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Thread: Improve physical therapy

  1. #21
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    May 2011
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    Illinois-"Chicagoland"
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    Quote Originally Posted by Mark Rippetoe View Post
    You had Knee Pain. You were diagnosed with patellofemoral tracking syndrome. How long have you been lifting? Wouldn't be 2 years, would it?
    Years ago I went in to see the doctor about knee pain. He told me I had patellofemoral pain syndrome, which is another way of saying "Your knee hurts because your knee hurts."

    I was unimpressed. It cleared right up when I started squatting, which, I note, is not mentioned as a recommended treatment on the wikipedia page for this particular disorder.

  2. #22
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    Nov 2012
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    Toronto, Ontario
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    for what it's worth, I've been suffering from what appears to be a supraspinatus injury since December of last year (from heavy dips). Been to a couple of physios, one of whom nodded their head when I mentioned presses as a rehab tool (but still prescribed band work). The other was against presses, not because of impingement, but because apparently the press works the traps too much, and this creates imbalances (I'm not making this up, I have a vivid memory of these words). This latter physio prescribed all manner of nonsense, including lying on a swiss ball and making superman poses.

    Anyway, I tried all sorts of stuff - presses seemed to help a lot, but one of the problems was that the smallest increments my gym affords me was too much at a certain point (adding 1 kg was the difference between no pain and pain).

    So four weeks ago, I ordered a barbell, a pair of 10's, 5's, 2.5's and fractional weights (as light as 1/4 lb plates). Did high rep presses twice a day, in the comfort of my bedroom, with as perfect form as I could muster. As the days passed, and the weight increased I reduced the volume and frequency. Before I ordered the barbell, a single rep of 56 lb would cause pain. Today I pressed 72 lb - three sets of 7 reps. No pain. My plan is to keep at this until I'm lifting my regular sets of 5.

    Remarkably, my shoulder is substantially better than it has been since the injury, and I've been able to incorporate weighted dips once a week without aggravating the injury. This stuff REALLY works. I can put on my backpack, scratch my back, dry my back with my towel without pain these days.

    I was going to wait until the shoulder had fully healed and write a post, but this seems like the right place to do it. So, on a personal note, thank you Mark. You are directly responsible for this.

  3. #23
    Join Date
    Jan 2015
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    State College, Pennsylvania
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    Lots of distraction happens in discussing semantics. The point that Rip, Austin and Jon make is the heart of the issue. In general, Physical Therapy exercise prescription fails to produce enough stress to cause the body to adapt and heal/change. PT's do not approach their treatment with this most basic principles in mind, and as a result- whether they are treating knee pain, or another knee pathology or whether they are trying to help some sweet old lady be able to get herself off the toilet, they miss the mark, because they fail to stress the body enough to make it become stronger.

    I do find, as an experienced PTA, who works in lots of different places, that many therapists know that what they are doing is ineffective, and they don't like it, but haven't really thought about how to be more effective.

    I recently gave an inservice to a rural hospital rehab staff on the stress-recovery-adaptatin cycle. It was like a light bulb went off for some of them-they had never thought of this concept so concretely before. I saw it immediately effects treatment choices- 1 week later...lots more squats in the exercise notes...not so many knee extensions. (Yes!!)

    Kudos to you new therapist for seeking more and better information. You will not go wrong to learn everything you can about the Starting Strength model and applying it to your patients.

  4. #24
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    Aug 2010
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    Wichita Falls, Texas
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    Quote Originally Posted by Mark Rippetoe View Post
    You had Knee Pain.
    That's my most common diagnosis for the knee.

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