Two knee injuries and what recovery taught me

This is session number 73 of the Performance Place Sports Care Podcast. You gots to know and hold them. Welcome to the Performance Place Sports Care Podcast, where you can learn about sports injury theory, rehab, diagnosis, and how to understand the doctor lingo you didn't understand at your appointment. And now, your host, Dr. Sebastian Gonzales. All right, everybody. Thanks for joining me back. I'm Dr. Sebastian Gonzales, your host for the Performance Place Sports Care Podcast. And I want you to realize that we're into a new month right now. We are into the knee month, and if you follow us through the last month, it was all about hamstrings.

And the prior month to that was all about low backs. So, knees are an interesting topic, and Kenny Rogers knows all about knees, and he probably had a movie theater sign as he was sitting there gambling, because he definitely knew when to hold them. He could be there for hours, probably. Kenny Rogers was actually one of my—it was probably the first CD I ever, ever owned. It was a white one. White album, I think. Oh, no, no. It was The Gambler. I'm thinking The Beatles was—there was a double disc that I had when I was younger. But my grandpa really liked Kenny Rogers, so we listened to it in his Forerunner that he had.

And he had—the reason I say Forerunners, because he had Forerunners for—he had tons of Forerunners, I think. He had three of them in a row, and he kept them immaculate. So, he'd play these by tape, and then we finally got into CDs, and I bought some CDs of The Gambler. And I remember Ruby. I remember Gambler. There was Lady, I think. But anyways, so Kenny Rogers was my thing back in the day, so I don't listen to it much anymore, but just a little known fact about me. I actually started—I think the first music I listened to was actually oldies, the doo-wop stuff. And I don't know why—I mean, I'm sure I sound we-sing.

That's going to be one of my gripes, we-sing. I'll probably go into it in different podcasts. But either way, but yeah, I started out in doo-wop, and we had an area—we had a radio station over here that was called KRTH-101. So, it was basically the oldies. So, anyways, let's get into the knee month and what you guys are going to hear. So, the first thing in today is going to be my personal battles with knee pain, and I've had two different knee injuries over the years. One is—it was IT ban, or maybe it was puploidal tendonitis. The reason I say I don't know is because we never really had an image to confirm, but the way it acted, I believe it was one of those.

And that one came first, that was with distance running, and another one was from trauma, and this was from playing baseball. So, there's a direct incident that created that. Now, the things you're going to hear the remainder of the month. This next podcast is going to be with Dr. Scott Dunaway at ChiroStrength. He is really, really popular on Instagram, and he's growing on YouTube, and he's a smart dude. And he looks like Kenny—sorry, he looks like Brad Paisley. So, he's a cool guy to listen to and have on. After that, we're having Dr. Colby Kondos, who is going to—actually, I should talk to— Dr. Scott Dunaway is going to be speaking about going beyond the band with knee rehab.

Now, Colby Kondos is going to talk about prevention of knee injuries and seeing how biofeedback can be an important tool for it. And lastly, we're going to go into a strength coach one with Jesse Machado, who is going to talk about painless squatting and some of the things around it. Now, before we start, I want everyone to realize, and the clinicians out there are probably going to already know this, so I'm going to sound like this is not going to be new news to them, but remember, we do have patients listening in here, is that knee conditions and less traumatic-based are oftentimes not the—they're not in isolation.

A lot of times, you'll find them from hip conditions, single-side loading, past injury on the other side, core instability, some type of ankle injury, foot injury, and so on, or gait mechanical issue. So, knees are kind of—they're just hinge joints. We call them simple hinge joints. I did a whole other podcast on this. I believe it was in session 32. You'd have to look back. It's around there. I know that. But we did a whole thing on knee anatomy back then, so I'm not going to spend a ton of time on it this time. And I also did some knee biomechanics. So, it's a little bit of a boring podcast, but it does go over all the important stuff that you might need if you're questioning, well, like, why is the knee a simple hinge joint?

What are the anatomical structures around the knee and so on? So, I found that knee injuries, again, if they're not traumatic, a lot of times we have to search for the original thing. Davis Koh in session 33, I think, maybe it's 36. That's 33 or 36. Either way, you can find those on the website, pgsportscoe.com slash podcast and search into the 30s. He talks about finding the sniper. So, it's always something that's irritating the knee. Stop looking at the knee. You're just looking at the injury. You're not looking at the cause. Now, before we actually go into this as well, I want to make sure that all the clinicians out there, especially the new ones coming out of school, if you're anything like me, then you are probably looking for things to educate patients and to gather patients.

And the reason why I put these things together, such as podcasts and infographics or posters and articles and YouTube videos and so on, by the way, we're doing a YouTube video every single day this year. So, if you've not found those yet, holy crap, that is something you need to see because it was not easy to do, nor am I done yet. For all I know, I will fail at it. I hope not. But it's a lot of things that you're going to want to use with your patients. So, these are all free tools for you to use in the digital version. All right? If you want to share a podcast with your patients, do so. All you have to do is share this from your phone to get the direct link, and then you'll probably get it or just email it to yourself, honestly, and then send it out to all your patients or put it on your newsletters and so on.

If you're looking for the poster model of any of the graphics that I have that you cannot find anywhere else because they're all my original artwork, then to go on to ptsportscare.com slash shop, and they're on there. And I think they're extremely affordable in regards to what you, if you get one patient, just one patient from looking at that poster and saying, hey, I have a friend with a knee injury. Maybe I should have them come in. Well, yeah. So, that poster just paid for itself tenfold. So, I would strongly suggest looking at those and seeing if it fits them within your population set that you see.

I see professional, I see athletic professionals, not professional athletes. So, if you have those same types of people, you're going to need to educate them about their injuries or else you're going to experience dropout rate, which is really hard for the patient as well because they will jump to different treatments, to treatments, to treatments, until they hear a podcast, hopefully like this, and they understand what's going on. So, check that thing out. If you have not gone to review the podcast, please do so for me. You'll be entered in the drawing for the t-shirt, which then starts again this month.

Okay? And email it over to me, info at ptsportscare.com. Meh. God, I'm going quick today. Info at ptsportscare.com. Just email your screenshot of your review. Okay, I'll slow it down, I'll slow it down, I'll slow it down. So, we will then go into, right now, the IT band version of a knee injury. So, I can tell you from personal experience that, in all honesty, I don't love running distance. I don't know why. I'd tell you why I probably started doing it. I started doing it because a lot of my patients did, and I wanted to understand what they were experiencing. So, I started running distance, and I like to say that from a genetic standpoint, and also a background of an athlete that I am, I'm a baseball player.

I sprint to the bases, I sprint from the outfield to get a ball, and then we stand around for another inning, maybe, a couple innings. I mean, crap, sometimes you only get, you know, five balls in the outfield during a game. It's just, that's what it is. You only get it at bat four to five times. So, there's really not a need to run long distance, so we never did, nor did I want to. So, when I started getting into groups with these patients, I started running more, and we got into 5Ks first. Actually, yeah, I started at 5K. Then we went to half marathon, did a bunch of half marathons, did some obstacle course races, did a half Ironman.

By the way, that was wildflower, so just you guys that have done them out there, wildflower is hell in regards to the heat, but it was just a long day. I remember that salt is the savior out there. That was amazing, and people love to run around naked with horse heads on in the campground. So, thank you, Cal Poly San Luis. I believe that was you guys, and we found one streaker. There's only one streaker on the course, but anyways. I did my fair share of distance, and I don't plan on doing much more, and it's not because I don't believe people should. It's because I don't believe that I should, nor do I like it.

I believe life is too short to do things that you really don't want to do, especially if it's not conducive for the other part of your athletics that you really want to do. I want to play baseball. I'd rather do 5Ks. I don't see any need to run any further than that, and I'd rather do short burst interval training for that regard, and I'd rather spend some time straight training. But that's just my personal goals. It all is based upon each person. Now, getting into kind of what I was leading into with the IT band thing. So, I remember this, and I wrote a whole article on it. It is on my website, p2sportscare.com.

Go into the article section, and it's on the runner's knee portion, or you hover over the knee part of the runner, and it's in the IT band section. So, I remember running around Back Bay. Back Bay is, it's in Newport Beach, California. It is part of the Back Bay, and it's about a, it's a 10-mile loop. And so, we park in this dirted area. We start running. We go around the thing. We come back. That's about 10 miles there. I forget the exact miles. I think it's 10. Anyways, so, there's a section where we kind of go through these neighborhoods, and I remember stopping. We had to stop at this, one of these lights, and we stood there.

Some people like to do this little makeshift jog when they're sitting there. I don't like doing that. Makes me feel silly. I'd rather just stand there, you know, do a couple squats here and there, and so on. Finally, the light changes, you go and stab. Like, I was just stabbing. I think it was on my left leg, now that I remember it. It was on my left leg, it was on the outer part of the knee. It was localized just underneath. If you feel underneath that ropey structure on the outer part of the knee, it was right under there. And the reason why I'm having you all feel right there is because that there is, that's really close to the joint line of the knee, but you can actually feel the IT band go down there.

