I've said a few times that my diet usually follows my workouts. If I'm working out, my diet is impeccable. If I'm not working out, i lose all motivation for diet. That being said, I've been doing tons of hip and core strengthening, as well as lifting upper body 4 times per week. I'm not really sure where I stand though, and thats probably the most frustrating thing for me at this point.
I'm really curious as to whether or not the osteochondral defects are just coincidental. I want to know if they're incidental, or if they are in fact the root of my problems. Basically if i try to do anything weight bearing on my right leg I get lateral knee pain. Let me rephrase that: Anything above 100% weight bearing. So for instance, I can stand on my left leg all day and not make my pain worse. However, if i do an activity that causes me to have to push down on top of the 100% weight bearing (stairs for example) I get a pain that makes me feel like my femur can't support the pressure. This is the key to my injury. If i can get that to improve I will be able to run again.
Going back to the cause of the injury: The OCD is on a non weight bearing area of the knee, so why does it feel like the femur can't support me? I'm wondering if the bone marrow edema is related to a stress fracture that just happens to be in the same area as the OCD. I'm going to see another orthopedist on Monday, and i'm going to have him examine me without any prior opinions. I need some fresh eyes. In the meantime, I plan to continue with the hip and core stuff as well as the diet. Hopefully I can have a head start if i'm ever going to run again.
Friday, October 30, 2009
Wednesday, October 28, 2009
Man I'm Weak
So I started doing a ton of hip and core strengthening exercises over the past few days. I'm really enjoying it, but one thing that is abudantly clear is that the right side of my core is strong as hell. Equally as clear is that my left side is embarassing. Its a really really really really really noticeable difference. One of the most obvious examples is doing planks. I can do a nice front plank, including the progressions (lifting one arm off the ground etc). However, when i do my side planks there is a huge discrepancy between the two sides. If i do a right plank, I can lift either leg off the ground and maintain the position for about 10 seconds or so before starting to fail. My left side is another story. When I started with these a few days ago, i couldn't even get a leg off the ground. Just the attempt would make me start to crumble. Today i forced myself to get the right leg off the ground. It was so incredibly difficult, and at the same time incredibly satisfying that I got it done.
Now that I've become aware of this imbalance, I've started to notice it in other activities. I had mentioned yesterday about the 4 way hip exercises. Now thats all i feel when i do the right side. Any lifting of my right leg and my pelvis starts to come off the floor. I'm really focusing on trying to get better and better at this.
On a side note, I have also noticed that my knee hurts less after doing these exercises than before. I am starting to wonder if it momentarily corrects the tracking in my patella. It makes sense because i'm doing just enough to get it where it should be, then my years of imbalances pull it back to the dark side. This is a similar concept to seeing a chiro. They put your pelvis back in alignment, but if you don't do the work to strengthen into that new posture, you go right back to your old habits. I MUST fix this problem if there is any chance of me running again. The good news is that it really motivates me.
One final note: I've been really doing a nice job with my eating now that i'm doing some form of workouts. I knew that would happen. Its so tough to convince yourself to get proper sleep and eat well when you can't train. Ironically its probably the time when you need to do these things the most! Go figure...
Now that I've become aware of this imbalance, I've started to notice it in other activities. I had mentioned yesterday about the 4 way hip exercises. Now thats all i feel when i do the right side. Any lifting of my right leg and my pelvis starts to come off the floor. I'm really focusing on trying to get better and better at this.
On a side note, I have also noticed that my knee hurts less after doing these exercises than before. I am starting to wonder if it momentarily corrects the tracking in my patella. It makes sense because i'm doing just enough to get it where it should be, then my years of imbalances pull it back to the dark side. This is a similar concept to seeing a chiro. They put your pelvis back in alignment, but if you don't do the work to strengthen into that new posture, you go right back to your old habits. I MUST fix this problem if there is any chance of me running again. The good news is that it really motivates me.
One final note: I've been really doing a nice job with my eating now that i'm doing some form of workouts. I knew that would happen. Its so tough to convince yourself to get proper sleep and eat well when you can't train. Ironically its probably the time when you need to do these things the most! Go figure...
Tuesday, October 27, 2009
Two days of working out in a row!
None of which included running...
However, it does feel good to get back into some sort of routine. Its also keeping me motivated to eat properly. I tried to post this about 10 minutes ago, but some sort of error kept it from going through. Annoying, but what can you do?
