Monthly Archives: January 2017

Knees – not just getting old? #21 – Before MRI scan

Mon 23 Jan 2017

Since my last blog post on Fri 06 Jan, the knee has improved only slightly.  For much of the time it is still tight in the joint, and it also seems tight around the lower IT Band area when I bend it – even if bending with no weight, i.e. lifting the leg up and bending at the knee.  The rest of the time, it is a bit better than this, but still has what feels like tightness in both of those places.

Lately I have begun to think that the “tightness” in the lower IT Band is not to the ITB muscle itself, but maybe just the sciatic nerve.  Whenever I foam roll, which is 2 or 3 times a day, that lower ITB is no tighter than on the other, healthy leg.

On once occasion I tried a foam roll on the ground and  with the affected knee joint bent, to see whether the ITB would seem to be tight – but this proved to be pretty much impossible to do properly, so I did not get a definitive result from it.

Whatever is up with the ITB, it feels like borderline pain that is sharper than in the knee joint itself.  I can even feel this borderline pain in the ITB if I press on that area with my fingers while the leg is straight and the muscles are not being worked.  This is partly why I suspect it is more to do with the sciatic nerve, than the muscles in that area.  The joint mainly feels tight around the outside, as it has done for some time.

I have done John’s new recommended ankle exercises every day since my last post on 06 Jan.  I cannot tell whether there are having any effect, but am doing them anyway.  If they are working to help the joint stay loose, I think it is only by a little.

I have done no running for 2 months now.  Since my last post on 06 Jan, I have played some table tennis.  This sometimes seems to leave the joint worse off the next day (tighter), but not always – and it does not seem to be related to the length of time I play, more to whether I hold back a bit when going for shots, or take them fully committed.  Unlike the more severe troubles I was having before early December, the joint is not sore on the day after table tennis.

When I bend the knee, even without putting weight on it, it still does not “pop” as much as the other, healthy knee joint.  When it hardly pops at all, these are times when the joint is always tighter.  When I have been working at the computer and get up, I often get a small pop from bending the knee, and the joint and ITB feel a bit less tight.  On days when I am not at the computer and do not do any sitting of that sort, the joint pops less, and is a bit tighter in general.  I find this to be a strange observation, but that’s what’s going on.  Maybe it tells us something about what’s wrong with the knee.

I have been walking most days, for around 1.5 miles or so usually.  Walking down a slope no longer results in that “goofy” gait, and there is no specific pain in the knee joint now, when on a downward slope   – but overall, I am still favouring the affected knee a bit when I walk, and I can almost always feel that something in the joint is not right, as I take each step.  I would not want to do any amount of running or even jogging on it, at this time.

I still cannot use my preferred sleeping position when on my left side.  It continues to give the same pain to the knee joint as it has done since early October last year.

I am having the MRI scan this Thursday 26 Jan.  I have spoken to a technician there, and they have told me that the area the scan will cover should include about a third of the way down the lower leg from the knee joint itself, and a third of the way up the upper leg from the joint.

With the lower IT Band clearly playing some sort of a role in the current state of the knee joint – even if it is just the part of the sciatic nerve that goes across the ITB – I am wondering whether it would be a good idea to ask the technician to aim the MRI scan down a bit lower, so it still includes the whole of the knee joint itself, but also picks up more of the lower ITB.

That is a question I would like to hear from John on, before the appointment for the scan on Thursday.

Thu 26 Jan 2017

The scan took place today.  There were no issues with how the scanning process went.  They told me the results should be with my GP in about 2 weeks.

From Marathon to Antarctic

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Will, after running the Berlin Marathon in September 2016.

 “Was a good run, quite sore from the outset but the cap, now known as ‘John’ worked very well to hold form. Hop flexors went to pieces around 32km but determination held it to the end!”

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Will has recently flown off to Antartica to film Penguins for the BBC Wildlife.

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Knees – not just getting old? #20 – After session 7 with John

Fri 06 Jan 2017

Since seeing John in session 7 this past Monday 02 Jan, the knee and lower IT Band issues hovered around being the same for a day or so, then seemed to get a bit worse for the next couple of days up to and including yesterday 05 Jan, but today there has been a noticeable improvement again.  During these few days since that session 7 appointment, I have not done any running or played any table tennis, just done my usual sets of daily exercises, and on most of these days I also have taken a walk of around 1.5 miles.

Since the appointment, my back has been really excellent the whole time.  John’s overall work on it from sessions 6 and 7, means we seem to have covered all of the back, from right down at the bottom all the way up to the neck.  It all now feels very solid and strong, as well as feeling even on each side of the spine.  My upper body and shoulder joints also continue to “pop” more equally on each side, as they have done since session 6.  If any previous discrepancies between the areas to the left and right of the spine, and/or any tensions anywhere along it, were contributing to the issues with the knee, I don’t think they are a factor any longer.

