BodyBuilding Physiotherapy/PT Thread

[gangaslayer]

Hey,

Can you tell me a couple more things about your knee...

Can you circle exactly where the pain is, sounds below the knee, but it would help if you point it out exactly- use this pic

http://www.bodiesinbalanceleth.ca/im...%20Diagram.jpg

Also, are there any other movements/ activities that give you pain besides running? Up or down stairs? sitting for long periods? Certain stretches
Does the pain start immediately with running? If not, how long can you run before it comes on? Then how long after the run does it take to go away?
is it a certain part of the run...e.g. when you push off with that leg/ when you land on that leg?

Thanks,
Prophylaxis

Thanks for getting back to me.



It does irritate me in day to day life if i walk a lot of stairs. Pain doesnt start immediately when running but will gradually build up. Id say over a period of 3-5 minutes. After running, its a good 12hrs at least for the pain to subside. i would say the landing on the knee is doing the most damage.

[youngbuckets5]

Hey,

That's helpful, thanks. I'd still like you to go through the movements, but ALSO, just bend forward to touch your toes now (just normally curve your back- NOT straight back). When you start to get the pain, put your head down chin-to-chest and tell me if it gets worse or better.

Here are the movements to do...
http://spinesurgeon.com.au/Neurologi.../movements.jpg

Talk to you soon,
Prophylaxis

no the pain gets neither better nor worse when i bend forward and put my chin to my chest. also of those movements only flexion and extension hurt. today is actually a better day though so the pain isnt terrible, i just know if i were to go play some intense basketball or something than id be in a world of hurt and those movements would hurt even more.

Thanks Prophylaxis I hope to hear from you soon.

[FuarkBrahhhhh]

Hey man,
Need you to clarify a few things
- it hurts if you do a straight leg raise, both standing and lying down? Anything else? Bending, sitting? walking?
- what do you mean when you say bending your knees relieves it? You mean while you're doing the straight leg raise? Does anything else relieve it?
Can you do these motions VERY CAREFULLY, take note of exactly which movements make it better/ worse?
spinesurgeon.com.au/Neurological_Conditions/images/movements.jpg

Let me know!
Thanks,
Prophylaxis

Thanks for the response! Yes straight leg raises cause pain both lying and standing from my lower back (upper glute) to my hamstrings mostly on the left side/leg.While sitting it hurts if I sit straight with my feet flat on the floor and if i try to arch my lower back. Standing straight doesn't hurt my back, but trying to arch my lower back causes pain in the same areas as doing the leg raises. Regarding the picture you posted, there is pain while bending forward, left and right side bends don't hurt however and left and right rotations hurt in the same areas.

"what do you mean when you say bending your knees relieves it?"
While sitting with my feet flat on the floor, if I bend my knees and bring my feet back the pain subsides. Also while doing straight leg raises both standing and lying.

Additional info: my hamstrings are very tight. I am quite tall so I have had a bad sitting posture for quite a few years already.

[Shane-0-Mac]

Sweet.

Just want to test your adductors now.

Does this test bring on your pain here? Can you feel like when your legs are straight?

http://www.youtube.com/watch?v=piD-0AtDMJs

No pain brought on by this either.

[KingofLifts]

Thanks for that man,

Sounds like there may still be some swelling inside the knee joint.

Can I get you perform this test for me (Thesally test) -do this by holding onto a surface - just to work out if the mensicus are causing your problems in the knee.

http://www.youtube.com/watch?v=ceBtpDXWErU

Does this bring on the 'popping' sound at all?

If this does not bring on the popping sound - I want you religiously stretch/foam roll the muscles around the knee - hamstring/quad/calf for a couple weeks - if it doesn't improve - I'd recommend getting some scans and seeing a physcian to rule out anything nasty. When there is swelling in the knee (or you feel a bubble as you squat) - it's a sign something intra-articular is happening in the knee - so it's wise to just play it safe!

Just did the Thessaly test, happy to report there is no popping

An weird observation i made though is that, the there is some tight feeling in the back part of my knee. When I fully lock out my knees (when standing), the affected knee feels like it gets pushed back more. Almost like my knee joint is being overstreched. It is possible that I hyperextended the knee?

[Prophylaxis]

Hi, yes that is the term I mean, i have had an X-ray and didnt have any sort of misshapen hip socket.

I used to squat with no pain, but i had glutes that where switched off and so my hamstring dominated and i never felt my glutes at all, apparently this can lead to hip impingement.

