As most of you know, after the weight gain, the issue with my knee, and then the broken toe (ouch!), I got back into stride with doing Couch to 5K. This has probably been the hardest time for me to get back to running again. It's not so much the injury as the weight gain. I'm trying to move 20 extra pounds and it's just not that cute. I will work it out, but it's going to take some time. I hate this weight gain and I feel like I've let myself down (and others, too), but I know it's not healthy for my joints and I'm taking the steps to get it gone the right way, so it's just a matter of time and effort.
Today I started back with physical therapy again. I don't know if I blogged about it, but the previous provider said that I had osteo-arthritis. When I tried to go back to CardioFunkytown and my knee started hurting again, his response was pretty much well, you're always going to have problems with your knees, etc. Huh? Nah. I need something better than that!
When I went to my PCP to follow up on the broken toe, I talked to her about the weight gain and also about my issues with my knee. I felt really comfortable talking to her because, in addition to being my PCP, she also does sports medicine, and she is a runner herself. She asked me if I'd be ok with doing another set of x-rays, just so she could take a look at my knees. She went over them with me thoroughly and did NOT see evidence of osteoarthritis. From the symptoms I described (pain and clicking in my knee, feeling like maybe it wasn't tracking properly), she felt that I had patella femoral syndrome. Finally - there's a name for it!
She referred me for PT with a new provider, and today was my first day. I really like my therapist. He was very thorough. He really read through my history and the notes from my doctor - I didn't have to rehash everything because he knew it already. He says that the problem with my knee is two fold:
1. like a lot of runners, I have tightness in my IT band. I never thought about it, but he pressed on it and it was tender/sore. That tightness is pulling my knee cap to track outward, when it should be tracking inward.
2. my inner thigh muscles are not strong enough to support my knee cap and sort of pull it back to where it needs to be.
Therapy is going to be 2x a week for 4 weeks to begin. I have exercises I can do at home, particularly some IT band stretches that should help. I chuckled because one of the stretches is something that we do at the end of yoga class sometimes. We are also going to do strengthening exercises like leg extensions, squats on the wall, and straight leg lifts. But for all of these I have to squeeze either a ball or a rolled up towels between my thighs, to keep my knees from sounding like a bowl of Rice Krispies (snap, crackle, pop!). I am looking forward to it because I like lifting weights and I wouldn't mind getting stronger.
One of the things he tried today, which I didn't have at the previous provider, was electrical muscle stimulation. Now, as a claims rep, I've seen this coded on bills many times, from PT providers and from chiropractors. I never thought much about it and didn't really know how it would work.
He hooked up the electrodes to my inner thigh. I was lying down on a table. He said that if I could tolerate it, he'd want to get it up to a level where it caused the inner thigh muscle to actually twitch. I told him to go for it. He turned it up and the level where he stopped was a bit too much for me to tolerate for 10 minutes, so he turned it down a notch. Then he added in the kicker - every time the stim kicked in, I was to flex my leg and tighten up my quad.
Let me just say that EMS is no joke! About halfway in that machine kicked in and I tightened up my thigh and I think I made a noise out loud...lol! The longer you sit the more intense it gets. I had to do some yoga breathing for the last 4 minutes or so. Whoo! BUT, afterwards it felt really good. I was able to get up from the table without much pain. It's feeling pretty good as I sit here and type this. I definitely want to continue with that as part of my treatment.
The best news was that neither he nor my PCP want me to stop yoga or running. I was really hoping they would say that. I made sure to ask about that, because I don't want to derail my healing/therapy, but I don't want to derail my fitness goals, either. Depending on how late I work tonight, I want to hit the greenway and start week 7 of C25K, since I went to PT instead of running this morning.
Hope you all are having a healthy, injury-free week! :)