Yesterday's visit to the physical therapist

[Bosch232]

Some of you may recall my recent posts about knee trouble I began having about 6 weeks into the WBB 1.1 routine. I got in to see my physical therapist yesterday morning and we had a good talk about what's been taking place since I began WBB 1.1 around Christmas time. First, let me make it clear that what I'm posting is not a criticism of Maki's routine. It's not a criticism of anything, actually. I just want to share the whole knee pain thing so that it may perhaps help someone else in the future.

I took my workout log book in with me, which has all of the days' lifts in it. So he looked it over. By the way, he's also one of the p.t.'s for the Nebraska Women's Volleyball team, which hold three national titles in the last 15 years. I realize that doesn't necessarily impress everyone. My point is merely that he's not one of those fluff-and-duff, plastic-banana p.t.'s. They're all about athletics here, and they are a postural restoration clinic. (Link at the bottom of the post).

He had me show him my actual squat form there in the clinic. He also had me perform a few other strength tests to help him evaluate my strong and weak links in my legs. To get right to the point in laymen's terms: During squats, for my body and posture, etc., I've been doing them with too much weight on the balls of my feet, and not enough on my heels. What this has done is over-strengthen some groups of muscles in my legs, while others have been getting left behind. These muscles all influence the alignment of the knee joint in one way or another, and I've been gradually pulling my knees out of alignment. Let me re-emphasize that I'm only talking about myself. My bone structure, my posture, my lifting form, etc.

So he's given me two solutions. First was an analogy to focus on while squatting. He said to visualize trying to hold a piece of paper between my butt cheeks while doing the move. Amusing analogy perhaps, but it works and causes me to rotate the top of my pelvis more to the rear. And I'm only talking about minor changes in posture here. You probably would never spot this in a real-world video clip. So I did squats yesterday afternoon with this in mind, and it most definitely caused me to have my weight back on my heels throughout the range of motion. And today, this morning, I can tell because my legs feel sore in different ways than 'normal'. He also gave me some other unconventional exercises to also help those smaller lagging muscles catch up.

I'm confident this will help, and in a week or so I'll resurrect this post and report any results. One other little side note: My mention of the success of foam rolling also helped him zero in on the source of the problem. So thanks, ZenMonkey.

http://hruskaclinic.com/our-approach...l-restoration/

[Runty]

I'd be interested in what he has you doing. This sounds like something I've dealt with where I get some knee aches from squatting. I had some back pain a while ago which seemed to stem from a hyperextended lower back which I've now realized is caused by inactive glutes and some forward tilting of the hips. The clenching of the glutes while squatting seems like it would rotate the hips back more. I'm gonna try that and like I said, am curious to see what sort of improvements you see.

The reason I feel I may be a similar case is because after going to see a sports ortho about a clicking in my knee a while back, he said it was probably a minor case of something he called crepetus. It's where overly active/tight hamstrings were causing my muscles to pull my knee out of alignment and putting my patella into very brief contact with my femur,. May not be exactly the same, but sounds very similar to what you're describing.

[JSully]

toes up is what I tell myself when squatting.. by lifting your toes up, your weight automatically shifts back to your heels..

great writeup..

[ehubbard]

toes up is what I tell myself when squatting.. by lifting your toes up, your weight automatically shifts back to your heels..

great writeup..

This.

Also, do you stretch? More likely than not, some stretching will help solve this problem as well (quads, IT band, hip flexors, etc).

[Bosch232]

I'll see if I can scan and post the paperwork he gave me for the strengthening. But I want to remind you that he gave me these and assigned me to do them specifically only on one side or another. In other words, they're not symmetrical exercises.

To follow up from my OP.. The pain is not totally gone, it is now at about 50% of what it was. I have probably performed the phys therapy exercises about 5 times over the last week or so.

Toes up. Good analogy.