knee injury help, please

Discussion in 'Health & Fitness' started by tennis forlife, Oct 27, 2011.

  1. tennis forlife

    tennis forlife New User

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    I'm 50. I have been playing a lot on a hard court, probably too much and I play basketball a couple of times a week. Last week my left knee felt weak, no pain, just kind of wonky. When riding my scooter for an hour to work it was uncomfortable unless I straightened it, I couldn't keep in bent. I rested because we had a tournament on Sunday. Sunday morning I played singles early and felt great. At the tournament I jumped once and then a second time for an overhead and when I came down there was a pronounced click-click and I had to stop, but then played on, but couldn't move. The next day I couldn't walk. After another day of rest and getting some crutches it feels better and I can walk around now less than 48 hours since the injury. My question is what happened and is it possible I will be able to play again soon? Thanks in advance.
     
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  2. fuzz nation

    fuzz nation Legend

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    All questions that can only be answered in reasonable terms by a qualified health care professional.
     
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  3. charliefedererer

    charliefedererer Legend

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    Go see an orthopod who specializes in sports medicine with a special interest in knee injuries.

    It is possible you don't have a permanent serious injury - yet.

    Why return to tennis/basketball with a partially torn meniscus or tendon, only to make it worse?


    "Doctor Examination
    Physical Examination and Patient History
    One of the main tests for meniscal tears is the McMurray test. Your doctor will bend your knee, then straighten and rotate it. This puts tension on a torn meniscus. If you have a meniscal tear, this movement will cause a clicking sound. Your knee will click each time your doctor does the test.

    The most common symptoms of meniscal tear are:

    Pain
    Stiffness and swelling
    Catching or locking of your knee
    The sensation of your knee "giving way"
    You are not able to move your knee through its full range of motion
    Without treatment, a piece of meniscus may come loose and drift into the joint. This can cause your knee to slip, pop or lock.
    Most people can still walk on their injured knee. Many athletes keep playing with a tear. Over 2 to 3 days, your knee will gradually become more stiff and swollen."
    - http://orthoinfo.aaos.org/topic.cfm?topic=a00358

    Check out the above site for more information on a torn meniscus. But go see a doctor.
     
    Last edited: Oct 28, 2011
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  4. escii_35

    escii_35 Rookie

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    A tale of two knees. A weekend warrior injures themselves in a bathtub. "Give out" event 1 occurs at a old man soccer match. Man goes to doc. Doc says, "you are getting old have some drugs." 2 weeks later event two happens. Man demands an MRI. Result... no more acl and a meniscus tear.

    In the next door cube slightly younger non-athletic but stupidly active person does something very bad in a tennis tourney. (Don't play in a tourney at 10:30pm on a friday when your work day starts at 7am.) Non-athletic active person knows they have done something really really bad and gets a MRI. Result almost torn MCL and no more ACL.

    Moral if you are having "give-out" events see an orthopod or get an MRI.
     
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  5. ollinger

    ollinger Legend

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    Playing basketball several times a week in your 50s is simply begging for orthopedic misery.
     
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  6. tennis forlife

    tennis forlife New User

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    Thank you kindly for the replies, everyone. I will go to the doctor realising my hooping days are over and praying I will be able to play tennis again. Bless you for your kindness.
     
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  7. Chas Tennis

    Chas Tennis Hall of Fame

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    Request a written copy of the MRI findings

    The Dr that you see will probably take an X Ray and ask you to get an MRI. Discuss the X Ray as it will show general cartilage conditions by the separation of the knee bones. The MRI will be evaluated by a separate specialist who will write a report listing the findings. That report is available in a few days. When getting the MRI request from the MRI lab a copy of the findings for yourself. Otherwise it will probably be sent to just your DR. Look up all terms and have some understanding of the injury and any other conditions in your knee. How your patella is tracking is one area with long term implications. Discuss each with your Dr.

    I'm just starting tennis again after a meniscus injury in June and did not need surgery this time. In 1999, I needed surgery and have had a very good result.

    I requested a posture evaluation as I am concerned about any posture issues that might possibly affect my knee joints. Taking some PT now to strengthen/align/stretch the weak areas, mostly hips and glutes.

