22 years old with possible Osteoarthritis?

Hi Davis,

Please don't panic!!

I think whoever is in charge of your healthcare is donig a bad job.  The info re joint degeneration that you're being given is very outdated. Even the docs (who I personally think are behind the times) are accepting that OA is NOT an inevitable wear and tear process but rather a wear and repair process. It's normal for joints to wear. It's only when they start to wear faster than your body is able to repair that it becomes a problem. Rectify the cause of the rapid wear and things CAN in fact repair. There is certainly no need for it to get any worse.

Mild wear to shoulder joints shouldn't be anything to worry about and  will rarely lead to irreversible symptoms. There's plenty of room in the shoulder joints to accomodate all sorts of lumps, bumps and worn bits. Fix the muscle imbalances and the wear should stop, could well reverse and you're unlikely to have any further problems. Nothing you've been told indicates that there's something special about your case. It shouldn't be an issue.

I KNOW I've got degeneration all down my spine - severe in my neck. That's from xrays 10 years ago. I don't have a single symptom. Joint wear honestly isn't a big deal. It won't necessarily get worse; It needn't cause pain; it CAN even repair - although in all practical terms it's unlikely to make a jot of difference to you whether it repairs or not. It's very unlikely to be causing your symptoms.

I have a lot on today, but I'll take some time ASAP to expand on this in more detail, provide resources/references and hopefully put your mind at rest. I just spotted your previous comment and I'm guessing that correcting muscle imbalances isn't going as fast as you like? That's normal too - remember, it took me years. But I got steady improvement and eventually complete resolution of symptoms. Don't despair - nothing you've said changes the situation in my mind. It still sounds like you have a muscle imbalance - just like I had.

 

Thanks for your reply, I really appreciate it. My anxiety has calmed down a bit because I've realized that this can change if done correctly. It's given me hope.

I've kind of self diagnosed myself at this point because waiting for an accurate diagnosis from multiple MRI scans is too time consuming. Basically, I believe that my shoulders are rounded forwards which is causing the pain.

For my shoulders, my physiotherapist has me doing external rotations to strengthen the rotator cuff and scapular retractions. I'm going to go to the gym and work on really building up the muscles surrounding the scapular as well as the rhomboid muscles, lower traps etc. In addition, I really need to loosen up my chest. Rolling the pecs and lats should help.

My physiotherapist told me recently that my right pelvis was rotated forwards. I'm going to add in core exercises that really target the internal muscles that stabilize the core. Planks should work.

As mentioned before, I think that I really need to work the hell out of my glutes. My right glute feels really odd in comparison to the left. I notice knee pain as well. I will work on adding strength to the game and quads.

I'm now covered by insurance as I'm back in school, so I will utilize massage therapy and physiotherapy as much as possible. Also, my right leg feels much weaker than the left. What is your opinion on this?

Thanks.

That's fitting very closely with my symptoms which should give you hope for complete cure.

I was pretty inactive as a child and developed a 'desk top posture'. So shoulders rounded forwards and an anterior pelivic tilt. As an adult I practiced karate - too much on one side and developed a twisted pelvis on top of that. In my case the right side of my pelvis was rotated back.

The thing about a twisted pelvis is that it messes up the resting tension of virtually every muscle in your body. It's hugely difficult to put right. Which is why so many of us get fobbed off with an OA diagnosis. They don't know what else to do with us!!!

My right hip eventually seized up. But for years I had the problem without being aware of it. That's the nature of muscle imbalances. They can lurk for a long time with your body compensating and adapting. Eventually though pain strikes - exactly WHERE it strikes is dependant upon a lot of factors. Basically where your particular body is feeling the most stress.

Hip went first with me but I soon had shoulder impingement too - I couldn't move my arms at all without sever pain and had bone on bone restriction according to the physio. I can now do 15 deadhang pullups, handstands etc. Full recovery is likely with correct rehab.

You've got problems young, but I'd hazard a guess that's a lot to do with your stress and anxiety. It really can play a part. My hip didn't lock up until I was under tremendous stress due to the illness and death of my parents.

Muscle imbalances are tricky to fix. Just strengthing and stretching won't provide a complete solutions as you do need to target things precisely. Physios are generally pretty good with shoulders. However, they tend not to look at the whole body's involvement. So get as much input as you can, discard any negativity and keep working towards better understanding things for yourself. You WILL need to figure out a lot of this for yourself.

