Knee Pain
Knee pain is a symptom. The cause is what we treat.
Assessment-led knee rehabilitation for athletes and active adults. From the first session: a diagnosis, a plan, and treatment — not a referral to come back next week.
Conditions
What we treat.
Both surgical and non-surgical ACL management — assessment-led decisions on whether reconstruction or conservative rehabilitation is the right path.
Post-operative rehabilitation following ACL reconstruction. Progressive loading through all stages — protection, strength, return-to-sport criteria.
Meniscal tears from acute trauma and degenerative causes. Conservative rehabilitation or post-surgical recovery depending on presentation and surgical status.
Anterior knee pain driven by load and biomechanical factors. Common in runners, cyclists, and overhead athletes. Responds well to loading-based rehabilitation.
Tendon-load mismatch injury common in jumping and sprinting athletes. Requires progressive tendon loading — not rest.
Lateral knee pain in runners. Driven by training load and hip mechanics. Addressed through load management and proximal strengthening.
Recovery after total knee replacement. Staged return to full function with strength, range of motion, and daily activity milestones.
Chronic or acute knee pain without a confirmed diagnosis. Assessment identifies the source and drives a targeted treatment plan — not generic management.
Who we see
Three kinds of knee patients.
The athlete with an acute injury.
An ACL, a meniscus, a tendon. Something happened in training or competition and now there is a structural question. Assessment clarifies the injury, defines the treatment path, and establishes whether surgery is needed — or whether conservative rehabilitation gets you back faster.
The runner with chronic pain.
Patellofemoral pain, IT band syndrome, patellar tendinopathy. Pain that comes on with mileage, worsens with descents, or limits training volume. The cause is usually load — not structure. Assessment identifies the load deficit and builds a plan that keeps you running while the tissue recovers.
The post-surgical patient.
ACL reconstruction, TKR, meniscus repair. Surgery repaired the structure — rehabilitation restores the capacity. Staged progressive loading from protection through to full return of strength, movement, and function.
The approach
How knee rehabilitation works here.
Assessment first
Movement screen, load testing, pain provocation, and functional testing in session one. The treatment plan follows what the examination finds — not what the complaint sounds like.
Progressive loading
Rest does not rebuild a knee. Controlled, progressive loading of the tissue — through appropriate range and at appropriate intensity — is what drives recovery. We establish what the tissue can tolerate and build from there.
Return-to-performance criteria
Clearance to return to sport is based on clinical criteria — single-leg strength benchmarks, load tolerance, movement quality — not a calendar. You return when the knee is ready, with evidence, not assumption.
Same clinician throughout
Every session is with Leonardo. The same assessment logic, the same clinical reasoning, the same relationship from session one through to discharge. No handoffs.
Case example
What recovery looks like.
A 26-year-old trail runner presented with six months of bilateral anterior knee pain, worsening on descents and after runs exceeding 15km. Previous advice: reduce mileage and ice. Three months of compliance, no improvement.
Assessment revealed significant single-leg load deficit and poor hip control under fatigue — patellofemoral load distribution was the driver, not a structural knee problem. Imaging was not indicated.
Treatment: graded hip and quadriceps loading, gait retraining under load, progressive return to running volume. By session six, pain was resolved on flat terrain. By session ten, full training volume was restored including hill work. No surgery. No extended rest.
Case presented with patient consent. Identifying details modified.
What delays recovery
Three things that slow knee rehabilitation.
Resting too long.
Pain reduction through rest does not equal recovery. Tissue capacity is not rebuilt through unloading — it requires progressive loading. Extended rest leads to strength loss, stiffness, and a longer return-to-sport timeline.
Treating the symptom, not the driver.
Knee pain is often a downstream result of hip weakness, load mismatch, or poor movement mechanics. Treating the knee in isolation without addressing the source leads to recurrence — sometimes within weeks of returning to activity.
Returning before the tissue is ready.
Clearance based on pain reduction alone is not safe clearance. Return-to-sport requires single-leg strength benchmarks to be met, load tolerance to be demonstrated, and movement quality to be verified. Skipping this step is how reinjury happens.
Questions
Common knee questions.
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Do I need an MRI before starting?
No. Clinical examination is the primary diagnostic tool for most knee conditions. MRI results are useful context when available, but assessment begins with what we find in the physical examination. Bring any imaging you have — it will be used, but it is not a prerequisite. Read more: Do You Need an MRI Before Physical Therapy? →
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Can I continue training while my knee recovers?
In most cases, yes — with appropriate load modification. Blanket rest is rarely the right answer. After assessment we establish what you can continue, what needs modification, and what to temporarily avoid. The goal is to keep you moving at the highest level the tissue can safely tolerate.
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How long before I return to sport?
This depends on injury type, severity, and pre-injury capacity. Return-to-sport is determined by clinical criteria — not a fixed calendar. After the first session you will have an honest estimate with specific milestones to hit before return.
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Will I need surgery?
Most knee injuries do not require surgery. Even many ACL tears can be managed without surgical reconstruction, depending on the patient's activity demands. Assessment clarifies what conservative treatment can achieve and whether surgical opinion should be sought.
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How is this different from standard physiotherapy?
Standard physiotherapy often focuses on pain reduction through passive treatment and generic exercise. PhysioPro uses a performance rehabilitation model: thorough assessment, progressive loading, and return-to-activity criteria built for what you need to do — not just for daily comfort.
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I've had physiotherapy for my knee before and it didn't last. Why would this be different?
The most common reason knee rehabilitation doesn't produce lasting results: the pain was addressed without rebuilding the tissue's capacity to tolerate load. When training resumed, the load the knee could no longer handle returned — and so did the pain. Assessment here identifies exactly what the capacity deficit is. The program builds it back systematically. Discharge happens when the tissue can demonstrate — not just report — that it is ready for the demands being placed on it.
Read more: Why Physical Therapy Didn't Work The First Time →
More questions? See the full FAQ →
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Assessment + treatment from session one. $750 MXN. Zona Rio, Tijuana.