I have been fighting off the “lurgy” that is making the rounds, since about a week ago.  After starting out as just a mild sore throat and slightly runny nose, so far it has not turned into a proper cold and has not gone down onto my chest.  The recent colder, more raw air quality has irritated it and made me cough a bit – and at times this gets out of hand and becomes deep coughing that seems to be an attempt to clear out the lower lungs.  I believe that John’s work on my back has played a key part in this cough not becoming, so far, too serious.  In the past, whenever I would get something like this, I would easily end up with a bad cough that hung around for some time.

I also note that, when around a year ago I was having one of these “fits” of deep coughing, it was at that point which I seemed to pull something around the rib area on my left side, and after that the various other issues also turned up on that same left side, where I eventually ended up with the knee troubles as well (see blog #02).  I have been keenly aware of this over the last few days, and without trying have made comparisons between how my current occasional spells of deep coughing feel, and how that one felt around a year ago.

My overall assessment of this, is that I think I am structurally in much better shape now – with the back etc all aligned much better following all of John’s work, and with the revamping, as per John’s advice, of my workstation since a year ago also contributing to me sitting with better posture for a lot more of the time, and so on.  This all leaves me feeling more confident, and less worried about any recurrence of last year’s rib troubles.  If nothing else, my current deep coughing is more evenly distributed left to right than it was a year ago, and this on its own means I feel less susceptible to any similar injury.

Incidentally, it seems clear now, after the last 2 sessions with John, that the tensions just to the left of the lower joints of the spine, which he was able to release in session 6, were probably the reason that I ended up pulling something in the first place, in the left side middle rib area around a year ago, during that coughing fit.  I say this because now, aside from occasionally feeling a little mild soreness around that middle rib area now and again, since the session 6 work the rest of the issues nearby have subsided – including the more acute soreness on the left side of the body and at waist level, and other soreness in the ribs, found lower down and also on the left.

Regarding the timing of things, I am fairly sure it was well before those rib troubles started up a year ago that, due to those previous lower spine tensions, my spine was slanting off to the right in my upper body, when viewed from the back (see session 6 “before” and “after” photos, in blog #16).  I believe this because, until session 6, and for a really long time – going back so far that I don’t remember just when it actually started – the joints in my upper body and shoulders were “popping” unevenly left and right, whenever I would do stretching that targeted those areas.  Since John’s work to release those tensions in session 6, they pop much more evenly.

Re my current cough, of course I am taking the usual precautions and treating it in a sensible way.  Hot drinks of raw garlic is one thing I find works especially well.  Also, the other day at a health shop I found a great sugar-free brand of cough drops from Switzerland, called “Ricola”, with something like 7 herbs in them.  Using these really helps settle the cough down, at points when it is trying to get started up again.

I have been doing the new ankle exercise John showed me in session 7, although I forgot it on a couple of occasions.  I think I have now managed to get it into my usual routine in such a way that I can better remember to do it every day.

When the knee and ITB got worse around the middle of this week, they felt even more “too tight” and hurt a bit more than recently. Yesterday this was so marked that it was happening even if I stood upright and did not have the knee bent at all.

By the end of yesterday I was beginning to think I might have to drop out of a table tennis session planned for this evening, if it felt the same today.  But this morning, it seems to have settled down a lot – there is still some ITB tension, but it’s less than yesterday, and the joint no longer feels nearly as tight as it did, even just yesterday.  Going up and down the stairs feels much more “normal” on that knee.  This unexpected improvement seems to have left me with more energy today, and I threw in some physical household cleaning tasks at the start of the day, which otherwise I would have been disinclined to do.

Based on how it feels today, I think the knee could even take some targeted exercises to strengthen it.  I will hold off on these for a few days though, to see whether things continue in the same direction.

As for why it got worse and then better, I think it might be the result of John’s work in session 7, especially including the treatment he gave to the top of the lower leg – just below the knee joint – where he found some further tightness, in addition to the pains in the IT Band itself (see blog #19).  As well as him deciding to do some work to loosen it up, that further tightness led him to recommend the new ankle exercise.  If the outcome of loosening this, and of me doing the ankle exercise, is that the knee is now more prone to sit “correctly” in comparison to its less correct alignment as from the past several months, then the long period of time during which it was misaligned, may mean it must now re-learn / re-adjust, to being in the right place again.

The degree of worsened pain, and generally what it felt like for those last couple of days before today, was a bit different to how it had felt previously.  This supports the idea that things are still in the process of making their own adjustments.

I just remembered that I noticed one more thing today, when doing squats as part of my usual morning exercises.  The affected left knee was “popping” much more of the time as I did these, than it did even yesterday – bringing it closer to doing this as frequently as the other leg, which for some time has popped more often.  I have always thought that the less frequent popping of the affected left knee has been a further sign that it is still not right.  If that’s true, then this increase of that frequency is a very positive sign that things are on the mend.

