T Nation

Best Physiotherapist, Osteopath, Chiropractor etc.. in Toronto area


#1

Does anyone have any recommendations?

I am looking for someone who can help me with my patellofemoral pain preferably in London Ontario, or Toronto area. If anyone knows someone who is exceptional and very good please let me know. I have tried so much therapists and no one seems to be able to solve my anterior knee pain.

Its preferred if he/she has one or more of the following:
1) Knee expert, patellofemoral pain syndrome expert
2) Lots of experience
3) High profile, strong resume, and background
4) Located in London Ontario (Toronto area is okay as most of you will not know anyone in London Ontario)
5) SFMS/FMA certified
6) Biomechanical/mobility expert
7) Glute activation expert
8) Neurokinetic therapy certified


#2

Sounds like you’ve already trained the crap outta your VMO. Maybe you don’t have patellofemoral pain syndrome? A bursitis?

If you’ve been to that many therapists (they all read the same books) chances are you should consider referral to a surgeon.


#3

MRI shows nothing wrong tho. So orthopedic surgeon cant really do anything. Everyone says its patellofemoral pain syndrome (PFPS). Multiple physiotherapist, sports medicine primary care physician, and sources from the internet. My symptoms match PFPS and nothing else. Also, I have multiple risk factors for PFPS including anterior pelvic tilt, leg length discrepancy, tight IT band, decreased glute strength, overactive TFL, and quad dominant, plus my patella looks slightly compressed into the femur in my right knee (the painful one) compared to my left. I would imagine this is causing the crepitus and grinding and pain sensation of the lateral patella on the lateral condyle of the femur.

The pain seems to be coming from underneath the patella were it articulates with the laterla condyle of the femur. The left patella has more space between the patella and the femur on the lateral aspect thats why its not experiencing pain. I dont know why my right knee is experiencing pain when my risk factors should make both knees having pain? Maybe something else is going on I am not aware of…


#4

Right leg is typically weaker than left in my experience. Typically left side issues, knee back, tend to arise from faulty patterns, whereas on the right side it’s typically more of a pure weakness problem. Again in my experience, the glute is at the core of all of these problems. You can do all the foam rolling and whatever else you want, but if you don’t get the glute stronger it usually will only have so much of an effect. There is alot of discussion about glutes these days, barbell hip thrusts, Bret Contreras etc… But keep this in mind. It doesn’t matter how high up or how esteemed someone is. Getting weak glutes to work properly is one of the rarest of skills in the strength, conditioning and therapy realm. That is because the cues need to be perfect.


#5

Also, you don’t need a knee expert. You need someone that knows knees rarely have issues on their own and if they do, it’s usually a orthopedic’s fix. If they don’t know what’s going on it’s probably a hip issue. Find a glute activation expert. I’d bet that fixes your knee.


#6

Thanks Shadowzz4 for your advice! I will add that in to the list.

I have indeed read a lot in regards to glutes and bret contreras. I think my hamstrings were taking the workload from my glutes when I was trying to strengthen my glutes. I have to figure out ways to address this. One thing I noticed that seems to help a little is “smashing” (rolling out with lacrosse ball) the psoas, TFL, and top of rectus femoris near TFL than stretching rectus femoris/hip flexors right before my glute strengthening/activation workout. I also try squeezing the glutes as I perform my strengthening routine. Even so, I think I might be overactivating my lower back and hamstrings still (but to a much less degree than before). I am starting to feel slight SI joint pain perhaps due to lumbar spine hyperextension during hip thrusts/glute bridges.

I wonder what the effect of doing electro-accupuncture on my TFL and psoas a few hours prior to glute activation/strengthening. Do you think that would help in terms of glute activation? theoretically it would allow those muscles to relax allowing more activation of glutes during glute exercises?

I have found a glute strengthening expert and patellofemoral pain expert named Chris Powers, but he is not even close to my area (he is in Los Angeles and I am in Toronto Area). He is a field leader in glute strengthening for patellofemoral pain syndrome. First one to link weak glutes to patellofemoral pain syndrome. He has a facility were they do biomechanical testing and physiotherapy protocols: http://movementpi.com/about-mpi/

It would be nice if I can find someone similar but closer to Toronto.


#7

Just to add.
I am able to contract my glutes easily when ever I want them to. For example as I am standing I can alternate between left and right glute contractions quickly or contract them to the beat of a song. Can I still have weak/inhibited glutes even if I can do this?