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› Forums › General › Chronic IT band/quad TIGHTNESS and knee pain (chondromalacia patella?) for 6 years! › Re: Chronic IT band/quad TIGHTNESS and knee pain (chondromalacia patella?) for 6 years!
08/07/2014 at 9:55 pm #75056
Things to work on:
1) Activate my deep core muscles (diaphragm, pelvic floor, TVA)
Since glute strengthening has only helped somewhat previous physiotherapist thinks weak, inactive deep core muscles is leading to poor stabilization of the lumbo-pelvic-femoral complex and leading to poor motor control and inappropriate movement of legs during functional activity leading to associated IT band tightness and knee pain
1) Diaphragmatic breathing – deep breathing using diaphragm rather than chest. Breath in as stomach expands. Breath out as stomach gets drawn back in.
2) Pelvic Floor activation – activate pelvic floor during deep breathing by imagining as if you are holding in your piss or lifting your testicles up. Should be completed when breathing out (stomach getting drawn in). When breathing in (stomach expanding) eccentrically activate pelvic floor by imagining as if you are pissing and forcing a piss out.
3) Transverse abdominis (TVA) activation – when breathing out (stomach getting drawn in) imagine drawing in your navel and belly button closer to your spine.
Note: When breathing in activate diaphragm. When breathing out activate pelvic floor and TVA.
2) Posture / lumbo-pelvic-femural symmetry
Release the deep gluteal muscles on the right side that might be causing my right femur to be more externally rotated relative the left. My right thigh muscle is normally more externally rotated during rest and functional activity when compared to left. This is a noticeable asymmetry that my new physiotherapist thinks might be leading to the tight IT band and knee pain. GUNS IMS will be completed to relax my deep gluteal muscles (piriformis, gemellus, obturator internus, quadratus femoris). Also, advised to perform stretches and smash this area with lacrosse ball.
Physiotherapist brought up rolfing as a possibility to re-establish body alignment. She said we need to get the body algined properly prior to physiotherapy exercises because without the proper alignment any exercises we do will reinforce the misalignment. She wants me to discontinue any exercises prescribed by my previous physiotherapist and focus re-aligning the body first. She said we will slowly start adding exercises in as the body becomes properly aligned