I've been going to doctors and pt's for 8 years. Seen at least a dozen doctors and dozen pt's. It feels like my legs are out of alignment, like the upper and lower legs aren't oriented with respect to each other correctly.
Every time I go to a doc or PT, they tell me that I only have minor issues, glute weakness, lack of stability, but it feels like major issues. I do glute work, stabalization work, etc, and nothing changes. In fact, everything only gets worse, slowly but steadily.
I've consulted with well known names in the mobility game, and they've not been able to help.
How do I find someone who will actually stick with me and help? I've tried the conventional doc/PT route, and it's been a utter failure. I have less than nothing to show for 8 years of work.
I'm about to snap. Doctors don't care to do any digging into my issues. Neither do PT's. They just plop me into a set formula/program, and if that doesn't work, they send me away.
That's kind of what it feels like. All the things PT's tell me to do provide NO improvement. It feels like things are in the way preventing other things from working properly, rather than the other way around.
No doctor, in probably a dozen plus, has diagnosed me with knocked knees. Though one PT, in a dozen or more has.
First of all, you haven't given us any information about what's actually wrong besides saying my knees are out of alignment. Are you having knee pain? are they limiting your function? Or are you just mad they are out of alignment for aesthetic reasons.
No offense but you come off sounding like a hypochondriac. Once you let symptoms or issues take over your entire life you lose hope, stay positive and focus on other improvements aka function.
You've consulted with all the well-known names in the game, yet continue to blame all them for your issues. Sounds like you might need to take a look in the mirror and start taking some accountability in your life. If your legs are out of alignment and not causing problems then jimmyity crickets I bet half the forums would take that over most of their current issues. You gotta deal with the hand you've been dealt. Most knee alignment issues stem from the foot or the hip, Have you had anyone examine your feet or have you tried any orthotics?
BHOLL, I've read some of your posts and it's a safe bet you know your stuff. Since you're fairly new to this site, there's some things I'd like to point out.
Although the purpose of the Injury Subforum is well-intended, it does, unfortunately, attract the following:
1) People who actually do NOT want to get better. I know this sounds absurd; however, there are those who subconsciously do the exact opposite of what's necessary in life.
My best guess is that, by suffering from their respective affliction, they now have an excuse to NOT reach their goals. Some of these people actually relish their self-imposed martyrdom.
NOW, OP - understand that I'm NOT accusing you of being in this category. Whether or not you are, I'm not sure nor do I care. For now, I'll keep what my instincts are telling me to myself.
2) There are also those in this forum who do want to improve their situation yet THINK they know how to fix it.
Well, this begs the question: Why are you here?
Basically, these are the folks who ask for advice and, if what they hear doesn't match their preconceived notions, will dismiss any advice you give them. Or sometimes they'll just pick and choose the aspects of what you tell them that they like. IME, this approach rarely yields optimal results. A highly skilled and experienced professional writes out a comprehensive program knowing that the whole is greater than the sum of its part. To take a bit here and a bit there often ruins the integrity of the program.
These folks also tend to display an entitled or even argumentative attitude.
Recently, a guy in this subforum tore his pec (in addition to a groin injury earlier in the year). Not only did he ignore my offer to help his groin injury, he balked at anything else I advised because I didn't bench/dead/squat to his standards. Rather than trying to debate such a moronic line of thinking, I decided to have fun with him; I challenged him to a 1-on-1 meet, about a year from now, in his precious little lifts (after he heals, of course) for money. Comically, he back-pedaled. Shit-stains like this are the rarity. But don't be surprised if you meet others like them. He'll no doubt return with another set of injuries in the future (either under his original account or as a ghost).
3) And there are those who, thanks to some horrendous advice (sometimes given by the very authors or the "celebrity" posters on this site) have gotten injured and they genuinely do want to get better. These people, I wager, are the reasons you contribute to this subforum. Just know that they're in the minority.
Ultimately, I can't and won't tell you who to advise and who to ignore. I will say that, in the 3+ years I've been a member of this forum (and several years more as just a lurker), I've seen a handful of very very impressive posters leave. Although they never gave specific reasons, I suspect they eventually reached a conclusion that the headaches of dealing with category 1s and 2s did not justify the time to reach out to the 3s. Call me jaded, yet I wish someone had given me similar advice when I first started advising folks here.
I have genuine problems. I have tons of crepitus. Chondromalacia diagnosed via MRI. Some fluid on the knee. Partial tear to left quad tendon per MRI - since repaired. Occasional pain, but not severe. So the hypochondriac thing is out.
I know it sounds odd, but my legs look and feel different than they used to. Yes they're less muscular, but that's only because of the problem has set me back quite a bit. The very shape of the muscle is very different, as is the location of the patella, and the fat pad below the patellar tendon.
And it feels like my legs are going to buckle inwards, particularly any time I'm on one leg.
I've been to PT's who say everything is fixed, and not a single symptom feels better. So not wanting to get better is out.
And physical therapists regularly tell me that I can do their exercises as well the best of their patients, so can't really offer me anything more. Again, this shows that it's not not wanting to get better. I do what they say, and they give up on me.
On the positive side, it looks like I can do TBDL's without too much trouble. Only did it once, and didn't feel great, but didn't feel anywhere as uncomfortable as squatting. Or as hard to maintain an arch as when deadlifting.
The "best" PT I saw eventually told me, in essence, that I was delusional. I did learn some things that were beneficial, but only for other parts of my body, torso/shoulders, but none of it addressed my actual complaints.