    Good luck finding a well qualified Dr.. I ask friends for recommendations.
     
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  8. tennis forlife

    tennis forlife New User

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    Thank you very kindly, Sir, for that most generous reply. In fact, I did go to a doctor the day after the injury. He took an x-ray and told me there were no broken bones, which I knew already. He showed me the x-ray and there was no mention of cartilage and as far as I could see it wasn't visible in the image, unless I am mistaken. Regarding an MRI, even with my insurance it is quite pricey and we are quite skint. Also, when I mentioned to the missis about seeing a specialist she asked me what do I expected them to do? Without an MRI I doubt I can get a detailed diagnosis. So, I believe my only course of action is to rest and strengthen, is that right?
     
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  9. Chas Tennis

    Chas Tennis Hall of Fame

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    Sports Medicine or Orthopaedic Dr?

    Here's some information that I believe but I'm not sure what you should do -

    X Ray With the X Ray you see the upper and bottom leg bones at the joint. They are separated by cartilage which appears dark in the X Ray similar to the air next to the knee. The spacing in mine was about 1/4" from one side to the other in both knees. The evenness of spacing can be interpreted by a Dr to indicate some cartilage/arthritis issues.

    It sounds as if you 1) don't have a diagnosis or 2) a clear course of treatment from the first Dr. You still need a Dr for a probable diagnosis & treatment. A qualified Dr & MRI are the best. If an MRI is not affordable you could still try to find a good Sports Medicine or Orthopaedic specialist and maybe that Dr can tell you what the injury is likely to be or not to be without the MRI. I'd get very active and ask everybody about their knee injuries and experiences with Sports Medicine and Orthopaedic Drs. Forget convenient locations for the Drs office and drive to nearby city if necessary.

    I would not take advice related to diagnosis or treatment of your injury from any forum or internet source. The typical advice is to purchase a $25-40 wrap or brace but there is never any information on your injury or how something applied to your skin might help the injury inside your knee. Inform yourself as much as possible.
     
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  10. stapletonj

    stapletonj Semi-Pro

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    I had a meniscus tear diagnosed by an orpthopod.
    He wanted to go in and cut, told me it would feel great, but that I would have bad arthritis in 10 years. I had an opportunity to go to the clinic of the famous Dr. James Andrews in Birmingham. (Does all the top athletes in the world).

    His "minion" doctor, told me I didn't need surgery at all.
    Got me on glucosamine sulfate and some exercises.
    3-6 months of no running and no tennis.

    Took the glucosamine, did the exercises.

    10 years later, I am running about 1000 miles a year on top of playing about 5 hours of tennis a week on hard courts.

    My knee is a little sore every now and again, but nothing that a couple of naprosyn once to twice a month can't handle. I'm 55 noe, so I figure I'm in the same boat as you.

    Moral fo the story? Spend the money, go see a specialist, not just any orthopod. I don't care how much it costs, it's worth it.
     
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  11. tennis forlife

    tennis forlife New User

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    The doctor today suspects a meniscus tear and I will have an MRI on 11/11. In the mean time my fingers are crossed. Thank you everyone. I'll report back with the results.
     
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  12. tennis forlife

    tennis forlife New User

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    Oh yeah, when he was testing my knee it was clicking beneath my knee cap each time he made a certain movement, a very small click.
     
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  13. mark999

    mark999 Rookie

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    same experience. first doctor wanted to cut, said i would never play tennis without surgery. went to rothman institute and doctor said no surgery needed. rested for 6 months and now perfectly fine for past 3 years.
     
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  14. tennis forlife

    tennis forlife New User

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    MRI revealed degeneration, but no tear. Going on five weeks and haven't played at all. I'm imagining I had a bad sprain. Going on five weeks now and haven't played yet, but may have a go tomorrow very cautiously.
     
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  15. Posture Guy

    Posture Guy Professional

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    if the MRI revealed degenerative changes, your knee is mispositioned so that when you use it, you are getting excessive friction within the joint capsule and you are both prematurely wearing articular cartilage, and probably creating some measure of arthritic change.

    There are many people who think that simply aging will necessarily mean that our load bearing joints must degenerate. This is not true. There is absolutely no reason that a properly positioned joint should develop degenerative change simply from playing tennis a few times a week.

    Moreover, if the joint is mispositioned, virtually ALL activity (even just walking around) is going to present degenerative stress to the knee.

    We tell our clients, once you have ruled out any pathology that requires medical intervention (like a tissue tear requiring surgery), focus on the POSITION of the joint, not the condition. The condition of a joint is almost always a direct result of the position of the joint.

    If you'd like a resource for starting down that path, I recommend the book Pain Free by Pete Egoscue. (Disclaimer: I own and operate the Egoscue Clinic in Austin, TX, but I will not make a penny from you buying one of Pete's books). It will give you tools for getting your knee back into a better position where you can reduce the friction load on it.

    I made that recommendation to someone in a similar situation on another thread and about 3 weeks later I got an email from a woman who said she read the post, had almost the exact same issue as being described by the OP here, got the book and started doing the exercises for knee pain, and within a week her knees were both pain free and she was back on the court.

    Best of luck to you, I know how frustrating it is to not be able to play because of pain.
     
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  16. tennis forlife

    tennis forlife New User

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    Yo, thanks for that quick reply. I'm interested in that book, but I don't know if I agree with you about the degeneration not occurring naturally over many years. Either way, perhaps I can get the book, but what I wanted to say is that I have not been not playing because of pain. In fact, the knee was never really painful. It's sore a bit after a long day, but not painful. I haven't been playing because the injury is fresh in my mind and I don't want to injure it again before it heals. Basically, I have been afraid to play. Also, perhaps I'm prone to arthritis because I have osteoarthritis in my big toe joint and last week I had a wrist ganglion, which I hear could be a precursor to arthritis. Anyway, I'm interested in the book, but at the same time I'd rather learn of the knee exercises without having to buy a book.
     
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  17. Chas Tennis

    Chas Tennis Hall of Fame

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    MRIs are the best but they are not perfect as some tissues and injuries are hard to see or evaluate. If you have pain or discomfort trust that it is telling you something.

    Time required to heal? -I have had a hard time getting definitive information on cartilage healing. It heals, it does not heal, some areas heal if they have blood flow. The Posture Guy has described some conditions including posture related ones that are important. Arthritis to some degree starts at some age....... There are healing tables in some of my books but best if you research the subject yourself. Allowing 3-4 months seems reasonable to me for healing time. Let's say healing time and degree is uncertain in general and for your situation - some arthritis & some injury - more uncertain. Tennis players want to play and have a very hard time with taking a few months off. Playing too soon might(?) be a very bad mistake regarding the progression of chronic injuries (I have many stories and almost all involve playing with pain.)

    In 1999 I gave a torn meniscus 4 months to heal with no running and then knew I had to have it scoped.

    This year I injured my knee somewhat and played on an uncomfortable knee. I then injured it worse in June stopping my tennis match. At first, before the MRI, the Dr said that I could ease back after resting two weeks but I knew that I could not run. Then an MRI indicated a torn meniscus. The Dr said it did not look so bad and that I could slowly start back a month after the injury. But I still could not run so I decided that I did not want to push it that early. I waited 3 months with no running and started by going to the gym for my legs and to a rubberized track for short runs. I very much needed that conditioning as it was not comfortable to start. After 6 weeks getting back into doubles tennis the knee feels almost normal. I am worried about how it will hold up over next year but OK for now........

    I also requested a posture evaluation and am doing corrective PT. My glutes & their function have been remodeled somewhat.

    5 weeks would not have worked for me.
     
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  18. Posture Guy

    Posture Guy Professional

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    the reason the book is important is to understand the concepts behind why you have a degenerative knee. Address the core problem, not symptom.

    re being "prone to osteoarthritis", my opinion (and clinical experience) is that such a phrase describes so few people statistically that it's not worth mentioning. The reason you have osteoarthritis in your toe joint is the same reason you have it in your knee. Your posture is compromised so the knee is out of position, and if the knee is out of position, the foot strike is compromised and you are not toeing off correctly. That's true if it's the same foot as the knee problem, or the other one. You are out of balance, posturally.

    I'm heading out the door but remind me to post the results of a Stanford study that showed the "wear and tear" theory of joint degeneration is an absolute myth. Studied runners over the course of about 20 years, high mileage, and definitively concluded that high mileage running over the course of many years does NOT degenerate knees.

    I'm 50, I've run and played tennis since I was 10, played basketball, racquetball, done some high-demand mountaineering, etc... I've USED my body in my 50 years. I had knee surgery a couple years ago to repair a torn meniscus suffered in a freak accident. They took photos in the knee and between the photos, the MRI and the xrays of the knee, the conclusion was my knees showed absolutely no evidence of arthritic change and I still had a full complement of articular cartilage.

    aging does NOT mean your knees must break down. It's a myth. Using your knees does NOT mean your knees must break down. That too is a myth.

    but using your knees (or any joint) in a compromised position absolutely WILL break them down, and that is what most people are doing, then they think that's just aging. It isn't.

    my recommendation is get the book above, read the first three chapters, THEN go to the chapter on knees. It will help you not just fix this immediate issue, but will help you keep your knees functioning and keep you on the court for many years to come.

    I play singles tennis now at a 4.5 level, trying to get to 5.0, and I plan to play singles for the next several decades. And my knees will do just fine.
     
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  19. Posture Guy

    Posture Guy Professional

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    and FYI, when I had my meniscus surgically repaired? Because the knee was properly positioned going into the surgery I had no quad de-activation, had almost full range of motion a week after the surgery and was doing light running at 3 weeks.

    when it comes to joint function, POSITION is paramount. Position dictates condition. Ignore a joint's position at your own peril.
     
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  20. tennis forlife

    tennis forlife New User

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    Thanks for the reply, Chas. What you said really struck a chord with me: I can't run. That's how I feel. I was just thinking about that earlier this evening. I was thinking that I could play even though I can't run. Also, foolishly, I tried to play basketball a couple of weeks ago. I started by jogging a little to warm up and immediately sensed that I couldn't run. Then when we started I felt like I was sort of trotting at about 50%. Then going back on D I tried to change direction and that was enough for me. So, yeah I'm not going to try and play. I'm going to get the book Posture Guy mentioned, work on strengthening and stretching and wait at least 3 months. No sense in kidding myself.

    And thanks, Posture Guy. Your previous post has convinced me about the degeneration. I'm sure I must have some serious position issues. When you mentioned that I recalled a friend of mine who was studying that and told me he learned how to walk all over again and it really improved his health. Thanks, man. I'm going to get the book and appreciate any other advice you can send my way.
     
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  21. tennis forlife

    tennis forlife New User

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    By the way, will the book tell me if my joint is out of position? Can you tell me how to evaluate that?
     
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  22. tennis forlife

    tennis forlife New User

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    Do I need the book if I'm not in pain? After looking at some reviews it seemed to me that it is meant for chronic pain. I know chronic pain because I had a lumbar discectomy many years ago. However, my big toe just gets sore and the knee is not painful.
     
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  23. Chas Tennis

    Chas Tennis Hall of Fame

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    That is exactly how I felt for about 2.5 months! That is also how I felt in 1999. For walking around the knee felt great and smooth but if it was raining and I had to break a stride and run a few steps - it was not right. It slowly felt better. When I felt somewhat pressured to be ready for our blocktime tennis, I started to push it very slowly, at first by jogging in a straight line for 100 meters on a rubberized track.

    I don't know if my cartilage healed to some degree or just got smushed into some out-of-the way corner inside my knee. ? And neither does my Dr who is at the top of his field.

    Research healing time.

    Did you get the evaluation written by the MRI specialist? Not your Dr, but the one who specializes in reading the MRI. You can get a copy from your Dr or the MRI lab. Sure it is in greek but you can search each term and learn a lot.

    If you are not satisfied with the guidance that you received from your Dr you have a fresh MRI and might look for a second opinion. It is also very important to know a good Dr for the next time that an injury occurs.
     
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  24. tennis forlife

    tennis forlife New User

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    Just sitting here in front of the computer right now I can feel that my leg is ailing. It's not painful, but definitely not right. I can also imagine how it would feel if I were forced to run. I would be limp-running and with each stride it would get sorer and sorer and when I stopped it would feel all swollen and sore behind my knee. So, you say give it at least 3 months, Chas, yeah?

    As far as the MRI report, I took the whole lot to the doctor and left it there and I trust his guidance.
     
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  25. Posture Guy

    Posture Guy Professional

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    While most of the people who get the book do so because of pain, the concept of restoring postural integrity is critical to anyone, in pain or no. Now, when you say you're not in pain, then my response is why were you on crutches a few days ago, and why not just go run and play tennis and basketball and be fine?

    that's a rhetorical question, because whatever the answer to that question is, THAT is why you need to restore the proper position and function of that knee. And yes, the book will tell you how to evaluate your knee position. If you need any help once you get it and read it, feel free to email me, I'm happy to help.

    I'll put it this way, I continue to do my own stuff. I'm not in pain. Why do I still do it? 2 reasons:

    1. I don't want to be in pain, so I want to keep my body in as much of a state of postural and functional balance as possible.

    2. Anyone's body, including mine, simply functions more efficiently when it's in postural balance. That means you're faster, stronger, more flexible. Your body just works better, which means you're a better tennis player.
     
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  26. tennis forlife

    tennis forlife New User

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    I can't wait to be balanced. I'm on that, Posture Guy! Thank you , you are very kind, sir. I'll let you know how it goes.

    One more thing. I have this constant nagging feeling that I need to go out to the tennis court and see if I can serve, see if I can hit. Do you think i should do that to satisfy my self one way or the other?
     
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  27. Posture Guy

    Posture Guy Professional

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    re going out to serve, trust your instincts, but my advice would be to stay off the court until your knee feels solid and stable, that you can trust it.

    you asked the question earlier about how to check knee position. here are a couple of quick checks you can do. First, your feet and knees should be both pointing straight ahead, with your hips level, shoulders level, and knees directly under the hip joint. Look at the first figure on this web page, this is the postural blueprint, our intrinsic design:

    http://www.egoscue.com/painfree/themethod.php

    Now look at yourself in a mirror, or have someone take postural photos of you wearing just a pair of shorts, no shoes, no shirt, shorts end above the knees. Compare what you see in the mirror or the pictures with this figure. Does it look the same, or different? If the latter, in what ways?

    March in place for a few seconds with your eyes closed, then come to rest where the feet feel naturally placed. Now open your eyes. Do your feet point straight ahead, or out to the side? They should point straight. Do they both do the same thing, or something different. Your body is designed to be symmetrical right vs left.

    those are just a few things you can do to check your postural balance. Hope that helps.
     
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  28. tennis forlife

    tennis forlife New User

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    Thank you, kind sir.
     
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  29. tennis forlife

    tennis forlife New User

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    Well, I went out and played today. I played three sets of doubles and four games of singles. I felt great. I was hitting some good serves. I didn't have any trouble at all with my knee. I just got back and as usual what is sore is my big toe joint. I'm going to stretch, do my leg raises and ice my knees and the big toe. I'm glad I overcame my fear and went out and now I know I'm okay.
    Thanks for all the help everyone!:)
     
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  30. Cindysphinx

    Cindysphinx G.O.A.T.

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    Can I make a suggestion?

    It would be a really good idea to get some physical therapy. If you are having an issue with tracking, then you are slowly grinding away your articular cartilage. A therapist will spot this and help treat it.

    Also, having a lengthy recovery from a knee injury can leave you with muscle weakness around the joint. If you don't have good muscle support, you are at risk for re-injury. A PT will give you exercises you can do to strengthen.

    If you cannot afford PT, you can find some exercises yourself on the internet. Don't do anything that hurts.

    Cindy -- who wouldn't be able to play at all if she didn't keep up with her lunges and squats
     
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  31. tennis forlife

    tennis forlife New User

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    Thanks, Cindy! Oh yeah, I'm determined to strengthen my quads. I just started doing the leg raises and man they are a bear. The doctor told me to do 30 reps holding them for 10 seconds and I'll tell you I thought that was going to be no sweat, but I struggle to finish the first ten. Anyway, maybe it'll get easier.
     
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  32. Posture Guy

    Posture Guy Professional

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    leg raises? Do you mean leg extensions on a machine?

    if so, I'd strongly recommend you not do that exercise. I have a LOT of problems with that exercise.

    and I can't stress this enough, it's NOT just a strength issue. If you have a mispositioned joint and you strengthen all the muscles around it without first normalizing the position of that joint, what you are doing is effectively increasing your body's ability to apply load to a mispositioned joint.

    does that intuitively seem like a good or bad idea?
     
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  33. tennis forlife

    tennis forlife New User

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    The doctor told me to lie flat, raise my extended leg a few inches off of the floor, hold it for ten seconds, repeat with the other leg and do 30 reps. It's meant to strengthen the quads. He also started to tell me something I could do in the gym, but I told him I don't go to a gym and he said the leg raises would be okay then.

    Also, I have ordered Pain Free. I will get back to you if I have any questions there.

    Thank you, sir.
     
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  34. Posture Guy

    Posture Guy Professional

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    cool, that's much better.

    when you raise the extended leg, two things to be aware of:

    1. Flex your foot back towards your ankle firmly. That will give you better quad engagement.

    2. Make sure the foot is pointing straight up, and not in or out. As you lift the leg, control the rotational angle of the leg and ensure the foot stays straight.

    good luck.
     
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  35. tennis forlife

    tennis forlife New User

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    Thanks for that advice on the leg raises, Posture Guy. Also, I have read the first three chapters and this morning did my first foot E-cises. It is amazing! I felt better immediately! Things were popping, clicking and repositioning! I'm so stoked about this!:)
     
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  36. Posture Guy

    Posture Guy Professional

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    awesome, I'm very glad it helped. If you have any questions, don't hesitate to email me, I'm happy to help.

    keep on rockin', brother.
     
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  37. tennis forlife

    tennis forlife New User

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    Rock on like avalanche...that's what I plan on doing tomorrow morning on the court for my first match back. Of course I will be watching it though, not overdoing it you know.

    Yeah, I'm so pumped about that book. It makes me feel like I need to get into physiotherapy. I've been teaching English for ages and I find it personally satisfying at times, but surely I'd enjoy helping people with their health more. Maybe could do.

    All right then, Posture Guy. Have a great weekend and I'll get back to you after to report on the progress I've made in the E-cises.

    Enjoy, brother!:)
     
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  38. tennis forlife

    tennis forlife New User

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    Sometimes when doing Point Flexes I get a muscle pull in the opposite leg. It's quite intense running from the hamstring all the way down my leg and I have to stop. Is that normal?

    Also, I like doing the foot E-cises. Is it cool to do them more than once in the morning, is it okay to do them throughout the day?
     
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  39. Posture Guy

    Posture Guy Professional

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    When you say a 'muscle pull' do you mean it's really tight, or it's cramping, or something else?

    and yes, you can do them more than once a day. Do the entire routine once in sequence, then you can either repeat it or just do selected ecises as desired later through the day.
     
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  40. tennis forlife

    tennis forlife New User

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    Thanks, man. Well, it's probably not important because it didn't happen this morning, but it was a cramp. However, it was different from the ones I'm used to in the sense that it ran all down the back of the leg and stopped when I did. Anyway, no big. Thanks for the reply.
     
    #40
  41. Posture Guy

    Posture Guy Professional

    Joined:
    Aug 14, 2011
    Messages:
    1,475
    Location:
    Austin, TX
    No problem.

    cramps like that can happen for a number of reasons. The muscle could be tight and resisting being stretched, the muscle could be lax and resisting being engaged, etc.... But as you do the exercise repeatedly the muscle should get the idea of what you're doing and begin to permit the movement in a functional way.
     
    #41
  42. tennis forlife

    tennis forlife New User

    Joined:
    Oct 27, 2011
    Messages:
    59
    Thanks, Posture Guy! Something I wanted to ask you, a doctor said I had osteoarthritis at the base of my big toe joint. It gets quite sore from playing or even walking. sometimes when I step[ on it wrong it is quite painful. This is the pain I am trying to deal with now. Do you think the foot E-cises will alleviate that? Also, is that something that just gets worse and worse. I have discomfort there for ages. However, recently, I had it looked at and the x-ray he showed me clearly showed worn down cartilage at the joint. It was as clear as day when comparing with the other toes. Anyway, just hoping you have some thoughts on that, kind sir.
     
    #42

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