I have decided to go for table tennis tonight after all, and to keep an eye on how the knee feels.

 

 

Knees – not just getting old? #19 – Session 7 with John – Mon 02 Jan 2017

We began this session by a review of where things are now with the knee.  John speed-read my blog #18 for this, we spoke a bit on it also.  I said that where things are can best be summed up by the fact that, even if I simply raise the affected left knee up so I am standing on the other leg only, bending the left knee while raising it and thus not putting any weight on it, the joint still feels too tight, especially around the outside area, and also I can feel the lower IT Band further down below this,  as though it is too tight, and also bordering on there being a little pain that is sharper.

After this we started some treatment .  First John checked the range of motion of each leg, as in earlier sessions.  They were more similar to each other than in the past, but the affected left leg was still not as flexible as the other one.

John had me show him how I was getting on with the modified lateral leg lifts, and was satisfied with my progress.  He also repeated the check of my back as in the previous session 6, and he found it had remained straight since the lower back manipulations he had done in that session, as had also been confirmed by the photos I had taken during the interim period since session 6 (see blogs #17 and #18).

Next John did some further manipulations on my back, starting with the middle section and working up to the top.  These were all done both to the right and the left of the spine itself, and the affected left side had noticeably more tensions in it, which seemed to release as he worked.

John continued with some work on the lower back area, again on each side, this time further down than even in the previous session 6.  He would get me into just the position he wanted, then have me take a breath and relax/release it, and then he would “push” with either his hand, an elbow, or whatever else worked best, to release the relevant joint, etc.

Next he repeated some of the range of motion checks, and the affected left leg had improved quite a lot, and seemed to me to be showing a range of motion that was now much closer to the other leg.

We discussed the apparent over-tightening of the affected knee joint and of the lower IT Band on that side.  Even after all these manipulations, which had certainly had an effect on how my back felt, the knee and IT Band still seemed too tight.  John described how the sciatic nerve also runs down past the lower IT Band, and up to the top of that bone in the leg.  He tested that bone just below the knee joint, and decided it was indeed tighter at the joint on the affected leg, compared to the other leg.  From his description, my instinct was that maybe the “almost painful” feeling I was having in the ITB was actually the sciatic nerve itself.  I could indeed also feel that sharper pain all the way up to the knee joint, right in the places where John said the sciatic is located, which would suggest it is the sciatic nerve I am feeling.

John did a bit of work on that area just under the knee joint, at the top of that long lower leg bone which runs all the way down to the ankle (the fibula? or tibia?  I can’t remember which).  He did this work on each leg, as with the manipulations to other areas, and was again satisfied afterwards that some of the extra tensions in the affected left leg had been released.

Next John showed me an ankle exercise as a recommendation to add into my usual daily exercise routine, one that he said should target this tightness around the leg bone, just under the knee joint.  While lying on my back and with my legs straight, with each leg I must bend the ankle joint “upwards and outwards” as far as I can, then straighten that ankle joint “downwards and inwards” as far as possible.  He suggested around 10 to 15 repetitions of this.  Both legs can be done at the same time.  Trying it out while lying on John’s treatment couch felt good, probably because up to now,  I have not had any other exercises in my usual daily set, that work the ankles in this way.

I commented to John that when I get into one of my usual sleeping positions, lying on one side, if it is on my right side (with the right leg thus under the other one), bending the right ankle joint to stretch it, usually gives a nice healthy “pop”, but when lying on my affected left side (with the left leg under the other one), bending the left ankle joint almost never gives any pop, and has not done so for a long time.  My instinct is that this discrepancy is due to this extra tension that John found just under the affected left knee joint.  If so, and if both John’s work today and doing the new exercise are to have the desired effect, then both legs might eventually behave more similarly to each other, when I do this ankle stretch while in bed.

I commented to John further, that when bending at the knee, the affected left knee joint still does not give off a “pop” as often as the other, healthy right knee joint.  I said that I think this is another sign that things are still not right in the affected left joint.  I will be keeping an eye on whether this now also changes over the next period, following our work in this session 7 today, and as I add in the new ankle exercise.  My suspicion is that we may now start to see a change to this.  I also told John that my instincts remain the same regarding possible damage to the meniscus – at this point, I still don’t believe there is any.

We spoke briefly about the upcoming NHS MRI scan of my affected left knee joint, which is scheduled for Thu 26 Jan.  John was pleased that we have a relatively early date for this, and said that there was not much more we could do until the scan results are in.  He thinks the scan will show something, but does not know just what.  It ought to tell us if anything is up with the meniscus, for example.

In the meantime, I will add in the new ankle flexing/moving exercise, and see what effect, if any, this has on how the leg feels.  I believe it will make some kind of a difference over time.  Today’s session 7 work on my back and knee joints, may also have an impact on what’s going on with the affected knee and its lower IT Band – I imagine this should show up over the next few days or so, if it is going to make a difference.