No problems as a kid. Clicking yes, not painful only slightly.

the site of clicking is at the front of my hip socket i believe.

Hi Hcat,

To minimise stresses through the hip - make sure you do plenty of hip flexor stretches - while keeping a neutral lumbar spine and posterior tilting



You are absolutely right, in that without activating your gluts properly - other muscles (e.g. adductors/hip flexor) can take over - as this muscles attach and run through the hip joint - they can predipose the hip to extra pressures (e.g impingement).

So to make sure you are strengthning the gluts WITHOUT hip flexor involvement -

perform clams - but push your two heels together while you seperate your knees (below). Alternatively you can also push your TOP heel against a wall (extending the hip) while you seperate the legs (to activate the gluts). You can also add in resistance (below) once you feel like you aren't fatiguing as much. Try to smash these and do until fatigue - 3 sets.



Finally you want to make sure you do plenty of bridges (Start with two legs first) but focus on squeezing your gluts as you extend back up - try to keep your heels ALL THE WAY to your buttocks so you fully activate glut max



Let me know how you go!

[Ronnie23G]

Hey Ronnie,

Where exactly is the pain in your back? In the lower back or neck? Not sure how pain around the traps could be caused by a tight glut med thats all!

Once we clarify that, we'll get going =)

Paint is just in the area circled in the attachment

I didnt quite understand how that could cause the pain either, just what the therapist had said

[Prophylaxis]

Body Chart: (Where exactly does it hurt?) - My right glute when i am standing up

Age: (How old are you?) 23

Mechanism of injury: I have L5-S1 herniation 8MM induced by vomiting (sigh).

Aggravating factors: What makes the pain worse? When i am standing up for a long time, i can sit all day and not have any pain but when i am standing up for 5+ minutes i feel a twisting pain in my right glute, like something is stabbing and twisting.

Easing factors: What relieves the pain? I have to sit down asap or start pacing so the pain can go away then i can stand for another 5 minutes, rinse and repeat.

I know it is due to my herniated disc, but maybe something else is happening to make it worse? I do suffer of an anterior pelvic tilt...i think...

Hey Donut,

I'm assuming you went to a DR and had an MRI - did you see a health-care professional? - If so what exercises did they give you?

Can I get you to bend backwards for me?



Now do 15 X 2 of sets of repeatedly bringing your knees to your chest.



Does this improve the pain at all bending backwards?

[XWildCardX]

Hey PT brah hoping you can help me out:

Body Chart: (Where exactly does it hurt?) - Neck - right side, starts just below where the necks meets the skull and goes down to around the shoulder area.
Age: (How old are you?) 25
Mechanism of injury: Strained my neck doing overhead press about 12 weeks ago and was barely able to move neck from side to side or up and down. Took about 8-9 days before it recovered to the point i could get back in the gym, however it still gets tight and has mild pain pretty regularly. My range of movement isn't restricted at all, but the tightness/pain is just annoying and i'm paranoid of re-injuring it so have been going easy on the overhead pressing movements.
Aggravating factors: What makes the pain worse? Gets worse if i don't move or stretch it for a while, is usually worst first thing in the morning.
Easing factors: What relieves the pain? Stretching helps a bit.

Thanks!

[Prophylaxis]

Body Chart: (Where exactly does it hurt?) - Left wrist. During pressing motions, but only when the hand is bent backwards, its fine if i keep a straight wrist. But for bench press thats impossible. cant put any weight on it, hurts during the lockout part of the lift. (press ups are out of the question too unless using handles to keep the straight arm)
Age: 23
Mechanism of injury: First started noticing it over the last year, I think it may have been where I came of a motobike at about 15mph, sprained my wrist pretty bad, no insurance so just taped it up for a couple of days. Stopped being painful after 3 or 4 weeks, (Maybe I fractured it slightly?) Ill never know.
Aggravating factors: If i wrap the wrist up literally in blankets throughout the night to stop it getting cold I dont have my symptons, I can press like normal, dont remember having any of these symptons throughout summer.
Easing factors: Keeping it warm.

Hey man,

Because your mechanism of injury was 'coming off a motorbike' - there could be a couple things going on - generally I would recommend getting a basic XRAY to rule out anything nasty (e.g. scaphoid fracture) - often I've seen clients who have small fractures in the wrist and barely noticed. These are quite serious, and can have long term implications - e.g. avascular necrosis of the bone (where the bone dies - since the blood supply to scaphoid is so delicate) or arthritis.

