knee injury reoccuring

[Lindz]

i went to a physio a year ago about a knee injury that flared up even when walking.

i was given some basic stretches and exercises and they helped dramatically

however i have taken up SCUBA diving and i find it is a real strain on my knees and my exercises are not helping.

Is there anything i can do that i can do to adjust my exercises

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[physio7]

Hi,
You need to give some more information.
Where abouts do you get the pain?
What makes the pain worse?
Is this pain just the same as the knee pain you got previously?
How long have you been getting the pain?
How long have you been scuba diving and is this the only thing that causes your pain?

[Lindz]

the pain is just behind the knee cap at first when the pain happened it could be as simple as walking for 5 mins

when i went to the physio it was caused by my inner thigh muscle being weaker than the outer muscle so it was causing my knee cap to sit in an abnmormal position i was given startches and squat exercise this helped dramitcally after 3 weeks and i managed to run a 10k for the first time and went to the gym every day which i could not manage for 5 years

i started Scuba a month ago and have ben doing so for 30mins evry sunday and i find that the pain is the same as last time but the previous exercises are not helping

however it is not affecting any other sports

[alophysio]

Hi,

In scuba diving, you will use your hip muscles a lot. There is a muscle called Tensor Fascia Lata (TFL) which attaches to a very strong tissue called the Iliotibial Band (aka ITB). Quite often this muscle is overactive and pulls the ITB which gives your knee pain (probably called patellofemoral pain).

The physio in the past has concentrated on giving VMO exercises which are the exercises for the inside muscle of the knee to balance the outside muscle. This is the right thing to do. The therapy is often referred to as McConnell treatment - the physio might have taped your kneecap as well - McConnell taping.

However, it sounds like you need exercises to strengthen your Gluteus Medius muscle. This muscle is supposed to work in a team with TFL to hold the ITB in the best possible position. But when TFL does all the work, Glut Med kinda goes to sleep. It is like the inside muscle of the knee not being as good as the the outside one - in fact, it is the same type of problem - muscle imbalance.

[edit: It also sounds like you have overactive muscles in the hip area which can cause your knee not to work properly]

Of course, there may be other reasons why you have pain but having a physio look at it again would be the best thing to do. If you mention "Thomas test for ITB", "TFL overactivity" and "checking Glut Med activation", the physio should know what they mean - if they don't, find another physio!!!

Hope this helps!