back of knee pain

[marj]

Have you assessed his lumbar spine, pelvis and hips? A more proximal problem may be causing neural irritability. Have you tested this pain to see if it can be reproduced with tensioning the saphenous nerve with hip extension and abduction combined with knee flexion? Marj

[karen.hankey]

What strength exercises is he doing?

[clarett]

Hi
He's doing
-v.m.o in sitting
- SLR with hip lat rotation
- knee F against resistance in sitting
- gastroc against resistance

His muscles are really strong bilaterally. It's just that the right is slightly weaker than the left.

[karen.hankey]

When I suspect meniscal damage I usually find that squats with correct alignment help.

You might find WB strength exercises help as thats when you will have increased pressure on the meniscus.

Hope that helps

[okphysio]

Hi Clarett,
Have you had a look at his calf length. The medial head of the gastroc does have a small attachment to the MM. I have found in the past that a calf release technique and relavant stretches are often quite helpful. I also agree with Karen with alignment exercises. Has he had any xrays done? If there is degenerative changes then it may be a matter of modified rest until his swelling reduces. Hope this helps

[clarett]

Thanks very much - we'll have a go.
okphysio - what do you mean by a calf release technique? He did get v. occasional pain but more in the lateral head of gastroc not the medial.
He hasn't had any x-rays done and won't have any done for the meantime (at least 1-2 months) and there's no history of swelling.
No active trigger points in the calf or foot.