Once the wrist is cleared of anything nasty we could begin to manage it.

Sorry to be such a downer man - but I can tell you it's better to be safe than sorry!



All other responses starting from Grevl will be answered tomorrow. Thanks for your patience

[HiddenMozart]

Body Chart: Right Wrist pain, Palm up pinky side, around the TFC socket I believe.

Age: 21

Mechanism of injury: Did the pain occur during ONE particular event? Yes, I used to do a lot of Trap pull-ups, with my wrist being in an acute angle as well as using the lap top with me laying on my back and having it on my chest.

Aggravating factors: What makes the pain worse? Using the laptop with it on my chest, right wrist is an at acute angle. Doing any pressing movements with dumbbells or bar. Push ups + shoulder pushups are fine

Easing factors:Resting it, icing doesn't help a lot. Also working out my forearms with light weight + pulling movements are fine.

[djkanna]

Hey man,

Because your mechanism of injury was 'coming off a motorbike' - there could be a couple things going on - generally I would recommend getting a basic XRAY to rule out anything nasty (e.g. scaphoid fracture) - often I've seen clients who have small fractures in the wrist and barely noticed. These are quite serious, and can have long term implications - e.g. avascular necrosis of the bone (where the bone dies - since the blood supply to scaphoid is so delicate) or arthritis.

Once the wrist is cleared of anything nasty we could begin to manage it.

Sorry to be such a downer man - but I can tell you it's better to be safe than sorry!



All other responses starting from Grevl will be answered tomorrow. Thanks for your patience

Thanks for the response, I dont know if it makes a difference, but I came of it onto my wrist which took all my body weight. This was approaching two years ago now though. Still worth going to get the xray?

[Grevl]

Those who are having wrist pain, try massaging your forearms




I used to get sharp shooting pains in wrist going up my arm when picking things up if my wrist wasnt angled in a certain way, even lifting up empty cardboard boxes when i was working in a warehouse.

I tried the above video for about 3 days and my wrist went from stiff and painful to loose quickly

I couldnt bicep curl either.

[Donut Juice]

Hey Donut,

I'm assuming you went to a DR and had an MRI - did you see a health-care professional? - If so what exercises did they give you?

Can I get you to bend backwards for me?

[img]http://www.thephysiotherapysite.co.uk/imgs/lumbar-extension.jpg[img]

Now do 15 X 2 of sets of repeatedly bringing your knees to your chest.

[img]http://www.prizmdevelopment.com/assets/images/exercise/ball.jpg[img]


Does this improve the pain at all bending backwards?

Doctor gave me 1 nerve block and that's it all the MAJOR pain went away. What is left now is literally just that lil pain which is a nuisance but if i can do anything to make it go away without another shot i will. No PT was given to me because it would aggravate the pain horribly. And i was doing so well afterwards, that she said not to worry about excercising. 6 months later i was back in the gym, as if nothing had happened. I don't squat or deadlift anymore.

I did the excercises you mentioned this morning at the gym, and YES it really improves the pain, it is very relieving. Thanks... Should i do this often? Anything else?

[Prophylaxis]

Those movements, all was fine, only bending forward, legs straight my hamstrings are clearly very tight (i do stretch them every other day). Calves are quite tight aswell.


Thanks alot for your help bro

Hey Grevl,

Thanks for being patient - been a BUSY week at the clinic!

I want you to take it easy on the hanging knee raises, planks and broom stick shoulder ?'dislocations'. (I assume this doesn't involve dislocating your shoulder). Sounds like you back doesn't respond well (at the moment) to anything involving bending over or sustained flexion.

Do you experience any pain performing these?

[Prophylaxis]

Body Chart:
Age: 29
Mechanism of injury: Over the last 12 months I've had the odd slight ache and minor pain in the same location especially whilst raising my arm laterally. Two weeks ago I was doing shoulder presses with dumb bells and my right shoulder gave way and I felt something pull slightly but the pain was only momentary and I was able to carry on with a light weight but it has been sore ever since. My shoulder also clicks when raising my arm laterally but isn't really painful.
Aggravating factors: Lateral raises with dumb bells.
Easing factors: Periods of rest and avoiding lateral raises (especially heavy).

Thanks for any help or advice in advance.

