Under knee-cap pain, no/little swelling - physio massage made it worse??

Hello,

Please would someone offer me some advice? About 2 weeks ago I started to have pain under my right knee cap - I went on a 10 mile hike and was in a lot of pain when I got back. I've stayed off heavy exercise since, taken ibuprofen and RICED, but my knee is still painful when walking/climbing stairs.

I went to the physio today to see if he could tell me what was wrong and whether I will be okay to cycle 50/60 miles in 2 weeks (London to Brighton). The physio said it must be an overuse injury and proceeded to carry out very forceful and VERY painful massage in and around the inside/front of my knee.

My knee is now 10 times worse than it was before and it hurts a lot to even straighten my knee. Admittedly, the kneecap beating only took place today but I was wondering whether the pain is normal/okay and was the physio right to pummel the bejeezus out of my knee?

Thanks in advance!

Naomi

Hi Flatfoot

I think that your nickname might be linked to your condition, as pronated feet are commonly a contributing factor in development of the PFPS.

Could you tell a little more about it? Was that the first time that you experienced such an exercise related pain at your knee cap, (if so) what did you do to resolve it, did you ever have any other issues with your knees or ankles in the past, what is your normal distance and level of fitness/activity?

From your description it seems that he had been using friction therapy, targeting the patella ligament. Nowadays this is considered as an "old school" approach and a vast majority of practitioners have stopped applying it, as there are much better solutions and interventions out there. Additionally, a friction therapy for patella tendon also doesn't have a reliable level of evidence in research.

Hi SportRehab,

Thanks for your reply.

I've never had knee pain before although in the past I've had foot and ankle pain due to my flat feet and wear moulded orthotics for everyday wear - although these are about 5 years old now.

I play netball regularly although this year I only train once a week and play a match once a week - for the last 3 years I have been training 3 times a week during season and playing once a week. For the 4-6 weeks prior to the knee injury I was cycling a couple of 20 mile rides a week as I was supposed to be doing the London to Brighton cycle this Sunday. I don't do much running as I have persistent shin splints but if I do go I only go slowly for about 5-8 miles.

Is there anything you would recommend me doing to speed up the recovery process? I have a walking holiday in Canada in 2 and a half weeks and I really want it to be gone by then!

Thank you for your help

Naomi