I went to the gym after work and did shoulders and core/hip. For shoulders I did sets of lateral and front raises, shrugs and military press. I was still a little bit sore from doing chest, but it was a good sore. It actually feels nice to know that i'm working my muscles again, even if its not with my method of choice.
I have been doing alot of hip and core strengthening over the past week. I am starting to really accelerate it too. Going back to the NDT thing: You have to learn to crawl before you can walk. I have always done my hip stuff with the left because of the injury, but just sort of ignored the right. My right hip actually has good strength relative to the left, but i felt like i needed to keep things even, especially if i'm planning on building myself back from the ground up.
That being said, when i did my right hip strengthening, i noticed that the left side of my abdominals really struggled to maintain a neutral pelvis. This is an interesting development because it shows part of the problem. I need to get the left side of my core to be the same as my right. I already knew that doing planks was tougher for me on the left (significantly) but didn't realize it was also bad with my basic hip stuff. At least it gives me something to work on in the interim.
The whole abs/hip routine lasted about 40 minutes. I did 4 way straight leg raises on both legs, physioball hamstring curls with a bridge, good mornings on the back extension machine and crunches. My legs were so tired, but my knee didn't hurt. This is also exciting. Now i just have to find a way to translate it all into getting back to running...one step at a time for now though.
However, it does feel good to get back into some sort of routine. Its also keeping me motivated to eat properly. I tried to post this about 10 minutes ago, but some sort of error kept it from going through. Annoying, but what can you do?
I went to the gym after work and did shoulders and core/hip. For shoulders I did sets of lateral and front raises, shrugs and military press. I was still a little bit sore from doing chest, but it was a good sore. It actually feels nice to know that i'm working my muscles again, even if its not with my method of choice.
I have been doing alot of hip and core strengthening over the past week. I am starting to really accelerate it too. Going back to the NDT thing: You have to learn to crawl before you can walk. I have always done my hip stuff with the left because of the injury, but just sort of ignored the right. My right hip actually has good strength relative to the left, but i felt like i needed to keep things even, especially if i'm planning on building myself back from the ground up.
That being said, when i did my right hip strengthening, i noticed that the left side of my abdominals really struggled to maintain a neutral pelvis. This is an interesting development because it shows part of the problem. I need to get the left side of my core to be the same as my right. I already knew that doing planks was tougher for me on the left (significantly) but didn't realize it was also bad with my basic hip stuff. At least it gives me something to work on in the interim.
The whole abs/hip routine lasted about 40 minutes. I did 4 way straight leg raises on both legs, physioball hamstring curls with a bridge, good mornings on the back extension machine and crunches. My legs were so tired, but my knee didn't hurt. This is also exciting. Now i just have to find a way to translate it all into getting back to running...one step at a time for now though.
NDT
NDT (Neuro Developmental Treatment) has been a staple in physical therapy for years. We use these techniques most commonly in patients who have suffered some sort of spinal cord injury or brain injury. The general gist without getting into too much is that you use the same pattern or strengthening and coordination that a newborn would use.
Think about it for a second: A newborn starts on its back. All it can do in this position is move its arms and legs for the most part. Over the course of a few months the baby develops a little bit of core strength as well as some arm strength, and then learns to roll over one day. Now the baby is on its stomach, but can't do much. So the process starts all over, and the baby gets strong enough in this position to get up on all fours. All fours is ok to maintain, but now the baby has to become even less stable to start moving limbs and crawling. This is the basis for NDT.
Now think about general core strengthening programs. You start with dying bug exercises on your back, then move into prone alternating arms and legs, followed by quadruped (all fours) alternating arms and legs. If you want to go further with it, you get into half kneeling and kneeling exercises.
What the baby is doing with all of this is developing great core strength so that he/she may eventually be able to perform a complex task like walking. Once the baby can walk it learns how to run/climb/jump etc.
The point of all of this is that we learn how to run and climb, but over the years we forget about the basic movements. This is important because we stay strong in the general running/jumping muscle groups, but weaken at the core.
My plan with all of this is to start from the ground up. I know that i can perform core exercises without making myself anymore sore. So...if i start from the ground up, hopefully i can reverse some of these muscle imbalances before I run again. Just a thought, and something to occupy my time while in purgatory.
On a side note, i really am curious what is going on with my knee at this point. It almost seems as though the OCD/fracture pain is greatly improved, and my hamstring/ITB are more aggrevated. The problem is that i won't know until i talk to the ortho on Monday. So in the meantime i'm going to do some core and upper body lifting and try not to think about the running thing too much. We shall see...