Hey Z,

Do you have any neck pain that coincides with the shoulder pain?
Does it hurt when you sleep on the shoulder?
Has your shoulder previously popped out or felt unstable? Or have you had any previous shoulder injuries?
Have you woken up with a dead arm or pins and needles since it happened?
When you do the full can test (below - resist with your left arm while you try to hold the right arm in the position) - any pain or weakness there? (Compared to good side)

If the full can doesn't hurt can you perform the empty can (below) - any pain there? Next I want you to retry but squeeze the shoulder blades slightly back - does that relieve the pain at all?


Let me know how it goes! Sounds like we may need to make a few tweaks with your workout regime - avoid lateral raises and heavy overhead lifting for the time being.

[karseet]

Body Chart: posterior area of left shoulder
Age: 23
Mechanism of injury: Happened while doing reverse cable flies about 4 years ago :/ still haven't been able to fix it
Aggravating factors: bench pressing, chest pressing, sometimes lateral presses, sometimes pullups
Easing factors: What relieves the pain? time. usually gone the next day or if I don't work out at all. But will flare up EVERY time if I'm at the gym and work out chest.

[asdf89]

Thanks for the advice on my previous post

Body Chart: (Where exactly does it hurt?) - back/rear shoulder/quadrilateral space
Age: 24
Mechanism of injury: was hit by a truck on the side..broken humerus..rod inserted.
Aggravating factors: bench press

so whenever i bench with dumbbells..i dont BB bench. i get a huge pump on my left side of my upper back i have my scapula retracted and my elbows not flared much. Im assuming this is because the rotator cuff muscles working overtime? not really sure but my left side is alot weaker as a result of the accident which was 7 or 8 years ago. After bench i normally go to overhead tricep extensions..and when i raise my arm over head with a dumbbell, it literally feels like my shoulder is going to come right out of the socket. I realize my labrum could have been torn when i took the hit on my side. However with the fact that my shoulder blade area is getting super pumped when im doing bench leads me to believe its something else. Normally when i have not done bench press i can hold the weight overhead fine and i am not nearly as unstable. My chiro pressed on my arm all sorts of different ways to see if i had pain indicitive of a labral tear and none of them hurt my shoulder.. i did have an mri arthogram and they said there is an indication of a possible posterior labral tear..no rotator cuff problems were noted. I also had a nerve conduction study and they said everything was fine


today i did rotator cuff exercises at the end of my push workout...(shoulders/chest/tris) and while lying on my side with the dumbbell across my stomach performing external rotation i had my shoulder somewhat painfully subluxate. Now like i said that upper back/shoulder blade area was already tired from benching. I also did the one with elbows out to the sides and raising the dumbbell while keeping my elbows at 90..i did not get the subluxation

what does this seem like to you?

what i was planning on doing is lowering the weight slightly on bench and stay stagnant there for awhile while i train my back/shoulders.

[Prophylaxis]

I used a different diagram, but as best I can tell, it's mainly inside this triangle.

The active straight leg raise doesn't cause pain, it's definitely more when I'm in the bottom of a squat or hack squat.

I think you're right about the lower back pain being related. I've ordered a stand thing to raise my monitor and keyboard up off my desk so I can stand while I work, which I think will help some with the lower back issues.

First thing's first. Great call using a sit/stand desk at work -I can't tell you what a difference this has made to some of my clients.

Generally, pain INSIDE the triangle is usually due to a hip flexor dysfunction - but it's hard to tell whether your particular pain is coming from your back or hip (or both!)

The best things we do in the interim are :

1) Unlock pelvic movements from the back (so the joints in the back don't become overloaded when you squat all the way).

Do plenty of posterior pelvic tilts throughout the day - http://www.youtube.com/watch?v=zqzjdfsVMME. Once you feel like you perform this movement well - try to incoporate these (slightly) as you do gentle unloaded squats. Try this initially against a wall for support.

2) Activate gluts with minimal hip flexor involvement.

Perform gentle bridges while squeezing glutes (and even gently adding in a posterior tilt if you like!)
Stretch the hip flexor++
Perform clam strengthening exercise - like I said previously - really focus on pushing that TOP leg against a wall - so you switch off hip flexor and activate glut med.


I think focusing on these two components will do something for your back Bubba, but it sounds like (given your history) - it would be well worth finding a good health-care professional to speed things up a bit.

Please feel free to let me know if you had any other questions!

Prophylaxis

[Prophylaxis]

Thanks for getting back to me.


