Chronic inside upper knee/thigh pain

[Roberts]

Hi Iceman,
how do I find a physio who will give me a thorough lumbar evaluation. Do I need a physio who specialises in this to get the best treatment?

All the nhs people I have seen say that my back isn't involved, I have had it mri'd and that is clear so they say its not causing any of my problems including my initial calf problem.
No one has said anything about my back being linked to my knee yet.

I think the feeling I used to get in my buttock, (which was finally sorted by the met stretch to release the spasm in the piriformis) is similar to the feeling I get in my vmo. When I walk the muscle slowly gets more tired and then eventually its too achey/tired to walk on anymore, it kinda gives up. This always leaves me wondering if it is linked to the buttock problem I had, and if it could be as easily sorted as that was.

[IceMan]

Originally Posted by Roberts

Hi Iceman,
how do I find a physio who will give me a thorough lumbar evaluation. Do I need a physio who specialises in this to get the best treatment?

I would look up all the clinics in the phonebook and call and speak to physios to see what kind of experience they have in treating these kind of symptoms. Maybe an internet search would yield some results. What many people don't realize is that within the profession of physio there are many different philosophies of treatment. For example for your symptoms a physio who follows the McKenzie approach may choose an entirely different plan of care than someone who is Maitland trained. That's not to say that one approach is necessarily better than the other. I believe that there may be a number of different ways to treat a particular condition but it is important that the patient is diagnosed correctly.

When calling ask what percentage of the patients they see are lumbar spine patients and the number of years experience the physio has had in treating these conditions.

Originally Posted by Roberts

All the nhs people I have seen say that my back isn't involved, I have had it mri'd and that is clear so they say its not causing any of my problems including my initial calf problem.
No one has said anything about my back being linked to my knee yet.

Forgive my ignorance but is the nhs some sort of government setup in the UK? Anyway a negative MRI does not mean you don't have a lumbar spine problem. An MRI is just one piece of the puzzle. A solid clinical evaluation(ie interview followed by hands on testing) should always be the primary driver in determining the plan of care from a physio perspective.

Originally Posted by Roberts

I think the feeling I used to get in my buttock, (which was finally sorted by the met stretch to release the spasm in the piriformis) is similar to the feeling I get in my vmo. When I walk the muscle slowly gets more tired and then eventually its too achey/tired to walk on anymore, it kinda gives up. This always leaves me wondering if it is linked to the buttock problem I had, and if it could be as easily sorted as that was.

What you're describing could indicate a lumbar radiculopathy ie impingement of a nerve root in the lumbar spine which is causing muscle weakness. If you find someone who can test for this, along with a comprehensive look at your back, pelvis and legs, and then treat you appropriately you may well find some relief.

[Yarok]

Hi

i do agree with Iceman, proper assessment and treatment umbar/pelvic part, followed by correct programme of lower limb re-education.

[Yarok]

Hi

re, at this stage to retrain/balance quads/knee joint you should try nonresistive in free of pain range of motion exercises and stretchings as well as exercise accesory muscles influancing knee ( hamstrings, calf, hip adductors,abductors)

re clam shell- this is not the best exercise for glut medius cos strain ITband which pulls a patella

[Roberts]

Hi
I have found a person who does structural massage and re-alignment therapy they say they identify and correct postural/structural misalignments by deep focussed massage and soft tissue release techniques. They have qualified as a McTimoney chiropractor so this should mean that they know more about the back. Do you think they would be any good? I'm also still looking into another physio.

Oh now I understand why the clamshells hurt my knee! That makes sense

Yarok please could you give me an example of nonresistive in free of pain range of motion exercises, as I'm unsure what you mean by these.

Iceman the nhs is a government set up allowing us to have free health treatment but unless its urgent you have to wait a long time to get it. In fact when I first tore my calf they told me it would take 6 months till I could see a physio, its a bit of a joke!

What you're describing could indicate a lumbar radiculopathy ie impingement of a nerve root in the lumbar spine which is causing muscle weakness. If you find someone who can test for this, along with a comprehensive look at your back, pelvis and legs, and then treat you appropriately you may well find some relief.

Its definitely worth looking into.

[Rockygrass]

I was relieved to find someone with the same symptoms and going through the same medical mess as me. I have been dealing with this for only a year and a half, so I guess I should consider myself lucky? I am also a female with a particuarly arched back that has the same symptoms (pain and tightness in the same areas, etc.) and tried many of the same things as you. Since you haven't posted in a while, I was hoping to get an update on what has been working for you.

[Roberts]

Hi Rockygrass, I went to see a physio in London where they treat top sports people so I figured they should be able to help me! The lady I saw checked out my knee and a few other things and decided that it seemed pretty healthy and that I shoudn't be experiencing the pain that I was. She then explained how some people when they get chronic pain their central nervous system starts to get oversensitive to pain signals and starts telling you your in pain when you shouldn't be. She thought this could be my problem and so the plan was to trick my brain into thinking that my knee is ok but just very weak, and to also try and ignore the pain, and my "homework" was to think of 3 things that made me happy everyday.

This all seemed a bit crazy to me as I have a background in science and factual stuff and thought mind stuff was all a bit weird. However I had decided that this was the last physio I was going to see so I had to commit to what she wanted me to do. And strangely it seems to be working!!!

She also stopped me from doing all physio exercises as they made my brain focus on my knee to much and the pain it was experiencing and told me to do functional exercises instead like going out on a bike, a gently walk. And arranged to do some hydrotherapy with me in their pool as the water supports the knee so it can do some weight bearing exercises better.

I was doing the exercises in a pool near home but now I have made such progress that I am able to take the dog for a walk and do stuff like shopping all in the same day and be fine the next day too! So I am just focussing on trying to build up my thigh muscles by walking and riding my bike on gentle slopes.

The pain above my knee seems to have gone but I now just have a jarring/jabbing type pain under my knee cap when I put my weight though it when my leg is bent, ie like when going up a hill. But the next day it feels fine, my main symptom is that the knee goes red and hot after a day of activity and then recovers over night.

Also I take green lipped mussel every night and that seems to calm the inflammation over night.

I hope this helps you. Let me know if you have any more questions about my injury tales!