pack with a rolled up towel or empty 2-liter soda bottle in the crook of your knee and bunching up the knee relaxing it. Do this exercise in 3 sets of 15 three times per day, and whatever you do on the surgical side of your body, do to the other knee as well because that knee needs to be stronger than ever when the other knee is out of commission.


The long awaited MRI results are in….

February 7, 2010 3 comments

Drum roll please…….And the winner is……tear of the meniscus.. 😦  A horizontal cleavage tear of the posterior horn of the medial meniscus to be exact.  AND and a special bonus that only 5% of meniscus tears get…a parameniscal cyst (I guess I’m an overachiever).  Awesome right?  Yeah that’s what I thought too, awesome.  Well, I haven’t seen the doctor yet to hear what he thinks but I got the results mailed to me.  I thought they would send the MRI pictures, but they sent a diagnosis in words.  That is probably better since I’ve been studying MRI pictures online for a month now and still have see what the descriptions are talking about.

What is a parameniscal cyst….good question, here is the answer,

Definition: A meniscal cyst is an outpouching of joint fluid caused by a tear within the meniscus. Meniscal cysts are most commonly seen near the lateral meniscus (outside of the knee) and are associated with a specific type of meniscal tear called a horizontal cleavage tear. Meniscal cysts can be drained with a needle in the office, but they will often come back. The reason for the return of the meniscal cyst is that the tear that leads to the cyst must also be treated. The meniscal cysts are usually best treated with arthroscopic treatment of the meniscal tear. The meniscal cyst will usually decompress and less commonly returns.

Meniscal cysts are related to popliteal or Baker’s cysts–however, these types of cysts are located in the back of the knee joint.

Although, my tear was not in the lateral meniscus, but the medial (inner part of knee).  So my original thought of an inflamed bursa sac was incorrect, it was actually the cyst that was bulging out of my knee, I guess.  At least it is much smaller now, 6mm to be exact.

I’m not too worried.  Although not the greatest news, I can handle it.  I will have a doctor visit hopefully sometime next week to get his thoughts on the next step.  Meanwhile I will strengthen my leg muscles as much as possible to help with a speedy rehab (assuming of course, I go under the knife).

I am confident in a quick and full recovery.  Boston Marathon plans will obviously have to be put on hold until next year.

Not mine, but an MRI of cyst and tear

Bad Knee News…(but don’t worry)

January 14, 2010 2 comments

Went to the doctor on Tuesday to check out the knee problem I’ve been having since extended kneeling while cleaning.  It appears to be a meniscus problem in my left inner knee.  The good thing is both of my knees are stable.  There is no problem with ACL, MCL, or PCL.  Everything is sturdy.  AND everything is relatively pain free.  I mean, I came in 4th in a triathlon with ease 🙂

Anyway, my knee doesn’t feel right, it feels “loose” and pops more then usual, which is why I succumbed to the medical professionals, which I really don’t like doing…

The doctor was cool, I actually picked him from a giant list of available doctors online with my insurance company.  The reason I picked HIM in particualar was he was a D.O. and not an M.D.

D.O.s bring something extra to medicine:

  • Osteopathic medical schools emphasize training students to be primary care physicians.
  • D.O.s practice a “whole person” approach to medicine. Instead of just treating specific symptoms or illnesses, they regard your body as an integrated whole.
  • Osteopathic physicians focus on preventive health care.
  • D.O.s receive extra training in the musculoskeletal system-your body’s interconnected system of nerves, muscles and bones that make up two-thirds of your body mass. This training provides osteopathic physicians with a better understanding of the ways that an illness or injury in one part of your body can affect another.

I didn’t even know what D.O. meant, and had never seen or noticed the abbreviation before.  I decided it would be a good option for my knee.  I then got lucky in that the D.O. I saw was a fellow triathlete!  I love athlete doctors!  They understand athletes so much better than normal doctors.  So the preliminary diagnosis is partial meniscus tear or fraying.  So I will take 2 weeks off of running or biking, so scar tissue can form and then I can test it out again.  If it is still swelling after running, an MRI will be taken to check out the extent of the damage.

