[Prophylaxis]

(06-09-2013 08:06 PM)Ensam Wrote:  

Nope, just started gradually. I only noticed it by accidentally bumping the sore spot then realized it hurt when I pressed on it. Thought I must have bruised it and not noticed and didn't think about it again. Then after a few months it got worse. No pain associated with any motion. No back pain or pins and needles. It did get worse after I started squatting heavy and doing deadlifts again. It doesn't hurt specifically when I squats/deadlifts but gets more noticeable a day or two afterwards.

Sounds like you might have a peroneal tendinopathy.

As your diagram shows, the peroneal tendons run around the lateral malleous. When these tendons become overloaded (excessive running/changing direction/jumping), microtears can occur, which leads to irritation, swelling and pain.

You want to strengthen the muscles and load the tendon to help the collagen fibres within the tendon reallign again and 'reset' so to speak.

Peroneals assist in ankle stability, so any balance exercises on 1 leg will help the peroneal muscles load and increase strength.

I would also introduce gentle calf raises, primarily loading through the big toe initially.

Taping is also great to help unload the tendons (think basic ankle strapping to unload the tendons) - http://www.physioadvisor.com.au/assets/2...0x300).jpg

Plenty of calf stretches as well - moving the ankle back and forth with towel.



Self release peroneals with foam roller, or self massage is going to be fantastic as well

Summary:

-1 Leg Balance Exercises - throughout the day
-Calf Raises through big toe
-Calf stretches
-Self taping/massage

Keep in mind, with tendinopathies - a bit of pain is OK. You want to load the tendon so it becomes stronger. Only STOP the exercises if the pain becomes more than 4/10.

Let me know how you go! - because you have had this for a while it may take a few weeks to notice any major differences

[bonkers]

(02-24-2013 02:28 AM)Prophylaxis Wrote:  

Hey fellas,

Just following up on how everyone is doing. How are the exercises going?

If there are any further questions, feel free to PM me

Hey Prophylaxis,

Just an update on my shoulder - I did the routine you suggested and did the occasional chin-ups / pull ups and my shoulder seems to have come good.

Thanks mate.

Cheers,
bonkers

[T and A Man]

From the PM about APT.

I work on mine every two days, typically as part of my warm down after weights. Typically after I foam roam my quads, hipflexors and traps, and a torsional stretch of the back, i then do the following 4 routines.;

Glute Bridge - raise for 2 deep inhales/exhales, lower to ground, but never touch ground.. x 10
Planking - on my elbows, alternate lifting each leg, each leg raises for 3 deep inhales/exhales, x 8 each leg.
Lunge stretch for hip flexors, then lift the arm on the side of the hip flexor being stretched and rotate - hold for 8 seconds - x5 each side.

The last was my previous message - in regards to treating my spinae erectors, I am currently doing a yoga table, then alternative inhale (dog), exhale (cat) 5 each.

I do this circuit 3 times.

So I am looking for

i) an optimal stretch, not strengthening, for my erectors

ii) what part of the APT corrective process should a foam roller (I also use a hockey ball on my hip flexors occasionally) be applied and where

iii) I described the acute soreness, not pain, in my lower back... more akin to DOMS, say the type I get in my trceips after I do 100 pushups. Is muscle soreness to be expected?

[Prophylaxis]

(06-12-2013 07:43 PM)T and A Man Wrote:  

From the PM about APT.

I work on mine every two days, typically as part of my warm down after weights. Typically after I foam roam my quads, hipflexors and traps, and a torsional stretch of the back, i then do the following 4 routines.;

Glute Bridge - raise for 2 deep inhales/exhales, lower to ground, but never touch ground.. x 10
Planking - on my elbows, alternate lifting each leg, each leg raises for 3 deep inhales/exhales, x 8 each leg.
Lunge stretch for hip flexors, then lift the arm on the side of the hip flexor being stretched and rotate - hold for 8 seconds - x5 each side.

The last was my previous message - in regards to treating my spinae erectors, I am currently doing a yoga table, then alternative inhale (dog), exhale (cat) 5 each.

I do this circuit 3 times.

So I am looking for

i) an optimal stretch, not strengthening, for my erectors

ii) what part of the APT corrective process should a foam roller (I also use a hockey ball on my hip flexors occasionally) be applied and where

iii) I described the acute soreness, not pain, in my lower back... more akin to DOMS, say the type I get in my trceips after I do 100 pushups. Is muscle soreness to be expected?

