Runners Knee – Physiotherapy Testimonial

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Having played hockey, lacrosse and tennis from a very young age, I took a couple of years out post-university before picking up my hockey stick again in 2005/6. I had never been seriously injured in my youth other than the occasional bump or twisted ankle. However, I started showing symptoms in 2006/7 of runner’s knee and pain in the arch of my feet (mostly left side) after playing any sport or when standing for long periods of time.

The symptoms were managed to a degree by physiotherapy with calf/thigh massage, strengthening exercises and acupuncture. The knee pain continued and so I was referred to a consultant surgeon. I had MRI scans which showed inflammation of the patella tendon and the arch pain was attributed to this. I was recommended to continue with Physiotherapy.

By 2008, the arch pain was still present but the knee pain had gone. The arch was considerably worse in the left foot, feeling like a knife had cut into my arch and it felt tight and about to snap but I also had the start of severe ankle pain on the top of the joint of the left ankle.

I was referred by my GP to a podiatrist, who believed I had one leg longer than the other and gave me off-the-shelf orthotics. My GP also referred me to an ankle consultant, an MRI scan only showed swelling, and so my left ankle joint simply received steroid injections.

The injections were incredibly painful and gave no real relief to my symptoms, so I sought a second opinion from another ankle specialist as I was now unable to play any sport, or even carry on life normally.

This new expert decided that he would carry out further MRI/ X-rays of the ankle joint to see if any thing could be highlighted. These showed swelling but little else, so he decided on a minor ankle keyhole operation to have a closer look. He found that I had scar tissue wrapped around the tendon, ligaments and the synovial capsule and other debris within the joint, which he cleaned up. Within 3 months the ankle pain had gone but the arch pain persisted. I was advised to keep up regular physiotherapy as my symptoms were believed to be Plantar Fasciitis which should fade now I was walking ‘normally’ and not compensating for any ankle pain.

I was still unable to play sport and even commuting was difficult, I needed to wear trainers almost daily and again the arches of both feet were still not improving only getting worse, added to this I was getting severe lumber back pain and neck pain that only strong sport massage was relieving, so I again got referred to another podiatrist, who disagreed with the initial observation about leg length but noted that my calves were exceptionally tight and this could be the issue with the arches. Again it was thought to be an unusual Plantar Fasciitis issue, given the pain was not apparent in the morning but grew steadily worst as the day progressed.

By this point I had decided against any more surgery as no one could pinpoint the issue. I was fitted for more orthotics, a very aggressive pair, solid insoles that lifted the heel of my foot by a considerable amount but also solidly supported my arches on both feet. This relieved the pain a little, but not entirely. I persevered, wearing these daily to commute and took up spinning exercise, as my weight had ballooned from lack of activity. By this point my ankle joints had both started to become painful, on some days I was simply unable to put pressure on one or the other.

Fortunately, I was eventually referred to Physio4life by a colleague. My initial consultation showed no specific issue other than tight calves and a weak core. I received acupuncture and calf massage and the ankle pain considerably reduced. I also commenced Pilates at the clinic to strengthen my core. As there was no obvious improvement in the arch pain I was referred internally to Mark Saunders, as a specialist in lower biomechanics, for his expert opinion.

In the first session with Mark, he suggested treatment to my rib area, which was a completely different approach to anything that had been suggested by anyone previously. Remarkably, by releasing my ribs I gained almost immediate pain relief! While short lived at first, lasting up to a day, frequent treatments over 3 months lengthened the pain free period.

I am now practically pain free the entire time, I am playing hockey and I have even completed, (albeit in a lengthy time) a 5k run with no pain other than being unfit! I have been expertly fitted for custom made orthotics by Mark that are a fantastic fit and more appropriate for my use in sport. I now only return for periodic treatment with Mark to ensure that the pain does not recur. I have also learnt to self release my ribs, ensuring that I do not go back to the days of being in constant pain in my ankles and arches and back.

From being in constant pain and discomfort for the majority of the time and unable to live life normally, I am finally getting back on my feet and having an active life playing sport again. A simple walk is no longer something I shy away from. Even when I do have a bad day due to poor posture at work or not releasing my ribs, it tends to be short lived and milder than before. To say this has changed my life is an understatement; it has allowed to me get on with what I enjoy without being worried about dealing with pain the entire time.

A massive thank you to Mark and his team!

X.B 2010 – Physio4Life Client

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