patellofemoral pain syndrome

donnam40

Does anyone have any experience with this? I have it at the moment and it's really giving me the sh*ts. I saw the physio today and it actually hurt more after the session with the physio.

Donna

Azdak

This is common problem with runners--in fact I would say it is the #1 cause of knee pain in runners. It usually occurs because of strength imbalances. Running does not really provide much resistance for the muscles and many runners have a combination of tight calves, tight hamstrings, and tight hip flexors along with weak quads and glutes. The result is that the patella does not track properly and tendonitis develops.

Treatment usually involves two phases--relieving the inflammation and strengthening the muscles so that the patella tracks properly. In some cases, the tendonitis pain can be persistent and continue even as strengthening is taking place.

If addressed soon enough, most cases I have seen have been treated successfully--you can come out of this much stronger than before and much better equipped to avoid a number of lower-leg injuries in the future.

In the "worse"-case scenarios, there might be structural physical issues that make full recovery difficult, but PFS treatment is usually pretty straightforward.

timeasterday

... a combination of tight calves, tight hamstrings, and tight hip flexors along with weak quads and glutes. The result is that the patella does not track properly and tendonitis develops.

^This is what you need to work on. Strengthen quad & glutes. Roll the IT band every day too.

FrenchMob

Yep. I waited to long now I have thinning of the cartilage of the knee cap on the lateral side. Damage is done.

Cherimoose

I saw the physio today and it actually hurt more after the session with the physio.

What did the physio have you do?

And what were you doing that started the problem?

donnam40

I am a very experienced runner and a gym rat. I do squats, single leg deadlifts, lunges and a variety of other leg exercises regularly. I ran a half marathon on the weekend very slowly (I accompanied my daughter) and the physio thinks this has caused it.

For the treatment he did some massage and dry needling and then had me start to stretch the outside of the quads (not the ITB). The flexion of the knee hurt but he persisted. I am not sure if this made it worse. I have gotten up today and some of the swelling has subsided, but I cannot bend the knee without pain.

I also have rheumatoid arthritis so whether this will complicate the healing process I am not sure.

Any suggestions would be welcome.

Donna

fleetzz

Are you sure that is what the diagnosis is? Sounds like you already have pretty decent experience running and doing appropriate strengthening exercises. Typically there is minimal swelling with patellofemoral syndrome, mostly pain, worse when sitting for long periods of time and when descending stairs.

I am a very experienced runner and a gym rat. I do squats, single leg deadlifts, lunges and a variety of other leg exercises regularly. I ran a half marathon on the weekend very slowly (I accompanied my daughter) and the physio thinks this has caused it.

For the treatment he did some massage and dry needling and then had me start to stretch the outside of the quads (not the ITB). The flexion of the knee hurt but he persisted. I am not sure if this made it worse. I have gotten up today and some of the swelling has subsided, but I cannot bend the knee without pain.

I also have rheumatoid arthritis so whether this will complicate the healing process I am not sure.

Any suggestions would be welcome.

Donna

Mustgetbuff

I've had this problem since I was 16. The pain fluctuates due to many variables: my weight, activity level, the weather, etc. I tried physio and didn't find it very effective; same with the custom orthopedics that were given to me. I'm currently seeing a trainer that specializes in corrective exercises in order to safely build strength in my quads and hamstrings, and while it's been helpful, I am by no means pain-free. I think this is due to the fact that my patellofemoral stems from my flat feet (thanks for that gift, Dad), so the problem may not be correctable, just improved. Since I don't have a lot of arch support, it throws off the tracking in my knee and will likely spread to my hips and back, as it has for my dad. He's 54, in great shape, very active, aaaaand needs a hip replacement. Lucky!

I find my knees get really tender after a workout that incorporates a lot of bent knee (squats, lunges), or if I'm sitting/driving for long periods of time. I think it's inevitable that you're going to feel some pain when you work on correcting the patella, but you can alleviate some of it by icing each knee for 15 minutes. You can also take some ibuprofen before and after physio/workouts to help with inflammation.

donnam40

I'm pretty confident in the diagnosis. But, my knee is in constant pain. I suspect runner's knee has aggravated my RA. I think I will see an acupuncturist today to see if I can get some relief from the tightness.