Great, thanks for clarifying that.

i) An optimal stretch for the erector spinae (ES) would be the posterior pelvic tilt - (just try a post tilt now and feel how the ES become much softer). I would also cease the planks until the muscle soreness resolves in the ES.

ii) I would use the foam roller for the quad muscle groups and hip flexors (as you have been doing) (don't bother foam rolling your back)

iii) As you know, muscle soreness occurs from over-recruiting a particular muscle group. In your case, you are most likely over-recruiting your ES (a muscle we don't want to get switched on!). I would cease the planks and really focus on post tilting the pelvis while continuing stretching the hip flexors to unload these.

If you strengthen and switch on the surrounding musculature of the back, the ES will generally begin to switch off and relax.

A lot of people I see in my clinic so way too heavy on 'core' exercise, and end up with hypertonic (overactive) abdominal muscles, ES, and as a consequence often develop this nasty ATP. Just relaxing these muscles initially seems to alleviate much of their symptoms.

As long as the yoga stretches are pain-free, they should be fine.

[xmlenigma]

You rock! I will write back with a certain issue Thanks in advance.

[CaptainChardonnay]

Delete

[dog24]

Hey prophylaxis sorry to bother you again seems like my doc doesnt give a fuck about me he said come see me in a month (i should be walking fine by then). Told me to only use one crutch now for maybe a week then walk normal, it doesnt hurt when i put all my weight on my leg but it feels weak, my leg looks like a toothpick now, also he didnt told me to go to a physio i started using the leg press por calves and seated calf raises also was planning on stretching with a towel. Got some advice on how to get used to using that leg again? Thanks

[We The Real]

Hey Prophylaxis, one question for you. Doctor told me i have "severe" arthritis in my right hip, i am 21. Until she told me this yesterday i felt much better by doing the stretches my physical therapist told me to for the past week, better than i have in months. Now this bitch told me this and idk if its my mind fucking with me but i "feel" it. I am going to see my pt tomorrow, but on your expertise, do you think ill be ok by stretching and working out alone? Am i doomed to a hip r surgery? Lots of shit running thru my head , thanks man

[Prophylaxis]

(07-01-2013 10:15 PM)CaptainChardonnay Wrote:  

Hey Prophylaxis,

Body Chart: Lower back, I think its the sacroiliac joint
Age: 22
Mechanism of injury: I was squatting my 5 rep, 3 set max and then dead lifting my 5 rep, 3 set max.
Aggravating factors: Bending down to grab something, sitting down (sitting on a toilet stands out), getting up from a chair, bending over to tie my shoe from a sitting position
Easing factors: Sleeping, lying down, I feel like working out the rest of my body helps
Date of injury: June 10

Does it hurt to bend down and touch your toes? Yes. Before I use to be able to bend over and touch my toes.
Does it hurt as you straighten back up from the position? No
Does it hurt to bend backwards? No
Does it hurt to side bend from the back? No



I researched online and I think I have "Issue #4" from this website.
http://liftstuff.blogspot.ca/2012/09/12-...ow-to.html
It says to do: "If your joint is currently out of place (read: in pain) then visit a physical therapist and/or a chiropractor to help you loosen the erector muscles and knock the joint back into place."

I really want to start doing squats again...

Sorry guys for the late reply!

Been flooded with work ATM


Hey CaptainChardonnay,

Do you have any pins and needles or numbness down the leg? Any pain down the leg?

Regardless, sounds like your back gains relief from 'extended' positions.

Try this exercise below - 15 times by 2.. every few hours for a couple days



Limit sitting for long periods (>30mins) and squats (for now)

Let me know if you get any relief!

(edit- the bolded text is a massive misconception and makes no anatomical sense - don't let these websites scare you)

[Prophylaxis]

(07-02-2013 04:31 AM)dog24 Wrote:  

Hey prophylaxis sorry to bother you again seems like my doc doesnt give a fuck about me he said come see me in a month (i should be walking fine by then). Told me to only use one crutch now for maybe a week then walk normal, it doesnt hurt when i put all my weight on my leg but it feels weak, my leg looks like a toothpick now, also he didnt told me to go to a physio i started using the leg press por calves and seated calf raises also was planning on stretching with a towel. Got some advice on how to get used to using that leg again? Thanks

Hey dog,

Just a few questions:
Are you able to fully weight-bear through the leg? Why do you still need 1 crutch? Are the repeat XRAY's all fine?

