So, it's been another 2 months! Since I last wrote I've started weekly sessions at a new physio who is addressing my biomechanics issues. I'm doing a lot of work to lengthen my quads as she said that their shortness was causing my pelvis to tip forwards and back to arch. I'm also trying to strengthen my core stomach muscles and muscles at the top and outer sides of my quads, by the glutes.

I've definitely had some improvement since I started with her (after just getting over some quite bad back pain caused by using the wrong muscles to change my posture I think), so that now I can sit for longer periods without it aching and don't feel it as much when I'm walking around etc. I am going to continue with this, as she said it would take 4 to 6 months for the necessary changes I'm making to become automatic, but I've also got an appointment in December with a consultant, in case it has still not recovered by then. Because of how slow and inconsistent my progress has been (it is currently worse than it was last week for instance after spending about 9 hours sat around on my friend's sofa, only moving to go to the toilet, and I had a similar setback after dancing at a wedding) I am not expecting it to be fully recovered by December, and after something my physio said yesterday, I am beginning to think that it is not ligament damage at all.

She was treating the ligament by rubbing up the inside of my leg with lotion and rubbing specifically over the point of my knee which is the most sensitive to touch - on the inside, right on the joint line - and I commented that while the whole thing was painful, the pain in my inner thigh above my knee was more like a stretch and the pain on the particular point of my knee she rubbed was more like a burning pain. She said that a burning pain was more likely to be nerve related, and that there was a chance that some fibers from the saphenous nerve could have become entrapped in the scar tissue of the ligament (which has been confirmed to be slightly thickened from my last Wikipedia reference-linkMRI).

The more I think about it the more it seems to fit. When I first started getting physio, approximately 3 months after I did the injury, there were 2 people who didn't believe I had injured the MCL because they couldn't find the point of the ligament which was particularly sensitive to the touch. Since coming back from travelling, this has very much not been the case and the region can be easily found which is tender.

The injury definitely changed when I first went away travelling, in Sep 2009, when I went out on my first weekend, got drunk and then woke up with pain again. I feel fairly sure that if there was a particularly bad fall or severe pain from the knee on the night I would have remembered it, and I remember even the next day thinking I'd only been set back a month or so at the time so it couldn't have been that bad. The injury changed though in that from that point on, sitting down would be incredibly uncomfortable unless my leg was stretched out, with pain coming generically from the knee area, so I always kept it up, and this could have affected it healing. It has also always been an anomaly that after 6 weeks of keeping my leg up all the time I went on 5 days intensive trekking (up to 10 hours walking a day, on very uneven ground) and didn't feel anything from my knee so I don't know if that could fit with a nerve related injury, but it certainly doesn't seem to fit with a ligament one.

A nerve related injury might also explain why I have never felt any weakness in the knee itself but have experienced pain in multiple different regions of my knee at different times over the last 6 months or so. This has died down recently, but it was when I did activity on it, such as a returning to sports physio class with twisting and turning involved, that it flared up, and the aching pain from my knee as a whole, became more regular.

Finally, just as an extra little anomaly, I had thought over the last few months that I was unable to sit back on my heals as when I did so I felt pain from the inside of my leg as I eased myself down, soon before I was fully resting on my heals. I still do get some pain as I do this, but it disappears when I continue to rest all my weight on it. My physio couldn't explain this so I just thought I'd put it out there.

Right, so if anyone is still reading and has any thoughts, please let me know!! I'd be extremely interested in any treatments that might be possible if it does seem like some nerve fibers may have become trapped. At the moment I'm feeling quite positive as it would mean my knee is actually strong in itself, and maybe there might be a quick solution which will have me playing football again, but if this is not the case and having a partially entrapped saphenous nerve is worse than a weak knee, I would definitely want to know.

Thanks, Sam