Hi fellow members,

I am a recently qualified Physio keen to diagnose everything in sight, will curb that though because my family are getting sick of me hee!

I just wanted some thought regarding a problem my dad has with his knee.

He's age 58 and 14 stone 5 ft 10 inches Occ: plumber

His job involves alot of kneeling and alot of getting up and down from the floor. He is a keen walker (though always on flat) and does about 5 miles a day.

I want to help treat him but he is adamant that surgery is the only thing to help him.

His problem seems to be mechanical, so there is no pain at rest, and he feels a sharp shooting pain medial to the patella during walking and stairs, but cannot feel pain in self palpation of this area. There is swelling also and he feels an ache inside the joint going into the back of the knee. He especially feel the 'shooting pain' coming down the stairs. Walking as he still is everyday aggravates and causes swelling, but he has altered his walking pattern to avoid pain.

So I am jus wondering if this sounds like the typical problems associated with patellofemoral syndrome and if so the best Rx for this.

I was thinking stretch ITB, taping VMO exercises but anybody know of additional things that may help.

I was thinking of recommending a visit to a podiatrist to analyse gait as I feel to inexperienced to do a good job of this, but I know he has inflexible flat feet and is hip flexed in walking.

He seems to have no hip extension with walking or when asked to do actively in standing.
There is no Hx of LBP just stiff in upper T.spine.

Any advice would be really great,

Thanks Njorl

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