Rolfing Injury

[Uncle Jam's Army]

Recognizing the wisdom (or more, accurately, lack thereof) of asking for medical advice over the internet, I'd like to hear from you what you know of any injuries as a result of Rolfing. About a month a go I presented to my PT with typical patellar tendinitis in my left knee due to overuse. I was suffering some pain and swelling below the knee in a horizontal plane.

After a week or so of treatment to simply calm down my symptoms (which was successful, as I no longer felt pain or swelling below my knee), my PT informed me that part of my problem was overdeveloped and tight quad muscles putting too much strain on my knee. He then proceeded to use a Rolfing technique on my left quad, which caused me to squeal like a pig. He had previously used that technique on my right calf when I was suffering from a partially torn Achilles tendon and that brought about almost instant relief, even though it hurt like hell when he dug his elbow into my right calf.

Ever since that session, I've had even greater pain above my knee, and it feels muscular, in my quad where it connects with my knee. My PT observed that I really had not allowed my knee sufficient time to rest since a month ago when the pain started (I'd only taken two days off in a row previously to address the pain), and suggested I take last Friday, Saturday, and Sunday off completely. I did that and started riding real easy on Monday, but the pain is still present above the knee.

I finally got my PT to admit on Thursday that I am dealing with a quad strain, which I didn't have before coming to him and before the Rolfing session. To repeat, I don't feel any patellar tendonitis issues anymore, as the pain is now above the knee and certainly feels muscular now. I haven't ridden since Wednesday until today and had to turn around after 1.5 miles as I felt sufficient low grade soreness and discomfort to conclude there was no point riding through it--pedaling a bike shouldn't hurt at all.

At this point, I'm really frustrated as I feel like I've had a month of training disrupted (just when I was getting a little bit of form and feeling good in races), and feel like the PT did me more harm than good in this instance. I'm prepared to go back to my Dr. and ask that an MRI be done to give a good diagnosis of what I am dealing with right now. But I've concluded I'm just not going to ride anymore until I'm completely pain free.

Any suggestions on how I should proceed or is this about right?

[radsmd]

If it clinically is a quad strain, then an MRI may not be of much use. Coming from a radiologist, the suggestion that an imaging study is unnecessary may seem unbelievable, but if the result of a test will not alter the treatment, then there is no use doing the test. I think you will just need to let your body heal itself with time and rest. It's unfortunate that the pt may have caused this problem, but all you can do now is do whatever you can to get better.

If your doc thinks that the pain may be due to something else, then imaging may be indicated.

[pbarry]

You might consider daily, light sports massage on the quad. Sounds like things are pretty tight. You can do this yourself. There ought to be some youtube instructional videos that will be helpful. I'm sure you know the differnce between the pain of injury and the tolerable pain of a massage. Go easy at first. Over time, the muscles will loosen up and you can go deeper. Ice after the massage or riding. Light stretching and heat before you ride.

[bargainguy]

Perhaps not a quad strain but rather a quad myofascial restriction. PT might have just knotted everything up in a ball. To qualify, the missus is a massage therapist trained by John Barnes in MFR, myofascial release.

MFR theory is simple: If for any reason the fascia starts restricting normal muscle and nerve function, the only chance at getting better is to release the restriction, at which point everything takes care of itself as long as you don't overdo. So essentially a knot/ball of tissue that needs to unravel before any healing can happen. MFR doesn't need to be deep or really painful to be effective.

I prefer MFR to any really deep tissue work such as rolfing; I like getting to the same therapeutic / physiologic space without going to that extreme. As always, YMMV, etc.

[kgreene10]

Sounds like the PT used the technique that my older brother used on me when we were kids -- oh, your knee hurts? Let me smack you around somewhere else!

I know nothing except that I've had more than my fair share of experience with PT, acupuncture, and a tiny bit of Rolfing. I've had very good luck with myofascial release including a home version using Acu-Cups (might be Accu-Cups). I've also had great outcomes with dry needling that my PT does. It would only help if the strain is accompanied by tightness. I would surprised though if your quad tightness went away entirely after that one bruising Rolfing move.

And now a cautionary tale to encourage you to deal with it properly even if it costs money and time. Before cycling, I was a runner. One day during a track workout, I complained of a bothersome hamstring and the coach told me to take it easy. I didn't and during the wind sprints, I pulled up lame. That was 14 years ago. My hamstring is still so funky that it's one of my main inhibitors on the bike. I rue the day!

[Climb01742]

Any healing modality is, unfortunately, only as good as the practitioner who does it. I'd be a bit skeptical of a PT who uses a Rolfing 'technique' in isolation, as a sort of one off.

Done well, Rolfing is a complete process. As background, I've been through four complete 10 session Rolfing protocols. 40 individual 90-120 minute sessions. So I have some experience with this. For me, Rolfing is indeed awfully painful during the session. Actually some of the most intense pain I've ever felt, sort of like rearranging your body cell by cell. That said, nothing -- and I mean nothing -- has done my sports-ravaged body more good than Rolfing. But I have never experienced anything close to what you describe. Every single Rolfing session made my body better, not injured or worse.

But my Rolfer, a cyclist BTW, is damn good and has amazing sensitivity in his hands to know what to do and how far to go.

From afar my rather useless best guess is that your PT f'ed up. Either he just did a technique wrong or applied too much pressure. It just doesn't sound like Rolfing done correctly because, again, Rolfing is a highly integrated process, not random, isolated techniques that can be applied as one-offs.

Sorry, man, sounds like you may have gotten mistreated, literally and figuratively. Hope you heal soon. Take care.

[Uncle Jam's Army]

Thank you, everybody who has responded. I'm not sure where to take this other than to make an appointment with my dr. and tell my PT my misgivings, or find a new PT altogether.

In the meantime, I'm trying to roll it out with two different types of rollers.