The Doctor, Mark Danziger, prescribed Physical Therapy and suggested investigating orthotics, supportive running shoes and strengthening of the quad since he suspects the injury is due to a muscular imbalance in that my VMO (inner quad) is relatively weak when compared to my vastic lateralis (outer quad).
Later in the day, I utilized my complimentary 1/2 injury screening at Sports and Spinal to see Robert Gillanders. He performed some functional tests on me (step down with one leg, one leg balance-eyes closed, one leg squats) and some leg strength evaluations testing the hip, quad, hamstring and foot. He said that I didn't necessarily need to rule out Comrades already but would need a number of weeks of PT to get rid of the pain. He suggested I come back for further analysis and then the start of a regimen. He suspected the same muscle imbalance but also stated that it could be an issue of the whole system of my leg, from my hips to my feet. Unfortunately, S&S is not really covered by anyone's insurance and it would cost $165 for the first visit and $100 for each additional. And that's the cash price. This against a $25 Co-Pay for insurance-covered PT and my decision was made.
The following Day, 1/19, I had my first session with Sonya. She did some tests similar to Robert (step down, walking barefoot, strength, flexibility) and came to the same diagnosis. She also felt that my lateral collateral ligament (LCL) was loose because she was able to move my lower leg laterally. She gave me the following exercises to do, 2-3 times per day:
- Laying leg raises. Lay on one side with body straight. Lift straightened leg up, hold 2-3 seconds and slowly lower. 3x10 reps; each leg.
- Hamstring Stretch. Preferably with stretching band but 3 sets of 30 seconds each.
- IT Band stretch. Preferable with stretching band but 3 sets of 30 seconds each.
I went back for my second session today, not feeling much better. Although I haven't been running, I have been bitten by the bug and feel the need to stay active so I've been doing some weight training and cycling and on Sunday, 1/22 I did an hour of water running. Possibly the most boring activity known to man.
In any event, today Sonya had me perform the same stretches and add another one to stretch my quads/hip flexor by laying on my back and letting one leg dangle and then pull that leg back with the stretching straps (3x30sec). She had me perform some strength exercises but wanted to wait until the next session to actually prescribe them. They included:
- one leg step downs (3x10; each leg)
- one leg multi-directional kicks using a resistance band (10x in each direction; each leg)
- walking lunges with twist while holding 2x2lb dumbbells (3x down and back)
- lateral walking with resistance band at ankles (3x)
- and a clamshell exercise where the resistance band is between knees and legs hinge at the feet and hips (3x30sec; each leg).
All exercises are meant to strengthen the legs and hips and possibly balance, too. I felt pain in my knee during the step downs and, to a lesser extent, during the lunges. I also felt some uncomfortable moments during the lateral walk.
I have my next session with her on Friday, 1/27 and will try and get an understanding of how long it should be before I start to see improvement. Tomorrow will be a month since the injury. This is very frustrating.