If you grab too far back, you're going to feel one of the hamstring tendons, but just kind of more to the side, there's a ropey structure that's the IT band. Now, just under that, there's bursa, there's also joint line in there and so on. But right there is where it felt like someone was taking like an ice pick and just stabbing me in there. And I had to, I mean, I took, I wanted to keep up with the group, so I kept going, but I was limping for sure. And after about 30 seconds or so, I think, I was okay. You know, so I kept going, going, going. We hit another red light, stopped, started again, felt the same thing.

Stab, stab, stab, stab, stab. 30 seconds, kept going. All right. Another stoplight. So this happened, I think about three, four times in there because we're kind of getting into the neighborhoods in there. So it wasn't an issue when I was actually running, which I never fully figured out, but the location I thought was an important thing. And I will be going, I did have a podcast which hasn't aired yet. But I had it with Dr. Michael Fanning, and we're talking about IT band syndrome versus a radiculopathy, which is a nerve condition. And I know within hamstring, the hamstring month, we talked about hamstring versus radiculopathy.

And we, this concept keeps coming up where we need to make sure that we're diagnosing things correctly. And I believe that my condition was not a radiculopathy, and I'll tell you the reasons why. By the way, radiculopathy, what, is when the knee is, sorry, when the nerve from the back, a nerve from the back is affected, irritated, compressed. I hate saying pinched because it's even light pressure can affect the nerve. It doesn't have to be a ton. It doesn't, pinched kind of makes me feel like it's just being crushed in a door. But it has light pressure on it, and it creates sensations of sometimes burning, sometimes aching.

It feels like it's over the entire IT band, and that's where people tend to foam roll and just beat the snot out of that area. And really, they're trying to roll out a sensation that is coming from somewhere else. Now, when I talked to Dr. Mike Fanning about the IT band, I said, well, how do you figure out if this is actually an IT band condition or not? And he's like, well, we'd roll out the low back and the nerve. I said, cool, great, what else you got? And he's like, well, the location's important. So if it's just behind and to the side of the knee, then it's a higher probability that it's actually that friction syndrome down there.

All the other stuff that's higher, it's more commonly the other thing, and we have to look higher than that. Now, I actually had this thing for, I want to say about a month or so, and I'm trying to remember all of the ... I remember it was really frustrating that I was not able to run as well as I was, not that I was running extremely well. I only ran like 8.30, 8.45 miles. They weren't that good. But either way, I was not able to be with the group that I was in. At the time, a lot of my friends who I hung out with, they were runners, and so it was kind of just a hangout time. It's like the Saturday morning run, you want to hang out with them and run, right?

Someone calls you, texts you, hey, you want to go run? Well, I can't. So it's super frustrating, and I understand that. Patients say this, whether they say it or not, I think the social aspect of the run is actually a major aspect of the reason why they want to get better. Sure, the reason maybe why they started running was because of fitness or weight loss or ... I mean, you do get those instances where people just love to run. I find that a little bit more rare, not to say that people don't love running, but running, a lot of times it's a solution to something else they're trying to solve. But yeah, some people love, they got to run, that's why they call it runner's height.

People love running. So I felt the social need with that, and I wasn't able to go, so I was super frustrated. So I went to a friend who actually does active release technique. He played with the IT band a bit as well as the hip. It didn't resolve. I did a little bit of strength training. I did some hip rotator stuff, some glute med stuff. I did some squatting stuff, and I'm saying stuff because I don't remember the exact things that we went through. But overall, I was self-programming for myself. But I remember it was rather uneventful for about a month. So finally, I was with that same friend.

We were doing a run, and I said, look, I feel like maybe it's ... It feels like it's right in this area right here. It kind of bothers me when it rotates, and it hurts when it locks. I'm like, maybe it's the popliteus tendon, or maybe it's the popliteus because it has an effect with locking and unlocking the knee. And if you listen to other podcasts that I was speaking about, that screw home mechanism is that last five degrees, it locks and locks. So that's important for a load transfer and being able to push off the ground effectively. So I'm like, maybe ... I'm like, can we treat that a little bit?

