Thursday, March 23, 2006

"You're not in pain..."

Today I started physical therapy for my buggered knee. It hurt, but I'm glad to finally be doing something about the problem.

The problem isn't serious, but as you know I compete at a fairly high level of sport, and I don't want it to become a serious problem, both for the sake of my rowing and my everyday life. Because of my arthritis, when I suddenly develop a problem in a joint which had heretofore* been problem free, I tend to take it pretty seriously.

Here's the problem: About a month ago, rather out of the blue, my left knee started popping, just like you can do to your knuckles, only about a hundred times a day, and I couldn't stop it. By the end of the day, the knee was sore and achy. I decided this was a problem for 3 reasons: 1, it caused me pain, 2, it never used to do this, and 3, the right knee does not do it.

These seemed like fairly sound arguements in favor of the conclusion that there is something wrong with my knee. No less than 2 doctors disagreed with me, however. I got to have the following conversation not once, but twice!

There's something wrong with my knee.
I can't find anything wrong.
But I'm in pain.
I can't find a cause.
Then refer me to a rheumatologist.
I can't refer you to a specialist if there's nothing wrong you.
There is something wrong with me: i'm in pain.
But I can't find a cause.
That's why I need a referal; you can't find the problem.
I can't be sure there is a problem.
Are you telling me I'm not actually in pain?!?
I'm telling you I can't find anything wrong with you...

And around and around we go. Finally she suggested that I see a physio at the University Health and Fitness Centre.

So I saw the physio on Monday. It took him 5 minutes to figure out that because of a slight misalignment in my lumbar spine, my patela was not tracking straight along the line of my femur but instead being pulled slightly to one side. My knee was popping because the patela kept trying to realign itself and pop itself back into place. The resulting friction was the cause of the pain. Another symptom of which I had been unaware, but which His Majesty the Physio demonstrated, was that I had also lost about 20% of the strenght in certain muscle groups in my upper leg and left buttock.

Went back today to begin treatment. His Majesty the Physio bent me into a pretzel, twisted me around a bit, put some pressure in certain spots which resulted in some "minor discomfort,"** and then did the relative strenght tests again. In just 30 minutes I actually managed to regain quite a bit of strength in the leg! It was fucking amazing! The problem isn't that the muscles can't do the work, it's that they are inhibited from doing the work by all the shit that's just slightly out of alignment, and no amount of straining on my part can change that.

So he gave me some stretches and moves to keep my lumbar spine in tip-top shape and some stretches and excercises for the weakend muscle groups, and sent me on my merry way.


(Now I just need to figure out how to pay for it. Since it's done by the Uni and not the NHS, it ain't free. 26 quid for today, another 19 for my follow-up session on monday. Lordy.)

Oh, and check out this photo of me and the gang on the ARA website (2nd from left, in lime green fleece vest).

*heretofore: world's coolest preposition
**that's "minor discomfort" in the medical sense of SERIOUSLY FUCKING PAINFUL.


hendrix said...

Glad you got it sorted out CB - and sorry you had to go through the whole NHS "if you're breathing then there's nothing wrong with you" routine...

Thought's for paying for it. You might get away with getting a letter from your physio which you can take to the docs and wave in front of him thus getting the treatment on the NHS. however waiting lists for NHS physios are massive so you could be waiting some time (my Aunt R has been waiting 2 years to see one for a frozen shoulder). Or, check out and see if your near a physio training college - they sometimes run cut price sessions...
or - and the final answer which goes against all my " I pay a fortune in bloody taxes so I should get free health care" principles...take out medical insurance. Its usually not much a month (probably about what you pay for the physio per session) but if you do some hunting around then you can get one which will cover your dental/eyesight/general medical requirements and any alternative therapies you may need as well...

ZB said...

I'm sure I diagnosed this months ago in an email. True, I recommended the mighty Steve Robson as being the man to fix it but at a push any physio will do. The exercises are a pain but they do work. The VMO muscle responsible for kneecap tracking along with the ITB atrophies very quickly when inhibited so keep working on the exercises. Also consider the position of your knee if you're sitting for long periods of time. Mine was aggravated by sitting with the knee at right angles. It moved the patella directly over the spot it was frictioning and made it vomit inducing agony to put any weight upon. Steve spotted it. A God. One of the few that I know but a God nevertheless.