Ask a guy who finished his physiotherapy degree today anything.

[TheProdigyBSN]

Finished my physiotherapy (physical therapy) degree today but it will take a few weeks before I'm registered so I have some time on my hands to offer some advice if anyone is interested. Hopefully I can help some people out!! Fire away.

[oldballs]

Patellofemoral Pain Syndrome

[Andru019]

I have tendonosis in my left knee, for about 8 months. I thought I fixed it completely with one legged squats for about a month but it has since come back. I suppose it healed, but did not heal properly. What would you recommend for a rehabilitation program in recovering from this injury, for good? Eccentric exercises are proving effective for me, however I have just started them, and have recently made a 25° decline board to use as well. Any suggestions would be much appreciated.

[TheProdigyBSN]

Patellofemoral Pain Syndrome

PFPS is an umbrella term rather than a specific diagnosis so it really depends on the cause of the pain and the biomechanics that cause the dysfunction. The key component of rehab regardless with be to unload the patella and the structures around it. This means don't do things that hurt + patella taping if maltracking is a factor. Loaded knee flexion increases retropatella force (how hard the patella is pressed against the femur) so in terms of exercises for your knee you should start with quads exercises in full knee extension (straight leg raises in supine). As I mentioned before, the rehab plan will depend on where your deficient in the kinetic chain so its difficult to give advice without assessment but common biomechanical reasons for PFPS are:

Patella maltracking - VMO weakness

Hip dysfunction - poor glute control namely glute med which increases the Q angle and femoral internal rotation, so in this case include progressive hip abduction strength and control but starting from a very low level

Poor foot biomechs - namely increased pronation

Not sure if this will help you but the keys are 1) settle the knee by unloading it 2) address the biomechanical factors.
Very rarely a quick fix.

[TheProdigyBSN]

I have tendonosis in my left knee, for about 8 months. I thought I fixed it completely with one legged squats for about a month but it has since come back. I suppose it healed, but did not heal properly. What would you recommend for a rehabilitation program in recovering from this injury, for good? Eccentric exercises are proving effective for me, however I have just started them, and have recently made a 25° decline board to use as well. Any suggestions would be much appreciated.

Tendinopathy can be tricky. Tendons don't like changes in load so completely unloading the tendon can be as harmful as overload. Off the top I'll say tendinopathies don't have a quick fix (6-12 months rehab). The first part of rehab is to reduce the abusive load. That is activities that cause say >3/10 pain or latent pain in the tendon (note this is a generalisation). Next is to treat the kinetic chain as a whole and progressively adapt the tendon to load. For patella tendinopathy, decline squats are key (for degenerative and disrepair tendinopathies as opposed to acute overload). Some common mistakes in treating tendinopathy are:

Not enough single leg work.
Not treating the kinetic chain as a whole - eg. for patella tendinopathy addressing glute and calf deficiencies. reduced dorsiflexion range has been linked to lower limb tendinopathies so consider calf stretches.
Returning to normal activity/sport when pain is gone - it will just come back as it has in your case. Need to continue rehab.
Being too aggressive in progressing load (be patient, remember no quick fix)
Not monitoring latent pain

So, a general rehab program will involve

0-3 Months
Muscle strength and bulk - quads, glutes, calves (directed by deficits)
Address biomechanics - ?ankle dorsiflexion rage (directed by defecits)

3-6 Months - Tendon strength
Gradually(!) progress load on tendon. Eccentric decline squats for patella tendinopathy. Use pain to guide progression, aim 2-3/10 pain during exercise but beware latent pain. If you experience latent pain, back the load off.
Continue with biomech deficiencies

6+ months
Slow progression of return to normal activity/sports
Begin to incorporate power (in addition to strength) - power rep ranges, ?plyometrics

In summary, do what has been working for you. Gradually progress those eccentric squats and continue even after symptom free or it will just come back. Hope that helps.

[riseboi]

congrats!

[TheProdigyBSN]

congrats!

Thanks mate! Pretty exciting.

[firatK]

Cervical Herniated Disk. How to heal and return to the weightlifting?

[TheProdigyBSN]

Cervical Herniated Disk. How to heal and return to the weightlifting?

Can you tell me more about the level, severity of symptoms and the acuity of the injury. It depends a lot on these factors as well as others but a generalised physiotherapy program will look something like:

Gentle stretching and range of motion exercises in first 6 weeks.
As pain settles, a gradual isometric strengthening program can begin graduating to resisted and active range of motion exercises as tolerable.
I'm not aware of any evidence recommending manipulation or traction of cervical herniations or radiculopathy.
Can also use heat/ice and massage early on as appropriate.

There is also the medical/pharmalogical modalities.

[ItsCrazyTim]

I'm having lower back tightness in L4-L5 that whenever I stretch forward, it starts to burn and tingle. Its fixated over the spine right at those levels. Sometimes it feels like its going to rip.

My hip flexors are extremely tight and the majority of my APT that I had is corrected, but I can't get the lower back tightness and my left leg to loosen up and stop hurting all the time.

Should I work through the pain to start strengthening stabilizers?

[IR0NMANN]

First of all, Congratulations.

I'm having trouble with both my elbows, they pop with every press excercise even with push-ups and with cable pressdowns my elbows gets a bit swolen.