It does irritate me in day to day life if i walk a lot of stairs. Pain doesnt start immediately when running but will gradually build up. Id say over a period of 3-5 minutes. After running, its a good 12hrs at least for the pain to subside. i would say the landing on the knee is doing the most damage.

Thanks for the image man - that tells me heaps.

Couple more tests then I'll let you know what's going on.

If you do this test (Thesally) - leaning onto something - does it give you the pain? http://www.youtube.com/watch?v=ceBtpDXWErU

Have you taken up a recent cycling/running regime?

Is it worse going DOWNHILL?

Is it tender here (looking at the outside of the knee:

[Prophylaxis]

No pain brought on by this either.

Hey Shane,

Doesn't sound like you've strained your hamstring or adductors muscles then (good news). Sounds like your adductor magnus has been overloaded from the excessive use of the rudder. When your hamstrings fatigue while using the rudder, the adductor magnus can take a lot of the load (I used to get pain in a similar area when I was fatiguing while doing leg press). Since part of the Adductor magnus muscle functions as part of the hamstring and is involved in hip extension - this explains the initial discomfort you get as you 'take off' to run.



So what do we do about this?

1)Stretch the following muscles: hamstrings, gluts and hip flexors - use a foam roller if necessary to release through rec fem. By releasing the hip flexors you allow the glutes to function better and less chance of adductor magnus being overloaded

2)Strengthen gluts while in HIP FLEXION (to mimic using your glutes while in the position of the rudder) - do this by performing a wall squat and tying a band around the knees holding the position (below) for 30secs a do a few reps a day. The band adds external rotation to the squat which will fire more glut max and take the load of magnus.



Let me know how it goes!

[Prophylaxis]

Just did the Thessaly test, happy to report there is no popping

An weird observation i made though is that, the there is some tight feeling in the back part of my knee. When I fully lock out my knees (when standing), the affected knee feels like it gets pushed back more. Almost like my knee joint is being overstreched. It is possible that I hyperextended the knee?

Hey KingofLifts,

I'm going to say that the tightness at the back of the knee could be due to some swelling inside the knee joint. Given the fact that the knee was swollen for a week after the injury - sounds like there was some trauma inside the knee. My advice would be to see a health-care professional to make sure there are no ligament or mensical tears inside the knee joint - once this is cleared we can move forward.

[Prophylaxis]

Thanks for the response, I dont know if it makes a difference, but I came of it onto my wrist which took all my body weight. This was approaching two years ago now though. Still worth going to get the xray?

Ahh I was under the impression this happened recently!

Alright, we'll give PT a go for now, but if the pain doesn't improve in a couple weeks - time to get some scans.

Can I get you to specify exactly where the pain is - is it near the pinky/thumb side (or just in the middle of the wrist) - front or back of wrist?
Any numbness or tingling around the wrist?
Is the night pain considerable?
Have you ever tried taping the wrist for support while you lift? Has this helped?

[Prophylaxis]

Doctor gave me 1 nerve block and that's it all the MAJOR pain went away. What is left now is literally just that lil pain which is a nuisance but if i can do anything to make it go away without another shot i will. No PT was given to me because it would aggravate the pain horribly. And i was doing so well afterwards, that she said not to worry about excercising. 6 months later i was back in the gym, as if nothing had happened. I don't squat or deadlift anymore.

I did the excercises you mentioned this morning at the gym, and YES it really improves the pain, it is very relieving. Thanks... Should i do this often? Anything else?

You got it! I want you to do these regularly (X3 a day - 15 reps X 2 each time) if they are providing relief. Do these for a couple weeks and we can progress from there.

Keep it simple for now and avoid standing for too long, or any back extensions that aggravate the pain. It sounds like gentle lumbar flexion (bending forward/bringing knees to chest) is taking pressure off the nerve in your back. Let me know how you go!

[KingofLifts]

Hey KingofLifts,

I'm going to say that the tightness at the back of the knee could be due to some swelling inside the knee joint. Given the fact that the knee was swollen for a week after the injury - sounds like there was some trauma inside the knee. My advice would be to see a health-care professional to make sure there are no ligament or mensical tears inside the knee joint - once this is cleared we can move forward.

I think I will schedule an appointment when i can.


