Posts Tagged ‘multifidus muscles’
2/15/11 – Back to the Physical Therapist, Right Knee
So, I have slowly ticked off physical therapy on all of my old and some new injuries. First, a new injury on the left posterial tibial tendon. Second, sciatica running down my left leg and associated with weak/non-functioning multifidus muscles. Third, an old injury on the right shoulder. Finally, a very old injury on the right knee.
I was diagnosed a long time ago with patellular tendonitis, which I believe I have talked about before. The inflammation in the knee comes and goes, but over winter break while skiing on an extended ski trip, I really aggravated it.
So, I went back to Travis today. I was more than a little embarrassed when he asked, “Are you still doing your low back exercises?” and I had to reply, “No” because I stupidly stopped doing them once I started right shoulder exercises. There are so many exercises that help the very important little muscles, and those exercises take a lot of time. It is difficult to prioritize which exercises to continue and which ones to stop, especially when I want to be able to say that I can squat 75 pounds! In other words, so much to do, so little time.
Well, Travis told me that I have fatigue in my hip abductor muscles, which is caused by a weak low back (i.e. multifidus muscles not firing.). OMG! Do you mean that if I had just done the silly back muscle move for 6 months I wouldn’t be here?!!! GAAAAHHHHH!!!
That’s frustration my friends.
It gets better. He then tells me to keep foam rolling, and when I tell him that it hurts when I foam roll over my hip bone, he says not to foam roll there because it will irritate the bursa. The bursa? According to http://www.medicinenet.com/hip_bursitis/article.htm, a bursa is a closed fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body. In the case of my hip, it is the fluid sac that allows the IT band to roll smoothly over the hip bone. Turns out that when you foam roll the bursa, you irritate it. Hmm. That makes sense. No wonder it hurts to roll over my hip bone! Personally, I’m happy to hear I have to foam roll less surface area – that equals less time foam rolling!
Also, my right patella actually sits a little wonky. When looking at your knee cap (patella), it should be like a triangle with the top side straight across. My patella is higher on one side than the other when at rest. When the muscles all pull on it, that means that it tracks incorrectly when it moves, which creates friction, irritation and pain. Apparently, my IT band is pulling on it, as well as other muscles in the quad series. With all of this uneven force, it’s no wonder the poor little patella isn’t able to find it’s groove.
So, as a quick fix today, Travis taped the knee. He said to try it out for a few days and see how it works. So far, it doesn’t hurt, but it is strange. I’m going to wear it during my workout with Melissa and see how that goes. I think I do kinda like it. He also said that if I do like it I needed to come in and learn how to tape myself for the upcoming ski trip. The tape should help while skiing.
He also said NO FLEXION! AGAIN! Bleh. So, no bending over to stretch, no squats, no dead lifts, nothing that causes my back to go out of neutral spine. So long 75 pound lifts. I guess I’ll see you later after I’ve got those multifidous muscles firing again.
Also, no more pigeon pose stretches. He said that those are probably not doing any good, not to mention they cause all kinds of flexion. I’m kind of ok with this because that’s one less stretch to do.
Ok, so back to the rehab again. I’m so glad I’ve a good team to help me get my body really functioning correctly! GO VILLAGE!
Physical Therapist, Chiropractor and Massage Therapist – Oh My! 6/2/10
So, the trifecta hits in one day! I must say that I truly do have some of the BEST doctors here in Seattle working for me and my high maintenance body.
This morning I went to Travis Orth, my awesome physical therapist, to report on my exercises. Lo and behold it is NOT my piriformis muscles because all that piriformis work did not do a whole lot. He said that he really thought it was my back, which was fortunate because I had a chiropractor appointment this evening. So, I have a whole new set of exercises to work on the multifidus muscles, which function to move the spine as a whole.
Fun Fact: according to Dr. Larry, my chiropractor, the multifidus muscles are unique in that each section works independently of the other sections both up and down the spine as well as the left and right. This means that the right lower multifidus can fire independently of the upper or left multifidus. Cool, huh!
Back to Travis, since it is my back, I am no longer allowed to do any exercises with flexion (meaning bending over). So, the dead lifts are out; the balancing bends, out; lunges, out (for good measure; biking, out (sitting in flexion); etc. However, I can walk (on treadmill or outside) and use the elliptical machine.I also have to sit in the neutral spine position at all times.
Fun Fact: To find neutral spine, lay on your back with your feet on the floor and knees bent. First lift your lower back in as high of an arch as possible. Then, press your lower back down as much as possible. Neutral spine is the position in between these two positions. Thanks, Travis!
So, I then head over to Dr. Larry’s office where he says that he thought he was my back all along 🙂 Anyway, the L5 adjustment was just the same as my lower back adjustment, but more focused on the specific vertebrae. I also requested a set up on the shoulder, which did the trick, and he pulled my left hip and ankle to pop them both. It was a fantastic adjustment day.
I then head into my massage therapist, Linda this week (“Where’s my jello?”). So, I’m explaining the sciatic and how it’s not piriformis, etc. Somehow I tell her my hip flexor (the ilopsoas) is really tight on my right side. She says that it is connected to the L5 vertebrae, and that she has to go in from the front to get to it since it is a deep muscle. Wow!!! I had never had anything like that done. Plus, if the hip flexor is pulling the vertebrae to the right, then no wonder it is the left sciatic nerve with issues.
This is getting better and better! I’m feeling like we’re about to figure some major stuff out.
Well, this massage was simply wonderful and very needed. I had knots in my right and especially my left quadriceps and my left hamstring was really, really sensitive. Linda said that my IT bands felt way better because they were moving rather than just stuck together! Yay!!! That is awesome because I have been working on them for a very long time, and, finally, I have confirmation of progress! Yippee!!!
Also, she worked on the left and right ankles. Well, that left ankle hurt me and apparently her as well because it was so tight. Then, she moved to the really weird iliopsoas muscles. She basically pushed down through the hip bone to the back where she just kind of pushed on the hip flexor. My left side was super easy, but my right side (the tight one) was incredibly painful.
I also asked Dr. Larry if I needed to sleep a certain way, and he said no. Just sleeping on different sides is good enough, and my husband confirmed that I am definitely sleeping on multiple sides with the fact that I always end up with the covers on my side or wrapped around me as proof. Dr. Larry also said that if my hip flexor was tight he would do some activation on it next time.
So, in summary, no running and no exercises with flexion until I have had a chance to further strengthen my back and get the sciatic inflammation down. Still a work in progress….