Case Study – Mountain Walking after Knee Pain

May 7, 2020

As it is #walkthismay month, we thought it would be good to share with you a case study of one of our patients (they have given us consent to share this information).

What symptoms did Mr. S present with?

Knee Pain, pain at the front and outside of his knee cap.

What was the diagnosis?

After completing a full assessment which involved asking questions, observing movements, carrying out special tests to clear anything serious with his knee, testing his ligaments, cartilage, joint, muscles and tendons. Also, assessing muscle strength and feeling around the area to determine what the diagnosis was:

Patellofemoral pain (anterior knee pain/pain at the front of his knee, around his knee cap).

What advice did we give?

Advice and reassurance that nothing serious was wrong.

The cause of the pain was due to some overloading of the soft tissues around his knee cap, which lead to certain muscles getting tight and others being weak.

What treatments did we do?

  • Exercises
  • Patella femoral joint knee mobilisations (knee cap)
  • Released TFL/ITB/VL – the muscles outside upper thigh using massage and trigger point release
What exercises did we prescribe?


This exercise helps strengthen the weaker inner thigh muscle to improve the muscle imbalance.

  • Feet hip width apart, toes pointing forwards. Squat down, sticking your bottom out like there is a chair behind you
  • Always keep your knees in line with second toe, do not drop your knees in
  • Repeat until your muscles ache/fatigue every day


Side Leg Raises

This exercise helps strengthen the gluteal muscles to improve the muscle imbalance around the knee.

  • Lying on your side with your back against a wall
  • Tighten your buttocks
  • Lift your top leg up, make sure you slide your heel up the wall so your leg stays in line with your body and doesn’t come forwards
  • Repeat until fatigue, every day



  • Stand with your legs in a lunge position.
  • Go down and up keeping your weight evenly distributed through your legs.
  • Make sure you keep your knees in line with your second toes and your back up straight.
  • This should be slow and controlled, so down for a count of 3 seconds and up for 3 seconds
  • Repeat until fatigue


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How did we help Mr. S to achieve his lifetime goal? 

We worked with him to ease his symptoms using hands on treatments (at this time we are working with patients and they are being taught self help hands on techniques they can do at home).

We then worked together to set tailored and specific exercises to enable Mr. S to improve his strength so he could complete his walking challenge.


Mr. S said ‘many thanks for the physiotherapy session today, we managed to climb Suilven, a mountain I’ve wanted to climb for the last 60 years since I saw it as a child. It is very remote and required a 15 mile walk over rough terrain as well as quite a difficult climb. Your physio work helped me greatly’

This is the mountain in the far North West of Scotland which Mr. S climbed with his son.



Have you got a walking challenge you are training for? We were supposed to be walking the three peaks this year, but there is always next year! It is good to prepare early for walking challenges to reduce the risk of injury.

If you are planning a walking challenge then we can work with you just as we did with Mr. S, to treat any niggles you have, to make sure you get strong enough or keep your muscles loose to reduce the risk of getting injured.

This service is being offered by our physio online service at this time.

To book please book online, call 07835 712306 or email

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