[Prophylaxis]

(07-02-2013 08:43 PM)We The Real Wrote:  

Hey Prophylaxis, one question for you. Doctor told me i have "severe" arthritis in my right hip, i am 21. Until she told me this yesterday i felt much better by doing the stretches my physical therapist told me to for the past week, better than i have in months. Now this bitch told me this and idk if its my mind fucking with me but i "feel" it. I am going to see my pt tomorrow, but on your expertise, do you think ill be ok by stretching and working out alone? Am i doomed to a hip r surgery? Lots of shit running thru my head , thanks man

A 21yo male with hip arthritis?!! I Have never heard of such a thing! Did you have Xray's to prove this? Did you see a general practitioner or an orthopaedic surgeon ( I would only take advice from the latter in your case).

As an aside did you have a congenital hip problem when you were a child?

[Prophylaxis]

Hey guys,

I'm currently involved in an exciting startup of an online PT/physiotherapy business and it would mean a lot to me if you could give me some assistance in completing a quick survey (as many of you will be part of our target market).

Please send me a PM if you are interested - it will only take a few mins and really help me clarify some assumptions prior to our service/product launch.

Cheers!

[dog24]

I can support the weight but seems like the muscles on my feet are stiff and weak. Since my last post ive been walking with the one crutch. Today i walked around at the gym without crutches, but i was pretty much dragging around my good foot. I was surprised when he told me no more xrays needed, although i fully trust him he is one of the best in my country. After the gym i walked home with one crutch and my achilles tendon started hurting like a motherfucker. Tomorrow im supposed to leave the crutches but i dont think ill get by without them yet. Also i been doing the abc's moving my feet in water with salt, standing calf raises are feeling good already. But like yiu predicted dorsiflex is fucked which concerns me the most.

[Prophylaxis]

(07-10-2013 11:37 PM)dog24 Wrote:  

I can support the weight but seems like the muscles on my feet are stiff and weak. Since my last post ive been walking with the one crutch. Today i walked around at the gym without crutches, but i was pretty much dragging around my good foot. I was surprised when he told me no more xrays needed, although i fully trust him he is one of the best in my country. After the gym i walked home with one crutch and my achilles tendon started hurting like a motherfucker. Tomorrow im supposed to leave the crutches but i dont think ill get by without them yet. Also i been doing the abc's moving my feet in water with salt, standing calf raises are feeling good already. But like yiu predicted dorsiflex is fucked which concerns me the most.

If the doctor has said you are now able to fully weight-bear - ditch the crutches. Continual use of crutches stiffens up the ankles and weakens the muscles which will further prolong your rehab.

It hasn't been loaded for a long time so a bit of joint and muscle pain is expected. You want to focus on retraining proprioception (balance) and improve joint range of motion.

Balance on 1 leg
Double leg calf raises
Loosening up the calf muscles (try a foam roller), and the towel stretch which you mentioned is great!
the 'sprinter' stretch - essentially you are leaning on a desk (higher than below) while gently moving both your heels up and down



It wouldn't hurt to pay a few visits to the physio, as some hands-on manual therapy would greatly assist in improving range.

Let me know how you go dog!

[Veloce]

Hey Prophylaxis, greatly appreciate the thread man. I've got an issue that won't go away:

Body Chart: the muscle/tendon directly above my kneecaps
Age: 32
Mechanism of injury: Seemed to be gradual, not a singular instance
Aggravating factors: Squatting
Easing factors: Massage

So I worked my way up to 240 on squat and towards the end there I developed a soreness that won't go away. The weird thing is that the soreness doesn't feel that different from typical soreness you get after a killer workout. It definitely doesn't feel like a joint injury; there's no internal pain in my kneecap. And the pain isn't that sprain-ey debilitating feeling either. Just a deep soreness.

My chiro/PT tells me it's just inflammation and did a few activator adjustments on my quads, showed me some massage and stretches. I've also been using a foam roller on my quads every day. I've been doing all that but the pain won't go away. It's been about 2 weeks since I've done any squats and it's still there (though I still do deadlifts) I'm making good progress on deadlifts so I'd rather not stop bangin those out but if you think I should give all legwork a rest then I guess that's what I gotta do...what's your take?