Think about it for a second: A newborn starts on its back. All it can do in this position is move its arms and legs for the most part. Over the course of a few months the baby develops a little bit of core strength as well as some arm strength, and then learns to roll over one day. Now the baby is on its stomach, but can't do much. So the process starts all over, and the baby gets strong enough in this position to get up on all fours. All fours is ok to maintain, but now the baby has to become even less stable to start moving limbs and crawling. This is the basis for NDT.
Now think about general core strengthening programs. You start with dying bug exercises on your back, then move into prone alternating arms and legs, followed by quadruped (all fours) alternating arms and legs. If you want to go further with it, you get into half kneeling and kneeling exercises.
What the baby is doing with all of this is developing great core strength so that he/she may eventually be able to perform a complex task like walking. Once the baby can walk it learns how to run/climb/jump etc.
The point of all of this is that we learn how to run and climb, but over the years we forget about the basic movements. This is important because we stay strong in the general running/jumping muscle groups, but weaken at the core.
My plan with all of this is to start from the ground up. I know that i can perform core exercises without making myself anymore sore. So...if i start from the ground up, hopefully i can reverse some of these muscle imbalances before I run again. Just a thought, and something to occupy my time while in purgatory.
On a side note, i really am curious what is going on with my knee at this point. It almost seems as though the OCD/fracture pain is greatly improved, and my hamstring/ITB are more aggrevated. The problem is that i won't know until i talk to the ortho on Monday. So in the meantime i'm going to do some core and upper body lifting and try not to think about the running thing too much. We shall see...
Sunday, October 25, 2009
Gotta learn to crawl before you can learn to walk
I decided that my focus is no longer going to be on the idea of when i can get back to running, but rather what can I actually do that won't put me backwards. I am hoping to get a more specific answer next week when I see Dr. Hulstyn, but in the meantime I am on my own.
I'm still a bit concerned that Dr. Mirrer very casually mentioned that i had a crack in my femur. He dropped it when i showed him the osteochondral defect, but now i'm not sure if its there or not. My cousin is a radiologist, and he has the CD at his house, so i asked him to look through it one more time just to be sure. Neither of us saw it on the films, but i want to be as safe with this as possible.
So getting back to what i actually can do: I woke up and did some sets of straight leg raises 4 ways on both legs. I also did some planks, some physioball hamstring exercises, some abs and then a series of stretches for the hip and knee. This afternoon i did some yardwork, but tried to keep the majority of the effort on my right knee.
I received a really nice email from Jimmy Brunelle this weekend also. He mentioned the idea of doing some relaxed focusing exercises...visualizing the bone healing/mending and everything getting strong. I actually believe in this stuff quite a bit, so i'm going to start incorporating it into my "program" as often as I think to.
Tomorrow morning i'm planning on going for a walk again. It didn't seem to make me any worse the other day, so i'm hoping its safe. I'm also going to go to the gym and do some upper body weights. I just need to get back into a normal routine of working out and eating. I think that the idea of focusing on what i can do, and not on what i can't do is the way to go.
I'm also working on using my PT education a bit. I'm going to start reviewing my NDT stuff (neuro developmental techniques). General idea is that you strengthen in supine, then prone, then quadruped, then half kneeling etc. Sort of the way a baby goes from being on its back to learning how to walk. In some ways i'm functioning like a baby here...more on NDT tomorrow.
I'm still a bit concerned that Dr. Mirrer very casually mentioned that i had a crack in my femur. He dropped it when i showed him the osteochondral defect, but now i'm not sure if its there or not. My cousin is a radiologist, and he has the CD at his house, so i asked him to look through it one more time just to be sure. Neither of us saw it on the films, but i want to be as safe with this as possible.
So getting back to what i actually can do: I woke up and did some sets of straight leg raises 4 ways on both legs. I also did some planks, some physioball hamstring exercises, some abs and then a series of stretches for the hip and knee. This afternoon i did some yardwork, but tried to keep the majority of the effort on my right knee.
I received a really nice email from Jimmy Brunelle this weekend also. He mentioned the idea of doing some relaxed focusing exercises...visualizing the bone healing/mending and everything getting strong. I actually believe in this stuff quite a bit, so i'm going to start incorporating it into my "program" as often as I think to.
Tomorrow morning i'm planning on going for a walk again. It didn't seem to make me any worse the other day, so i'm hoping its safe. I'm also going to go to the gym and do some upper body weights. I just need to get back into a normal routine of working out and eating. I think that the idea of focusing on what i can do, and not on what i can't do is the way to go.
