Exercise
Carpool tunnel syndrome
I have many body parts, but out of all these my legs are probably my favourite. So I was surprised the other day when the physio told me that one was shorter than the other. Not because of this fact, but because he had actually noticed. I had a similar suspicion myself after looking in the mirror and noticing my hips weren’t exactly even. But I do that every day, and here this guy had only known me for five minutes.
The discrepancy isn’t much, about 4mm, but it’s enough to compress the discs in my lower back slightly more on one side than the other. This would explain the annoying twinge I have been feeling at the gym and the mild pain after long hours standing up. The temporary solution so far has been to stick a second insole in my shoes. And I’m already drafting up plans for a medieval torture device that will stretch my right tibia to its proper dimensions.
This, however, was not why I was at the physio. I was there to treat an ongoing case of patello-femoral pain syndrome that had been causing trouble in my right knee. It is a condition that is common among young adults, but most prevalent in soccer players, cyclists, rowers, tennis players, ballet dancers, horseback riders, and runners, of which I am none. You can imagine my irritation at this fact, but nevertheless I would like to fix it before I turn 43 and discover that the cartilage on my kneecap has been whittled to dust and I have been left with a nice case of arthritis.
The answer, thankfully, is quite simple. As well as a multittude of stretches for the muscles surrounding the knee, I have to do an exercise which involves moving just one small muscle of the quadriceps, the vastus medialis obliquus. Moving this muscle without moving anything else is for me nigh on impossible. Apparently, because it is not ’switching on’ properly when I bend my leg, my kneecap drifts slightly in the wrong direction, and that’s where all the trouble starts.
This means the problem, funnily enough, is not with my knee, but with my brain. Its ability to control the VMO is poor, and so I must work on building up the nerve connections to the muscle in order for it to start doing its job. This may sound easy, but it is in fact rather difficult. When I was in Vienna, I met a rather tall Norwegian guy who had gotten really drunk one night and slept on his arm in an awkward position. When he woke up the next morning, he couldn’t move his hand, and a few weeks later when I met him he had only just regained a slight range of movement in his fingers. He was a medical student, and proceeded to explain in great detail that in his drunken slumber he had severed an important nerve in his forearm, the name of which I now can’t remember. The amazing thing is that the brain can slowly regrow the nerve and form a new pathway to the muscles, so within a few months he would be repaired. I’d like to think the thing with my knee is working in roughly the same manner, except with less alcohol and Scandinavians.
The other related factor is mind-muscle connection. Lots of people can flex their biceps, but ask them to flex their lats and they will struggle. Your mental ability to move specific muscle groups in isolation determines your ability to do such things. I’m usually pretty good in this regard, as evidenced by anyone who has seen me move my entire scalp. But somewhere along the line, something went horribly wrong. And I think I can work out where.
Way back in year 9 or 10, I went downhill biking with some friends on a firetrail at Bulli pass. Unlickily for me, I came a crocker on a steep section and badly sprained my ankle. I went to a physio at the time, who, inbetween thrusting my foot into his groin, showed me pictures of a normal ligament and a damaged ligament. In the normal ligament, the tissue fibres were nicely aligned with each other. In the damaged ligament, the tissue fibres looked like someone had gone nuts with a spirograph. He said it was impossible to fully repair, and he was right. Ever since then my right ankle has clicked and popped itself in and out of place, and it’s nowhere near as flexible as the left one.
My hypothesis is that I began to use my right leg in an unorthodox way to overcome the lack of flexibility in the ankle. This led to a muscle imbalance, which led to the ongoing knee problem. And because it happened when I was still growing, it might have caused the right leg to grow slightly shorter than the left leg. A bit like the kid at school who broke his thumb one day and after that it never grew as long as the other one. Leg length discrepancies are common, so this scenario is unlikely. But it may just be that that accident was the cause of all these troubles.
So what if… what if I’d never been downhill riding that day. What if I’d been to the cinema. Or wasted the day indoors on the computer, like I did all too many other times.
Well, I don’t know. And I don’t really care. But if you are the sort of person who wants perfectly symmetrical tibiae, or ankles that don’t click, don’t go downhill riding on a BMX. Watch a movie of it instead.