[Prophylaxis]

(08-23-2013 11:46 PM)thedude3737 Wrote:  

Hey Prophylaxis, greatly appreciate the thread man. I've got an issue that won't go away:

Body Chart: the muscle/tendon directly above my kneecaps
Age: 32
Mechanism of injury: Seemed to be gradual, not a singular instance
Aggravating factors: Squatting
Easing factors: Massage

Hey thedude,

Certainly sounds like a quadricep tendinopathy.

Basically the tendon where the quad connects to the kneecap has become overloaded and slight tears have occured in the fibres of the tendon.

There are varying types of tendinopathies - and these vastly affect how you manage your injury. (with some types of tendinopathies we need to REST and others we need to LOAD). We need to work out whether it is 'reactive' (rest is best) or 'degenerative' (load is best).

The easiest way to do this - have you tried taking an anti-inflammatories (NSAID), and has this eased the pain? (discuss with your doctor/pharmacist, but in Australia there are Over-the-Counter anti-inflammatories you can get without a prescription)

Let me know how you go

[Veloce]

(08-27-2013 12:32 AM)Prophylaxis Wrote:  

(08-23-2013 11:46 PM)thedude3737 Wrote:  

Hey Prophylaxis, greatly appreciate the thread man. I've got an issue that won't go away:

Body Chart: the muscle/tendon directly above my kneecaps
Age: 32
Mechanism of injury: Seemed to be gradual, not a singular instance
Aggravating factors: Squatting
Easing factors: Massage

Hey thedude,

Certainly sounds like a quadricep tendinopathy.

Basically the tendon where the quad connects to the kneecap has become overloaded and slight tears have occured in the fibres of the tendon.

There are varying types of tendinopathies - and these vastly affect how you manage your injury. (with some types of tendinopathies we need to REST and others we need to LOAD). We need to work out whether it is 'reactive' (rest is best) or 'degenerative' (load is best).

The easiest way to do this - have you tried taking an anti-inflammatories (NSAID), and has this eased the pain? (discuss with your doctor/pharmacist, but in Australia there are Over-the-Counter anti-inflammatories you can get without a prescription)

Let me know how you go

You mean like ibuprofin? I do take it when I have bad body aches and pains but I try to go easy on it because it wreaks havoc on my stomach. I usually stick to a half tab when I'm having back aches and such.

I'm down to take some, but is that a solution? Should I try doing some light leg extensions after dosing some ibuprofin?

[Prophylaxis]

(08-27-2013 03:36 PM)thedude3737 Wrote:  

You mean like ibuprofin? I do take it when I have bad body aches and pains but I try to go easy on it because it wreaks havoc on my stomach. I usually stick to a half tab when I'm having back aches and such.

I'm down to take some, but is that a solution? Should I try doing some light leg extensions after dosing some ibuprofin?

I mean NSAID's and heavier anti-inflammatories - if it's bad on your stomach, definitely talk to your pharmacist about it. My clients usually use voltaren - http://www.drugs.com/voltaren.html

Basically it's just a quick easy way to differentiate between the two types of tendinopathies (reactive and degenerative - if it's the later the NSAIDS will do nothing for the pain).

[samsamsam]

Prophylaxis,

Thanks for being so generous with your knowledge.

I was benching 315 several months ago and did something to my left shoulder. The part that is the most tender (and probably not my shoulder) is the front tendon running vertically down. It seems to be at where the arm connects to the torso. If that makes any sense. Someone mentioned it might be a rotator cuff. When I lower weight while benching I feel soreness in that area. Also the size of this tendon seems to be bigger than the one on my right side. Just wondering if there is anything I can do work the soreness out of it.

I am avoiding lifting more than 225 because I don't want to lose 6 months again. But it would be nice to lift without worrying about it.

Thanks.

[Prophylaxis]

(08-27-2013 07:12 PM)samsamsam Wrote:  

Prophylaxis,

Thanks for being so generous with your knowledge.

I was benching 315 several months ago and did something to my left shoulder. The part that is the most tender (and probably not my shoulder) is the front tendon running vertically down. It seems to be at where the arm connects to the torso. If that makes any sense. Someone mentioned it might be a rotator cuff. When I lower weight while benching I feel soreness in that area. Also the size of this tendon seems to be bigger than the one on my right side. Just wondering if there is anything I can do work the soreness out of it.

I am avoiding lifting more than 225 because I don't want to lose 6 months again. But it would be nice to lift without worrying about it.