One thing is certain - regardless of the root cause of your problems you will feel much, much better and will protect your joints better if you address all muscle imbalances. So you can't lose taking this approach. Worse case scenario it will help. Best case scenario (highly likely) is that you'll get full recovery - IF you work at it over a long period of time.

Start working on trigger point therapy. (I'll send you a link to a good book).

Google for exercise for 'cross crawl pattern' - when your pelvis gets twisted your nervous system gets a bit fuzzy about where everything is. Cross crawl exercise can play a part in getting things balanced out.

Try adding in some stretches to untwist your spine. Also loosen off your thoracic spine. Try this one :

Lie on your right side with knees bent and left hand on your left knee. Keeping your right thigh on the floor and knees together, stretch out your left arm and roll your upper body back so that both shoulders, arm and hand touch the floor. Then roll back to starting position. Repeat 10 times or so. The aim is to be getting the movement from your upper back. You'll probably be too tight to do this at first so just get as big a movement as you can without straining anything. It'll loosen up in time.

Get as much exercise as you can without aggravating things. Exercise helps. It pumps oxygen and nutrients through joints and tendons helping to keep them healthy. It gets you fitter and stronger which helps you to cope with dysfunction. It will help to relieve stress which I'm guessing is a factor for you.

I'll drop you a line with a link to that trigger point therapy book.

Good luck and stay positive.

And yes, my glutes felt weird. The muscles are all twisted due to the pelvic position. You have to work hard on glute activation and strengthening and get the hip flexors stretched out. BUT - because of the twisting it's not as simple as it sounds. Work on unraveling the twist and that will help. Your real challenge is making your body do the corrective exercises the right way. It's forgotten how to move normally. You need to try and teach it.

With right side forwards that suggests that your right hip is in external rotation and left hip in internal rotation.  Working on correcting that as well as untwisting the spine will help. Important first step is to buid awareness of what's going wrong in your body. you're on the right track.

Thanks... The biggest issue for me is the shoulders and right leg... The shoulder I'm confident in fixing. Its my gait/leg I'm worried about. My right leg feels so tight and stressed, as if my body is leaning all onto my right side. In addition to the tightness there's weakness. I hope what you are saying is correct because information on this is tough to find. What are some hip strengthening exercises that I can do?

I'll try and provide you with a more indepth idea of what exactly is wrong. It's not really enough to just think of strengthening the hips. You need to realign them. When the pelvis is twisted you'll find that you almost get a mirror image - the muscles that are tight on the right side will for the most part be weak and overstretched on the left side. And vise versa.

I think from what you've said we're pretty clear that your pelvis is rotating towards the left. Your symptomatic hip is the right one.

Your pelvis will be tilted to one side - so your hip will be higher on one side - which side? The fact that you're saying your body feels as if it's leaning to the right suggest that the left side is hitched up.

**IF** you're hitched up on the left and rotating to the left with a symptomatic right side that's suggestive of what osteopaths call a 'left on left sacral torsion - posterior fix'. But please do your best to answer my questions and that will give us a more definite idea of what your dysfunction is.

Have you any idea of what your general posture is like - so for example, anterior pelvic tilt, swayback, posterior pelvic tilt? Google for pictures of these posture types and see which - if any - match your posture.

If you answer these questions as best you can I'll send you diagrams and charts showing what's likely to be tight/lengthened etc. This will help you to understand what's going on. It will also help you to find the best possible corrective exercises for you.

But with regards to the tightness in your leg - put a lot of effort into trigger point therapy. That should give you lots of relief and you'll learn a lot about what's going on in your body in the process! That book I recommended should really help a lot.

 

Looking in the mirror, it appears that my I have a bit of Anterior pelvic tilt. One of the main clues I believe is my pants/belt slightly rotating downwards. I also have a history of excessive sitting.

I mentioned strengthening because from what I've gathered, it's impossible for me to keep the alignments made by stretching and my physiotherapist without a solid foundation.

But I think you're correct on the other issues. The tightness is quite profound on my right side. Foam rolling my right calf muscle kills and when bending over to touch my toes, my right hamstring feels strained.

My right leg is also weaker. For example when I try to stand with one leg, I'm much more unstable on my right leg. When I squeeze and contract my glutes, my right glute doesn't fire as much. Both legs are the same size (i measured) so the atrophy isn't too bad.

For the pelvis, I've started doing hip flexor stretches as well as clamshells and side lying leg raises.