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Old 06-28-2007, 07:05 AM   #1
Darren Zega
 
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Another burning question for you all as a follow up to my flat foot question earlier:

In the past, on my flat footed side, I've the balancing act between hurting my knee and training. One time in particular, last September, I pretty seriously injured it and spent about a month not training my leg and then another two months in physical therapy trying to shake off the effects of atrophy from unloading it.

The muscles and tendons on that side are still smaller and weaker in comparison, and I'm starting to have some of the similar symptoms - joint pain in the knee directly behind the patella, pain in the tendons on the back of the knee and occasionally the inside - and as a result I've slowed my pace of training on it. (before you ask, I'm seeing an ortho and getting an MRI to finally get the ******* thing taken care of for good)

My major question is this, how much training is too much? Should any joint pain at all be cause to stop training and deal with muscle atrophy in the associated area, or should you balance your workouts, dealing with a little bit of pain and still training just to hedge off the effects of atrophy?
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Old 06-28-2007, 12:05 PM   #2
Trevor Thompson
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Knee pain can be hard to treat without actually seeing the way your hips, knee ankle and foot move while you run walk and workout. You would do yourself some good to go to a very good running shoe store and ask them what they think about your form and stride. they may tell you you have been wearing an inappropriate shoe all this time...You should also be doing some other things to help in muscle building, swimming perhaps, or cycling? running is high impact and not everybody is built perfectly to run a lot weekly. Ice that puppy for 20 min. a few times a day too, take some ibuprofin and i hope that helps with what could be some swelling there.

My knee can get sore from time to time due to my left foot being flatter than my right, i just fight through it ice it and take it as my body tells me, aching is just annoying, pain can be delt with, sharp pains are a no no to keep going on.

(Message edited by trevorthompson on June 28, 2007)
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Old 07-03-2007, 07:50 AM   #3
Darren Zega
 
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Actually, after an MRI and a few visits to a new ortho I finally got a good response. I'll post it in case anyone has a similar problem.

I found out that during some army training last summer I gave myself a grade two ACL sprain (partially torn). Thanks to the great people in my platoon carrying my gear, and a rucksack full of wadded newspapers, I was able to finish and my sprain healed...kind of.

As it turns out, my MRI showed that my ACL hangs loosely inside of the joint with a noticeable curve. My patellar tendon has been doing overtime causing moderate chondromalacia, which in turn has made the area prone to spats of pain, swelling and numbness.

Thankfully, he gave me the best Crossfit prescription possible, train through the pain!

As long as I want to stay athletic, I'll need to add isolateral leg exercises of the quads, hamstrings and hip-flexors in addition to all the rest of my activities. The key to it all being that I do these iso-lats for life, not temporarily.

Overall, it sure made me happy. I was certain I'd need tendon replacement surgery and saw myself in bed for the next three months, but not so. I'll take it easy and look forward to a slightly modified Anne tonight with my iso-lats added at the end.

BTW if any of you find yourself in NJ in need of a great orthopedist (plug coming), I highly recommend Dr. Robert D'Agostini (www.dhortho.com w/f safe). He caught what two other ortho's just thought was tendonitis.
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Old 07-15-2007, 10:45 PM   #4
Wayne Nelson
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Keep in mind that the quadriceps are antagonist to the ACL and Hamstrings are agonists. Squats place a very minimal stress on the ACL when performed at parallel or higher.

Also, Dysfunction leads to compensation, overload, injury and pain. The knee may not be the only source of concern.

The leg functions with the foot solidly placed on the ground, (not moving around, closed chain) so that is how it should be trained (e.g. squats). To improve reactivity (especially of the hamstring) and stability, you can train on unstable surfaces: rocker board, Bosu, foam pads, etc. (that's rehab, not Crossfit)
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Old 07-18-2007, 06:48 AM   #5
Paul J. Haber II
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I've searched the board, and hope I've finally found the right place to ask a question.
I'm 61 and seriously overweight( working on THAT as we speak). I love doing the WOD (scaled)but it seems every time I do squats (tabata, weighted, even squat cleans) my left knee begins to hurt and continues for about a week. Some swelling on the front interior aspect. Ice helps for about an hour, but only rest really works. OK--the question is (are) how do I strenghten the knee, and how do I modify the WOD in the meantime?
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Old 07-18-2007, 06:09 PM   #6
Elliot Royce
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Paul - I'm younger but old enough to feel your pain, literally and figuratively. I am doing a lot of squatting as I learn the O lifts and one of the areas that periodically hurts is just where you describe.

