I recently went to a dual certified (Sports PT / ATC) professional regarding pain in front of my kneecap that I noticed during bent single knee weight support, while training to skate.
He made a diagnosis of muscle use imbalance (quad dominant, inadequate use of other leg, hip and sensoredock area muscles), determined that I did not have arthritic cartilage damage, and gave me exercises to alleviate the problem and improve my athletic performance. He said my past history of multiple ankle sprains and a broken leg was consistent with poor balance associated such asymmetric muscle use. The diagnosis procedure included watching me move, and feeling my muscles as I did so, and of testing strength and range of motion.
In relation to my limited range of motion (very limited forward bend, and split-type motions), he confirmed my problems were consistent with tight psoas muscles (whose tension I can feel at the limits of my range of motion). He confirmed it made _some_ sense to selectively warm-up muscles that I specifically wished to stretch, so as to prepare them for stretching, though I get the feeling such selective warm-up is uncommon.
I wish to suggest to other skaters they consider getting a similar examination to determine whether they are making optimal use of their muscles, and determine what joints and muscles should and should not be stretched. It is quite obvious that habitual muscle use and muscle/joint flexibilty are very individual things, which most athletes would be unable to reliably and safely diagnose themselves.
What I am unsure of is whether any sports oriented PT, or any ATC, or any other professionals would have the knowledge and legal right to make all these diagnosis. I selected the professional because he was both, had been an athlete himself, and people had made strong positive statements about him, and because I had known him a long time ago. But relatively few professionals are dual certified, and they tend to be expensive, so perhaps it isn't reasonable to suggest they see such.
So, which certifications would give the professional both the knowledge and the legal right to make such diagnosis, and to prescribe exercises to correct such problems?
Is the answer state specific in the U.S? His office mentioned that in his state he would not have been legally permitted to see me a few years ago without a doctor's referral. And many years ago, after coming out of the cast for my broken leg, I had physical therapy, but the therapist only gave what the physician asked - suggested exercises to strengthen my muscles, and made no independent diagnosis whatsoever.
Posted By mitch on June 13, 2009 at 20:00:58: