Diagnosis - find out everything about the problem

Just as you expect your garage mechanic to fix your car, people expect the doctor to fix them

And in many ways the process is similar!

I saw a young lad in the clinic two days ago. a 24 year old security guard, with a pain in the knee. He had been off work for a month and he could barely walk. He had seen his GP, been referred to a specialist and was seeing a physiotherapist with a diagnosis of "Patellar misalignment"

Except it didn't add up. I don't like the diagnosis "Patellar misalignment". The patella is a bone that sits in the quadruceps tendon. It is not a bone like the femur or thigh bone, it is a "sesamoid" bone. The patella sits in the quadruceps or thigh muscle where the muscle crosses the knee joint. If the patella is "misaligned", the muscle not the patella has a problem. Nonetheless, surgeons get so excited by the diagnosis of "patella misalignment that they even remove the patella.

The typical patient with patella misalignment is a teenage girl, not a fit young man

I looked at his knee, not swollen and full movement but he had an acutely painful spot where the muscle joined the top of the patella. Nonetheless, his legs did not look right and he did not look right. He was zipped up in a jacket even though he was in the clinic. My attennae were burning.

The penny finally dropped. "Do you do weight training?" "Yes" "Take your top off"

Once the jacket was off, there was the incredible hulk. Massive pects, and taut abdominals and tiny spindly legs. I got the full story. He weight trained in the gym but he only did his torso because that was the bit people saw first. Until May of last year, he had trained as a boxer but he had stopped the boxing training and within a month the pain had started in his knee.

I know I was the not the first person to tell him about the dangers of concentrating on a few muscle groups in the gym rather than whole body training. He had a boxing trainer but he did the weights on his own

The diagnosis - "patellar misalignment" - but anyone who builds up part of their body and neglects the rest is building a maching with a lever partly made of reinforced steel - the massive pects and taut abdominals and partly twigs - the puny legs and knees.

The lad's twig legs were having trouble holding up the steel girder, causing Pain in his knees.

The remedy - weight training with a professional trainer and all round training such as boxing. This would help his body to come back into balance and help him lose the hulk on matchsticks profile.