I'm also working on using my PT education a bit. I'm going to start reviewing my NDT stuff (neuro developmental techniques). General idea is that you strengthen in supine, then prone, then quadruped, then half kneeling etc. Sort of the way a baby goes from being on its back to learning how to walk. In some ways i'm functioning like a baby here...more on NDT tomorrow.
Saturday, October 24, 2009
A typical Saturday
No working out today for me. I'm having a hard time getting motivated for anything that doesn't really involve cardio. I'm also still just a tiny bit concerned that Dr. Mirrer thought he saw a crack. It sort of leaves me in "No man's land". I need to know that i'm not trying to walk on a crack before i start doing it. As much as I want to work out, its not worth it if the bone is still healing.
I spent my Saturday like I usually do: treating patients. Our company typically has a little bit of weekend overload with patients. There might be 3 or 4 that didn't get picked up yet by PT, so either i overload myself on Monday, or i see them on Saturday at a per diem rate. I personally find that if i have both days off and can't workout or anything, i get incredibly bored. Weird to think that i can't just relax at home, but i really can't. One day is perfect. So...I saw 7 patients today (throw in 3 more for the Quincy office) and i'm now home relaxing. I can sleep in Sunday and just focus on watching the Patriots in London.
Thats all for now. I guess i'm going to be in limbo a little until next Monday, but what is another week when its been 10 months? My goal for this week is to do a fair amount of core and flexibility, and also to watch my eating. Gotta take it day by day.
I spent my Saturday like I usually do: treating patients. Our company typically has a little bit of weekend overload with patients. There might be 3 or 4 that didn't get picked up yet by PT, so either i overload myself on Monday, or i see them on Saturday at a per diem rate. I personally find that if i have both days off and can't workout or anything, i get incredibly bored. Weird to think that i can't just relax at home, but i really can't. One day is perfect. So...I saw 7 patients today (throw in 3 more for the Quincy office) and i'm now home relaxing. I can sleep in Sunday and just focus on watching the Patriots in London.
Thats all for now. I guess i'm going to be in limbo a little until next Monday, but what is another week when its been 10 months? My goal for this week is to do a fair amount of core and flexibility, and also to watch my eating. Gotta take it day by day.
Friday, October 23, 2009
What now?
I decided that I would go for a walk this morning and reassess. I ended up doing about 60 minutes of brisk walking outside this morning. I was pleasantly surprised that it gave me a similar outlet to running in terms of time to think. When i'm at the gym I find that its tough to do that because there is so much going on. Running is usually my outlet for thinking and unwinding, but I don't get the same effect at the gym. Walking definitely helped to alleviate some of that.
I'm still undecided as to whether or not my knee liked it. I think i may still be a bit sore from the biking on Wednesday. I was starting to think that i was going backwards, but now i just think that i'm dealing with a multitude of injuries in the same general area.
To be more specific, when i was biking, the entire ride was pain free. However, when I got off the bike, I immediately felt my left lateral hamstring tighten up and get sore. Technically speaking, my "injury" is in the very front of my knee, under the knee cap. So am I dealing with some coincidental hamstring tendonitis, or is this just part of the overall stress response type of issue. To prove this point further, my knee is still sore from biking, yet stairs still feel pretty decent. This tells me that the stress response/fracture may actually be improving, but i still have some tendonitis type of issue. The hamstring is also what I feel when swimming. Its not the fracture type of pain that i'm used to.
My biggest frustration is that i can never tell which activity is setting the knee off. Today is a great example. Was is the walk or was it the biking from two days ago. My better judgment tells me it was 2 days ago, but it certainly doesn't make me confident to go walking again tomorrow. I'm also finding it hard to eat well when i can't reap the fitness benefits that should go along with it.
I spoke with my friend Michaela who hooked me up with an appointment to see Dr. Michael Hustyn at University Orthopedics. I see Dr. Frank Mirrer myself, but i really lost some confidence in him with regards to this particular injury. I do respect him for being honest though. He said, "Well I really don't even know how to suggest you most forward from this. I would just take the next 3 months to a year off and see what happens." He wasn't trying to be sarcastic or anything like that. He just really doesn't know how to advise me to move forward and get rid of it. I'm hopeful that Dr. Hulstyn can give me a better opinion.
