Leg & back problems - please give me suggestions

[Indecisivelurcher]

This year I would really like to get on top of these persistent leg and back issues that are limiting me. Sorry this is long but I feel I'm not getting anywhere here so wondering has anyone had similar?

I'm early 40s. Healthy, ran, cycled etc (past tense at I've had to give up). Knee and leg issues ongoing about 8yrs now, saw a couple of physios but no improvement.

Physio 3 diagnosed prolapsed discs in lower back as the source cause approx 6 years ago. Improved with pilates and exercises, mainly back bends, cobras, also glute strengthening. I still end up going back annually when things become so stiff I cannot self manage. I did see the GP but they didn't see need to do an MRI.

Ticked along ok , not perfect, until about 2 years ago knee pain that worsened to the point of severe pain in May 24, ruined holiday, limping about, in bad pain. Physio no3 still said it's my backs fault.

In Oct I pushed physio to look at both knees, ultrasound of patella tendons identified lots of scarring and holes, patella tendonitis. Words used were 'significant' and 'degenerative', was told it's just the way I grew. Was told however good it was by Christmas was probably as good as it would get. Set knee dips on decline board x30 X3 sets a day.

These exercises aggravated my back. I went to the GP, musculoskeletal person there said they don't call things degenerative, all tendons show signs of age, it may take 6m to improve, generally a bit more positive. Was then put onto NHS physio, physio 4.

Physio 4 ran through physical tests and said no signs of significant patella tendonitis. Said tight hamstrings playing in. Set different exercises that don't pull my back. Sit to stand one legged squats, wall squats, hamstring stretches. Back in a few weeks.

I'm ok ish for every day life now. Luckily I live somewhere flat and my dog is old! Today for a change I did a 1hr walk that involved slopes. My knee hurts below my knee cap. Down the back of my leg was tight. There muscles in the fleshy part of my bum. Lower back slightly too. I feel like I can't make that stepping motion without thinking about it. I end up limping. And then it's bad for the rest of the day and probably will stay bad for a few days. Driving when it's bad can be really painful as in gritting teeth, something about keeping my foot on the accelerator in that position.

The thing is I feel like I'm not getting any further. I'm not convinced of even having a diagnosis really. I don't feel like I could live anywhere not flat, this effects what holidays I choose, where I live, what hobbies I do, the stuff of life. Can anyone help?

Sounds like sciatica could possibly be involved as well. You need to be on proper pain killers. Can your doctor refer you to a pain clinic?

Thanks for replying. I have had sciatica all times but not at present. I'm not in pain constantly so not sure that's the right route. It's more that it's limiting what I do in life and I can't get to the bottom of what's wrong or how to sort.

Pilates. A decent Pilates instructor will be able to give you modified exercises to help you build strength to support all your problem areas. A couple of my instructors are attached to physio practices. Look for someone trained in Body Control Pilates with a Back4Good qualification. https://www.bodycontrolpilates.com/find-your-local-teacher/back4good/

If you are carrying extra weight, you need to lose it. I've lost over 25 kgs and my knees are so much better for it, Pilates four times a week has also helped my back. It is still stiff in the lumbar due to old injury, but is no longer unstable and unsupported.

Sounds like you’re making progress with the exercises physio 4 gave you. How,often are you doing them? I’ve come to the conclusion you need to do stretches, mobility exercises every single day.

also have you thought about seeing a good podiatrist? A lot of knee and back problems start from the feet up. I’ve got very flat feet and the podiatrist measured me for custom orthotics. I actually don’t think they’ve helped me but lots of people do find it a help.

i also swear by an osteopath and see one quite regularly

I do a pilates class with a trained physio every week, have done for 6yrs. I usually do another session myself. I'm not over weight, a slightly dumpy size 10.

That's great. When I went from one to four classes, the difference was quite noticeable. Maybe some extra classes with a different teacher, they all teach in slightly different ways. Is your physio trained in Pilates? I have found BCP and Stott to be the best types for my back.

I'm not able to fit in another class very easily but can do more myself. I've also just messaged my pilates instructor who is a physio to see if she can give me an assessment, almost starting at the beginning.

There’s a YouTube channel I use……run better with Ash is the name of it. It’s all stretching and mobility in 20 odd min videos. I’m no runner but I find his videos good for back pain.