mgl45 wrote: ↑Mon Dec 05, 2022 7:34 pm
benlen wrote: ↑Mon Dec 05, 2022 7:34 am
Dave B wrote: ↑Mon Dec 05, 2022 5:35 am
I agree with everything Justin said, except for this. Strength training is exceptionally effective at preventing and eliminating overuse injuries such as PT syndrome. It also makes the body more resilient to stress and faster to recover from hard efforts. The scientific literature is pretty much unequivocal on this.
I'll echo this. My trainer's regimen for tackling PFS is first to get muscles firing correctly again, THEN strength training. If you dive straight into strength training without addressing gets the muscles firing correctly, you can injure yourself, but afterwards, you can build up badass strength in your glutes and quads in particular, which will keep your knee aligned correctly on long hikes.
Thanks for the additional reply!
Could you elaborate on what "getting the muscles firing correctly" refers to? Is that what the foam rolling does? I haven't heard my PT use that terminology.
Sure, that's because (and this gets into a larger debate of physical therapists vs athletic trainers) physical therapists (typically, in my experience) take a different approach to PFS than athletic trainers do. In that a lot of PTs legitimately aren't familiar really with the problem. Many PTs spend more time doing post-op stuff, which doesn't help those of us cursed with PFS.
I went through the same process you did––orthopedic surgeon, MRI, the diagnosis, except that I was referred to an athletic trainer over PTs, because PTs in my case didn't really know how to tackle my problem. It really varies PT to PT. But it was a PT who said "That's bizarre, here's a brace, you probably won't ski again."
It was an athletic trainer who said, "That's bulls**t, follow my program, you'll ski again."
In my case, my right knee was the one with PFS.
A big part of the problem was that my right glute (the entire muscle) was knotted up. If I foam rolled my right glute a few years ago, it was extremely painful.
That pain/muscle being all knotted up was indicative of a larger problem, that the muscle wasn't firing/activating when performing exercises that mimicked what happens when hiking/skiing. The glute literally was not working while walking, hiking, or skiing.
The glute is largely responsible for stabilizing your knee, along with your quad.
So if one of those muscles isn't working, BOOM, suddenly you have mal tracking and patella pain problems, because your knee is going all over the place while engaged in dynamic activities like hiking.
Both glute and quad need to work together properly to keep your knee healthy and your knee cap aligned.
What foam rolling does is keep your muscles loose, limber, and healthy, so that they'll be in the best default shape to do their jobs. Foam rolling promotes faster muscle recovery after big days in the hills.
I started from a place for weeks and weeks of foam rolling everyday, and minimal strength training. Only after my trainer saw I wasn't experiencing discomfort from foam rolling did we begin strength training, doing specific exercises to get my glute to fire again, and gradually, to then strengthen the quad and glute to stabilize the knee.
Donny LeBlanc is known as a Jedi Master/genius in the Vail Colorado area for his program that specifically tackles PFS, and he preaches what I've tried to explain above. Being from out of state, it probably would be difficult/impossible to see him, but if you're in Colorado at some point and serious about tackling this problem, he's the guy.