So that is the knee rant of the day. On a totally unrelated note, I am going to Pawtucket tonight to watch Kristen dance in a Halloween cabaret show. As unorthodox as it is, its been really cool to see her get passionate about something other than 14 hour work days and coaches that call our house at 10pm. I figure I should go support her. She really does have a knack for dancing. Ok thats all for now.
I'm still undecided as to whether or not my knee liked it. I think i may still be a bit sore from the biking on Wednesday. I was starting to think that i was going backwards, but now i just think that i'm dealing with a multitude of injuries in the same general area.
To be more specific, when i was biking, the entire ride was pain free. However, when I got off the bike, I immediately felt my left lateral hamstring tighten up and get sore. Technically speaking, my "injury" is in the very front of my knee, under the knee cap. So am I dealing with some coincidental hamstring tendonitis, or is this just part of the overall stress response type of issue. To prove this point further, my knee is still sore from biking, yet stairs still feel pretty decent. This tells me that the stress response/fracture may actually be improving, but i still have some tendonitis type of issue. The hamstring is also what I feel when swimming. Its not the fracture type of pain that i'm used to.
My biggest frustration is that i can never tell which activity is setting the knee off. Today is a great example. Was is the walk or was it the biking from two days ago. My better judgment tells me it was 2 days ago, but it certainly doesn't make me confident to go walking again tomorrow. I'm also finding it hard to eat well when i can't reap the fitness benefits that should go along with it.
I spoke with my friend Michaela who hooked me up with an appointment to see Dr. Michael Hustyn at University Orthopedics. I see Dr. Frank Mirrer myself, but i really lost some confidence in him with regards to this particular injury. I do respect him for being honest though. He said, "Well I really don't even know how to suggest you most forward from this. I would just take the next 3 months to a year off and see what happens." He wasn't trying to be sarcastic or anything like that. He just really doesn't know how to advise me to move forward and get rid of it. I'm hopeful that Dr. Hulstyn can give me a better opinion.
So that is the knee rant of the day. On a totally unrelated note, I am going to Pawtucket tonight to watch Kristen dance in a Halloween cabaret show. As unorthodox as it is, its been really cool to see her get passionate about something other than 14 hour work days and coaches that call our house at 10pm. I figure I should go support her. She really does have a knack for dancing. Ok thats all for now.
Thursday, October 22, 2009
What am I getting myself into?
I'm not quite sure why I decided to start blogging, but i'm hoping it keeps me from getting antsy while I attempt to recover. My plan is to start doing this on a day to day basis, but who knows if I will actually keep up with it.
I figure that I will blog about my recovery/failure to recover instead of posting on facebook. This way, if you come to the blog site you are reading it on your on volition. Nice guy right?
Anyway, i attempted to do some light biking yesterday as well as some light hip/core stuff. My knee got a little stiff and sore throughout the day, and i decided that biking was no longer a good idea. The problem is that I have to avoid exercises that compress my patella up against the front of my femur. This is difficult to do because pretty much any exercise is going to do this.
So I'm back here at square one for about the 30th time in 10 long months. I have noticed that i'm capable of doing some brisk walking without irritating it (My ortho believes that this is the best thing for me right now), so i'm going to try to get myself into a routine of walking one to two times per day as well as start back up with core, flexiblity and upper body lifting.
I don't know about anyone else, but i find that any sort of workout routine at all keeps me eating properly. I also find that if i'm unable to exercise, I lose all motivation to eat properly. You would almost think it would be the opposite, but not for me. We'll see what tomorrow brings...
I figure that I will blog about my recovery/failure to recover instead of posting on facebook. This way, if you come to the blog site you are reading it on your on volition. Nice guy right?
Anyway, i attempted to do some light biking yesterday as well as some light hip/core stuff. My knee got a little stiff and sore throughout the day, and i decided that biking was no longer a good idea. The problem is that I have to avoid exercises that compress my patella up against the front of my femur. This is difficult to do because pretty much any exercise is going to do this.
So I'm back here at square one for about the 30th time in 10 long months. I have noticed that i'm capable of doing some brisk walking without irritating it (My ortho believes that this is the best thing for me right now), so i'm going to try to get myself into a routine of walking one to two times per day as well as start back up with core, flexiblity and upper body lifting.
I don't know about anyone else, but i find that any sort of workout routine at all keeps me eating properly. I also find that if i'm unable to exercise, I lose all motivation to eat properly. You would almost think it would be the opposite, but not for me. We'll see what tomorrow brings...
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