T Nation

Dr. Ryan- PrimeTime

Time for another round of questions.

Only an hour tonight, but I’ll be on for three tomorrow, so feel free to post.


Doc, I’m on the same schedule. Why must you copy me?


I’ve always aspired to be just like you…

Except for the whole Canadian, atrophied, goofy looking thing you have going on.

Try answering a PM now and then.

I look forward to seeing you at the Staley Bootcamp.

I hope everything is going well for you in Canada.

Take care,


hey doctor,

 never got around to pm you, but i go back to the doctors tomarrow about my kne sprain.  it feels alot better after the week of rest and ice.  still swollen  and still a little pain, but i should be back in pads monday.

ill let you know how the appionment goes

I just got out of the hospital for meningitis. How long before my back stops hurting from those damn (3) spinal taps? Should I take extra care with my back? How long before I really get back into heavy lifting?

(My Dr`s here dont speak my language and dont know how to treat athletic women)



Keep me posted and if you have any questions after the appt, feel free to ask.

Take care,



What kind of pain are you having?

When was the last procedure?

Is there any pain/swelling/redness around the puncture site?

Do you have any headaches?

How long have you had the meningitis/treatment, etc?

Take care,


Dr. Ryan,
A friend of mine in Tae Kwon Do blew her ACL. It has been 6-7 months since surgery. She is able to do everything in the sport except maximal jumps/speed movements. She said her Pys therapist is really good but is stumped because she still has a lot of knee pain and her quad muscle is only at 48% of her other quad. The PT keeps telling her she has to fatigue that muscle when doing her exercises to make it grow but when she experiences pain, she can’t push it any further.

I told her to also focus on her glute strength because I find that athletes with limited glute strength tend to bend the knees forward and tuck the “tail” because they have no ass to stabilize. She is definately staying away from knee extensions which is a good thing. she does leg presses and does bike, stair mill and elliptical. She also said she does light squats… which I should have watched her do because I bet she is bending at the knees and not the hips, again, no glute strength (possibly).

Any other tips to give me to help her out. She is very frustrated right now and her PT is stumped as well. Thanks for your time



Does she have full ROM? What about swelling?

Where is her pain located and what exercises seem to produce the pain?

Does she have hamstring weakness as well as quad weakness?

Was the ACL the only problem or did she have other issues as well?

Take care,


no swelling. think the pain is located at the apex of the patella. But she got the tendon removed from her patella. Think it could be scar tissue related?

I will have to ask her on the hamstring weakness. thanks for the input

[quote]Dr. Ryan wrote:

What kind of pain are you having?

My back/neck is really tight and at the puncture sites it feels like I have been punched.

When was the last procedure? My last spinal tap was 3 days ago.

Is there any pain/swelling/redness around the puncture site? It is bruised and swollen.

Do you have any headaches? I still have a headache and dizziness. I guess for another week or so?

How long have you had the meningitis/treatment, etc? I got out of the hospital 2 days ago and have had meningitis for about 1 1/2 weeks now.

Take care,


Thanks again. I cant tell you what it feels like not to be able to speak to your doctors in the same language.



Dr. Ryan:

Did something the other day at foosball practice. Coming in and out of my breaks I noticed a pain that has slowly been getting worse in my HEEL. (I don’t know what these little things are ) At first it felt like a bruise on the bottom of my heel and when it strikes the ground cutting backwards and such it felt like I bruised it instantly again. Then I was cutting out of a break and I started limping and the bottom inside of my heal felt soo bruised I couldn’t really put my weight on my heel when walking. I am having to walk on my toes because my heel hurts. I noticed when I took off my shoes and socks I have a little spot of blue and some capillaries it look like on the inside of my heel.

It hurts and I’m going to see my trainer but what the hell is it?

I also included a foot picture. The foot is not mine but I circled where the bruise is and the bottom of my heel feels horrible bruised.

I just wanted to add one more thing in. When I do put pressure on it… It feels like pain or whatever is going up the inside of my heal.

Right not my heel feels swollen but it does not appear to be.

-Get Lifted

The time difference made me post too late last time, so I will repeat my q on this thread:

Hello, Dr. R,

What long term consequences can I expect from squatting given that I have lost the cartilage in my left hip due to a rugby accident? Rehab work was basically gluteus exercises. I can go down to close to parallel before my pelvis starts to drift to the left.


So she had bone-patellar tendon graft. That could possibly explain her pain.

Some people refer to the pointed bottom part of the patella as the apex. So is her pain at the bottom of the patella where the graft was harvested or is it at the top of the patella?

Also, you said she is six months post surgery, when is her next post-op follow-up appt?

Take care,



What type of meningitis did you have?

Some of your symptoms are probably due to the disease process itself. Stiffness and aching are common.

Usually you only have to avoid strenuous activity for a few days following a spinal tap. It sounds like the area is irritated due to the multiple tests. The bruising will heal like any other bruise. The main thing is to make sure there isn’t any redness/swelling/heat or drainage (pus) that could be a sign of infection at the site.

Since you have Internet access, I would suggest that you do a Google search for meningitis. There are many sites that should be able to provide you with information about the disease/recovery.

If you have any questions, please let me know.

Take care,


hey, doctors didnt go as i would have hoped.

He said something has a tear in it but im not sure what is torn. its a band that goes i think from my femur to my tibula. i think he said the ibulatibula band or somthing.

he said it takes 6 weeks to heal. i was hopeing to come back next week, but that aint happening

Get Lifted,

Well there are quite a few structures in the area. It could be related to tendon/ligament/fascia irritation.

Do you have low arches or problems relating to pronation?

Is the pain more on the bottom of the foot or on the medial side?

Take care,



What kind of injury did you have?

If you have a loss of cartilage, I would recommend that you use a good glucosamine supplement to help maintain the remaining cartilage.

As for how squats would affect you condition, it would really depend on how much cartilage is gone and if there is significant bone/bone forces due to loss of joint space.

Obviously squats will create a compressive load on the hip joints, which could potentially irritate the hip. However, the increased loading is performed for relatively short duration. I would think that long distance running would be more problematic.

Are you performing squats currently? If so, how does the hip feel the next couple of days?

Take care,



From your post, it sounds like the Doc thinks that you tore your ITB (iliotibial band). Did he say anything about your LCL (lateral collateral ligament)?

What kind of symptoms are you having right now?

Have you been able to practice or perform any kind of running or exercise?

What do feel most limited in and what gives you the most pain?

Take care,


I think I injured my lower ab while sprinting and making abrupt stops
the pain was in the left side of the pubes.
I looked around and I believe I have a sports hernia.

I stoped running and lifting till it healed now I’m pain free but I want to strenghten that part of my bod.
how do I do it?
I still feel it’s hurt when I’m sprinting smoetimes but absolutly no pain, my brain just knows something happened.