Because Active Release has a specific protocol just for that. So we said, sure, let's do it. And holy hell, that thing hurts so bad. It hurts so bad. And it's funny, going to people that do Active Release, we all know it hurts. Some people say it's the good hurt. I don't think it hurts good at all. I think it just hurts. And when you go to seminars, sometimes they say, if it hurts, you're not doing it right, I feel like everyone that we do it on, every person that's ever treated me, it hurts. And obviously, you can lighten up. But when you're on a spot and you pin it and you get to the area that's affected, it seems like it always hurts.

So anyways, so he treated the popliteus. And lo and behold, the next day felt so much better. So much better. And it felt so much better that I actually did a article that I do not have live on the website right now. But it was a kind of like a case study on myself, which I probably should have looked up before I did this podcast, but it was all about popliteal tendonitis, the unknown, I think I called it the unknown version or the unknown reason for knee pain or phantom IT band syndrome because they're very close to each other. And I've actually done a fair amount of musculoskeletal ultrasounds, which is a type of imaging, which is a dynamic image.

You use sound waves to look inside, look in and around the knee. You cannot see inside because it's almost like a fish finder. A fish finder can't see the bottom of the, can't see past the bottom of the ocean. If there's a big rock there and a fish is underneath the rock, it won't see the fish. So we can see the IT band. We can see the popliteus. We can see the popliteal groove. We can see the femoral, uh, uh, uh, femoral condyle. We can see all the tendons and muscles around the knee. And I typically find that with people that I image that the IT band looks normal, extremely normal. But we, what we find is a lot of times is the popliteal tendon within the popliteal groove has fluid around it.

Now, the reason why I'm bringing this up is because, um, of the misdiagnosis factor, I think, with people. And I think if I had, uh, gone back to treat my injury, I might've done it a little bit differently too, knowing what I do know now. I probably would've done a little bit more stabilization of the knee and the stabilization of the torso. Because here's the reason, here's the reason why. So, the popliteal tendon has a sheath and it is, uh, it is connected and continuous with, uh, a portion of the knee capsule. The knee capsule a lot of times fills up when you have internal knee issues. That could be an ACL injury, which is the anterior cruciate ligament, a PCL injury, the posterior cruciate ligament, the LCL lateral cruciate ligament, MCL medial cruciate ligament, um, as well as some cartilaginous structures in there, um, floating bodies, things of that nature.

So, there are, there's a reason to believe that there was some type of irritation to the knee. Um, even congenital malachia patella a lot of times presents into this fashion. So, there could've been some softening of the cartilage within the knee. So, I think I would've done a little bit more of stabilization of the hip, looked at the ankle, looked at the foot, rather than just done, uh, treatment directly to the knee. But, I tend, I, I, I think what I did, actually, I did do this. I did do part of it. Um, I think my strength training back in the day or my rehab was a little bit more archaic than I would, uh, do now.

But, either way, it seemed to work. Um, I do remember that the resolution of this, um, was that after he treated me, uh, he had to treat me one more time and it was nearly better, but it still hurt a little bit with runs. And, I remember I was running, um, south side Huntington Beach at nighttime, it was in the, or in the afternoon. And, there's a, uh, a beach pathway. We're right by the sand. Um, I remember all the, there's the periodic lights and you always wonder, like, those campers that are out there sitting between the lights in the dark, uh, do you want to rush past them or not? You know, south side of the pier, uh, all the way down to Beach Boulevard is not very, uh, populated, I think, or especially even down towards, uh, the jetty.

The other side is, uh, I think a little bit better, but either way, that's not the point. So, uh, I, I, right before I went for that run, I did a lot of, uh, it was Bulgarian split squats at the time and it was, or sorry, not, not right before, it was the day before. So, I was pretty sore, actually. And, I remember during that run that my legs were sore from the workout, but my knee didn't actually hurt. And, I kind of took that to heart and I realized that there, that stiffness around the knee and around the hip, I think, was helpful to stabilize the knee. Even, and, and also, in addition to treating the structure, which I think this case was the popliteus, maybe it was IT band, maybe it was both, but either way, that's how I came over my IT band issue or my popliteal tendon injury.

And I think if you guys have this injury, you definitely can too. Now, you just have to find the right people. You have to modify your miles. You have to realize that if you are, uh, going to these groups on Saturday groups, group runs, why are you going? Are you going to hang out with friends? Are you going to get the mileage in? Do you have a race coming up? Does it really matter what pace that you run at? Do you need to run at all? You know, is it okay to walk? Because intermittent walking is great core training. We do that with back injuries. So, why not just walk? So, or is your ego in the way?