This gives me more time to work on my swim stroke, which I did today.  I think I’m faster already!


How to Rehab a Torn Meniscus-VIDEO

My knee has been feeling good.  Still popping from time to time.  I’m working on hamstring flexibility and doing the standard R.I.C.E with an addition of ultrasound, so U.R.I.C.E.  Ultrasound is good because it increases blood flow to the injured area, and since swelling is down, blood flow is a key to healing, especially in things like cartilage which get very little blood flow as it is.

A few more great articles from Livestrong…

5 Things You Need to Know About the Knee Mensicus

1. What Is a Meniscus?

The meniscus is a C-shaped piece of fibrocartilage that acts like a cushion between the femur (thigh bone) and tibia (shin bone). It is wedge-shaped, such that it is larger on the outer rim of the meniscus and tapers towards the inner rim. There is one on the lateral side and one on the medial side of the knee. The medial one is torn approximately three times more often than the lateral meniscus.

2. What Is Its Function?

The meniscus serves to distribute the forces more evenly across the joint. The end of the femur is curved, whereas the tibia is relatively flat. A curved object meeting a flat surface only has a small contact area, and therefore higher peak contact pressures. The meniscus “cups” the end of the femur and spreads out the pressure. It also functions as a shock-absorber. Its collagen fibers are oriented both radially and circumferentially to accomplish these tasks.

3. How Is It Torn?

The meniscus can be torn with an injury (traumatic) or with wear-and-tear over time (degenerative). Traumatic tears usually happen in younger patients, with twisting motions or sudden changes in direction or speed. They also happen in conjunction with other injuries, especially anterior cruciate ligament (ACL) tears, up to 70% of the time in some studies. Degenerative tears occur because the meniscus thins out and becomes more easily torn. Over time, the meniscus has less collagen and more water content. It is less able to resist the forces put upon it. There are numerous configurations of meniscus tears–horizontal, vertical, radial, longitudinal, complex, bird beak, flap and bucket-handle tears.

4. How Do I Know If I Tore My Meniscus?

People with traumatic tears can sometimes pinpoint it to a specific activity, oftentimes associated with a popping or tearing sensation. In other cases, there is no inciting event and no limitations to activity, except for occasional pain. Common symptoms include pain and swelling, tenderness on the joint line, effusion (water on the knee), catching or locking, and a sensation of your knee giving out. Sometimes, the tear is large and unstable. It can flip inside-out upon itself, like the handle of a pail (bucket-handle tears). When that happens, the knee can lock up and get stuck at a certain angle or it is unable to be fully straightened. A radiograph (x-ray) may be useful in ruling out other causes of these symptoms, but it largely only shows bones. Remember, the meniscus is made up of cartilage. Magnetic resonance imaging (MRI) is useful in diagnosis, because it shows not only bones, but muscles, tendons, ligaments, articular cartilage and, of course, the meniscus.

5. I Don’t Want Surgery–What Are My Options?

Non-surgical treatments include rest, anti-inflammatory medications and physical therapy. Meniscus tears tend not to heal by themselves due to a poor blood supply. However, it may get to the point where it doesn’t bother you, especially with smaller tears. There are plenty of people out there walking around with meniscus tears. By calming down the inflammation and strengthening the muscles around the knee, the tear may only cause an occasional twinge or flare-up. If you know certain activities aggravate the meniscus tear, but if you can live within those limitations, then you may want to just observe tear to see what happens. On the other hand, if the symptoms are affecting the activities you want to do, then it’s probably time to talk about surgery.

Signs of a Torn Miniscus

The purposes of the knee meniscus (menisci for plural because there are two in each knee joint) is to disperse the stresses of weight across a large area of the knee in an attempt to keep the joint cartilage healthy. The menisci also serve as shock absorbers in the knee as well as stabilizers of the joint during most activities. They are crescent-shaped and have a tapered appearance.
Because the meniscus is composed of a tough rubber-like cartilage, it tends to not heal when torn. In turn, the knee can exhibit certain particular signs and symptoms indicating a torn meniscus.


If the injury is recent enough, there may be pain, ranging from mild soreness to severe disabling pain. This occurs primarily because there are pain nerve endings in the outer zones of the cartilage, as well as pain receptors located within the joint cartilage cells. When weight is applied, or motion exerted, on the knee joint, pain receptors fire to warn the host of a problem within the knee.

Excessive Fluid Production in the Knee (Effusion)

In cases of a torn meniscus, the tear pattern can be such that a portion of the meniscus can displace into the knee joint, creating a mechanical blockage or irritant. If this happens, the body only knows one way to battle against the irritation that is caused by the meniscal tear, and that is to produce additional joint fluid. This is done as the body’s effort to increase lubrication to reduce the local mechanical irritation. This is called “joint effusion.”

Limited Range of Motion

Meniscal tears, especially with the added problem of extra fluid buildup in the joint, can easily translate into altered range of motion of the knee. The mere presence of excess fluid can cause hydraulic pressure to be exerted when there is an attempt to bend the knee, effectively blocking full motion.

Additionally, the torn meniscus can, and usually does, play an important role in altered mobility of the joint, particularly if the meniscus has been damaged to the point of mobile flasp that flip in and out of the knee, causing a “catching” sensation.

Popping Sensation

A torn cartilage can often “flip” in and out of the joint, getting “stuck” and then releasing back to its near-normal position and shape. The catching is frequently referred to as a “popping” in the knee and is one of the most common complaints.

Bursitis in my Knee :(

December 28, 2009 Leave a comment

I did an intense cleaning session at the restaurant that I’m the Chef at and it required a lot of kneeling and vacuuming, about 2 weeks ago.  I think all of the kneeling set off some irritation in my left knee and now when I run over 30 minutes I get this inflamation just below kneecap and slightly to the inside of my leg.   The good thing is, it is not painful.  I have read up on bursitis of the knee, and there are several bursa sacs in the knee.  My particular problem is called

Pes anserinus bursitis

Bursa in the Knee

The remedy is R.I.C.E, (Rest, Ice, Compression, Elevation) so I’ve been taking it easy and doing cross training on the bike and elliptical and running a little less.

Plus, Ice and compression combined with topical NSAID like Traumeel or MSM cream.

Nutritional Supplements can also be very effective at reducing inflamation and may be a better long term solution to controlling the bursitis or arthritis.

Nutrition and Supplements

Eat whole grains, fruits, vegetables, and fatty fish or help reduce inflammation. Avoid processed foods and foods high in sugar and fat. The following supplements may help.

(excerpt taken from University of Maryland Medical Center

Pes Anserine Bursitis Treatment Options for a P.T.

· Have patient refrain from activities which increase symptoms

· Ice Massage/Ice Packs

· Postural Training/Functional Training

· ROM/Stretching

· Strengthening

· Massage/Soft Tissue Mobilization

· Joint Mobilization

· Gait Training

· Orthotics

· Ultrasound/Phonophoresis/Iontophoresis

There is a good site about bursitis at

I’m pretty sure that the kneeling episode set it off, but only combined with my high mileage, and poor mechanics on my left leg.  So I am working on stregthening my lower left leg.  Also the rolfing sessions are helping with proper mechanics.

On a “lighter” note…the Christmas season was great but not an ideal setting for losing weight.  Yeah, I put on a couple pounds, but I’m still much lighter than I was at this time last year, by about 10 lbs.  My favorite thing to do after the Holidays is the 5-day Reset, which is a nutritional based weight loss system made by a company that I work with and use.

5 Day RESET Kit

I was 194 this morning before I went to the gym…not good.  I’ll keep you updated on my 5 day results.

I also registered for my first triathlon, albeit an INDOOR tri, I’m excited.  I’m a little worried about the swim though, I haven’t swam for speed in, well, never.  I’ve swam laps before when I was younger, like 20 years ago.  Oh well, you gotta start somewhere right?  I will try to get in a pool before the Jan. 10th event, but it may not happen.  It’s only a 10 minute swim, then 30 min on the bike, then 20 min on the treadmill.  I’ve always wanted to get into Tri’s since I feel like my body type is more suited to that than it is to long distance running.  We’ll see where I stack up with very little training 🙂

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