Ultimate Frisbee Knee Pain with Wil Seto
Mark: Hi, it's Mark from Remarkable Speaking. I'm here with Wil Seto of Insync Physio in Vancouver, Vancouver's best physiotherapy office, many time winners of best physiotherapists in Vancouver as voted by their customers. And we're gonna talk about Ultimate Frisbee knee pain. What's different about Ultimate Frisbee and knee pain Wil?
Wil: Well there's a couple of things I want to address with that. So there's the traumatic side of things, where you can have an impact injury or something happens where you maybe not have an impact from another player or contact injury, where you might have done something to it. So the traumatic injury. You might have strained something or torn something from another ligament or a tendon or something related inside of knee joint, like a meniscus.
So basically that traumatic injury, you know, those ones they happen definitely a lot, but the other side of things are the non-traumatic type of knee injuries and non-traumatic knee pain that also happens quite a bit. A lot of players, when they're playing Ultimate, and I've worked with a lot of different Ultimate players from different national teams, from different world championships, world games where, you know, it happens at all levels. So it's not just the beginner is starting off.
It happens even with the intermediate, more advanced veteran to like, they're competitive, like world class type of player. And so I wanna talk a little bit more about that today, the non-traumatic type of injuries. And those are the ones that are like, well, I don't know really what's going on. I didn't really do anything. Or they may not necessarily feel the pain until later on after the game or later on that night after you take a shower or waking up the next day. And then it sort of gradually builds or it may feel more sore at the beginning of a practice or warmup or when they first start playing. But then it kind of goes away, but then it it sore again after.
So those are classic symptoms that we see quite often with Ultimate Frisbee players. And so we treat a lot of Ultimate Frisbee players at our clinic. You know, we've been working with the Vancouver Ultimate Frisbee League for quite some time now in partnership. And so with these type of non-traumatic injuries, what we see a lot of is this specific type of knee issue, it's called the iliotibial band syndrome.
And it's basically a movement dysfunction issue. And so you can build up a lot of imbalance where you have this thing called the IT band. It's a connective tissue that basically connects from the outer upper part of the hip, all the way down to the outer part of the thigh, lateral thigh, the knee, and its function is to really hold the thigh muscle and then part of that lateral hamstring and all those muscles on the side that tied together.
But like when everything starts to get really tight, you gotta ask in the history, how are you recovering from your games? How are you recovering from your workout training sessions? And that usually says a lot too. And so they're probably not doing the proper things to recover those muscles and they start to pull onto that fascia or that connective tissue to the IT band, and causing that knee pain, which is usually more on the lateral or the outside of the knee. So that's your classic symptom presentation of this type of non-traumatic knee pain, most often.
Mark: So the possible causes really are over training and not recovering properly. Could we sum it up that way?
Wil: Yeah, pretty much. You kinda have to dig a little bit too, history wise because, you know, there's a few Ultimate players that we're treating now that they've had some injuries in the past.
So for example, you know, if you've had an injury on the other knee, okay, so now you're compensating a little bit more on your knee that is now affected. So that compensation, you know, is why you're getting the knee pain and so there may be stuff that's going on, right, where you never fully rehabbed, or it's not fully strong enough on that knee that you originally injured and you're compensating on that knee that's now affected, that you have that gradual pain. They're like, this isn't even my injured side. I don't know what's going on. We hear that a lot.
Mark: So you've diagnosed it, you've dug into the history, you're pretty clear on the direction, what's the course of treatment look like?
Wil: So we wanna look at what the driving factors are to this knee pain. So what are the muscles that are really tight and pulling on it. Or is it the IT band just really super tight for whatever reason. And usually though it's a series or a few different areas pulling on it. So you gotta figure out what it is. And so once you figure that out and you start to work on increasing that mobility in those areas, then what's really important is to address the functional part of it.
So you gotta get things stronger, but then you have to help that person retrain the way they do their sprints again. The way they cut. The way they want to move on the field because if we just release it, it'll help for a little bit, but it'll most likely come back if you don't do other things to, you know, even strengthening, we can give you some strengthening release stuff. But likelihood of it coming back is pretty high, if you don't address that muscle activation pattern.
So could we sum that up even as saying like, when you've injured yourself or in the gradual process of injuring yourself, you've adopted unconsciously ways of moving that are not good. They're gonna cause the issue to come back up again. And that needs to be addressed. That needs to be, you need to relearn that basically somatically.
Yep, exactly. Yeah. You need to relearn that on a neuromuscular level. That's a big word, but it's basically trying to learn how to walk again for the first time like after you've been on crutches because you broke your leg and now you're like fresh out of the cast or whatever. But it's harder to actually relate with it because now, well I've been running and I'm playing, so I don't know what's wrong. Like why do I need to relearn that? But like, it's amazing how when we show people and we give people the exercises to do that are weak, they're like, oh my God, I can't believe how weak this is. Or, oh, I never realized. Like, I can actually play a full game, but I can't even do like one set of 10 of what you're giving me here because it's so difficult.
Mark: Expert diagnosis, expert exercise prescription so that you don't re-injure yourself. The people to see are Insync Physio. You can book online at insyncphysio.com. They have two offices in Vancouver and North Burnaby. You can call the Vancouver office, (604) 566-9716 to book your appointment. You gotta call and book ahead. They're always busy. Thanks Wil.
Wil: Thanks Mark.