So, I think a lot of times people need to do a check. And this is the reason why I think runners get, uh, so many injuries or random spots that build up over time is because they don't want to check themselves. So, I believe in checking myself. And I did it. I did at that point. I definitely cut miles back. Um, I don't believe that I am a serious runner at all, or at least I didn't think I was at that time either. So, I think that everybody, when they go to these Saturday groups, just, just go to have fun. You know, meet everyone for coffee, beers, uh, food after, you know, you don't need to actually go on the run.

You don't have to always suffer together. Sometimes it's just good fun to, it's fun to see friends. So, I think you all can come through those things. ITVan doesn't have to be the death of you. Um, and I know that on Runners World's forums and other running forums, it is an extremely, extremely popular topic. And I believe one of the major reasons why is why I mentioned earlier that radiculopathy. If you guys keep foam rolling the heck out of that lateral thigh and nothing changes, then I think you need to come to the conclusion there's a strong possibility that you're not doing the right thing.

I always tell people what's, or ask people, what's the definition of insanity? And it's doing the same thing over and over again, expecting different results. And I think if you really find the right treatment or rehab or resolution to an issue, a lot of times within even a minute, you'll, you'll feel better. And this happens a lot of times with back injuries or neurological conditions. I had one just the other day. Um, he believed it was a, uh, uh, actually I think he was on the right track, but, um, people thought it was a neuralgia, uh, neuralgia parasitica, which is a numbness into the thigh.

He was trying to stretch his hip flexor. But so we found that it was some postural changes. We were able to diminish even some, even some lean away from that side, aggravated as pain, leaning back towards neutral or towards the side of the numbness was helpful. So changes can be found really quickly, whether you stick them or not as a whole different story. So if you're foam rolling these things out and they're not sticking, then you need to make sure that you're doing the right thing in the first place. Or if you are doing the right thing, make sure that you're treating your body responsibly after you find that resolution.

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To see if you qualify, get a free quote today at healthiq.com slash performance or mention the promo code performance when you talk to a health IQ agent. Now back to the show. Now going on to the second case of mine, this was a trauma case. And this one, I believe, was either a lateral meniscus tear or I think it was a lateral meniscus tear plus a tibial plateau, lateral tibial plateau compression fracture. So this one, I was actually playing baseball and it was actually, I mean, I was, I was going home. I was, so I was, I was at bat. I, I, I know, I know the play happened at the plate and I know the, some of the fields that we play on, uh, the right hand of batters batters box is just completely dug out.

And I don't know what it is with some of these schools. Sometimes we pay good fees to play at these schools. And I mean, we just, we just want a good field. Sometimes these boxes are good. Three inches, three, four inches deep. So deep that you need to shift your feet around. Like you have to go to a different part of the box. Like hopefully, cause you don't dig into someone else. Like I'm, I'm not, I mean, I'm only five, seven. Uh, if someone else is a bunch of everyone, I mean, what's the average male height, like six foot or something now. I mean, they have a wider stance than me. So I don't want to step that wide.

So either way, but these things are completely dug out. So I was at bat and maybe I'm making this up in my head, but I'm pretty sure this, this was, this was the scenario. Um, so I'm relatively fast. Like I said earlier, I, I've, I, I still bases. Um, I don't run fast for long distance, but either way. So I have the, I have the ability to get, uh, triples, doubles pretty easy. But in this case, in this case, this doesn't happen all the time, which is, uh, I was excited about when this happened that twice that season was, uh, and in the park home, home run with no errors, I might add. So I was really excited about that.

So ball hits a right center, went out into the gap. I don't know where they were playing, but, but it's a pretty big, it's a good size field. It was at, uh, Irvine high school at the time. So I went all the way around, around the third base, was going home and there was a play at the plate. So I had to dive. Um, I chose to do a sideways slide off to the rights or towards the bleachers and stick my left hand out to try to get into the plate. Um, I don't know why I didn't go feet first. I probably should have because the catcher was standing right there. I was out by the way. Um, so it was a big tumble, the plate.

I remember I tore my shoulder up. Um, my elbow was just torn up and then my right knee, it actually one is, was, uh, impacted at the lip of the dugout portion of the batter's box. So I limped off. I couldn't play the next inning. Um, gosh, it seems like all my injuries happen at Irvine high school, Irvine high school. I like your field. I love that Ivy wall, but I think you're bad luck for me. So anyways, um, this thing just swelled up. Um, not huge, by the way, for all the clinicians out there, there was no pop. Um, there, uh, I was able to bend it. It swelled up, uh, I would say minorly. So that's a, that's a sign a lot of times of a meniscal tear and it swelled up later.

