Thank you both Kit and Nathan for your replies. I'll try and address all the questions and responses you have both given, in a fairly systematic method.
1. Adjustment to Advanced Piriformis: I think I have understood your instruction Nathan. I've attached two photos (update could not attach them, will try in a separate post). If you could confirm if I have understood correctly, would be greatly appreciated
- Old way - this was how I used to do it
- New way - based on your instructions, this is how I just tried it. The foot is almost floating in the air, instead of being outside ankle down on a mat. Like this, the lower leg and upper leg are both supported by the bolster (instead of old way which had just the upper leg supported by bolster). This feels much better, though not totally pain free.
Note however that when I do it the new way and still try to do the compression where I sweep the foot like I am trying to pass the little toe through the floor, this still hurts as it is applying the same forces to the knee as before. The compression where I try to sit the butt/hip down on the bolster is fine, so maybe I should just stick to that one.
2. Strapping: I don't really know much about strapping, but I put the knee brace on it I used for Brazilian Ju Jitsu and this seems to help when combined with the new method as well. Can't believe I didn't somehow think of that myself.
3.Injury: Occurred when grappling, Brazilian Ju Jitsu. Long response following, please feel free to ignore, wasn't sure how much info to provide.
Was trying to extract my leg from between someone else's (in a position called half guard where they hold their leg with yours). Knee took rotational/lateral force and there was a loud pop. The type of pop I have heard when I've heard other people's ACL tear in the past. Was pretty much painless and was walking around 5 minutes later, but the next day and for 3 days after was limping, then everything was fine when running, boxing, heavy squats, etc. My initial fear was that I had torn a knee ligament like ACL, MCL, LCL, but when I could do all these sports I figured it was ok. The one thing that gave me problems was sweeping my leg in a rotational direction, much like the movement that is required for advanced piriformis and particularly doing the compression trying to sweep the little toe through the ground. Unfortunately this movement is constantly required in BJJ, with the other guy/gal trying with 100% of their force to push back the other way. So there is no strength in that movement at all and it hurts. Saw an orthopedic surgeon here in China, and got an MRI and he said the knee joint itself is fine, but there are 3 partially torn ligaments in the tibiofibular joint, that bony knob at the side of the knee. I'm not a Dr, but based on the pain and limitations I have, I would tend to agree. Because I was late seeing a specialist, I continued to box for the first 8 weeks of the injury (after a 10 day rest at the start), but no BJJ because that hurt. After 8 weeks we did the MRI and the Dr proposed a full leg brace for the next 6 weeks. When I asked him if this would fix the problem he replied "Probably not, but might do." Maybe a mistake of mine to not listen, but I wasn't prepared to sit on the couch for 6 weeks doing nothing, for a "might do something, might not" solution, so I'm back to full activity, but the knee still bothers me a lot during Brazilian Ju Jitsu.
4. Recovery: I am doing nothing to rehabilitate .the injured knee, as the surgeon proposed nothing but 100% rest with the knee in a full leg brace. I consulted with a physio online in Australia and he said that for ligaments, there is no rehabilitation, just rest to heal it. At the end of the day, I have found it difficult to get the advice I have been looking for in China. I feel like the surgeon I have seen has difficulty communicating with me due to language and cultural differences. I will be back in Australia in August and I have made appointments to get a second opinion. The culture in China is not one where sports are important, and I feel like my Dr here does not understand that continuing sport is important to me. I am not so arrogant that I believe I am smarter or know better than Doctors, but I was also told by multiple surgeons that after 5 surgeries on my right hand after a surfing accident in 2010 I would never be able to box or do Brazilian Ju Jitsu. And I did both this week. So I also realize that surgeons are humans and can sometimes be wrong.
Thanks again for the advice, it is really appreciated, and apologies if I have provided too much information