Knee pain - unclear diagnosis and looking for advice

[Natan Milgram]

Hi guys,

I need help / guidance / support or anything I can get .

First some background on how it started:  I was doing cross-fit type training and doing great on squats, kb swings and deadlifts. Nevertheless, I went too far too fast and injured my neck. That same weekend listened to coach w Tim Ferris and decided to switch to GST training.  I also decided to get a stand-up desk for the office.

After several days with the stand-up desk I began to develop stiffness and pain in my legs.  This was 3 months ago and since then, that pain ebbs and flows but doesn't seem to want to away.  The pain is felt on both sides of the knee as well as behind it. It was then that I started getting clicking on my knees as the patellar tendon goes "off track" a bit. On bad days, the muscles on the legs stiffen up and I also feel pain in my ankles and at the top of the hamstring (close to my buttocks) when stretching it. 

Since the pain began I stopped any "high-impact" exercise on my knees and only practiced the F1 regimen.  I do the daily limber in the morning and the evening and foam roll my quads, hamstrings, IT band as well. Moreover, on weeks when pain is strong I dont do the deck squats / skiers in order to avoid aggravation.  I even added the front stretch series to see if it would help, but found that it often aggravates my pain the day after and can take several days for the pain to dissipate.

Some weeks ago I went to see a PT who evaluated me and said that I just needed rest and constant stretching and to add leg stability exercises when the pain subsided.   Nevertheless, Ive already been through three iterations where I dont do anything for a week or so, go back to doing SLS and front leg stretch only for the pain to flare back up a few weeks later.  This makes it impossible to keep on track with the SLS series and the front leg stretch series which I have read have helped others in the forum.

Any thoughts, guidance or advice would be tremendously appreciated!

Thanks in advance

 

 

 

[Everett Carroll]

Hi Natan,

This is out of my scope but @Wesley Tan and @Mark Collins may have some advice. 

 

[Ryan Bailey]

Hi Natan,

You mentioned strong pain as well as several days needed for the pain to dissipate. You also mentioned a combination of ankle, behind the knee region, as well as more proximal symptoms. You have a job with desk work which may include static prolonged positions.

All this with a history of neck pain. I would have referred you to the doctor after my physical therapy initial evaluation Prior to further treatment.

I recommend you get a work up with your physician until further advice is given.

Best of luck,

Ryan

[Natan Milgram]

Hi Ryan, 

Thanks for the reply. 

So here's a bit more info regarding the points you touch on. 

First, following the neck injury, where pain took days to recover I had an mri done which revealed a herniated disc in c4/c5.  I did not present any nerve pain symptoms at the time (still don't). No loss of strength, radiating pain, numbness, tingling etc. The orthopedic Dr prescribed physical therapy. Moreover, the physical therapist that saw me afterwards said that he believed the herniated disc had probably been there for some time. I have not had neck pain issues since (even doing tripod headstands). 

Second, during the times when I have had the pain in the ankle and behind the knee it is not permanent pain but rather one that comes and goes. It is at most a 4/10 in terms of intensity. 

Third, I work a desk job in front of a computer monitor for 10 /11 hours a day. 

Lastly, my last physical was also around 3 months ago (after neck issue). No issues were brought up by Dr. 

Do you still recommend going back to orthopedic Dr? 

 

Thanks 

[Ryan Bailey]

Hi Natan,

I assume you meant C4/C5. No radiculopathy is a good thing to clear from the MRI and your clinical presentation. However, You still do not have an adequate diagnosis and you are having to skip specific training exercises due to the pain. This is halting your progress. 

Ankle to behind the knee pain lasting 3 months, (4/10) is not necessarily low. You may benefit from either another ortho visit, or I would get a nonorthopedic screen from your primary physician.  

[Coach Sommer]

Hi Natan,

The leg pain is probably a simple solution.  You went from sitting all the time to standing all the time.  Too much too soon.

Scale back the standing and begin experimenting with adding sitting back into your daily schedule.  Keep experimenting with the mix until you find a balance between standing and sitting that brings you relief; than scale back the standing a bit more.

Stay with this for a few weeks and then gradually begin increasing your standing time again.

Yours in Fitness,

Coach Sommer

[Eva Pelegrin]

I kinda was thinking in the lines of Coach in the sense that if you're not used to standing for long periods of time, you want to at least rule out that you didn't progress from one to the other "too much/Too soon."

I happen to be a great athlete in both the sport of "sitting and standing." People don't take me serious when I say that but I can go for looong hours from many, many years of hard core training and I don't say this with pride either. It's just a fact. It's taken me years to develop, and of course, I've come up with several strategies to counter balance said abuse. 

 

 

[Natan Milgram]

Thanks to both. Will try to see whether this can solve it. 

[Wesley Tan]

Was about to point out exactly what Coach had.

I would also add to try only the FS stretch course alone and see how your legs feel after. Do the same for the SLS on a separate week to ascertain which is most likely stressing the knees in a fashion the are not quite used to.

Best wishes,

Wesley

[Mark Collins]

On 21 September 2016 at 9:54 AM, Coach Sommer said:

Hi Natan,

The leg pain is probably a simple solution.  You went from sitting all the time to standing all the time.  Too much too soon.

Scale back the standing and begin experimenting with adding sitting back into your daily schedule.  Keep experimenting with the mix until you find a balance between standing and sitting that brings you relief; than scale back the standing a bit more.

Stay with this for a few weeks and then gradually begin increasing your standing time again.

Yours in Fitness,

Coach Sommer

I also think this is the problem. The human body loves constant varied movement. People that work in retail and stand daily have alot of pain in the legs. I would change from sitting to standing every 30 mins.

[Natan Milgram]

Thank you Wesley and Mark. 

I have already followed the advice from coach and Eva and reduced sitting and have pretty much gotten rid of the pain. Now I will do as Wesley suggests and add the FS on its own to see how that goes. 

Thanks!