Uh, it took about a day or so. Um, I did ice it at the time, but I remember that over the course of the next couple months, the swelling just remained and it wasn't on top of the kneecap. So for all you people out there who are thinking like maybe it's water on the knee, well, it wasn't, it wasn't above the kneecap. It was inside and I can feel it was inside because it felt like there was a Ziploc bag in my knee that was about to not explode, but extremely full, extremely full. And to the point to where if I bend it, if I bent it to squat down into a chair, even of that height, I can feel it start to pressurize.

I can't even feel at nighttime. I remember, I remember I was thinking that this was kind of one of my outcome measures to see if I was improving. I, when I laid in bed, I can just feel the fullness. I can feel the pressure inside. And by what I mean by inside, it was in the front. It was also in the back. Um, and with squatting down, I can feel it start to pressurize, not just in the front, but kind of into the back. So it made me think, holy crap, maybe I have a Baker cyst like this isn't good. Um, and maybe I have something really, um, I don't want to say really damaged in there, but damaged enough to produce this kind of swelling.

So I, I, I used a couple modalities. I, I won't name ones, I won't name ones which yet, but, um, maybe in the future I will because I want to make sure that I don't bad mouth anything. But there was actually, there was a guy presented in my office that he was trying to sell me a, uh, a device to use the people. Um, I, I used it for the record amount of time. Um, it was a, it was a, it was a stem unit of some type or electrical electrical, you know, some type with pads. Um, I said, Hey, look, here's what I needed to, uh, see if I will recommend this to my patients because I want this fluid to go away.

And he said, look, if this fluid doesn't go away, either your body, the body, your body doesn't work. I said, great, cool. How long, how many days and so on. So I did it all. Um, it didn't actually work. The, the swelling stayed. Um, I told, I was told the guy straight up, it didn't work. And, um, I forget what, what we were to end up talking about with that, but I didn't end up, uh, uh, recommending the machine to, to anybody because of that. Um, but the swelling didn't go away, which I think in the, in this part of the story, it's important to realize that swelling in the knee can affect, uh, other aspects of rehab.

Uh, it will really make it so your rehab drags. It's like, you will not be able to fully bend into a squat. Um, there, your knee will, from what I understand, actually, I want, if, if someone knows this research, uh, you can, can you send it to me? Actually, info at p2sportscare.com. Um, from what I understand is when the knee swells, uh, the hamstrings inhibit, which if this is the case, then it's hard to rehab the knee completely. Sure, I can do trunk stuff. I can do hip stuff. I can do ankle things and so on. But I, I mean, if we're going to train the knee to learn how to bend again and resist rotation and lateral bend, then we need to bend the knee, right?

But I couldn't bend the knee, which is a huge problem. So, um, I tried a lot of things to, uh, try to get the swelling out. I tried ice. I tried heat. I tried biking at that time, and it, it didn't really help out a lot. I couldn't actually kneel on the ground and sit my, my butt to my heels because it felt like my knee was going to explode and there was a pinch in the back. So, um, by the way, later before I, I mean, before I forget, I figured out that there was, uh, a lateral meniscus as well as a, looks like an old tibial fracture laterally, um, because we did a musculoskeletal ultrasound on it.

So you can see amazing things with a musculoskeletal ultrasound. And what it looked like was that the knee or the tibial plateau had a slight deformity in it. Um, or people, uh, patients will probably think of this as like a, uh, bone spur. Um, but it was a, I guess in this case an abnormality because I don't believe it was arthritic at the time. Um, and it looked like the meniscus just jumps over it and it still, it still continues to do that. So it created a local pocket of irritation right around there. So, uh, where was I going with that? Uh, oh, I tried a lot of things. Heat, ice, um, Epsom salt.

I tried stretching the knee. I tried soft tissue on the muscles around the knee. I tried working the lymphatic channel into the adductor area. I tried a lot of things. Um, I didn't try acupuncture. Uh, I didn't try, I did try a spurt of Advil actually, um, to see if I can decrease swelling, uh, systemically. But, you know, really, actually I tried SinVist as well. That didn't help. I tried about, uh, two rounds of it. So that's that synthetic, synthetic snow oil fluid. Because I like, actually it's, it's funny. Like when that, when that was proposed to me, I said, look, I, I don't know anything about it.

And they said, well, it's used for people who are going to be having a knee replacement in some point. And it just prolongs it. And I said, why? And they said, well, it's, it's synthetic synovial fluid, which is the natural fluid, which is in your knee. And it decreases, uh, rub or friction around there. I'm like, wow, that sounds, that sounds cool. Okay. So I got some probably rubbing in there. Let's do it. Right. Um, I, the, uh, they, they didn't. They didn't help out. Um, maybe they'll help out with some people. They didn't help out for me. I'm not bashing them. I just say they didn't help for me.

It's a true story. So lastly, I was kind of at wit's end with it. And I, I didn't want to do any anti-inflammatory local injection, but I opted to. And I tell patients this even now, because I was about two and a half, three months out from this injury and I was still inflated there enough to where I couldn't really rehab as well as I wanted to. And so I told myself, I said, Hey, look, I'm going to get this injection done in the pure for the pure effort to decrease swelling. If pain goes away, I will still not be as active as I think I want to be. I will still not run and throw miles upon it. Um, I will rehab it.

And at that time I was off season, so I wasn't playing baseball either. So I opted to do that. The swelling decreased. It was great. And so I rehabbed the hell out of it for about two or three months and it feels better. And I haven't really had any major issues with it since. Um, I, I do remember the timeline or time of year because I remember the, the day where I could finally, uh, bend the knee and sit in that fashion that I said earlier, kind of with my hips to my hips to my, uh, to my butt, to my heels is so it was around, it was the new is around the new year because, uh, usually in the new year, I'll go to, uh, central California and I'll go biking.

I haven't the last couple of years, but I went biking. I went biking from, uh, Cambria, California to San Simeon. It's only about a 12, 13 mile ride. And I took my bike up there and before I rode, I was kind of bummed out. The knee wasn't a hundred percent better, but it felt there was still that pinch in the back, which is really frustrating. The swelling was down. It was overall better. But, um, anytime you have an injury, I'm sure that you all feel this too, is when you have an injury, it's, it's, it's just frustrating. You know, uh, I know for me, every time I have an injury, I think it's kind of the end of the world.

Like, I'm not saying I'm a hypochondriac, but I'm thinking that I know that I've thought about this recently with one of the injuries I've experienced is that, um, I know that since, since ever, since, since I was younger, I've been athletic, right? I've been in shape, um, I never been overweight, um, the heaviest I've ever been, ever been is 165 and I'm five, seven and fairly muscular build. So it's, it's not like, you know, I don't like, as part of my identity, that's like, I'd been that since like, what, 15 or so. Um, and I think in high school, I was like 140 or something. I ain't sure. So it's been my identity for a long time.

I've been athletic. I've always been good at baseball and I run fast. That's, that's just me. I mean, if I had to put it on a gravestone, those are the things that I could probably do. Um, and the, the people that have played sports with me will, will remember. So what if one of these injuries took a lot away, you know, and it made me start to, to realize that, or at least now makes me realize that, um, you know, the purpose in life should not be for, you know, your physical attributes. It should be for things like this, like podcasting, sharing, helping other people and so on. Um, that's why I started the drawing recently that you guys have probably seen on Instagram, all those original drawings of things that I thought would better the sports injury world.

Um, so with this knee injury, I was pretty bummed out as well. Uh, I didn't realize all that stuff at the time, but every time I think it's kind of the end of the world and that injury is going to take me out of what I like doing and kind of who I am. So anyways, I jumped on the bike, went 12, 13 miles, St. Simeon came back, kneeled down and holy crap, the pinch was gone. It was gone. It was great. And I haven't had it since. And the only thing I could think of is that the knee gets nutrients from movement. So it wasn't a very hard ride. Fluid is moving around. I probably, uh, it probably got some lubrication.

It probably moved the meniscus around to where it wanted to go and it was not pinching, which is an awesome thing. So that was my experience with that. Um, now, will I have issues later with either of these? Maybe. Cause that was the right knee actually. I do remember that one. Uh, the left knee on the other one. Am I going to have any issues? I could. I've done a musculoskeletal ultrasound on my knees over the last couple of years. Um, just to show on YouTube videos and so on, which you can find those by the way, if you look up, uh, diagnostic or musculoskeletal ultrasound, Sebastian on YouTube, you'll find them probably on the knee.

So, uh, I know that they look fairly good now. I don't see any arthritis, but here's, here's the thing. And I don't want to like just go down the route of saying arthritis is the end all, but arthritis is the body's response to, uh, instability. Um, I know that a lot of people say old age. Um, sure there, I don't remember if there's any research to validate that or not. Maybe there is. I'd love for you to email it to me, by the way. I love being corrected. I'm always learning. Um, but in, in the case of the ACL injuries with knees, with girls, they, they get osteoarthritis, which is that old age arthritis within five years, signs of it, not major, but minor signs of it within five years of having an ACL injury.

And an ACL injury is one that is creates instability in that knee. And consider the age group we're talking about here. We're talking about, you know, 14 to 18 roughly. That's the most common group of girls, soccer, soccer, volleyball, basketball players who get these. So around mid twenties, they're getting signs of osteoarthritis. Well, what happened to this old age thing, right? It's trauma based. Um, it's instability based. Um, so if you're asking your body to use its bony architecture to start, uh, stabilizing an unstable joint, then you are going to develop it. So my thought with my knees is going to making, is going to be making them as bulletproof as I possibly can, making sure that the, actually, before I, before I explain that, uh, I do have a video on YouTube, by the way, there's a whole knee pain series for runners.

Um, I believe it's on the runner's knee one. So if you, if you go into my YouTube channel, uh, and look up the, uh, it's going to be under playlist and you'll find knee pain with running series. Uh, there's a section in the very back. It's a 30 minute video, by the way. So don't get freaked out. Um, it is, it is everything I want to say about runners knee or con or con your release patella, because I like making small videos, but at the same time, I mean, if I'm going to have a really popular video, which by the way, if you guys like it and share it, that'll help out. I want to make sure all this good information pops to the top and it floats.

So, uh, you got to have the best video out there. You got to have the best content out there. So at the very end, I did do a cascade of events, which creates, uh, knee pain. And at the top of it all is, uh, loss of midline stabilization or loss of your pillar system. And if you guys haven't read my article on the pillar, uh, system, which I did not invent, by the way, I did give credit to who did it in that pot or in that video, sorry, in that article, um, the, you, if you lose your stability there, you lose your pelvic control, you twist the femur and the knee becomes unstable. So no matter what we do to the knee directly, it's, uh, it's nearly, I'd say nearly 95% of the time I'm making that number up.

It's dependent upon the torso, the pelvis, the hip, the ankle, the foot, and so on. So I plan on working those structures and making them bulletproof. So my knees will then become bulletproof. All right, so I'm going to stop there today and let you guys digest that information because we do have some great information coming over the next month on knee conditions. Now, if you have not been to the YouTube channel yet, you can find it on the show notes, by the way, it's very easy. Go to p2sportscare.com slash podcast pound or slash pound. This is going to be session number 73. Or if you go through just the patient section, go to I'm a patient.

It's on the main page. You'll see the podcast link as well. You'll find a bunch of spots where you can find the YouTube channel. So just go through there and subscribe and you'll get all these videos as they come out because this entire month is on knees, like I said. So I'm going to be sharing a bunch of things related to knees, knee test, knee rehab, knee treatment. And these are all on YouTube. I do have them posting every day on Instagram as well as Twitter and Facebook as well. The only spot you'll find on Facebook is in that closed Facebook group that I mentioned. That is the patient education or modern patient education.

Oh God, I am. I don't have my computer in front of me. I apologize. So modern sports medicine patient education, you'll find it. I will link to that in the show notes as well. Sorry, that is a mouthful. Maybe I need to change the name for that thing. We'll see. But that's what it is. It's modern sports medicine patient education. So that's for the clinicians. But if you are clients, people's clients or general population, we like to say, go to Instagram. There's one minute videos on there. That is at performance HB. The Facebook page, my Facebook page is at or it's performance HB. Twitter is the exact same thing.

So it's really easy to find. Now, if you're looking for the show notes on this, again, go to that podcast link that I am providing as well. And if you are a clinician, do not forget, you can share these with patients. I want you to share them with patients. I want you to put them on your monthly emails. I want you to have access to this Google Doc that has all of these topics categorized for you. Okay, I'm not trying to make this hard. I'm trying to make it extremely easy. I want you to share this with your patients. It helps me. It helps you. It helps them. It's a win-win-win. I'm sure there's a fourth win in there somewhere, but I don't know where it is.

So if you're looking for, you can get access to that document if you go into the shop section and just buy one single poster of any size, branded or not. Okay, so I will leave you guys with that. I will talk to you next week, and you're going to hear from Dr. Scott Dunaway at that point, who is going to leave some excellent, give you some excellent examples of how to use the band and go beyond it for knee rehab. Remember, make sure you guys leave each other better than how you found each other, and I'll talk to you guys soon.