Another nagging injury i had:

Body Chart: Anterior Part of Right Shoulder, Could be rotator cuff.
Age:18
Mechanism of Injury: I remember waking up one day with a horrible pain in my shoulder. I couldn't move it very much. I think I slept on the shoulder in an awkward position. Now the shoulder seems to shift when I raise it overhead. It pops in and out of place. There isn't a smooth motion in my shoulder. When I do arm circles to the side, it shifts in and out of place to get to the desired motion.
Aggravating Factors: Upright Rows seem to make the pain worst.
Easing Factors: Weirdly, I found a spot on my scapula where there is a pain. When i massage that spot the anterior part of my shoulder feels the pain, but after my shoulder gets a bit smoother.




Thanks a bunch for taking the time to do this brother.

[CuteManlet]

Body Chart: Severe L4/L5 S1 Disc Herniations on lower back/left side
Age: 20
Mechanism of injury: Improper deadlift/squat form being new to the gym without help. Using too much weight.
Aggravating factors: Flexion and extension both cause pain to this day. Straightening legs while bending forward or sitting on butt with legs straight in front is almost impossible.
Easing factors: Stretching the glutes/hamstrings/hipflexors, and piriformis muscle by sitting on tennis ball, end of a dumbbell literally changes the pain from night to day, but only temporarily.

How long have you been experiencing this pain? Almost a year now. Literally was crippled for about 2 weeks without being able to walk...and took about 7 months of physical therapy before I could even walk without a limp.

[Prophylaxis]

Thanks for the response! Yes straight leg raises cause pain both lying and standing from my lower back (upper glute) to my hamstrings mostly on the left side/leg.While sitting it hurts if I sit straight with my feet flat on the floor and if i try to arch my lower back. Standing straight doesn't hurt my back, but trying to arch my lower back causes pain in the same areas as doing the leg raises. Regarding the picture you posted, there is pain while bending forward, left and right side bends don't hurt however and left and right rotations hurt in the same areas.

"what do you mean when you say bending your knees relieves it?"
While sitting with my feet flat on the floor, if I bend my knees and bring my feet back the pain subsides. Also while doing straight leg raises both standing and lying.

Additional info: my hamstrings are very tight. I am quite tall so I have had a bad sitting posture for quite a few years already.

Hey Brahhh,

I had to think about this one. I agree with the surgeon that it sounds like a ‘lumbar strain’ as in a joint strain, more than any other structure in the back like a disc or muscles. They can go away on their own, but if it’s still bugging you, it could mean that the joint is continually getting irritated by the activities you do or your posture.

Here’s what I recommend, the following 3 simple exercises AND for the next couple weeks try not to provoke the pain (e.g. arching back, sitting up straight or lifting your leg straight…etc), that will give the area a better chance of settling down.

EXERCISES

#1 Knees to chest stretch- 10 sec 10 reps. Always lift one leg at a time going in to the stretch.
http://www.topendsports.com/medicine...ack-supine.gif

#2 Lumbar rotation stretch (make sure you’re not arching your back, so as not to provoke pain), 10x 10sec
http://www.hardcorebodybuildingonthe..._off/trunk.jpg

#3 Thoracic spine stretch- there are many ways to do this one…e.g. using foam rollers etc… you just have to make sure you keep your knees bent (like this guy) to protect your low back.
http://www.scody.com.au/data/images/...%20stretch.jpg

AND FINALLY, this is a progression- only do this one if you’ve already done a week of the others and you’re feeling a bit better
#4 Active straight leg raise with muscle contraction

You described pain in your back when lying down and lifting your leg up straight. There are different muscle groups that can support the low back to protect the irritated joint. If you figure out how to use them, it can really help your back problem.

The point is to figure out which muscle group is most helpful by squeezing the muscles, then doing the straight leg raise and seeing if the pain is gone.
First try squeezing your abs- gently is better, and keep breathing…. then straight leg raise…see what happens
Next try glutes, try not to arch your back then, straight leg raise…see what happens

Next try tucking in your pelvis (also uses abs), then straight leg raise…see what happens
When you figure out the right one, do as many pain free straight leg raises as you can (5-6 to start is good). Go slowly and keep breathing, and that will be your strengthening for the area around your strained joint, add a couple reps each day- ALWAYS pain free. If you can’t do this one pain free even in a week, let me know and we’ll work it out.

Talk to you soon,
Prophylaxis

[Prophylaxis]

no the pain gets neither better nor worse when i bend forward and put my chin to my chest. also of those movements only flexion and extension hurt. today is actually a better day though so the pain isnt terrible, i just know if i were to go play some intense basketball or something than id be in a world of hurt and those movements would hurt even more.

