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Samantha Inman
09-23-2012, 11:04 AM
So I'm looking for some advice/at-home PT I can do for my knee injury. I am a horseback rider (mostly Western, but I experimented with English) and I had a knee injury when I was 18 that I have been trying to figure out for YEARS....I have had MRI's, xrays, numerous doctor visits and they all told me there was some miscellaneous swelling, but no torn or scarred ligaments/tendons so there wasn't anything surgically they could do....and although there's some minor management through braces, I haven't been able to FIX it, or IMPROVE it....not to mention the braces are really movement-constrictive. I finally figured all of this out after consulting with a trainer at a previous box, who also happened to be a licensed PT.

I found an article that explains what happened to my knee as it happens to all riders over time; however keep in mind that this all happened in one really bad injury that had me limping for weeks, unable to take stairs, and unable to singularly bear weight on my left leg. I can explain the injury in detail if anyone wants, but if you're not a rider you probably won't get it :/

Over the years, this pressure causes the medial collateral ligament to tighten and the lateral ligament to weaken and stretch. Disruption of either ligament shifts the tibia in the opposite direction, so lateral-ligament weakness results in deviation of the tibia inward (medially) to produce a bowed leg. Once the knee starts to bow, the stresses on the joint accelerate. When standing and walking the body presses down on the knee unevenly, with more weight borne on the medial surface of the tibia. The resulting compression of the medial meniscus causes inflammation in the joint and degradation of the cartilage that can eventually lead to osteoarthritis.

Now, it was an acute injury, so I don't have bowed tibia's, just a singularly compressed/inflamed medial meniscus. Because at the time I wasn't very active outside of horses, I was able to take a few weeks off, ice the crap out of my knee and load up on Tylenol and then slowly get back into things.

My knee "pain" was/is always at about a 3....I wouldn't call it pain exactly but I am aware of the joint itself. Its very hard to explain. However it didn't REALLY bother me until I started doing Crossfit. I was in it for about a year, but I wasn't really getting the results I wanted, partially because of my knee and partially because of my diet. In my year of CF, because I had no idea what was going on, I managed to make the situation worse and give myself full blown burstitis (pes anserine burstitis, for those interested). I took another 9 months or so off to try and figure out what I can do to work on my knee, and fix my diet. I have managed to figure out what my issue is, but other than basic/initial after-injury care, I haven't found anything that really explains how to improve on the situation or if it can be improved. I am without health insurance at the moment so I can't head over to my local PT office. I have browsed the MWOD archives but haven't managed to find anything that tailors specifically to this kind of problem.

If anyone has any advice as far as ROM exercises or personal experience it would be SUPER helpful!

Brian Strump
09-23-2012, 11:24 AM
While not familiar with this way of getting knee pain, I think you can't also full ignore the rest of the twists,sprains and compensations that occur along the way.

Just looking for what may be the cause, but disregarding the mobility of your hips and ankles, and hip strength may leave you with future problems.

Samantha Inman
09-23-2012, 12:28 PM
Just looking for what may be the cause, but disregarding the mobility of your hips and ankles, and hip strength may leave you with future problems.

Well, I think the future problems are already here. Because no one was able to figure it out, and I stupidly assumed when a specialist tells me that they can't find anything wrong with me that there IS nothing wrong with me, I kind of went on about my business until things, like back squats, would leave me limping. So I think no matter what I do I'll probably have some degree of arthritis in my knee eventually.

I also know that this injury is throwing everything out of whack--again, the braces work well as far as keeping everything in line and moving the way that they should...but if you've ever tried running or squatting or jumping in a heavy support brace, its almost impossible to do, so strength building is hard. Riding has given me great flexibility in my lower joints, which is why I think I didn't have more of an issue after I "healed"

I have tried doing 2 days off/ 2-3 days on with the brace and that seemed to work, but if I can, I want to get away from it completely.

I will say that after some manual work the other day my knee did pop and it felt better temporarily.