Thanks.

Hey sam,

Just a few questions to clarify:

The Pain is at the front of the shoulder? (There is no pain in the traps or neck - or radiating down the arm?) There is no pins and needles or numbness down the arm?

What previous shoulder injuries have you done? - have you previously damaged your rotator cuff? If so, does this feel similar?

Apart from heavy benching - what else bring on the pain?

Have you ever subluxed or popped your shoulder out?

[samsamsam]

(08-27-2013 09:31 PM)Prophylaxis Wrote:  

(08-27-2013 07:12 PM)samsamsam Wrote:  

Prophylaxis,

Thanks for being so generous with your knowledge.

I was benching 315 several months ago and did something to my left shoulder. The part that is the most tender (and probably not my shoulder) is the front tendon running vertically down. It seems to be at where the arm connects to the torso. If that makes any sense. Someone mentioned it might be a rotator cuff. When I lower weight while benching I feel soreness in that area. Also the size of this tendon seems to be bigger than the one on my right side. Just wondering if there is anything I can do work the soreness out of it.

I am avoiding lifting more than 225 because I don't want to lose 6 months again. But it would be nice to lift without worrying about it.

Thanks.

Hey sam,

Just a few questions to clarify:

The Pain is at the front of the shoulder? (There is no pain in the traps or neck - or radiating down the arm?) There is no pins and needles or numbness down the arm?
- Yes just the front - not really pain any more just a sore feeling when lifting. I don't notice it during the day. It seems like it is only about 2 inches long.

What previous shoulder injuries have you done? - have you previously damaged your rotator cuff? If so, does this feel similar?
- No other shoulder injuries in the past. May have mispoke about the rotator cuff. I mentioned it to a couple of trainers at the gym and they thought it might be that and suggested these barbell exercises.

   
   


Apart from heavy benching - what else bring on the pain?

- Not much else. Only when I start rubbing on the spot trying to massage it - then it gets a tender feeling. If I dig really deep into with my hand - I do get a little tingle in my index finger - I really have to rub it pretty hard though to get that reaction.

Have you ever subluxed or popped your shoulder out?
- No

[Prophylaxis]

Thanks for the info. I'd probably stop rubbing deep on that spot, sounds like you're irritating the nerve around the shoulder haha

Just want you to perform a few tests for me:

Does this test bring on the pain at the front of the shoulder?



Does it hurt to do this test? (Push your sore arm down with the good arm)



Does it hurt to do this test? (Again, push your sore arm down with the good arm)



Let me know how you go!

Cheers,

Prophylaxis

[samsamsam]

Prophylaxis.

The one that generated some reaction was the last one. Especially as the arm got lower.

The first one definitely did not. (Other than tightness since I am so buff my muscles were smashing together just messing).

Thanks so much for your time.

[Prophylaxis]

(08-28-2013 12:46 PM)samsamsam Wrote:  

Prophylaxis.

The one that generated some reaction was the last one. Especially as the arm got lower.

The first one definitely did not. (Other than tightness since I am so buff my muscles were smashing together just messing).

Thanks so much for your time.

Hey Sam,

I'd say you might have a bicep tendinopathy. (What is it with RooshV forum and tendon problems? haha) You're all getting too ripped no doubt

Where the bicep tendon attaches to the shoulder joint, has become overloaded (perhaps working overtime while you are benching heavy loads, as the bar is coming down). Small tears and irritation occur in this tendon, right at the front of the shoulder joint.

What do you do?

Stretch and massage the bicep to unload tension from the tendon



Also do regular nerve glides to loosen things up around the arm



Finally you want to load the bicep tendon in a controlled manner (to build up the strength of the tendon).

I recommend doing this exercise (but one arm at a time and below shoulder height if it hurts). Recent evidence says that pain less than 4/10 is fine when loading tendons, however because I can't formally assess you, I'd suggest if it hurts - stop it.




Go easy on the bench for next two weeks until you no longer have pain with that test I showed you.

Summary:

Stretch/massage bicep
Dynamic/nerve glides
Load the bicep tendon in a controlled manner

Let me know how you go!

Edit - and the rotator cuff exercises the trainers told you are great for shoulders as well, so continue them (as long as they're not hurting)

[samsamsam]

Thanks so much - you rock!

Just tender/sore not sharp pain thankfully. But I will incorporate your suggestions. Very generous of you.

Thanks!