Sports Therapy · Brighton & Hove
From acute ligament injuries to chronic knee pain, expert assessment and treatment to get you moving again, including clear guidance on when rehabilitation is enough and when surgery is needed.
Conditions Treated
The knee is a complex joint subject to high load demands. Each condition has a distinct presentation and a different treatment approach, accurate diagnosis is the essential first step.
Anterior cruciate ligament tears are among the most significant knee injuries in sport. Typically occurring with a non-contact pivoting or landing mechanism, often accompanied by a "pop" and rapid swelling. The decision between rehabilitation and surgery is more nuanced than most patients are led to believe, see the dedicated section below for a clear breakdown.
Medial collateral ligament injuries range from mild stretch to complete rupture. Grade I and II MCL injuries almost always heal well with conservative management. Even Grade III tears frequently resolve without surgery. Pain and tenderness on the inner knee, often with some instability on valgus stress.
The medial and lateral menisci are C-shaped cartilage structures that distribute load and provide stability. Tears can occur traumatically or through degeneration. Not all meniscus tears require surgery, and research shows that for many degenerative tears, rehabilitation produces comparable outcomes to arthroscopic surgery.
Pain at the front of the knee, just below the kneecap, that worsens with jumping, squatting and stairs. Common in jumping athletes but also seen in runners and gym-goers. Requires a specific progressive tendon loading programme, passive treatment and rest alone are insufficient and often counterproductive.
Diffuse pain around or behind the kneecap, aggravated by stairs, squatting, prolonged sitting and running. Typically driven by hip weakness and altered lower limb mechanics rather than a local knee problem. One of the most common knee presentations, and one of the most frequently undertreated.
Progressive degeneration of knee cartilage producing pain, stiffness and swelling, particularly after activity and in the morning. The relationship between imaging findings and symptoms is variable, many patients with significant radiographic changes have manageable symptoms with the right approach. Exercise is the single most effective intervention.
Inflammation of the bursae around the knee, or a fluid-filled cyst behind the knee (Baker's cyst), often secondary to intra-articular pathology such as osteoarthritis or a meniscus tear. Treating the primary cause rather than the bursa or cyst directly produces more lasting results.
Sharp lateral knee pain appearing at a consistent point during a run, typically between 20 and 40 minutes. The iliotibial band itself is rarely the primary problem, hip weakness and altered running mechanics are more commonly the driver. Repeated aggressive stretching of the ITB is one of the least effective management strategies, yet remains the most commonly prescribed.
A Closer Look
The advice patients receive on ACL injury management is often polarised and frequently outdated. The evidence tells a more nuanced story.
A landmark Scandinavian study (the KANON trial) found no significant difference in outcomes at two and five years between early ACL reconstruction and structured rehabilitation with optional delayed surgery. Approximately 50% of patients in the rehabilitation group never needed surgery. This doesn't mean surgery is never needed, it means it is not always the default answer it is sometimes presented as.
The conservative pathway
Patients with good quadriceps control and proprioception, lower-demand sports or activities, older patients, those with medical contraindications to surgery, or anyone who prefers to attempt conservative management first.
When surgery is the right choice
Surgery does not replace rehabilitation. Return-to-sport outcomes after ACL reconstruction are heavily determined by the quality of post-operative rehabilitation, not the surgery alone. Psychological readiness and quadriceps strength symmetry are key determinants of safe return.
ACL management should be individualised. Sport level, age, associated injuries, instability symptoms and patient preference all influence the decision. If you have been told you definitely need surgery immediately after an ACL injury, it is reasonable to seek a second opinion and explore what a structured rehabilitation trial looks like first. If you have been told you definitely don't need surgery, but your knee remains unstable despite good rehabilitation, that conclusion should also be revisited. The right answer depends on you, not a blanket protocol.
How I Work
Every knee injury needs a clear diagnosis, a plan with milestones, and honest guidance on what the realistic outcomes are.
Orthopaedic testing to identify the structures involved, grade the injury severity, and rule out anything requiring urgent referral before any treatment begins.
Targeted work to the quadriceps, hamstrings, calf and ITB to reduce pain, restore normal tissue tone and prepare the knee for progressive loading.
Effective for patella tendinopathy, ITB syndrome and chronic knee pain presentations where trigger point activity is contributing to symptoms.
A structured, progressive programme with clear milestones, addressing strength, neuromuscular control and movement quality specific to the injury and the patient's goals.
A clear criteria-based return to sport protocol, not just time-based. Strength symmetry, movement quality and psychological readiness all form part of the decision.
Clear guidance on when onward referral for imaging or orthopaedic opinion is appropriate, and what to ask for when you get there.
Most knee injuries can wait for a routine appointment. The following warrant urgent assessment to rule out serious injury or complications.
"Went to see Tim after having some issues with my knee and hip from running. He was able to explain in detail what my issue was and how to treat it. My pain decreased significantly after only a day and I left knowing exactly how to help myself heal."
Whether it's an acute injury or a long-standing problem, the right assessment changes the outcome. Book an appointment and get clarity on what you're dealing with and what the options are.