My advice, which may be useful only for me, is that you should continue what you are doing, emphasizing full range of motion. Start just air squats for about 5 minutes, then move to empty bar squats for perhaps 5-10 minutes, and then if you still feel good, try 90lbs on the bar. Don't try to do too much at first. If there is no (or less) pain after that, then move to a higher weight but continue the gradual warmup.

My O lifting coach never lets us start lifting till we have warmed up with air and light squats and done enough dislocates to get the shoulders warmed up.

Your enemy would be heavy weights in a limited range of motion so just make sure you avoid that.
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Old 07-18-2007, 08:10 PM   #7
Jim Gotti
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Hey Darren, thanks for the follow up post to your orignal. Nothing worse than seeing people post how they fixed their issues but never explain how.

I am also in Jersey, so that ortho reference is appreciated in case I get tired of my doctor's abruptness and never explaining anything to me. :dunno:

I'd like to second what Wayne said "The knee may not be the only source of concern." As stated in another post on here, I had acl recon back in 1993 and it started to act up within the last 3 years, however it was a result of flat feet (now wear orthodics), weak VMO/Quads, even weaker hamstring and completely lack of flexibility. All of that just lead to disaster for my knee, and all the while it was blowing up with water and in the beginning I just thought it was how my knee was going to be and it turned out it was just the end result of everything in my leg going awry.



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Old 07-18-2007, 09:47 PM   #8
Wayne Nelson
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Jim, It is interesting you note the VMO after an ACL tear. All the so-called "altered motor control as the result of an injury" research began from recurrant knee injuries. They found that after knee injuriesa slowing of the VMO which did not resolve after the pain was gone and back to normal activites. The timing of the VMO could actually differentiate who had a previous injury and who didn't. After correction of VMO timing reinjuries decreased significantly!!
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Old 07-20-2007, 08:27 AM   #9
Darren Zega
 
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Wayne,

Thanks a bunch for the tip. One thing I've found after getting strength back in my hams and quads is that my calf is sorely lacking in strength compares to the good leg. I’ll keep your advice in mind as I keep looking for more of these little “gremlins” to pop out. Also, my dojo has this sort of inflatable, flat…squishy…pad thing (is that what a bosu is I guess?) that I can put under my support leg when kicking. I’ll add that to strengthen the co-contractors some more.

Paul,

Does your pain feel like it’s coming from directly behind the knee cap? If so, the big bad chondro probably loves you too. My knee would feel like there was a balloon inside of it and was in pure agony pushing the clutch in my car driving home from a workout. All of the above is great advice and does work. Just stay positive and be diligent about warming up and stretching post workout. My problems really came from something that should have been more minor because I was too determined\stubborn\stupid to stop and sit out.

Jim,

I’m glad that plug will help you. D’Agostini has the bedside manner of a rock but he’s the best there is. He’s also an athlete himself, former college football player, so he understands how we think. You might want to check another post of mine about flat feet earlier on. If you haven’t considered it, POSE running is an excellent way to improve your arches and regain strength in your weak flat feet. The drills included in the method have helped me tremendously.
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Old 07-20-2007, 08:44 PM   #10
Wayne Nelson
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Whenever you begin with labile surfaces, step back in the technical requirements, simplify the movements, establish proper control and balance, and then progress to the next level of difficulty.

Example: Stand on one leg; one leg and raise knee then touch the floor behind; one leg half-squats; half kicks; three quarter kicks; full kicks; half kicks with rotation...etc. Keep supporting knee cap over your big toe for proper lower extremity stabilization. (That's the hardest part)

A bosu is blue half ball with black platform on the other side. Foam works good, can be a bit too challenging though. Place a board over the foam and stand on that.
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