Things we can't change: Crepitus-most people have it, nothing we can do for it Patella-femoral damage already done (cartilage) Repaired left quad tendon location of the fat pad shape of the muscle
Things we can try and address:
Fluid in the knee-try wearing a rubber knee sleeve with exercise and 1 hour post, it may help to prevent fluid fluctuations while also providing some proprioceptive input aiding in stability.
Knee Buckling-we need more info, stairs, do you feel a loose body is it bilateral? What stabilization exercises are you performing to address this issue, it sounds like you need to learn neuromuscular control of the knee. Are you performing single leg variations promoting co-contraction?
Why do you allow your knees to ever go in because a.) it causes you instability and b.) it places your knee in a vulnerable position to be injured.
You only have occasional pain?? I'm sure most people would take that any day of the week.
C.) Why are you squatting ATG? You realize this is horrendous for your meniscus and cartilage, I would't have uninjured people do this, let alone someone with a partial quad tear and knee pain. Other than that your squat form looks decent.
Have you ever considered your patella tracking? Have you ever taped your patella?
Fluid isn't really an issue. It's not visible from the outside, but some doctor did an ultrasound that showed some minor accumulation.
My knees don't actually buckle. However it feels like they are already buckled inward, and are stuck there. It feels like the lower leg has rotated out of position or twisted with respect to the upper leg, or the other way around. The end result is that even when my knee is directly over my toes, it still feels like it's buckling inward. My knees always feel extremely vulnerable.
Single leg stuff makes the sensation far worse.
I don't allow my knees to go in. In squats I have always made an effort to keep my knees at least in line with my toes and have better form in that respect than almost anyone I have ever seen in any gym in 10 years.
I wanted to learn to do the olymptic lifts. That's why the ATG. And I've heard parallel squats are worse for knees than ATG.
As far as the squat goes, your right its controversial. A recent review was published on pubmed citing there are no increases in risk during a deep squat with the use of the monosynaptic reflex and soft tissue bounce at the bottom. As always in science, there is an opposition:
Force platform and kinematic data were collected to calculate pEKFM. To assess the differences among loads and depths, a 2-factor (load and depth) repeated measures analysis of variance with significance set at the p < 0.05 level was used. Squat 1RM significantly decreased 13.6% from the above-parallel to the parallel squat and another 3.6% from the parallel to the below-parallel squat (p < 0.05). Net peak external knee flexion moments significantly increased as both squat depth and load were increased (p ≤ 0.02).
As far as my own opinion: It makes sense, touching your butt on the ground is worse then going to parallel or just above parallel and I'd be nervous if I have a repaired quad tendon already. You have to make your own decision in this manner.
What single leg stuff are you doing, you just say stuff. Are you doing static closed chain exercises? Or are you a cross fitter that tries and do pistol squats?
Taping? have you tried taping
The fluid in the knee is a problem, as it can be a main contributor to pain, which can then lead to decreased muscular response.
Again, what activities are you doing where your knees feel unsteady? Just squatting? Running? Jumping?
You don't let your knees go in but are you actively externally rotating the femur on the eccentric portion?
Anything on single leg. I don't do much specific single leg stuff. I'm seeing a pt right now. I CAN do a full pistol on my right leg, and barely on my left. But it feels TERRIBLE. Not painful, but dangerous, like I should not be doing it.
Any time most of my weight is on a single leg it feels dangerous.
Taping is the only thing that has EVER helped, but even that was very minor improvement.
What feels unsteady? Everything. Literally. No exaggeration.
External rotation during eccentric portion? Don't know. But I do know that no matter what I do squatting feels terrible. If I push my knees out on the way down it doesn't change the way it feels at all.
If you can do a full pistol squat on your left (im not sure why anyone would ever want to do a pistol squat) then you may want to initiate Closed Chain Single Leg Stabilization exercises. The best way to improve single leg stability is by working on single leg stability. Initially the exercise should be static with 30 degrees knee flexion as this promotes the greatest recruitment of the quads and hamstrings and on a stable surface and progressing to dynamic exercises on an unstable surface. If your seeing a PT ask him if your patella is tracking incorrectly and to try mcconnell taping, if that works you can order a brace that will hold the glide better. Has the PT ruled out ligamentous injury? Or Meniscal as giving out is common signs, MRI's aren't 100 % .
If your not going to provide specific examples then dont bother answering, you continue to just say everything. Details are important in biomechanical issues, just saying o my knees feel like they're going in doesn't help.
You should learn how to externally rotate the femur on the eccentric portion of the squat, google it. Have you tried other squatting variations?
Just because they thought, doesn't mean its not true, are you seeing a PT? Ask them to perform some ACL testing (lachman, pivot-shift) and some meniscal (stand-pivot, mcmurrays, joint line palpation). Did they perform bilateral hand held dynamometry to test quad strength differences bilaterally? Have you considered your feet???? Does your knee cap feel like it will dislocate? How long ago was your MRI? What kind of stability program are you doing?
And yes I mean rotating, not spreading, by actively engaging your your external rotators and abductors.
They are inter-related, remember instabilty can lead to mis-alignment and increased Q-angle.
of course squatting goes bad, you think squatting feels as good to me as when I was 18!!! heck no, I wake up feeling sore all over.
By squatting feeling perfect, I don't mean it doesn't make me sore. I mean it felt good. I felt stable. Everything felt like it was in the right place, and it felt natural. I was weak, and I've always been weak on the squat. But there was a time when it still felt great. Even when doing 20 rep breathing squats and being sore for 4 days afterwards. I'd say it still felt great.