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Knee problems 5 months down the road

Jan 11th, 2014

Dominic McVeigh asked The Guru for the following Physiotherapy Advice:

Hi! 5 months ago i took a heavy fall in Rugby on my right knee. I had significant swelling and pain to the front of my knee. With ice and rest this went but still I cant fully straighten it without pain and going downstairs causes major discomfort. I have taken anti inflams and iced for nearly 5mths however it just doesnt seem to want to go. How do you recommend i get back from this?

The Guru Responded:

Hi Dom
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Pretty interesting that you can’t straighten your knee, which is fairly indicative of only a few things.
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I’ll go for the most obvious and that’s an irritated infrapatella fat pad (the squidgy bit below your knee cap). It’s huge and pretty under diagnosed for giving problems.
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Every time you straighten your knee your irritated fat pad is squished between your femur and tibia (top and bottom bones) – the more this happens the more it swells, and then less available space there is for the fat pad to be compressed, and so it blocks the knee.
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Going downstairs gives a similar issue, but I think the vast majority of these symptoms is that your kneecap “drags” through the fat pad increasing your pain.
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What you need to do is see someone who can comprehensively assess your kneecap, fat pad and all the other workings of your knee. You may need to be taped and shown things like inner range quad control and lower limb balancing stuff! The McConnell (a specific way of dealing with knees and fat pads) approach will rock this, and you!
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Good Luck

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