Yup I’ve been to 3 different doctors in town and 2 physical therapists. Not a whole lot of material out there to answer the right questions for finding the right place where I live.  One of the draw backs of living in a smaller city.

Just curious to know if anyone else with “relatively” healthy knees has a similar bulge.

If anyone has a similar bulge on the lateral side of the patella, I found out that it’s not necessarily bad or abnormal.

When in to see a physio yesterday and got good and bad news:

Good news: All my mobility and strength work has paid off. I don’t really have muscular imbalances or range of motion issues that would contribute to my knee pain.

Bad news: He thinks that a have a degenerative patella tendon that needs attention for proper healing.

Essentially my bad biomechanics injured the tendon. While I’ve fixed the issues contributing to the bad biomechanics, I’ve never allowed the tissue to heal properly.

He’s recommending Astym. I used to get Graston treatments – which after some research is just about the same thing. There are sights that say the goals of each are different, but from what I can tell – they both do the same thing to accomplish their goal and the others as well.

I actually think that the Graston is the reason why my left knee is a lot better than my right. My left used to be the worse knee, and I had additional graston treatments to it. The left patella tendon healed better, and now the right is the worse one.

Now my focus is to cut back on activity and focus on the damaged tissue – I’ll probably start another thread asking about how to go about finding what supplements are legit and which are a waste of time.

So far I’ve found the following list:

Ligaplex
Calcifood
Powdered Collagen
Glucosamine
Chondritin
MSM

Otherwise, combine those with the Astym/Graston and some good exercises that stretch and strengthen the tissue (within reason) is all I should need over about 6 months.

Do you think Graston is better than Astym? (Assuming both are done by qualified and experienced staff)

I just assume that with the lack of nutrition in our food, supplements couldn’t hurt. I try and eat as healthy as possible, but I find it hard to believe that I’m getting everything my body needs to not only perform, but also to recover and heal.

I’m also up for learning about what I can eat more of to get at the right nutrients for tendon repair.

Thanks for the Wellness FX link. I’ve never heard of this and will definitely dig into it. 🙂

David and Kaitlin,

Thanks for all the great info.

I did some more research nutrition analysis and found that there’s different kinds.

Blood work – which Wellness FX does; but also a kind that looks more at your muscle instead of the blood.

The latter focuses on the fact that your blood can change throughout the day, but the muscle fibers are more consistent. A local chiro couple does their nutrition analysis with this method.

Have either of you heard of this other method? If so, I assume you believe Wellness FX is better – since that’s what was suggested. Why do you think Wellness FX is the better choice?

Otherwise, I’m meeting with a physicians assistant today to get the referral for a PT and hopefully some deep tissue work.  I plan on getting the Astym/Graston and isolate any remaining strength deficiencies through PT and mobility work.

One product that has come up on my radar is Knox Gelatin. Apparently gelatin used to be common in our diets when cows and such were grass fed. Now they’re corn fed, and the meat lacks the gelatin. Any thoughts on this?

Aside from the gelatin, the only other thing I’ve heard consistent word on is fish oil. I’m already taking some, but was curious to know if there are any brands that are legitimately more reputable?

I have good form during squats and deadlifts (at least I think I do :P), but when I hit single leg work or balancing exercises I become very unstable. I also feel that when I have the time to setup for a lift, I can perform with proper form – but if I’m doing something dynamic; like jumping for a set so I can spike it – my form suffers and this is where the damage to the tendon occurs. I can lift all week long with no pain to my knee, but if I play volleyball for 1 or 2 nights in a week, the tendon lights up.

My plan is to cut out volleyball for a few months. I’ve contacted a personal trainer that’s FMS qualified. I spoke with him and felt very comfortable with his approach and his understanding of my situation and what my goals are. He also uses other means of measure on top of FMS to be thorough with his evaluation.  So I think this should help in that area and meets a lot of the recommendations you gave. I just wish he was also a trained PT.

But I plan on seeing a PT as well for the Graston/Astym in addition to possibly seeing a massage therapist for deep tissue and trigger point work. I have all kinds of spots on my quads, ITB, and inner thigh that won’t go away with foam rolling and using a lax ball.

Thanks for the tip on the fish oil, I’ll definitely be checking that out and hitting up the health foods store to find the grassfed meat.

Oh also, the trainer I mentioned also highlighted that while I may have fixed my strength issues to a good extent since I first felt the knee pain 2 years ago – I might still have reactive/reflexive issues. So my muscles might not be firing with the proper timing which could result in excessive shearing forces on my knee. He sounded very familiar with this and seemed to be able to setup a program that would address it.

Most PT’s don’t seem to have this education. They almost seem to focus on the controlled environment movement. Finding this personal trainer with all this extra education is a huge benefit. I have to travel 45 minutes to see him, but I think it’s worth it if I can get rid of the knee pain and learn proper movement mechanics during intense dynamic actions.

Thanks David! I’ll definitely share the results. I have a meeting setup for Monday with the trainer.

I love the concept of FMS. It’s always been what I thought would occur when seeing a doctor or PT.

4 Doctors and 4 PT’s later – The closest I’ve gotten is one PT watching me jump on 2 legs a couple of times. All he really noted was that I didn’t really go deep when I landed and that could be creating more impact on my joints than is ideal. He was the best PT I’ve seen, so I really don’t want to bash him, I just had a lot higher expectations.

Do you think that’s a problem with the “system”?

I feel that PT’s should get you from pain to no-pain AND Full function.  Trainers should increase performance once you’re at full function. Coaches hone in on the specific skills involved in an activity.

That’s “ideal” in my opinion. But if enough people think the same – then as a whole, maybe we can influence the system to change and be better for the general population.

Just a thought.

That’s really good to hear. 🙂  At least the ball is rolling, hopefully it won’t take too much longer for it to pick up some speed.

One thing I recently discovered, in Illinois, is that in order to even see get PT – you need to see an M.D. and get their referral. 2 of the 4 doctors didn’t even mention PT as a recommendation. I’ve said this before – one told me “These kinds of things just burn themselves out over time.” Looking back on this statement infuriates me. Really – they just burn themselves out? Are you referring to my tendon specifically so that you can get a surgery out of it???

The only reason I got Graston was because I called his office back after doing some research and asked why he hadn’t recommended that treatment. His nurse immediately said, “oh, we can definitely get you into our clinic area for that. I’ll talk to the doctor and get it all set up.”  So I have to do the research myself and ask for non-surgical treatment? While I definitely support the idea of the general population being educated and knowing what options are available to maintain our bodies – I really think that the moral hazard here punishes those that don’t get enough information on their own.

Apparently in this state, because the AMA has bigger pockets, they are able to influence the health care to flow from the M.D.’s down. If this is the case, and they’re not recommending non-surgical procedures while leaving you prone to further injury, then this is a huge risk for patients.

Those 2 doctors I mentioned earlier were orthopedic surgeons – so it’s in their best interest for you to actually get worse.

I wonder how common this approach is in other states?

I get all that – but all of what you said further supports the argument that people shouldn’t have to go through a doctor to see a physical therapist.

I agree that the money spent is a great investment – but if one’s insurance covers x number of physical therapy sessions a year, then why do I need a doctor (who’s best interest is me NOT seeing a physical therapist if they’re a surgeon) to give me a referral in order to get that preventative treatment. Especially when they don’t understand the entire population.

Why? – Because the system is set up that way. My question is: Is the way the system is set up appropriate and in the populations best interest?