BinaryPulsar

I was born with a genetic problem in my feet/legs, that was corrected (back in the late 70's) with casts and then shoes that are like wearing shoes on the wrong feet. Then I became a dancer and developed a growing problem when I was 14 (my legs were growing faster than my knee caps), so I developed patella femoral pain syndrome and Chondromalacea Patella and it was made worse by the intensive dance training. Then I was in a car accident (no seat belts in the car), then I was hit by an elderly women that could not see well enough to be driving while I was riding my bike. So, anyway, I have had a lot of struggles with this along with re-injury. It did resolve when my growing was finished. But, recently has become a problem again (I lift weights now). I work with a physio on strengthening, sport's massage to release muscle tension, and working on form for my weight lifting. I still dance and have continued all the way through. And I run here and there for fun or in dancing, but I don't do long distance running as part of my fitness.

Walking uphill and upstairs helps. But walking downhill/stairs hurts (because of the tracking problems in my knee caps). Sitting makes it worse, so I am very active.

I do the Strong Curves Program bretcontreras.com and find that to be the best for me.

I do ice massages as needed.

hurtknees12

I've had patellofemoral pain syndrome for over two years and have learned some things.

Something you need to understand about PFPS is there is no one cause. PFPS describes a set of symptoms (anterior knee pain, pain worsened by sitting down, etc.) but there are multiple things that can cause it. This means that treating it can sometimes be very challenging (as in my case). This also means what works for some people with PFPS might not work for you.

If I knew you had the same exact problem with your knee that I have with mine this is what I'd say: Since you work out I'm sure you know what types of pain exercise normally causes. If doing something causes any type of pain that that activity doesn't normally cause, don't do it. Every time I've worked through the pain when something didn't feel right I've worsened the condition of my knees.

The above might not apply to you because what's causing your pain might not be the same thing that is causing my pain. Also, even if you did have the same thing this advice might not apply since you have RA, which might complicate things (I know nothing about RA).

Someone above said " I think it's inevitable that you're going to feel some pain when you work on correcting the patella"
Question this. It hasn't been true for me and it might not be true for you either.

"You can also take some ibuprofen before and after physio/workouts to help with inflammation. "
Question this too. If you take ibuprofen you might mask your pain and you won't be able to hear your body when it tries to tell you something you're doing is bad for it.

I highly recommend you read these two books:
http://saveyourself.ca/tutorials/patellofemoral-pain-syndrome.php#updates
http://www.amazon.com/Saving-My-Knees-Doctors-Chronic-ebook/dp/B004JHYTEI

It might seem like a lot of reading but if you don't learn about treating this now you might suffer a lot of unnecessary pain.

shano25

I have been dealing with this for 20 years now, had to quit competitive figure skating because of it. I saw specialists for it and they ruled out it being a problem with my feet however my physiotherapist used to tape my feet before I would go to teach skating and my knees felt much better after.

For years I stayed away from the exercises that made it worse. But then two years ago I started yoga and it has made such an improvement. Bikram yoga is fantastic because the heat has been excellent and poses I thought I wouldn't be able to do because of my knees are some of my favourites. I also regularly do a video that focuses on hips, because tight hips have also made the problem worse for me.

Since I've started yoga I've been able to do more of exercises that used to hurt right away such as squats, lunges, and stairs.

BinaryPulsar

Yeah, that is all good advice. People with knee problems need to be aware of how the problem can be made worse both from the feet and the hips. Hip opening exercises are good to do.

splproductions

Hi,

As another poster mentioned, you DEFINITELY need to go to this link and read! http://saveyourself.ca/tutorials/patellofemoral-pain-syndrome.php#updates

My PFPS started about 7 years ago and after many, many therapy sessions and bilateral surgery, I'm still dealing with it. Before you spend more time and money on therapy (and surgery), definitely, definitely go to that link. You can read plenty at that link, but then the full PDF book costs $20. It was the best $20 I ever spent, and I wish I would have spent that $20 instead of spending thousands on a surgery that has been shown in multiple studies not to work.

Good luck!