Knees – not just getting old? #29 – Before session 9 with John, including recent summary

It’s been 7 1/2 weeks since my last blog update #28 on 22 July.  I have just made a further appointment with John for later this afternoon.  At the end of this blog page I will outline what I would like us to cover in that appointment, but first below is a summary of the key events since blog 28.

On 28 July I saw the other practitioner, an orthotics specialist, for what will, for the immediate future, probably be the last time.  My new orthotic insoles were ready – one for each foot – and as well as trying them out in various pairs of shoes to ensure they fit fine, he got me onto the treadmill and filmed me running, to see whether they had any effect on the rotations noted at the back of each leg, especially the affected left leg, whose knee had been giving the long-standing problems in the tibio-fibular joint, which I originally first came to see John about in October of 2016.

This 28 July appointment also coincided with the day I could remove the final 3mm from the original, “non-slanted/non-orthotic” insole I had been wearing only in the left shoe (see blog #28), taking me down to having nothing at all, rendering my posture completely “unassisted”.  The transition “down to nothing” had been made over the previous 3 months, and as this other practitioner had predicted and hoped, I had been having minimal issues with the neck pains during this transition.  Those neck pains were what had led me to try a”normal” insole, on the recommendation of a different physiotherapist altogether, someone I had seen many years ago (see blog #01).

This coinciding was helpful, as it was now time to try out the new orthotic insoles, which look fairly strange and have slanting down from the inside to the outside of each foot, near the heel.  Here is what these new ones look like.

.                                   Top view                                                                               Bottom view

 

 

.                                               Side view, upside down from the back

There is around 3mm more extra height added to the one for the left leg, the one I have been having the knee issues with.  This was deliberate and was at the discretion of this other practitioner.  They are a bit weird looking, but they do work: his observation of me running on the treadmill during that final appointment with him on 28 July, was that there was no more rotation in the left leg – the insole had apparently worked as expected – and there was just a little rotation in the right leg.  He commented that the causes of the rotations in each leg are different to each other.  I did not follow up with him on this.

Up to that appointment, I had not been doing any full running since the middle of June, as not just the tib-fib but also main the joint itself had been feeling not quite properly aligned, and had been giving some pains (see previous blog #28).  Instead I had been mixing in a few very short runs of 1 min or less, while taking walks.  So when I ran on the treadmill in the 28 July appointment with the other practitioner, it was the first time I had done that much in several weeks.  In the end he had me going for over 7 minutes, and he told me that was equivalent to around 3/4 of a mile.  With my much better running technique, I had found this “short” treadmill run to be really easy, and was amazed I had run that far so easily.  Afterwards I did not have any soreness, either.

The other practitioner’s assessment was that I could now start to gradually increase the time I was taking when mixing the running in, while walking.  That was the conclusion of the appointment with him.

Also around the end of July – starting a few days before that 28 July appointment – I had made an interesting and helpful discovery.  Due to the continuing pains in the other, right leg’s hip joint from sitting at the computer while working, I had decided to experiment more with how I was using the tennis ball to stretch out the glutes and piriformis muscles (see blog #28).

When that other practitioner first brought the importance of the piriformis to my attention in the spring of this year, I had started to use the tennis ball on that area, as well as on the glute max and glute medius muscles.  What I realised in late July, was that I was only using the tennis ball around the middle area of each of these muscle sets.  I figured this out because the first time I tried moving it around to cover much more of these muscles groups’ areas, I found huge amounts of muscle knotting, especially around the [quite large/”long”] edges of each group.

As with other places in the body where I have found knotting, I went after this with a vengeance, and within a couple weeks, it was completely gone.  But even just after the very first time I worked the tennis ball all the way around the glute medius and piriformis, I was amazed at how much better all those muscles felt, and I noted especially that it seemed like I was now able to get a proper “transfer” of power into my backside muscles and get them to do what I really wanted them to.  It was as if they had not been getting fully engaged before this, and now, when walking, doing the other practitioner’s recommended exercises for the backside, and even just standing and clenching the butt muscles a bit, they were working “to full design specification”.

Since then, any time I walk anywhere, the backside really feels like it is working as it should, and this has made it a more enjoyable activity.  Table tennis has also been impacted by this, in a very good way.  I am getting a lot more power into my shots than before.

By around the start of the second week in August, I had experimented that much more with the tennis ball, and had discovered more muscle knotting right around the hip joints, especially the other, right leg hip.  Within a couple of days of including working all this out with the tennis ball, in both hip joints, I found that the long-standing pains I had been having in that right hip joint from sitting at the computer, had improved dramatically.  Since then, this had hardly troubled me at all , and I have concluded that knotting was the cause of this, and that using the tennis ball has cured it, provided I keep doing that.  Horray!

Using the tennis ball, around this time I was also able to partly address some long-standing pains around the middle of the affected left side’s waist area, where the ITB muscle turns into a tendon at the waist, and in the muscle around the ribs at the front of the body on that same left side – another issue perhaps related to the poor sitting posture I had until I came to see John and we eventually sorted out my workstation setup etc.  These waist and rib sorenesses have improved markedly as a result of targeting them with the tennis ball.

Also around the start of the second week in August, I woke up one morning with soreness deep inside and under the right shoulder blade (scapula).  It felt like I had pulled a muscle in there, perhaps while shifting around during sleep.  I had a very old injury around there from my late 20s (over 35 years ago), and wondered whether this mild recurrence of trouble in that area, might be related to the changes in the body taking place since wearing the new insoles.  In any case, it took around 2 weeks for this to get back to normal.

I then had a similar thing happen under the other shoulder blade, but not as bad.  For prevention of this in the future, I decided maybe it was time to branch out the foam rolling I had been doing on the lower body for nearly a year now, to include the back as well.  On the internet I found some simple rolls for lower, middle and upper back, and even one for the scapula area – just where I wanted to target, among the other places.

As with other parts of the body, when I did a first foam roll of all these bits of the back, it showed there was significant knotting, and it also felt really good.  I was immediately hooked, and since them have included them in my usual daily morning and late afternoon exercises.   Table tennis especially has benefitted from this rolling of the back, but also in general I feel much better in my upper body, and this includes my breathing, which I think is using more of the upper part of the lungs now, something I was weak on before.

Also around the start of the second week in August, I had increased the duration of 4 short stints of running mixed in with walks, up to around 3 minutes each – so 12 minutes of running within a walk, done every third day.  But I had started to feel some pains in the main knee joint again, but slightly different to anything felt before, and more related to the main joint.

I decided that the body was probably still adjusting to me wearing the new orthotic insoles, and that at least for the time being, I would have to stop doing any running at all.  So I packed it in and just played table tennis, which didn’t seem to bother these main joint pains as much, although I could still feel them, and my table tennis game was definitely hampered by them.

After another 1 1/2 weeks, in late August, these main knee joint pains were a bit better, and then one day as I was doing the hoovering around the house, the joint gave a nice “snap” at one point, and after that the main joint felt much better.  Since then it has not been an issue, provided I am able to get in walks and/or table tennis on a regular basis.  My conclusion from this is that I was right in thinking that the body was adjusting to the new orthotic insoles.

By late August I had decided I could start freshly with mixing in short runs with walks, to begin with just 4 stints of 1 minute each, i.e. “back to square 1”.  I was just at the point where I was ready to do this, but then came down with a nasty infection in the bursa of my left elbow, partly due to both elbows being sore from using them to prop up while foam rolling, and partly because I have eczema which makes the ends of the elbows itchy, and I had scratched this open on the left one, then put some aloe vera lotion on it, which led to the infection.

The elbow swelled up a lot with excess fluid and was also quite painful, and I couldn’t do anything much at all without it hurting.  Also the whole elbow joint was out of alignment from all the fluid.  I saw an NHS doctor who prescribed antibiotics and rest for the elbow.  After the full 5 days of antibiotics were done, there was still pain and swelling, and they recommended I take anti-inflammatory painkillers for a few days.

Eventually this was all fine again, but of course I had not resumed any running, and still have not done so.  I have played a fair amount of table tennis over the past week, and as well as the elbow being fine from this, the knee is feeling really good, so I am at the point where I think I can start adding in running to walks again.  But I wanted to see John again first, to go through a few things with him.  Here is a list of what I would like us to cover when I see him later this afternoon:

  • Now that I don’t wear the “normal” insole only on the left leg and wear slanted, orthotic insoles on both feet, the height difference between left and right is that the left one is around 3mm higher than the right.  Following the 3 months of transition down from the original, “normal” insole of 11-12mm on the left side only, to where things are now, there have definitely been some adjustments made in various places, including the upper body, and the left knee itself.  Let’s have John take a look at my “left to right” posture and photograph my back again, to compare with pics he tool in earlier sessions I had with him, and perhaps to examine me for range of motion in each leg, as he has done in previous sessions.
  • When foam rolling, recently I have become aware that one roll I do, always makes the vertebrae click a lot when I roll on my left side, but not at all when I roll on my right side.  I suspect this might mean I still have some residual knotting in my right side, just to the right of the spine itself.  John found some of this in an earlier session and worked on that area, which helped at that time.  Let’s repeat the examination for this and, if he thinks it’s knotted up again, have him work on it again.  I think the fact that my body weight etc is now closer to being more evenly distributed left and right of the spine, might mean this treatment would “stick” better now, than the last time he did it.  I will bring my rolling foam along to demonstrate this strange, “one side only” clicking I have noticed.
  • I want to show John the bumpf the other practitioner gave me of the exercises he has recommended I do for the backside muscles.  They have really helped to wake up the muscles on my backside, which has completely transformed both my walking and running gaits – they each had a quite short stride for one thing, which is no longer the case.  I will bring these bits of bumpf along.
  • Let’s get me on the treadmill and film me running, so we can compare my form to the films we took in previous sessions.

 

 

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