Dr. Ryan -PTime 6/19-6/20

Bigger Stronger Leaner Competitive Bodybuilding
21

[quote]Dr. Ryan wrote:
leon79,

Did you get evaluated at the time when you fell down the stairs. If so, what was the diagnosis? Did they do any X-rays or diagnostic testing?

Ryan[/quote]

No, a lifetime without medical insurance has left me without a formal diagnosis. No treatment was sought at the time of the injury or any time since. Because this has never been a major problem, I never mentioned anything about it to a doctor. But now I feel it deserves my attention.

Basically, standing in one place for any length of time and lifting anything with an arched upper back are the major contributors to pain.

22

Get Lifted,

Thanks! Definitely ask Eric, he has a wealth of knowledge not only from his studies, but also through his ‘in the trenches’ work with the athletic program. It’s always nice to see how theory and practical application mix. I’ll be sure to look for his reply.

Take care,

Ryan

23

Dr. Ryan, I have pretty good hamstring flexibility sitting back and down(like squatting deep or doing gm’s). I am extremely INFLEXIBLE however in my hammies when bending downwards towards my toes; like when performing a stiff-legged deadlift.

Does this make sense that I could be tight in one aspect of my hamstring mobility but not another? What are some good stretches for this tightness. The usually hamstring stretches that involve sitting back dont seem to work. Currently I have been doing dynamic stretches such as inchworms.

24

WiZlon,

If you are going to see a sports med chiro, then he/she should be able to do an orthopedic assessment of the knee at the same time.

The creaking with squatting down could be chondromalacia patella or some early arthritis. Chondromalacia patella refers to irritation of the cartilage on the back of the knee cap. It can be caused by patelllar tracking problems or excessive patellofemoral compression. Again, the doc should be able to evaluate this.

The most serious thing that I would want to rule out with regards to the clicking when you stand and pivot, would be any kind of meniscus problem. If the clicking can be reproduced with orthopedic testing that stresses the meniscus, then that may suggest some involvement. However, the fact that it is non-painful and doesn’t seem to affect your normal activities, would suggest that is is not a serious problem. More significant meniscal injuries would result in pain, joint locking or giving way.

Keep me posted on what you find out. There may be more I can suggest once you have it checked out.

Take care,

Ryan

25

leon79,

The area you are referring to sounds like the thoracolumbar junction region. This is the area where the thoracic kyphotic curvature is starting to change into the lumbar lordotic curvature. Due to this, the area is exposed to quite a bit of stress.

Excessive standing as well as the extension (arching) can overload the facet joints as well as the paraspinal and supporting musculature.

I would suggest that you get evaluated by a good sports med chiro. They should be fairly economical and may even be willing to take an X-ray of the area for little extra charge.

What exercises have you been doing to try to help the problem?

Take care,

Ryan

26

leon79,

The area you are referring to sounds like the thoracolumbar junction region. This is the area where the thoracic kyphotic curvature is starting to change into the lumbar lordotic curvature. Due to this, the area is exposed to quite a bit of stress.

Excessive standing as well as the extension (arching) can overload the facet joints as well as the paraspinal and supporting musculature.

I would suggest that you get evaluated by a good sports med chiro. They should be fairly economical and may even be willing to take an X-ray of the area for little extra charge.

What exercises have you been doing to try to help the problem?

Take care,

Ryan

27

Helix,

Check back tomorrow, I will answer your question in the morning.

Take care,

Ryan

28

Dr. Ryan…I hope you’re still on.

I told Mike Robertson about some knee problems that I am having, and he suggested that I contact you. I am receiving Graston treatments on my right thigh. It hurts like hell, but the muscles seem to be “freed up”. Only my right thigh is being treated b/c of insurance (I have a slight tear of the patella tendon on my right knee). I have been working my VMO on both legs address tendonitis but now my right VMO is noticeably bigger than the left. I am really worried about an imbalance now.

What do you think about Graston? Is it smart to be working on the thigh muscles? The PT says my patella is very high on both sides. I have very tight hip flexors and my glutes are not firing properly (anterior loading big time). Any advice on fixing those issues? Thanks for your time.

BTW, I am trying to set up an assessment with Mike Robertson as he just moved to Indianapolis. I will have a much better idea of my problems after that takes place.

29

[quote]Dr. Ryan wrote:
Jeep69,

Sorry to hear about the problem.

From what you have said there was no acute trauma to initiate the inflammation, so you would think it must be related to the accumulated strain/stress from the calf training in addtion to your running. What kind of running volume have you been doing? Has it changed recently? Also, what calf exercises have you been doing and at what freq/intensity/volume?

What kind of warm-up/stretching program do you do?

If it was swollen as much as you indicated, then use ice only for 72 hours and then do some combo heat/ice.

Use heat prior to activity, followed by a mild warm-up and some gentle stretching. Ice following activity.

I would take a few days off of running to give the injured tissue a chance to recover. You could do some cycling or swimming instead. Also, avoid calf training for 7-10 days and then start back with about half the volume/intensity. Do not do any intense stretching right now as you don’t want to further aggravate the problem. After 7-10 days from the initial onset, you can start with some gentle stretching and assess your tolerance.

Let meknow what kind of symptoms you have currently and what kind of activity/movements make it better/worse, and I may be able to give you some additional advice.

If it continues to bother you after you have rested it for 7-10 days, I would see either a chiro/PT/ortho to check it out. I don’t know how old you are or if you have had problems with it before, but you don’t want to develop a more severe problem involving the Achille’s tendon.

Take care,

Ryan[/quote]

the things that make it worse would be if I rotate my foor outwards or inwards- it hurts then. also if I point my toes down it hurts. it is more of a dull pain, rather than a sharp piercing pain.

If I try to do a calf raise it feels ok when I go up but when I come down it hurts.

Also- my big toe on that foot has kinda been feelin wierd as well-

What ya think???

30

Wow thanks alot Dr.Ryan. I can sprint short distances say 10-20 yds and not as i used to (i run a 4.6 40 at 215lbs) So should i be able to sprint again regularly, september is fast approaching :frowning: But either way thank you a million you took a load off of my mind.

Also i was offered a scholarship to a school in north dakota which i declined for a college in canada (ontario) to take pre-service firefighting ( they only accept 30 people out of over 1000 apps as it is now legislature that u must have this program to be a fireman) so yea life > football haha :stuck_out_tongue: