Monthly Archives: December 2016

Knees – not just getting old? #18 – Before session 7 with John

Sat 31 Dec 2016

Despite the very positive signs over the 3 days before my previous 23 Dec entry in blog #17, in the week and a bit since making that entry, the knee has not settled down as I would have expected.

That evening of 23 Dec I played a bit more table tennis – only around an hour in total with a rest in the middle – but this did not feel as good as my previous 3.5 hour session from a few days earlier in that week.  When doing some movements, I could feel that same pain at the outside of the knee joint in the usual place, especially if I had to move forward to make a shot close to the net, and then move backwards again.

Although I did not have any soreness or stiffness to speak of after this session of table tennis or on the next day, the joint continued to feel weak, and I could also feel the lower IT Band muscles being overworked, whenever I would bend the knee to any degree or make any movement that involved the lower leg.  As well as feeling that set of ITB muscles being tightened more than they should, there was even a little amount of muscle pain in them at times.  These symptoms have persisted since then, up to today 31 Dec.

I have also still not been able to adopt my usual sleeping position when on my left side in bed, as it continues to start hurting in the knee joint, within a minute or two of trying out that position.

I have continued doing all my usual morning and late afternoon exercises, including the modified lateral leg lifts to target the glutes, as well as all the usual number of squats.  The squats are possible, but they do also show that the joint isn’t quite right yet.

Walking has stayed the same – I don’t have the significant limp any more when going down a slope, but doing a downward slope does still give some pain to that outside part of the joint.  I have not tried to do any running, and prefer to wait until the MRI scan scheduled for Thu 26 Jan, in case the meniscus has damage.  Instead of any running, I have been walking a little more than usual – although given the fact that I am doing nothing aside from that and my usual exercises and table tennis, I ought to be walking more, to take up the slack in my usual running routine, which for cardiovascular exercise is especially good.

I took a long walk on Boxing Day, on paths in the forest and including much up- and downhill work.  This was the first time in a while that I had done any walking “off-road” and over uneven terrain, and I really noticed that the knee did not feel 100%.  I could feel it being on the edge of pain for much of that more challenging walk, though almost never properly into pain, and it was weak.  I need to start some exercises to build up the joint strength at some point, but for now will hold off on that, until it’s clear what is still wrong with it.

Whenever I bend down at the knee, the outside of the joint in particular feels like it is under too much pressure, and usually I can also feel the lower IT Band to a degree that I would describe as “too much” on the affected leg, especially when comparing it to the other, healthy leg when doing the same movement with it.

On the positive side, as far as I can tell, John’s work from session 6 on 19 Dec to straighten up my spine, which was leaning to the right, has held up properly since then.  For example, the two sides of my upper body continue to feel similar to each other when I stretch and “pop” the various upper back and arm joints, which they did not before session 6.  Also, the “banana” stretch (see blog #02) still results in the left and right sides of the body feeling very similar to each other, whereas before, there was a big difference between them.

Also good news, is that the other areas on the affected left side of the body, one spot near the waist and two others near the middle and lower ribcage, have settled down and are almost never felt now.  John’s assessment in session 6 of these, when he said he thought they were caused by tensions near the lower spine – which he addressed in that session – appears to have been correct.

My instincts are that something is still putting the IT Band under too much unnatural stress, and this is giving the continued trouble with the knee joint.

Based on how the upper body has felt, I suspected that doing another photo of my back would show the spine is still straight.  Having taken a photo, I was at first quite surprised to find that it suggested things had reverted back to much the same as before John’s work in session 6.  But then I noticed that the photo was not straight in the vertical, when the lines of the door I was standing in front of were taken into account – and then, after I did some photo jiggery-pokery to correct for this, it turns out the spine is indeed still straight.

Below is that photo, after adjustments so the vertical is in line with the edges of the door, which I then cropped off the picture.  The usual yellow lines show that both the spine itself and the position of my elbows are unchanged since 23 Dec.

nelson-back-view-31-dec-cropped

There is a possibility that the persistent troubles with the knee are due to meniscus damage.  But I would not expect that in itself to also make the lower IT Band continue to tense up.  The upcoming MRI scan is the only way to find out if the meniscus is OK or not, but it is not taking place for nearly 4 weeks, after which I might also have to wait a bit for the results.  In the meantime, I am thinking it would be a good idea for John and I to investigate this further.

If these ongoing issues are not due to the meniscus, and they are not from stored tensions just to the left of the lower spine – which I believe are permanently cured – then what else could be causing them?  Has there perhaps been a shift of the unequal leg lengths I have had for many years when standing – for which I have worn a “straight left-to-right” insole in all footwear on the same, affected left knee joint side for the last 6 years (see blog #01) – a shift that means I am now not standing “evenly” from left to right, on the affected left leg / foot?  Or are there other tensions elsewhere in the body that we have not yet discovered, perhaps “hidden” until now by the significant ones in the lower spine, and maybe also playing into the mix by tightening up the left leg’s lower IT Band?

The only way to find out will be to see John again.  I checked his appointment schedule for next week, and he has a session available on Monday 02 Jan, which I have booked.  In that session 7, we will have one objective, which is to have him check me over thoroughly, to find out if there is anything else that we can treat, and which we may have missed so far, and if not, whether anything we have done so far – including the work on my walking and running posture, my workstation setup and posture, and all the things John has been able to address – is still not right and needs further attention.  I will dress in my running gear once again for this upcoming session on Monday, in case we decide to get me back onto the treadmill etc.

Knees – not just getting old? #17 – After session 6 with John

Tue 20 Dec 2016

There are a number of positive signs following session 6 yesterday.  The treatment John carried out to release some tensions in my lower back, to the left of the spine, is already starting to look like it may resolve a lot of the issues that have been outstanding since the breakthrough events of early December (see blog #14).  Here are a few observations since our appointment yesterday:

  • There was a small amount of bile in my stool yesterday evening.  This is very unusual for me and normally only happens if I have been ill, or when the body is having some sort of clearout.  I suspect this is a consequence of the tensions that were released by John’s treatment yesterday, being close to the lower part of the colon, kidneys etc.  To me this is a good sign.
  • When I went to bed, while adopting a temporary position I use to stretch the back muscles out a bit, there were no pains to the waist or rib areas, where I have sometimes had them since the other issues in those areas first appeared much earlier in the year (see blog #02).  John had told me near the end of our session 6 yesterday, that he thought those pains were caused by the tensions near the spine, the ones he was able to release.  It looks like he was exactly right about this.
  • I tried adding 2 inches of foam rubber between my knees as I got into one of my usual sleeping positions in bed, one that for the last few weeks I have been unable to use, as it has tended to give pain to the outside of the affected knee joint.  John had suggested in our session 6 that I try something along these lines, such as with a feather pillow etc.  Failing that I used some foam.  This did not work, and I still began to feel the usual pains after just a few moments, which did not surprise me as it seems to be the actual weight of the other leg on top that has been causing this pain, and even with some padding between the knees, that weight is still there.  However, after abandoning the foam, I got into one of the alternative positions I have tried using over the last few weeks, one for when positioned onto my left, affected side – and unlike the recent attempts in this position, which did not allow me to drop into sleep as it was just not comfortable enough, this time I was able to nod off easily.  I think this might be partly because the waist and rib areas were not giving any pains as all, as outlined in the previous bullet above – either way, it’s a new development, one I welcome.
  • I woke up this morning noticeably more refreshed after the night’s sleep, than I had in some time.
  • After rising, as I did my usual morning foam rolling and exercises, which include a variety of different movements, stretching etc, I noticed that the joints in my upper body  – back, neck, and shoulders – seemed to feel a little different, and they “popped” more evenly left to right, as I did various stretches and exercises.  I have been aware of the “uneven” quality of these, for many years.  Are they down to my upper body having been leaning a bit to the right, which John’s manipulations seem to have addressed?
  • I was able to do the lateral leg lifts exercise properly, just as John showed me in session 6 yesterday.  It does work the muscles a bit differently to how I had been doing it before.
  • I seemed to cough a bit less than usual as I exercised.  This coughing has been around for a long time and is not due to having a cold or anything.  Also I am not a smoker, so it’s nothing to do with that either.  I have always put it down to maybe just the air quality here in Bristol or something along those lines, but perhaps my own posture has also been a factor.
  • When I did the “banana” stretch (see blog #02), I felt the various muscles much more evenly on the affected left side, compared to the right side.  Again, my previous observed “unevenness” in the two sides when doing this stretch, is something John had suggested was due to those same tensions he had managed to work out of the lower back – and again it appears he was spot on with this assessment.
  • While laying on my back with my knees up, I usually do a few different exercises.  They include: a set of 60 pressing down onto the legs with the hands for around 2 seconds and then releasing this for 1 second, to work the abdominals as an alternative to sit-ups (I had a hernia about 15 years ago, and must not do sit-ups); stretches for the back of the neck; swinging the knees back and forth (another one for the abdominals); wrist exercises; getting the backside up off the floor while keeping the head and feet on it (to stretch the spine in a “reversed” way), and some further neck stretches done while lying on each side.  Over recent days, the continuing issues I have had with the knee joint included the outside area getting sore and stiff – and also some soreness down a bit onto the lower leg and onto the lower IT Band – after just a minute or two in any position with the knees bent, such as this one in which I do all these exercises.  This morning, there was almost none of that soreness or stiffness at all in this position, only a brief “suggestion” of it for a few seconds, which then disappeared.  This is a marked change also.
  • As I did the swinging of the knees back and forth exercise to work the abdominals as in the previous bullet, the outside of the affected knee joint did not give any pain at all – this is another significant change.
  • During recent morning exercise sessions, the lower IT Band on the affected leg had often felt a bit tight, even after foam rolling – or if not tight, it was certainly being activated by various of my usual exercises, in a way that I thought was wrong – it was as though it was being “coupled” with movements of the knee joint, and was on the borderline of actually hurting a bit, which even when doing a specific exercise which is supposed to work that muscle group, should not happen.  Today this did not seem to be taking place at all, as though it had been “uncoupled” from the knee joint to some degree.
  • Near the end of doing my remaining exercises, I usually include a set of 3 dozen squats.  John and I had spoken about this in our session yesterday, when I asked him whether he thought I ought to leave them out for a while, given my recent troubles with the outside part of the affected knee joint.  He pointed out that in the Far East, there are very few instances of knee problems such as we have in the West, and this is partly because the people there spend much more time down on bent knees than we do – which naturally works the joint more.  My question to John was due to there being a possibility that I have meniscus issues outstanding in the affected knee joint, and after we spoke a little on this in session 6 yesterday, we agreed that it was a good idea for me to try and do the usual squats as best I could, watching out for any pains and backing off if needed.  As I did the squats this morning, the joint felt better than it had for some time.  In fact, it was now “popping” much more often, nearly as often as the other, healthy right knee joint does – again, something that recently it was not doing, which I have always taken as a sign that things are not right with it.  Not only was I able do all 3 dozen squats as per my usual routines, I breezed through them easily, and there was no pain.
  • Since starting the day with my usual foam rolling, exercises and then breakfast, I have been working at the computer, getting up and back down fairly often as usual.  After I get up each time, the knee feels much better whenever I go downstairs, than it has been doing recently.  It would typically feel noticeably weak as I did the stairs, but today it doesn’t.

All of the above are highly encouraging.  I am beginning to think that I might not have any outstanding meniscus issues with this knee at all, and that everything still going on since the breakthrough events in early December (see blog #14), is down to those tensions in the lower back which John was able to loosen up in session 6 yesterday.  If so, then the next few days should see further improvements.  In any case, I have already seen enough change in the right direction, that I have decided to play table tennis this evening, and see how it goes.

Fri 23 Dec 2016

Things are really looking good now.  The knee has been improving every day since the start of the week, when John did some work manipulating out tensions just to the left of my lower spine, in our session 6 on Monday 19 Dec.   On the Tuesday evening after that I played table tennis again, and by then the knee was feeling better enough that I was able to play for 3.5 hours non-stop, with no issues of soreness or pain, either that evening or the next day.  I played very well, which is a bonus.

Each day since then, the pains to the outside part of the knee joint have been a bit less and less, and now they are unnoticed most of the time.  My upper back, shoulders and arms also seem to be keeping that “evenness” on each side of the body when everything pops as I do various stretches, which suggests I am still standing up straight, as after John’s sterling work on Monday 19 Dec.  More on this shortly.

Last night I think I was able to get to sleep using my “normal” position when on my left side, for the first time in weeks.  I am not certain, as I went into a deep sleep to start with, and seemed to have rolled off that side and onto my back temporarily, when I next woke up.  I will know for sure over the next few nights.  Either way, I did not have any knee pain that prevented me from getting to sleep after having started out in that usual position, and I didn’t feel that previous soreness at any of those other spots, by the waist and near the middle and lower ribs (see blog #02).  This is all a big change from before session 6.

I also don’t seem to be needing as much sleep as before, which makes sense as the quality of it is better.  Being more properly aligned means I am getting a better rest through the night.

I have kept up the lateral leg lifts exercise as part of my usual routines, and will continue to do so.  After doing them, I can really feel the correct set of glutes having been worked, partly because I then immediately sit on a chair, pull each leg back one at a time until the hip joint gives a “click”, then also one at a time, put one leg across the other and do a stretch to touch my chin onto the foot of that crossed leg – something that always tells you which muscles around the hip area, you just managed to target.

My coughing during exercise does not in fact seem to have improved since session 6, but I am not especially concerned about this, as it’s something I have had going on for years, and is probably unrelated to these recent physiological shifts, after all.

The “banana” stretch continues to feel more “even” on each side.  I have now noticed that it’s not just that I can feel more muscles now being worked on the left, affected side of the body – the ones on the right side are also now being worked a bit less than before, and these two things together result in the two sides being closer to each other, in how they feel.  To me this means that before, when doing this stretch on the apparently healthy, right side, it was in fact not giving the right results, and was overworking all the muscles down that side, while those on the affected left side were being underworked.  I think this is simply due to the vertebrae joints that had been working “in tandem” with each other when they should have been moving more independently as I stretch and do other movements, and the cause of that “tandemness” was the tensions that John released in session 6.

There is no soreness or stiffness to the knee joint during any of my usual morning exercises now, and I barely notice the previous more sharp pains to the outside of the joint, as I do my usual squats.  At this rate those pains may disappear completely in another few days or so, which if it happens, will be the first time since around spring of this year, that I don’t feel them at least while doing some activities, such as hoovering.

Walking also seems to be showing more improvement.  I had been relatively close to being fully “even” in my walk on each leg already, and am that much nearer to this now.

I thought it would be a good idea to take another photo of my back, to see whether it confirms my instincts that everything John did in session 6, has continued to remain correctly aligned.  Below is the result, from today Fri 23 Dec 2016.  I think it does show that things have stayed about the same:

nelson-back-on-23-dec-2016-cropped

The only thing I do notice from this, is that the left elbow seems to be “back” to being a bit higher than the right one.  But the spine itself is still straight, and that’s the important thing as, according to John, the area he worked on in session 6, just to the left of the lower spine, has most likely been the source of my continued IT Band troubles, which have also affected the knee joint and slowed its recovery down, until that work John did.

Today I received details of my NHS appointment for an MRI scan on the knee, something my GP recommended we do, following the x-ray results that came in a week ago, and which did not show any bone or attached cartilage wear to the joint, leaving him / us with no indication from the x-ray, of what might be wrong.  The date for this MRI is Thu 26 Jan 2017, so just under a month from now.  For the time being I will assume I am going to attend this appointment, and will confirm it.  If over the next 2 weeks or so, things improve to the point where John and I feel there is no need, I can always cancel it.  But given the long period of several months during which I have had the various issues with the IT Band, the knee joint and the other areas on the same left side of the body, I am inclined to go ahead with the scan, even if recovery seems complete.  If nothing else, it will enable having a “benchmark” set of results for future reference, should there be any other and/or further issues with the knee, for example.

 

 

 

Knees – not just getting old? #16 – Session 6 with John – Mon 19 Dec 2016

We began this session 6 with a brief catch-up on the state of things.  Since my last blog #15 from a few days ago on Fri 16 Dec, I had started having some soreness and stiffness around the outside of the affected left knee joint, if I bent the knee for any length of time – either while it was bearing weight, or even when it was not, such as when resting on the couch.

We also discussed what my GP had said in his phone call to me on that same Fri 16 Dec, when I was told that the x-ray report said the bones showed no wear and were also the right distances apart from each other, which means there was no deterioration to any attached cartilage.  In short, the x-rays of the knee had been evaluated as “normal”.

I went through again with John, the key details of what happened in early December just after the x-rays were taken, when the lower IT Band below the affected knee joint had coloured up and seemed to release a significant amount of residual tension – what I called a “breakthrough” in blog #14.  Among other things, this had resulted in an almost complete disappearance of the pronounced limp I had been experiencing when walking down any slope, and I also then found that the whole joint had stopped getting sore and stiff after even just a few minutes of sitting down.  There had continued to be more localised pains on the outside of the knee joint, which had persisted since that time.

I outlined to John what my GP had said about the report on the x-rays: that although the “normal” results are very good news, they don’t tell us what’s going on – and that, having ruled out bone or attached cartilage issues, this leaves the meniscus as a distinct possibility for being the source of the issues that are still there.

John explained how the meniscus cartilage works and showed me a small mock-up of the knee joint.  He described what takes place when there are “meniscal” issues, as he put it.  One thing he said which I thought quite accurately summed up where we seem to be with the knee, was that once any significant ITB tightnesses are resolved, sometimes any accompanying troubles, such as anything up with the meniscus, then become more apparent.  I think that’s a good description of the events since early December.

In reference to my account of how some soreness and stiffness seemed to have appeared over the last couple of days with no apparent cause, John said that these problems can tend to seem like they are coming and going for no reason, especially if they are due to the meniscus.  He was pleased to learn that my GP had sent off a request for an MRI scan of the knee, as this would enable us to see just what is going on with the various layers of tissue around the joint, and any problems with meniscus, or with anything else, ought to show up on the scans.

John agreed with my suggestion that, since it might take several weeks for the appointment for an MRI scan to come up, in the meantime he and I should see whether we can fix this.

We next moved onto some examination.  John had me stand with a couple of fingers from each hand against the wall, with my shirt off and standing with my back to him.  After noticing a couple of things, he photographed my posture from the back, while I tried to stand up straight, as I would do normally.  We later repeated this, after he carried out some treatment (at that point further on in this blog’s narrative, I have included the “before” and “after” photos next to each other, for comparison).

We had spoken briefly just before this, about the other muscle issues on the affected left side of my body (see blog #02), side-on near the waist, and more to the front from there – around the ribs – as well as lower down and more to the front, i.e. closer to the bottom of all the ribs.  John had me put my arms down to my sides, again while facing the wall with my back to him, and to then lean over to each side – kind of like doing that “banana” stretch exercise I had noticed a difference in and had included in my set of questions for us to cover in this session, but without crossing over the feet.  John observed a significant difference in how the spinal joints seemed to handle me bending to each side.  Leaning to the right was relatively “normal”, but doing this to the left resulted in a number of joints moving all “as one”, instead of each one flexing individually.

This difference seemed to be an important signpost to John, and he was ready to proceed further from here.  He next got me on the treatment couch, and we repeated a “range of motion” test that he had done in our first session 1 on 21 October, including the “big toe test” (see blog #03).  The two legs were more similar than they had been at that time.  John was not surprised by this, and seemed to allude to this perhaps being due to that “breakthrough” release of ITB tension from around 2 weeks ago, an assessment I agreed with.

He then tried a few other checks to see how much movement I had in each leg, and from this he got a good picture of how far I could go before there was any pain on the outside of the affected joint.  At one point he tried to position the affected leg so it was straight, and I commented that as well as giving some pain around the outside part of the joint, and down on below that into the lower leg and even into the IT Band area –  the usual places since the breakthrough events of early December – this positioning felt to me as though the leg was pointing “inwards”.  As I suspected, when he then pointed it a bit “outwards”, it seemed to feel more straight to me, and the pains were less.  John seemed to expect this, and so did I – what feels like a natural position to me, but in fact is not, appeared to be the result of me having had these issues for some time.

The differences between the affected knee and the other, healthy one, were confirmation to me that there is still a fair bit of further improvement to come – something I knew already, but which this set of checks seemed to help me “quantify / measure / gage” somehow.  I was able to get a feel from this, how much I ought to be able to do in terms of my usual forms of exercise.  More on this later.

We then took a look at how I should actually be doing the “lateral leg lifts” exercise to target hip drop, something I had been using for a few weeks (see blog #12).  I had mentioned to John earlier in this session, that of the 3 “hip-drop-targeting” exercises I began doing in mid November, I had stopped the other 2, after trying some light jogging on 20 November resulted in the whole knee joint getting very sore afterwards, especially the next day.  However, I had continued doing these lateral leg lift exercises ever since then.

John had me lay on my side on the treatment couch, and he got me to adjust the angle of my body so that with the side facing upwards, I was leaning forwards from being perpendicular to the ground, by about 15 degrees.  He then had me also modify how I raised the leg, so that rather than mostly activating the muscles right along the side of the body, the glutes should be getting worked more instead.  We tried this while I lay on each side, and when working the affected left side of the body, the glutes were not being activated very well.

At this point John had me lay on my stomach, and he did some work to loosen up some tension just to the left of the spine, around the L1-5 area.  He had identified this tension from having had me stand facing the wall, and he had photographed the effects of it on my posture.  There were knotted-up bits close to several of the L1-5 joints, and he was able to release these.

While he worked, we talked about where these tensions might have come from.  He thought it could have been from the original, poor sitting positions I used to have while working at the computer at home, in my old chair and before overhauling the desk and chair arrangements gradually over the course of our treatment sessions a few weeks ago (see blog #s 04, 06, 08 and 10, especially the photos).

I agreed that those old postures might well explain these tensions, especially since I had been sitting a bit offset at the desk, due to having stored some equipment on the floor underneath the area where the left leg should have had room to stretch out, and this had resulted in me both working with my left leg not fully extended as much as the right leg, as well as probably tensing up the back muscles on the left side, due to sitting a bit “skewed” i.e. with the chair pulled out more on the left side, instead of being parallel to the desk as it is now, in my fully revamped workstation setup.

As he worked these tensions out of the back muscles on the left side, John also commented that this area he was working on, is likely to be the source of the various troubles I have been having, including the IT Band tightening up.

I could really feel the spots John was reaching with what he was doing, and although they hurt a bit as he did them, it felt better afterwards, similar to how it feels when using a foam roller to get out any knots in the leg muscles.

After doing this, John immediately had me try the lateral leg lifts again, to see how it went now.  As well as putting his own thumb and index finger on the 2 sets of muscles that needed checking to be sure the glute muscles were correctly being activated by the exercise, John had shown me how to use my own thumb and index finger to check this myself.  As we repeated this exercise, it was clear to both John and to me, that the glutes were now working much better, more like they should be.  From having done this with him, I am confident I can now monitor this each time I do this exercise.

This modification of the lateral lag lift exercise seems to be key to ensuring that the glutes continue to work correctly on the affected left side, as well as on the right (where our checks had shown that everything seems to be working as it should).

After all this work on the treatment couch, John had me stand facing the wall again, to re-assess my standing posture as seen from behind.  He noticed an improvement, and took an “after” photo.  Below are the images of both “before” and “after” this treatment to the L1-5 areas of the lower back, to the left of the spine.  Although the original photos were from slightly different distances away, I have been able to adjust the sizes to match up reasonably well, and as you can see, I have added some horizontal and vertical lines, to enable comparisons of how everything is positioned.

nelson-back-view-js-session-6-on-19-dec-2016-before-and-after-treatment-cropped

Taking into account the yellow lines, I think there are several things of note:

  • In the “before” image on the left above, the spine slants away to the right from the vertical yellow line, starting around the bottom of the shoulder bones, and going all the way up to the top of the shoulders from there.  This is much straighter in the “after” image on the right above.
  • The right shoulder is “dipped” downwards in “before”, compared to “after”.
  • There is a big difference in how far down the left and right arms hang, in each picture.  Keep in mind that these images are not identical in their overall proportions, so we cannot compare, say, the right arm in one image to the right arm in the other one.  But just look at the difference between the left and right arms from the same image, comparing the locations of the two elbows in that image with each other.  This clearly shows that before John’s treatment, the right arm was hanging down much lower than the left, and after his work, right and left are much closer to being the same as each other.  This is very interesting, as I noticed many years ago – all the way back to my teenage years – that my right arm seems to have more extension than my left, and hangs lower.  This is despite the fact that, a few years ago, another practitioner measured the actual bones in each arm and found that they are all within 1mm of being the same length as each other!

After the treatment part of the session, we wrapped up with a few questions from me, and final comments from John.  When I asked him whether there were any specific exercises I could do to target the other areas on the affected left side – waist, upper ribs, lower ribs – he said that these probably all stem from the lower back area where he had found and released tensions during his treatment, and that doing the lower leg lifts properly as he had shown me, should address the occasional pains in those other areas.  He also repeated his thought that the ITB getting tense was coming from that same area he had treated.

I asked him whether, given what he had found with the current pains and the limits to range of movement in the affected knee joint, I should hold off for awhile longer on any running.  He said, “Yes, if it won’t do your head in”.  I said it wouldn’t, and that I had not done any running since 20 November.  His suggestion tallied with my own instincts, which our work in this session had helped me to clarify.

John did think I would want to do something else for exercise, in place of running.  I asked about table tennis, and he said it’s probably good as a substitute, but maybe not for such longer sessions as I had been having recently, maybe just for an hour instead.  I commented that table tennis isn’t quite such a pure cardiovascular workout, but he still felt that it would act as a substitute to some degree.

John also said that he was pleased my GP was willing to proceed with ordering an MRI scan, as some doctors might just have told me that I was getting old and should expect this kind of thing.  My GP has always been very helpful, and in this case we will be able to take advantage of having a scan to come, in our treatment.  John also mentioned that if the MRI shows there is any meniscus “polyp” etc, I might need arthroscopic surgery on that, but of course we would have to wait and see what the scan turns up, if anything.

In the meantime, I am very pleased that, as well as having potentially identified a further source of the knee issues, and maybe even the original source itself – the tensions in the mid to lower back muscles to the left of the spine – and having treated them, I can now take away something I can do myself to impact recovery, namely the modifications to the lateral leg lifts exercise.

Knees – not just getting old? #15 – Prior to session 6

Fri 16 Dec 2016

Since my last diary post on Mon 05 Dec, the knee has in general stayed more or less the same as it was at that time.  The colouration of the IT Band muscles below the affect left knee joint (see previous blog #14) has gradually subsided and is now no longer visible.  Up until a few days ago, I continued using a more “advanced” roller, that gets in deeper, on the lower IT Band muscles of both legs, and since then I reverted back to the smoother foam roller again, the same one I use for all the other muscle sets.  Although the colouring is gone, the IT Band muscles on the affected leg are still a bit sore, but in terms of how they feel when I roll, they now seem identical to those on the other leg.

While we have been waiting for the results of x-rays (see previous blog #14), I have not made any further attempts to do any running at all  – in fact not since 20 Nov.  But I have been able to start playing table tennis again, including longer sessions – one for around 3 hours and another for around 3.5 hours – without any soreness in the knee joint either after playing, or on the day following that.  This is a  major improvement, and strongly points to the apparent very deep knot in the IT Band muscle, as being the cause of all that soreness and stiffness, which was always felt throughout the whole joint.

Spending any amount of time sitting down – such as when working at the computer – is no longer leading to the affected knee joint getting stiff, but when I get up, which is often, the joint feels like it is still weak in comparison to the other, healthy leg, especially if I then go down some stairs.

My walking gait continues to be almost completely normal on that leg now, without the pronounced limp when going downhill such as I had even a couple of days before the IT Band muscle below that joint began to colour up on 03 Dec.  There is still a very slight limp to my walk though, which might just be from the joint being weak, although I have my doubts about this because, as on 05 Dec, there is still some pain in the joint, on the outside area as before.  This is not soreness and does not feel like it is necessarily muscular either – it tends to be a sharper pain and is felt more when I bend down onto the knee, for example.

Earlier today my NHS GP phoned, and we discussed the results of the x-rays on the knee, which were finally in.  Unfortunately he says he was only sent a written report from the specialists who assessed the images, and that they are unlikely to allow me to have a copy of the x-rays themselves.  But on the very positive side, their report said there is no sign of wear to any of the bones, and the distances between them also appear to be normal, which my GP says means it is unlikely that I have wear to any of the attached cartilage.

This is good news, although it does leave unexplained why, even after the breakthrough events of around 10 days ago (see blog #14), I now continue to have  pains in the joint, in the outside area.  My GP said that it is possible the meniscus cartilage – which unlike the attached cartilage is the relatively more “free floating” version – may have suffered a slight tear or have come loose.  My feeling is that this is possible, as it would explain what it feels like in the affected joint when I bend down at the knees – going back as far as late spring of this year, when I had the waist soreness on the same affected left side of the body (see blog #02), doing such bending down sometimes results in a “late” movement of something that could very well be the meniscus, around the outside of the joint.  This has always felt a bit “wrong” since I first noticed it in late spring of this year, during the 4 weeks while I did no running and instead was using a cycle machine for cardiovascular workouts.

When lying on my left side in bed, I continue to be unable to use my usual sleeping position – with the upper right leg on top of the affected left one, knees a bit offset so the bony parts nestle into the gaps.  After just 1 or 2 minutes in this position, the affected left knee joint – which is underneath when I am lying like this – starts to hurt.  Other positions also on my left side are not comfortable these days either, and I usually end up always asleep on my right side, for which the usual position does not give any pain.  This is affecting the overall quality of my sleep.

It is also still unclear why I was able to run for 14 years – up to the start of 2016 – without any of these knee or IT Band issues at all, and then first the other problems on my left side (see blog #02), then the knee issues, began after that.  If the apparent very deep knot right in the heart of the lower IT Band of the affected leg was the sole cause of all this, I believe the troubles would have shown up many years earlier.

In the phone conversation with my GP, I asked him whether he thought that the troubles with my waist on the affected left side – which go back to spring of this year (after I first noticed something up with my walking gait, but well before the knee started getting sore) – and my use since the spring of Kinesiology Therapeutic (KT) tape in that waist area to allow me to run with no pain to that waist area, all might have gradually led to the lower IT Band muscles getting tighter over time, in the affected leg.  I only began using a foam roller in late September, so any extra IT Band tensions due to either the waist and/or other muscle issues (see blog #02), or to starting to use the KT tape – or due to both of these things – were not getting “rolled out”.

My GP felt that it is definitely possible for the waist and other troubles on that left side to have resulted in the knee issues.  He said that any change to the overall relationships between the various muscles and other parts of the body, could lead to something like this.  He also agreed with my suggestion that using the KT tape might have at least partly led to my gluteus medius muscle on the affected left side getting lazy, which as we know is something else that will result in further tightening of the lower IT Band and thereby contribute to any knee issues.

As a next step, my GP wanted to send me for an MRI scan on the knee, as he felt it would help to further clarify what’s going on with it.  It won’t cost me anything, and due to the length of time I have been having these issues and their apparent seriousness, I readily agreed with his suggestion.  Because his request will probably take a few weeks to make its way through the NHS systems, in the meantime, I said I would arrange to have another session with physio John, which is now booked for this Monday 19 Dec, and that I would keep him up to date with any further developments from my work with John.  In this next appointment, I would like us to cover the following tasks and address some questions, all as bulleted below.

NLJ suggested tasks for upcoming session 6, and questions related to them:

  • Let’s have John examine the knee again freshly, especially the outer part of the joint, and also the lower leg IT Band muscles.  Can John tell whether the lower ITB may still be tighter than it should be on the affected leg?  Does it now feel “normal” to him?  Does he think I may have some tearing or dislodging of the meniscus cartilage?   What is his assessment now, of what is still wrong with the knee, and what I need to do to enable recovery?  Should I still hold back from any running at all?  If so, for how long?
  • From having done extra “hip drop” exercises in late November and early December to specifically target the gluteus medius (one exercise of which I have continued with ever since), I noticed that those muscles feel identical to each other on each side of the body, both before, during and after each exercise.  The only things that have felt different are some lingering pain / soreness to the vertical fascia (sp) muscle just below the waist, and to the nearby rib muscle around on the front of the torso , both on the affected left side of the body (the other issues as in blog #02).  My feeling is that, given the breakthrough events with the lower ITB as in blog #14, I should switch out some of those extra gluteus medius exercises, for others that would more directly target these other muscles instead, to help them heal up.  Let’s have John examine these other muscle areas on the affected left side, and assess them.  Can John recommend exercises to target any residual troubles there?
  • Until I don’t get even any occasional pain in that waist area vertical fascia (sp) muscle any more, my instincts are that I should continue to use Kinetic Therapeutic (KT) tape on it, whenever I play table tennis or do any walking into which I am mixing any amount of jogging / running.  However, it is still not entirely clear just what led to me ending up with the hip drop when planting the affected left leg while running etc.  One reason I think there might be a connection between the KT tape and the hip drop as we filmed it in my earlier sessions, is that I believe the vertical fascia (sp) is in fact the upper extension of the same IT band muscle set, the lower leg portion of which ended up being overly tensed up, through whatever means.  If so then their relationship is fairly direct.  Let’s have me show John how I usually position the KT tape, and historically, how I did it from the beginning of when I started using it, when I was originally using a full length piece (around 8 inches) vertically right down the side of the body, with half that length above and half below the waist, as well as putting on a 2nd piece (about 4 inches long) horizontally, across the waist area.  Let’s also have me show John where, when I do the “banana stretch ” (see blog #02), the muscles down the left side of the body still feel very different to those down the right side.  Is that apparent difference in how the muscles on each side feel, a sign of remaining injury / damage to the affected left side?   Does John think that using the KT tape on that waist area for several months since early summer, in the way I did, resulted in the left leg gluteus medius getting “lazy”, and led to the hip drop downwards to the right, when I plant the left leg?  If so, should I try and move towards full recovery of that vertical fascia (sp) muscle, without any further use of KT tape on it?  What does John recommend re using/not using KT tape, and if he thinks I should use it, given his assessment of the state of this area of the body now, how does he think I should I position it?
  • From the x-rays, we now know that the bones are fine, and the attached cartilages also.  Taking that and everything else into account about the current state of the knee, the waist area etc, what specific exercises does John recommend, to facilitate full recovery?  Would any of the runners’ exercises such as those in the 2nd half of this runner’s video from her website, be a good idea for example?  

Back Pain Help – Final Session

For our final session – a follow-up after a three week break – I was glad to report that I’d been feeling no pain, and only a little discomfort and stiffness in my neck and shoulders still. This was usually in the morning, after sleeping on my side on rounded shoulders, as I always do. We discussed this and thought about how inevitable that might be, and which exercises and stretches actually alleviated that stiffness quite quickly.
Otherwise, John tested the power in my arms and hands, and the flexibility in my legs, all of which were significantly better and functioning quite well. There was still a bit of treatment we could do with the neck, so a bit of clicking and stretching later, I was feeling pretty well mobile and “stacked properly”, as John calls it.
I’m aware now that I really need to keep up the exercises and stretches I’ve been doing, to strengthen particular muscles and also keep my body mobile. I spend so much time in front of a screen at a desk that not to counter that with even the minimal amount of activity was putting huge amounts of strain on my joints, nerves, and muscles. I know now which joints, nerves and muscles these are, and at least part of the way to remedying the issues I’ve been having with them.
We agreed to check in after a couple of months or so to see how I’m doing. Right now, I’m incredibly happy with the progress I’ve made over six sessions, and pain-free.

Back Pain Help – Conscious Competence

Today I came to see John after two weeks off physio – I’ve noticed that the pain is almost entirely gone, and I’m now just a bit clicky and stiff at times. Any pain there is can be quite quickly resolved with posture amendments. Now, my challenge is to up my stretching, pilates and yoga so that it’s a part of a regular routine, rather than a remedy when I feel a bit stiff.
We talked about the ‘competence square’ (I think that’s what it was called) – travelling from Unconscious Incompetence (you don’t know what you’re doing wrong) to Conscious Incompetence (you know, but you’ve not yet fixed it) through to Conscious Competence (where I am now – I know what’s wrong and am fixing it)…next stage, of course, is Unconscious Competence. That should look like regular exercise, and less sitting at a screen; automatic dynamic sitting posture; better strength in my muscles and better posture all round; leading to better movement, and more comfort, zero pain.
We essentially came full circle today – most of the tightness in my pelvic region, glutes, and shoulders has been relieved easily by treatment and stretching. The remaining stiffness now is in my neck and thoracic spine, where the pain originally was that I came to get physio in order to alleviate. So there is a clear path I’ve taken, it seems, that has allowed me to work through the mobility problems throughout my body, and the significant problem areas are all that’s left.
After a bit of treatment, and checking what was stiff/painful/immobile, John and I talked a little about what I could do to maximise further recovery. Ultimately, it’s now up to me to incorporate into my regular routine the particular stretches I’ve been tasked with, experiment with other ones that may help, and generally optimise my lifestyle around my physical health. We’ve booked a follow up appointment to check in in three weeks time. I’m very happy with my journey from beginning to now!

Back Pain Help – First Session

John briefly went over what we had talked about the previous week in my assessment, and asked me whether I’d experienced any new pain from any of the exercise – which I hadn’t. We recapped dynamic sitting, to make sure I was enacting it correctly. Throughout the week, I had still been experiencing pain in my neck and shoulders, but I noticed it had eased significantly when I performed dynamic sitting. The remaining pain was most likely due to the fact that I hadn’t yet bought my planned amendments to my workstation – an adjustable laptop stand, and remote keyboard – and so my posture was still suffering from using a laptop in a way that adversely affected my posture. My vertebrae c3 and c7 were still overloaded much of the time, until I reminded myself to reset my posture which brought temporary relief.
He then tested my flexibility, from not only my neck and shoulders, but also in my hips and feet. He explained that this demonstrated the way that my nerves worked together throughout my body – the nerves, he explained, are like long bits of ‘floss’ that run throughout your body; when you stretch the right arm out, they pull rightwards along your shoulder blades, as though you’re flossing from left to right, and vice versa. Having this visual helped me to understand how and why my body was, or wasn’t, moving… For example, when lying flat my right leg could be raised over 90 degrees, and then adducted (turned inwards) with ease. Whereas my left leg struggled to raise to 90, and was incredibly painful in the hip and buttock when adducted at all.
John then felt the joints in my neck in a few places to identify issues, and clicked my back in a few places – which felt great. Testing the leg flexibility again, just five or ten minutes later, my left leg was almost as flexible as my right, with no pain whatsoever. John gave me a few exercises I could do to ease up the left leg joints and prevent the tightness in the nerves and joints. They were similar to some yoga moves I’d done before, and I could feel that they were quite relieving already.
That brought the session to a close, and we discussed meeting again the following week. I already feel that I’m progressing significantly, and a huge amount of that is in the explanation that John gives, and the resources he gives me to take away, such as videos of stretches and links to information about posture etc. This means I understand not only what to do to help myself, but why I’m doing it.

Back Pain Help – Assessment session

I was really glad of the option to have a 15 minute initial assessment. I’ve previously seen chiropractors, podiatrists, masseuses, and a physio, and so I was eager to accept what AAA Physio was offering: a free appointment that would tell me if a course of physio was right for me, and what it was that I might be able to address with another course of treatment at this point.
dynamic1_nospace
I was sure that I must have caused myself an injury, because my neck, shoulders and back were in almost constant pain, especially on my left side. I assumed that after years of discomfort issues which had got progressively worse, that I had only half-dedicated myself to resolving via one off appointments for treatment, I must have done some sort of irreversible damage – to the muscles in my neck particularly.
John very soon removed that fear, informing me that it was a nerve and particular joints – not a muscle – that was causing pain. He explained that there is a long nerve that runs between my vertebrae C3 and C7 that was likely causing the pain. He examined and adjusted my posture to demonstrate how my usual way of sitting was overloading those two particular joints. He told me that he believed we could achieve a “significant improvement with around 3 to 6 sessions.”
We ended the session by exchanging emails, and John gave me some exercises and examples of ‘dynamic sitting’ – all of which he gave me access to through his website so I could easily review them. That gave me something to work with until our first session.

My 10k Journey #01

I’ve never considered myself a ‘proper’ runner, but in my time I have managed to plod my way round a few 10k routes. Plod is very much the right word. Running has never felt effortless or easy, but rather something I’ve managed to just about conquer.

bridge-runner

That was until the 2015 Bristol 10k, where I was in such horrible pain and discomfort that I decided I really wasn’t a runner and so vowed never to run again. At several parts during the run I had to stop running and was reduced to an awful whimpering hobble, all the while clutching at the root of the pain, my left hip. After a little bit of walking the pain would subside enough for me to run another couple of kilometres before having to repeat the same whimper-hobble-hip hold.

To be fair, I really shouldn’t be too harsh on the Bristol 10k. My hip pain wasn’t it’s fault. It had been there though the other 10k events I’d done that year, steadily getting worse with each run, but then all too quickly forgotten in that post-run euphoria. Giving up running seemed to be the most obvious way to eradicate the pain. And it worked! For a while. Over the past six months the pain has returned when I’ve tried everyday things that never caused me any issues previously – walking moderate distances, gardening, even simply sitting sometimes left me with that all too familiar dull ache in my hip.

Determined to face my nemesis once again, I have signed up for the 2017 Bristol 10k and I want to do it without hobbling. In fact, I want to be able to walk, sit or just generally exist without that nagging pain. I’ve decided to be sensible and grown up this time around and rather than taking the ‘doing more exercise will surely make it better’ approach I’ve decided to get the problem sorted properly.

And so it was that I found myself in John’s clinic last week. After a few questions about my general health, activity and mobility he had me skipping with an imaginary rope to see how each of my legs performed. (At this point I should also mention that I purposely went for a very long walk the day before to make my hip bad – though I really needn’t have bothered as John was able to pinpoint the cause of the problem pretty quickly anyway). It came as no great surprise to me that my left leg didn’t feel anywhere near as stable as my right. Onto the couch and again my left leg continued to be the poor relation when it came to mobility and strength. The most fascinating part for me was seeing how much weaker my left big toe was than my right – it was as if I had absolutely no control over it!

As the consultation continued it became clear that the problem was not actually in the hip itself, but rather in my back, which was causing me to compensate through other parts of my body and thus causing the pain in my hip. John then taught me how to stand properly. At 34 years old, I have finally learned how to stand in a way that doesn’t cause my back to ache – how have I never worked this out for myself?! John also did a little bit of cracking of my back, which led to an immediate improvement in the mobility and strength of my left leg. Clever stuff.

My homework for the week was to practise standing properly. Apparently I tend to stand ‘like a ballerina’, which might look great but actually does nothing good for my back and shoulders. So this week I have been learning to stand like a ski-jumper. I’m delighted to say it’s definitely making a difference. My hip hasn’t been achy, and I’m far more aware of how I’m holding myself and definitely feel less tension in my shoulders. I know this is only the first part of correcting a lifetime of bad habits, but I’m already encouraged by the results.

Knees – not just getting old? #14 – Breakthrough

Something very significant has been happening over the last 3 days, since I saw my GP on Fri 02 Dec and then had an x-ray done on the knee later that day.  I believe these developments have clarified what’s been going on with the knee apparently not responding.  Here are the details:

Fri 02 Dec

After seeing my GP, I stopped by the MOTI store to see whether they had received the delivery of the long, smooth foam roller I had needed, to replace the one I deliberately left on the other end of my recent trip away.  In the meantime, since last Monday 28 Nov, I had been using the shorter, more “advanced” roller, which is harder and has an uneven surface that is said to give a deeper roll.  MOTI did have their delivery, so I bought the smooth one.

I had indeed found that the advanced roller was working deeper into my various muscles.  However, as I am so bony, I was not as keen on it as the smooth one, and so I returned to using that one for my late afternoon roll on this Friday 02 Dec.  Even so, by the end of this day, I noticed that an area on the affected leg’s IT band below the knee joint, had started to colour up a little, and I could also feel some soreness there, as if from bruising.  I thought this might be due to the more advanced roller having reached something deeper, and for now decided to keep an eye on this area over the next few days.

Sat 03 Dec

Today’s plans included travelling out of town to visit friends for the day, and in the evening to attend a stage play that one of them was performing in.  This would involve taking a 90-minute car trip, and I was to stay overnight with them and return on the next day, Sunday 04 Dec.

When I got up on this Saturday and prepared for my usual early morning foam roll and daily set of exercises, I noticed that the spot on the IT band of the affected leg had coloured up more, and there was more localised soreness there.  As I moved around before exercising and rolling, I could feel that localised soreness.  I took the photo below, in which the bruising is circled, and blew that area up as in the 2nd picture:

nelson-it-band-area-bruise-04-dec-2016-reduced-1-sp-cropped     nelson-it-band-area-bruise-04-dec-2016-reduced-1-sp-cropped-blown-up

I considered what might be going on, and put this together with experiences of having noticed something unusual at this spot on my left leg, in both the medium-term and the long-term past.  I had been aware of it since well before I began running over 15 years so, perhaps going back a far as 20 or 25 years.  Some leg movements would very occasionally result in a slight “twinge” coming from that spot.  I never thought much about this over the years, as it didn’t get worse in any way or show any other symptoms, and there was never anything to see.  I had put it down to perhaps being a potential varicose vein (I don’t have any of these that I know of, but there is some history of them in my family), or just an anomaly of some kind.  I certainly never had any injury there.

Once I started running in 2001, any instances of feeling this area give a twinge, seemed to become more and more rare, and over the last few years, I had not had it happen for some time.

The first time this spot came to my attention again recently, was when I started foam rolling a few weeks ago in late September.  Each time I would roll out the IT band muscles below the affected left knee joint, as well as finding, at least to begin with, that there was significantly more muscle tightness in general in that part of the IT band set in comparison to the other leg, I also noticed that rolling over this specific spot seemed to highlight it again as being a little lumpy, in such a way that rolling would come up to it, then “jump” past it.  Because I had known about it for many years and had more or less concluded that it must be some kind of aberration, I did not give it any specific extra attention when rolling.

Now that this spot had coloured up as if bruised, and was sore like a bruise, I began to realise that this might in fact be just another knot in my muscles.  I thought that maybe using the more advanced roller for a few days had reached it, whereas the smoother one had not.  I decided that for the time being, I would keep doing the lower leg IT band rolling with the more advanced roller, and use the smoother one for all the other rolling.  With this in mind, I packed both rollers into my luggage for the car trip to visit my friends for the day.

As the time to take the 90-minute drive approached, I had also started to notice that even moving around in the house, I could feel this specific spot’s soreness a bit.  I began to wonder whether this was simply a really deep knot, and it was finally working its way out.  I decided that just before setting off on the drive, I would take my usual walk in a local park, and would pay special attention to how everything felt and behaved, in particular as I did a short, steep downwards sloping section that, even in the recent days before this, was still making me limp on the affected leg.

John had told me in one of our early sessions, that such a limp when doing a downward slope, is a sign that the IT band is tight and is affecting the knee joint.  My GP had also pointed this out in my appointment with him, the day before this.

When I did the downward sloping section of my usual walk on this Saturday, there were two things different about it.  The first was that I did not limp as much as in recent days.  The second was that I could feel the localised soreness in the area of the IT band on that leg, where the bruising had appeared.  Each step onto that left leg would “trigger” the soreness in the bruised area.  There appeared to be a clear connection between these two areas.

By this time I was fairly convinced that a major shift of some kind might be underway.  I kept an eye on how the knee was feeling for the rest of the day, both during the 90-minute drive, after arriving at my destination, and during and after sitting to watch my friend perform in the stage play that Saturday evening.  In a further significant development, I noticed that the knee was no longer getting stiff at all, even after sitting for these prolonged periods.  This was very different to how the knee had been behaving recently, even just a day or two before this.

As I slept that night, I tried my usual left side sleeping position, and although it did seem a bit better than recently – not giving as much pain to the affect left knee – I ended up settling in less comfortable alternative positions when on my left side, as recently.  I am a light sleeper and turn over a lot, so am never in any one position for the whole night.

Sun 04 Dec 2016

I slept well and long and awoke very refreshed.  My friends live in the countryside, and it was very quiet there.

The bruised area was still sore locally and was perhaps a bit more coloured up, and as I did my usual morning rolling and exercises – following breakfast in this instance – I could feel it.  Right after exercising, we went out for a walk in the countryside.  In all we covered around 4 miles or so, at first on roads, then on footpaths up into a forested area on a long hill, then along the top of the hill, then back onto roads for the rest of the walk.  Once we got back onto the road, there was a long steep downwards section, as in the photo below.  This was an ideal chance to check out how my usual limp was on the affected leg, as this slope was even steeper than the one from my usual walk near where I live, and much longer:

nelson-walk-long-downward-sloping-road-reduced

I could not detect any limping at all as I made my way down this section of the road.   I could feel the sore bruised area a bit, but not as much as on the previous day, when I had done the short sloped section on my usual local walk.

I began to get a bit excited about these developments.  It looks like I just had some really deep knotting in my left lower leg muscle, which happens to have been right on the IT band.  Why this never bothered me for the first 14 years of running, I cannot say, but it could be that those muscle injuries up near the waist on that same left side – from earlier this year (see blog #02) – had contributed to giving me hip drop, and that, combined with this really deep, old knot, had given rise to my knee troubles.

That evening I drove back home, and as expected, when I arrived after the 90-minute drive and got out of the car, there was again no stiffness at all in the affected knee joint.

Immediately on arriving, I did another session of rolling.  I have been finding that after any travelling – either as a driver or a passenger, in whatever form of transport – rolling is a great way to relax all the muscles of the lower body, and it also gives me a chance to check for any special areas of knotting or tension, etc.  On this occasion there was nothing unusual, and the IT bands on both legs were more or less equal to each other, with the exception of the bruised area on the affected leg, which of course is still sore.  I rolled it out anyway.

Right after this quick roll, I took my usual walk in a nearby park, partly to again test out what it was like to do that downward sloping section.  I was not limping for it at all, and moreover, the bruised area was also no longer sore with each step I took on that leg.  This was a further sign that the direction of travel of this old, deep knot, is outwards / towards it dissipating.  Horray!

After the walk, I did my usual late afternoon / early evening rolling, stretching and exercises, which also felt very good.  As you can tell, on this particular day, I ended up rolling quite a lot.

Part of my usual stretches at the moment is one called the “banana” stretch.  To do this, stand side-on by a table or desk, cross the leg closest to the table/desk over the other one – across the ankles – and then bend the upper body towards the table / desk, while resting the arm nearest to it, on the table/desktop.  This should stretch out various sets of muscles that run all the way up and down the side of the body.

Since I had been having the other muscle troubles going back to earlier on in the year (see blog #02), this banana stretch had been feeling very different when done on the affected left side, compared to how it felt on the right side, something I had been thinking was perhaps an indication that those other muscle problems had not fully healed up yet on the affected left side.  I might have been imagining it, but it seemed that now, this felt more similar on both sides.

I decided I would go try playing some table tennis, as Sunday is one of the days I can play at one of my usual venues.  When I arrived there, a league tournament was still underway from earlier in the day, which was running late.  I opted to stay and wait for a chance to do some playing, and spent much of the next hour standing up, which felt good.

I was then able to play 2 stints of around 20 minutes, with a gap of about the same length of time between them.  As well as not feeling any pain in the knee joint – even in the area on the outside of the joint where the more acute pain had sometimes been occurring – I seemed to be able to extend the leg more properly when going for shots that were a bit out of my reach.  It’s not easy to put into words just what felt different, but my instincts were that this was all now going to settle down and heal up, finally.

I took a hot bath after getting home, then rolled, after which I applied some homeopathic Arnica cream to the bruised area, to help draw it out, and then took it easy on the couch.  When I was ready to go to bed later, I had been lying on the couch for a while, something that previously, even just a few days ago, would have left the knee noticeably stiff when I would then get up off the couch.  It was not stiff at all this time, when I got up.

Mon 05 Dec 2016

Today the knee has not been stiff or sore at all during the first part of the day, which is a major change from the days following me doing any amount of either running, jogging or playing table tennis, going back over 2 months.  I have been sitting at my new chair at the computer since late this morning – getting up often as I usually do.  Although there is still no stiffness or soreness when I get up, going downstairs does show that the affected left knee is still a bit weak.  But I am certain this is partly from this new positive shift being such a recent development.  Also I believe that when I take my usual walk again today, it will do the knee much further good.  I hope to clean the house fairly thoroughly this afternoon, which will also be good exercise.  The body seems to want activity right now, so I intend to comply.

Here is what the leg looks like today, after having applied the Arnica cream yesterday evening – it’s fairly similar to last Saturday, 2 days ago:

nelson-it-band-area-bruise-05-dec-2016-reduced

The best part of having been able to play table tennis yesterday without ending up really sore today, is that I am confident I can now very gradually begin to add some jogging into some of my walks, as well as playing table tennis again – and because I won’t be relying just on any running/jogging for significant exercise, I can take my time about getting back to doing my usual running distance of around 4 miles every 3 days.

I am now convinced that the reason the knee troubles have been lingering so long, following all the other changes we have made from my treatments and sessions with John, is that this one really deep area of muscle knotting, right on the IT band, has only now started to let go – as it happens, probably because for a few days, I have been using the more “advanced” roller, for the first time ever.

I don’t intend to be doing much running or jogging in terms of distance, until after we have had the results of the x-rays of the knee that were taken last Friday 02 Dec, following the appointment with my GP.  That’s a precautionary measure which is easy to take and is sensible, given the severity of the troubles I have been having with this knee.  My instincts are that the x-rays will not show anything amiss, but let’s wait and see.

I now have a couple of questions for John, in light of all these recent events:

  • From recently having been doing the hip drop exercises to specifically target the gluteus medius, I have noticed that those muscles have been feeling identical to each other on each side of the body, both before, during and after each exercise.  The only things that have felt different are some lingering pain / soreness to the vertical fascia (sp) muscle just below the waist, and to the nearby rib muscle around on the front of the torso, both on the affected left side of the body.  My feeling is that, given the breakthrough events as in this blog #14, I should switch out some of those gluteus medius exercises, for others that would more directly target these other muscles instead, to help them heal up.  Can John recommend any such exercises?
  • Until I don’t get even any occasional pain in that waist area vertical fascia (sp) muscle any more, my instincts are that I should consider continuing to use some Kinetic Therapeutic (KT) tape on it, whenever I play table tennis or do any walking into which I am mixing any amount of jogging / running.  However, it is still not entirely clear just what led to me ending up with the hip drop when planting the affected left leg while running etc.  Is it possible that using the KT tape on that waist area for several months since early summer, resulted in the gluteus medius getting “lazy”, and led to the hip drop?  If so, should I try and move towards full recovery of that vertical fascia (sp) muscle without the use of any KT tape on it?  One reason I think there might be a connection between the KT tape and the hip drop as we filmed it in my earlier sessions, is that I believe that vertical fascia is in fact the upper extension of the same IT band muscle set, the one which ended up being overly tensed up, through whatever means.  If so then their relationship is fairly direct.  What does John recommend?
  • Now that we seem to have achieved a breakthrough on the knee joint itself, my instincts are that I need to add in some further exercises to specifically add strength to the knees.  I was impressed by the other exercises for runners as demonstrated by that runner from Portland Oregon in her website :http://carrotbowl.com/how-i-cured-my-runners-knee/

    The exercises also followed her showing how to foam roll, from this video embedded in her site:

    Does John think it would be a good idea for me to now begin adding some of these in?  If not, does he have any other, perhaps more suitable ones he would recommend?