Chronic inside upper knee/thigh pain

[IceMan]

Hi Iceman,
how do I find a physio who will give me a thorough lumbar evaluation. Do I need a physio who specialises in this to get the best treatment?

I would look up all the clinics in the phonebook and call and speak to physios to see what kind of experience they have in treating these kind of symptoms. Maybe an internet search would yield some results. What many people don't realize is that within the profession of physio there are many different philosophies of treatment. For example for your symptoms a physio who follows the McKenzie approach may choose an entirely different plan of care than someone who is Maitland trained. That's not to say that one approach is necessarily better than the other. I believe that there may be a number of different ways to treat a particular condition but it is important that the patient is diagnosed correctly.

When calling ask what percentage of the patients they see are lumbar spine patients and the number of years experience the physio has had in treating these conditions.

All the nhs people I have seen say that my back isn't involved, I have had it mri'd and that is clear so they say its not causing any of my problems including my initial calf problem.
No one has said anything about my back being linked to my knee yet.

Forgive my ignorance but is the nhs some sort of government setup in the UK? Anyway a negative MRI does not mean you don't have a lumbar spine problem. An MRI is just one piece of the puzzle. A solid clinical evaluation(ie interview followed by hands on testing) should always be the primary driver in determining the plan of care from a physio perspective.

I think the feeling I used to get in my buttock, (which was finally sorted by the met stretch to release the spasm in the piriformis) is similar to the feeling I get in my vmo. When I walk the muscle slowly gets more tired and then eventually its too achey/tired to walk on anymore, it kinda gives up. This always leaves me wondering if it is linked to the buttock problem I had, and if it could be as easily sorted as that was.

What you're describing could indicate a lumbar radiculopathy ie impingement of a nerve root in the lumbar spine which is causing muscle weakness. If you find someone who can test for this, along with a comprehensive look at your back, pelvis and legs, and then treat you appropriately you may well find some relief.