Knee Pain and the Value of Excellent PT

by Mary on February 28, 2016

I’ve had great progress lately on my patellofemoral pain in PT and I’m grateful for the care I’ve received. My physical therapist Lauren is really sharp. So is her PT assistant Julie, who is also a skater (had her eighth figure test) and a yoga teacher. Unfortunately, I think it’s uncommon to be able to access really good PT.

Just recently I was talking to a friend whose son had a disc injury and was told by his doctor that ‘PT wouldn’t help.’ As a result he’s had no help with the pain for years. I feel badly for him and for others who have not been able to access good care. I want to share more about my PT, and as a start, here’s some detailed info about core stabilization that I learned from Olympic PT.  

Olympic has been an exceptional PT service that has served not only the general public but athletes such as the U.S. Ski Team. Some PT’s don’t mention the core at all or will just tell you in a general way to ‘activate the core.’ Olympic, on the other hand, gives detailed handouts and instruction on how to train the multifidus muscles along the spine, the transverse abdominus muscle, and the pelvic floor.

Olympic has held classes about “The Missing Link” to teach providers about the role of the multifidus muscles in stabilizing the spine. They call the multifidi “the most neglected muscles in traditional spinal PT” and say that neglect of their rehabilitation is one of the reasons for the high rate of recurrence of low back pain.

Pelvic floor rehab is often suggested for women with prolapse or incontinence, but Olympic incorporates pelvic floor muscle training for both male and female athletes.

For all these various muscles of the deep core, they teach how to identify them, how to turn them on at a low level (2 out of 10 for effort) and how to turn them on to various levels of effort, from maximum effort to the smallest possible effort (2) to various levels in between. Some of their athletes will do as many as 1000 reps of some of these exercises, or hold a small amount of tension in these muscles for up to two hours.

While my needs are not as intense as those of an elite athlete or a person with severe disc problems, I’ve still worked on these areas and benefited. One exercise my PT gave me that I’ve done a lot of– but still needs work– is sidelying quadrants or H & I’s. Olympic made their own handout to teach these. I appreciate that they have done the work to present things in their own way instead of using a generic database of exercise handouts– my trainer even knew who the model was for these.

The H & I’s, along with other exercises, finally gave me the hip strength that I’ve needed for a long time. I went to my sports medicine doctor last week and when he tested my hip strength he said I was strong. That meant a whole lot to me because this is the third time that I have tried to build that strength to help my knees (the hip muscles help control the positions the knees get in to, and if they are weak the knees can get into positions that irritate them).

I still have work to do for my knees and some other problems but this is a good start. I’ve been jumping now for over a month, and while I have some pain in my knees, it’s much less than in previous years. I can go up and down the stairs after jumping and have no flash point of pain when I put weight onto a step. Olympic has been bought out and is now a part of a much larger corporate entity, ATI. I hope it can still maintain its special character.

{ 4 comments… read them below or add one }

Eva March 2, 2016 at 7:38 pm

Sending you healing thoughts, Mary. I had patellofemoral pain in high school so I understand what you’re going through. You are lucky that your PT and PT assistant knows about figure skaters!

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Mary March 4, 2016 at 3:00 am

Thanks Eva. I’m glad that for you, the pain hasn’t returned from figure skating. I am very lucky to have my PT and PT assistant. When the PT I was referred to at S.T.A.R.S. stopped doing clinic work he passed me on to these two colleagues, and it’s worked out very well.

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Jo March 3, 2016 at 3:40 am

Inspiring post, Mary. I anticipate working with my therapist for a good long while, even though I’m making progress on correcting those muscle imbalances. Working on the core, multifidus, and pelvic floor have been revelatory for me. Here’s to the power of conditioning!
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Mary March 4, 2016 at 3:02 am

Yes I think I’ll be working this for a good long while, too, Lauren has plenty she wants to do with me. I hope that PT can do a lot more for both of us. I’m in LA for Sectionals and just wondering whether the hotel has an ice machine: I jumped a lot today and my knee resents it.

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