Hi all - interesting discussion!

With all due respect, there is research that suggests that there is innervation of spinal segments up to 4 levels IN EACH DIRECTION via the long sinuvertebral nerve. Therefore, it is not inconceivable that referral of pain from L1 can be picked up at the L5 level and then moved on...

Secondly, fascial tension is a funny thing - it is not directly related to dermatonal distribution nor easily and obkectively measured. I would support Yarok's assertion that CO/C1 can cause dysfunctions that lead to the said knee pain but usually this idea is scoffed at amongst physiotherapists. Having said that, i have seen people who come to me with neck and apparently unrelated back pain and have their back pain improve with only C/S treatment...go figure! I am not brave enough to rule it out, not these days - i have seen too many wierd things to do that!!

In this current case, it seems to me that the problem is not a knee problem. My initial impressions were:
1. What is the lumbopelvic hip complex doing
2. Referral from L/S
3. Thorax dysfunction
4. Foot dysfunction

T10-T12 may be tight but it is an area where long erector spinae muscles attach - why are they overactive (if they are in fact overactive causing stiffness)??

THere hasn't been any mention of pelvic assessment, load transfer tests, assessment of vascular status (although it doesn't sound like this is a problem...), etc.

Brian_C - how are you going?