Expert: Thomas Sabalaske DO - 10/11/2009

Question
Hello

I hurt myself after falling badly during a martial art lesson.
The back of my leg was quite painful so I stopped the lesson and rested.
I have now a very stiff right leg, the back of my knee/ calf is quite sore giving me hard time kneeling down and getting up.
After kneeling down for 5 minutes it's practically impossible to stand up naturally,  I need a few minutes to stretch myself up straight and walk, (I couldn't deal with an emergency "get up" if yousee what I mean!)

Also Since, looking over my shoulder and tilting my head backward on the right side is really painful and feel really stiff!!
My lower back is also painful.
During an abdominal manipulation, the osteopath found out that the psoa muscle was in spasm as it was quite sore under pressure applied. Could it be why since the incident(sorry this is quite intimate)I feel a great pain in the right side of my abddominal during intercourse?

My leg gets stiffer and stiffer evry day and I am a bit worried as walking is not so natural now!

I used to have occasional sciatica in the past that got worst during pregnancy 3 1/2 years ago. I'm fine now and only suffer from it after heavy liftings!

I'm quite healthy, appart from I have being diagnoses with bacterial vaginosis since about 4 months,( PH/Alkaline imbalance in the vaginal flora resulting in abnormal discharges..I am still trying to find a cure but research says that apparently causes are unknow!!
It all started since the incident really ..a bit much for my 28 years of age...I feel 60 really ;-(

Anyway getting back to the knee/ back/ neck / and possibly psoa problem, as the osteo doesn't give me any exercises to do or streching to help me feeling better....could you help?

What do you think it is happening to me?

Thank you so much for your help.

W  

Answer
 Hi Winnie, and thank you for writing.  Of course all I can give you is general information and you have to actually be examined to get a true diagnosis and treatment plan.  So information wise, lets take issues as you presented them.  
1.  knee pain - its really difficult to know what the pathology is without an exam, but it sounds like you may have some increased fluid in the knee from whatever you did to it (sprain/strain/meniscus injury) and that is why it is getting stiff and not letting you leap to your feet.  You need either the osteopath if they are comfortable or a physician to examine the knee and say if they think there is internal damage or not, if not then you can pursue correcting the biomechanics involved with the knee to see improvement.  

2. lower back/neck pain - I'm sure with your injury you pelvis is probably asymmetric, and that strain in the soft tissues (fascia) is throwing the rest of your body off

3.  psoas spasm - part of the pelvis trauma, straightening out the pelvis and sacrum should alleviate much of this.

4.  dyspareunia - pain with intercourse is very common when the abdominal and visceral fascias get torsed with trauma, releasing the entire pelvis and soft tissues should resolve this.

5.  bacterial vaginosis - a thorough culture should be taken to see if there is a particular bacteria responsible for the changing of the vaginal flora - after this is eradicated, loosening the fascia of the area can help the autonomic nervous system function better and may restore the health down there

6.  home exercises - I agree with you there should be some direction you can control in your healing process, but without an exam I can't recommend anything.  

So overall, the biggest thing to figure out is what is the actual diagnosis for the knee and what do we do to fix that.  If that continues to hurt, your body will change the other muscles that affect the knee to try to "splint" it and it can throw off your gait etc.  I wish you good luck in getting a proper diagnosis and thorough treatment!  Tom