Thanks Prophylaxis I hope to hear from you soon.

Hey Youngbuckets5,

Hmm tough one. Good that it’s feeling better today- sounds like it gets provoked by the harder activities… I am thinking that strengthening the smaller muscles that support the back would help build up the endurance/ tolerance in the area.

I would suggest starting with glutes exercises, making sure you’re not compensating with other muscle groups in the area like hip flexors, or bracing with your abs. This is sometimes what the body does over time when there’s a lack of endurance in the low back….that can be part of why the problem is persisting.
The guy in the picture has a hand on his hip while doing a clam exercise- you can do this to try to feel if hip flexors are overworking.

http://www.physioadvisor.com.au/asse...6(400x400).jpg

It’s also important to keep good mobility in the upper back
There are many ways to do this one…e.g. using foam rollers etc… you just have to make sure you keep your knees bent (like this guy) to protect your low back.
http://www.scody.com.au/data/images/...%20stretch.jpg


I don’t think these will make a difference immediately because you’ve had the problem for a while. I suggest you try these daily for a couple weeks, then we can see if it’s helping at all and give you some others.

Talk to you soon,
Prophylaxis

[Prophylaxis]

Hey PT brah hoping you can help me out:

Body Chart: (Where exactly does it hurt?) - Neck - right side, starts just below where the necks meets the skull and goes down to around the shoulder area.
Age: (How old are you?) 25
Mechanism of injury: Strained my neck doing overhead press about 12 weeks ago and was barely able to move neck from side to side or up and down. Took about 8-9 days before it recovered to the point i could get back in the gym, however it still gets tight and has mild pain pretty regularly. My range of movement isn't restricted at all, but the tightness/pain is just annoying and i'm paranoid of re-injuring it so have been going easy on the overhead pressing movements.
Aggravating factors: What makes the pain worse? Gets worse if i don't move or stretch it for a while, is usually worst first thing in the morning.
Easing factors: What relieves the pain? Stretching helps a bit.

Thanks!

Hey,

Sounds like you strained a muscle, and you’re doing all the right things to take care of the problem, like stretching and reducing the weight on overhead press.
You’ve regained your full range of motion, and you haven’t said anything about pins and needles or pain down the arm- sounds like a good recovery so far, but it should take about It should take about 3 weeks to get back to normal, as you keep gradually increasing your weight at the gym.

Exercises that can help prevent this in the future are scapular control exercises- you can start the ones in the picture 3sets of 10 daily.
I would also suggest seated rows and lat pull downs in the gym making sure your shoulders are back, with your back straight (not cheating by arching your back at all).
http://i1.ytimg.com/vi/CJK6fDKjlko/hqdefault.jpg

This one is also a good protective neck stretch
http://www.capognachiropractic.com/i...k_chintuck.jpg

If you do these exercises regularly, progress your gym work gradually, and keep up your stretches, you will be doing your best to prevent this in the future.

Let me know how you go,
Prophylaxis

[Grevl]

Hey Grevl,

Thanks for being patient - been a BUSY week at the clinic!

I want you to take it easy on the hanging knee raises, planks and broom stick shoulder ?'dislocations'. (I assume this doesn't involve dislocating your shoulder). Sounds like you back doesn't respond well (at the moment) to anything involving bending over or sustained flexion.

Do you experience any pain performing these?

Sup brah

both of those feel fine, in fact that 1st one along with hamstring stretch and knee hugs is what relieves the pain.

The shoulder dislocations is where you hold a broom, wide grip and raise it to the sky and back down behind your back, and back round again. Its supposed to improve shoulder flexibility

As of now my back still feels fine, the new routine either seems to be helping fix it, or just avoiding putting stress on it.

I forgot to mention, the times that my back goes to a state where its very stiff and painful, is usually when it is fatigues in the 1st place (maybe why its not hurting currently, no lower back training when working out)
The last time i had the serious pain was i think after leg presses about 2 months ago.





One other problem i have noticed, is clicking in my shoulders *no pain or anything

just trying this test


and my left hand behind back is fine, but my right hand behind back barely makes it half way up my back. Do you know what exact muscle i would need to stretch to fix this?

Cheers


Edit: Im also getting slight pain in the shoulders when hanging. The same for when stretching my lats, i pull on something and my shoulder gets pulled away from me and hurts a little