In early September I injured my left leg going down a set of steps, landing my foot incorrectly and twisting my knee. Jump ahead 1 month - Primary care physician orders an x-ray and find arthritis in knee and calcium deposits on tendons, but nothing to explain pain and impaired mobility. Next, he orders an MRI. Insurance company will not pay for MRI until I've gone to physical therapy.

So, off I go to PT. PT is nice enough and seems to be knowledgeable, but I have no real background that would allow me to make an informed judgment. What I do know is that when he uses the Graston Technique to massage soft tissue in the region where the iliotibial band (ITB) gets close to the knee, I feel some immediate relief. However, two hours later the area becomes very painful and swells considerably. This condition can persist for two days before inflammation is reduced and pain subsides. During this time stairs are almost impossible, and even having my knee bent as far as it needs to be to drive my car is painful. He's also given me a series of stretching exercises and the ones that stretch the area around the ITB cause the same pain and swelling.

I'm maintaining that it doesn't make sense to do things that make the symptoms worse. He thinks his course of action if fine. So, yesterday he indicated that he would not write the report I'll need to get the MRI until I finish the full course of his "treatment plan." I'm telling him that I'm not doing anything that makes it worse. Now he's using the term "non-compliant with treatment plan" in his report to my primary care physician.

So, I'm feeling really stuck here. It's been almost three months of not being able to walk up stairs with any sense of comfort, an inability to drive more than 20 to 30 minutes, and many sleepless nights because of persistent pain. Today, I'm thinking of writing a detailed letter indicating my experience of this whole thing and sending a copy to him and my primary care physician. The gist of the letter, as I'm currently thinking about it, is that I want to move forward to get this resolved, but will not participate in activities that make the situation worse. So, we need to find some middle ground.

I'm pretty annoyed by this, and not at all sure my plans are solid or just an emotional reaction. I'm open to suggestions and feedback.