Niall asked The Guru for the following Physiotherapy Advice:
Hi, I have been suffering with knee pain since July 2010. At the time I had just gone back training/ playing sport (nothing specific, maybe 20 miles/week and football training 4 nights/week (on artificial grass)) after a 2 year hiatus.
After finishing a football session one evening I had a severe ache on the outside of my right knee.
I rested, iced it for a few days but after 4 days I broke into a brief jog (chasing a stray shot on the golf course) and almost immediately felt a sharp pain on the outside of the knee, almost like a nerve was pinched.
Unfortunately I didn’t go to a PT immediately, and after speaking with a personal trainer at my gym and a bit of self-diagnosis decided it was probably my it band.
At the time I did a lot of foam rolling, stretching and strengthening exercises, and the pain did subside a little, but never enough to be able to run more than 2 miles. I may also have run through the pain on a number of occasions which was probably not the brightest thing to do.
But here is the really annoying part. I finally booked an appointment with my PT, who I had previously seen (in 2002) and had gotten orthotics from. My feet do pronate and I have a slight leg length discrepancy. I hadn’t been wearing the orthotics for 2 years so first thing he did was have me a pair remade. The thing was however, he diagnosed me with a damaged cartilage. For almost over a months he treated the injury with heat machine in his practice 4 times a week, and I was treating it with a hat damp towel 3-4 times daily. He said it was to try and entice the blood in to heal the cartilage.
Eventually however, I was visiting London (nearly a year ago to the day) and it was in the middle of the really cold spell,. I walked around the city for hours doing the touristy things, and my knee started to ache until eventually I got that sharp sudden pain shooting through my leg from my knee, enough to cause the leg to collapse under me.
On my next PT visit, he just said it’s too damaged, and he wrote to my GP for me to be seen for an MRI with the most likely outcome of me needing surgery for the “horizontal tear in my horizontal tear in lateral meniscus” as he put it in the email to my GP.
In January I moved to London, and started a new job. I ignored the fact that my knee was in need of treatment. The pain had subsided but I couldn’t do any exercise. It wasn’t until this July just gone, on another holiday requiring a lot of walking that the pain flared up again. Since then I have seen a physio on the NHS, still thinking it was my cartilage.
Last week I finally was referred to a PT who had a different view to what the injury was. The IT band.
He said he was very confident that was the issue. He gave me a local anaesthetic to the location of the pain and asked me to try and aggravate it in a way that usually induces the pain. I ran for 3 miles home, and there was no real pain. The next day it was very sore agin though. The PT said he is now sure that it is my IT band. I don’t really know, is this a common way of diagnosing injury. Numb it and try aggravate it.
I don’t know what to think, I’ve no real faith after spending so much time and money last year thinking it was my cartilage.
I just need to get it sorted, my heart is broken from it. The PT offered me a cortisone injection but I declined, If it is my IT Band I think I need to start from scratch and find the route cause.
Can you point me in the right direction. I now live in Islington, so hopefully you know somewhere I can get the right treatment.
Cheers.