Hi, I am an australian physiotherapist and have 30 years of experience seeing patients and have looked after girls doing elite gymnastics. I think that you have a good lot of treatment ideas above so hopefully you can get your daughter treated soon.


I would start with
stop gym training for a week to allow the effusion to settle ( I presume this is the water that you can feel behind the patella)
Start with specific quadriceps retraining as per the Maconnnail programme
Maintain good hamstring stretches but no quadriceps stretching for a month

When the pain and swelling is settling start increasing the strengthening programme. The knee should be OK for everyday activities especially walking up and down stairs before starting the gymnastic programme . ...with absolutely no impact loading eg landing off the beam, she could probably work on the bar and get really good at this and only land in the foam pit. I would suggest this for around 6 months.

A lot of physios may not appreciate the huge number of impacts that gymnasts do in training and I have seen a case like this get diagnosed as a patella stress fracture. (However I think the Wikipedia reference-linkMRI she has had would have ruled this out)

good luck!