Persistent knee pain - where to begin?

[janeseymour78]

For about 2 months now I've had knee pain on and off. Im 31 and in my 20s had a lot of issues with plantar fasciitis and over pronation

I realised a trigger was walking down the narrow stairs at my workplace and now seems to be most stairs at all, or bending down. The pain is mostly around the knee cap and the moment the calf is very painful too. If I self massage the area it makes me wince.

I'm trying to lose weight at the moment, as I've gone from a 12 to a 14-16 since the lockdowns. I'm hoping that will help. To do this I'm combining diet changes with weight training, swimming & lots of walking.

I've heard physio can help, but do you have to see a doctor first or self refer? I feel miserable with it

It depends on your area, if you contact the surgery (or have a look on their website) it should say whether you can self refer or need to be referred.

I'd look at deep tissue massage on ham strings and stretches both can be caused by tight ham strings.

Get some shoe insoles and you can self refer for physio. Your doctor's website should tell you how. If I don't wear insoles, my knees are really painful. They're fine with them.

You can usually self refer to physio via your GP these days, if not going private might be quickest.

Physio is absolutely what you need. They’ll give you exercises, it’ll be fine.

Running probably isn’t for you (I totally buggered my knees running, so always feel I have to say that)

@Mabelface do these need to be custom made or can I order my shoe size to see a difference?

Yep, physio. You need that first to understand the root cause, otherwise the other suggestions might be wrong for your needs.

Custom made is the ideal. The physio can refer you to podiatry. I'm currently using the half shoe off the shelf ones which do work for me. I overpronate due to hypermobility.

If you can afford it, a private MSK assessment at a good podiatrists would find the root cause of the issue and devise an effective treatment plan. They are around the £200 mark. A lot of money but the quickest and most effective way to treat the issue. How is your PF these days? Highly plausible that your gait has changed to compensate the PF which has had a knock on effect on your poor knees.

You can buy arch insoles (and even half ones for smaller shoes) which will help with your feet. Probably not as good as ones made specifically for you but a good (and cheaper) start.
I take high strength vitamin B and magnesium and also wear shoes with cushioned soles so I don't get that hard jolt when I'm walking.