Its near the ulnar nerve but I don't think it is the ulnar nerve, because when people have ulnar nerve subluxation you can see the ulnar nerve pop and move if they bend there arms, my ulnar nerve doesn't move are pop when bending my arms. But close to my nerve it pops only if my arms have to push a weight.

I already have a topic on this, but nobody responds so I hope you can help me out.

Thanks a lot.

(I can't add the link here because haven't 50 posts yet, but I hope you want to check it, its still on page 1)

[rossmcd87]

Finished my physiotherapy (physical therapy) degree today but it will take a few weeks before I'm registered so I have some time on my hands to offer some advice if anyone is interested. Hopefully I can help some people out!! Fire away.

Was it worth it ?

[Urumar]

Congratulations bro!

Maybe you know what may be wrong with my shoulder. I injured my left shoulder 8 months ago doing heavy bench press, happened over a period of time it was not a sudden strain. I kept on benching (I know stupid) until I eventually decided to stop and change the way I trained. I started doing incline bench instead the pain went away. 2 months ago I started flat barbell benching again the pain returned but much worse so I completely stopped working chest or delts for 2 months. The pain never goes away hurts when I take a deep breath or yawn or when I stand for long periods a time. The strange part is I can move my arm in every direction without pain but there is something wrong deep inside the shoulder. Doing any pushing movement irritates it even doing pushups against a wall. What can this injury be.. Please help me!

[Akbaa]

Finished my physiotherapy (physical therapy) degree today but it will take a few weeks before I'm registered so I have some time on my hands to offer some advice if anyone is interested. Hopefully I can help some people out!! Fire away.

I have an exostosis near the knee (at the same location and looks exactly the same as the picture there http ://en . wikipedia . org/wiki/Exostosis, except mine is slightly bigger)
Does it increase significantly the risk of injury ?
Can it "break" without my hitting it, that's to say only by contracting muscles/doing high intensity leg exercises ?
Should I wait until it gets removed (sucks, it'll take a year before I can get it removed) or can I train seriously anyway with it ?

[CalvinPRobins]

Hey, i'm in my third year of university studying product design.
I'm designing a new product to help prevent injuries in the gym.
Any insights or experiences you have to help me design a better way to help inexperienced users keep the correct form etc would be much appreciated!
Thanks

[RedJay67]

Elbow tendonitis:

Been to Doctor and to Physio and both told me I can do whatever exercises I want without doing further damage as long as I do my physio exercises; however, this isn't working because I get it feeling good and then my workouts destroy my progress completely and sometimes set it back even further. I understand it is a balancing act day to day but I can't see an end in sight as it is going.

Which exercises should I avoid for tennis elbow? Specifically, are pulling exercises harder on this than pushing exercises (ie. bench press versus rows)? Are deadlifts hard on the elbow or are they okay because there is no bending of the elbow? Should I just stop working out with that arm completely for X amount of weeks?

[firatK]

Can you tell me more about the level, severity of symptoms and the acuity of the injury. It depends a lot on these factors as well as others but a generalised physiotherapy program will look something like:

Gentle stretching and range of motion exercises in first 6 weeks.
As pain settles, a gradual isometric strengthening program can begin graduating to resisted and active range of motion exercises as tolerable.
I'm not aware of any evidence recommending manipulation or traction of cervical herniations or radiculopathy.
Can also use heat/ice and massage early on as appropriate.

There is also the medical/pharmalogical modalities.

C5-C6 level, extruded type (MRI Date : May-2013) Stopped exercising 5 months ago. Never felt weakness or numbness. Have little pain occasionally. Feeling 80-90%.

[Wobzy]

Finished my physiotherapy (physical therapy) degree today but it will take a few weeks before I'm registered so I have some time on my hands to offer some advice if anyone is interested. Hopefully I can help some people out!! Fire away.

Ok its a long shot but im going to repost my question from another thread;


- pain; localized, top / interior brachioradialis approx 2" in from elbow.
- frequency; non resting, during flexion subjected to any kind of opposing force / resistance.
- sensation; almost dull, but severe corked / bruised feeling. not sharp or burning.

The injury was caused by repetitive strain;
- continually holding my newborn in the same position.

As she got heavier and my arm became more strained, i began feeling the pain.
With increased use i now cannot do things like close the car door or pick things up.

I feel my doctor has misdiagnosed the issue as tennis elbow;
- in an unrelated injury i have experienced this.
- it is in the wrong area and it is not the same sensation.

Also reading above regarding nerve entrapment;
- due to other unrelated injury i have undergone ulnar nerve release surgery.
- i have experienced nerve entrapment, this is not nerve related.
The guy with radiating pain throughout the arm may well have a nerve injury, i know i don't though.

Thats about as much info as i can think to provide.
Any help would be much appreciated.

NB; have not trained during the time since my daughter was born.
No heavy lifting of any kind has contributed to my current condition.

[Wobzy]

Hey, i'm in my third year of university studying product design.
I'm designing a new product to help prevent injuries in the gym.
Any insights or experiences you have to help me design a better way to help inexperienced users keep the correct form etc would be much appreciated!
Thanks

You're going to cure stupidity ignorance and arrogance?