Hello. I have been dealing with a very difficult case of PFPS for about a year and a half now. I have tried everything from activity modification to surgery and the issue is still there. I have had tons of imaging, and there is no obvious structural problem. I also had blood work that showed no reasonable explanations.
I have tried multiple rounds of PT, ART, injections, acupuncture, orthotics. The only thing that has helped is PT, but the results are only temporary and minimal. Not only have I not been able to do any exercise, but I often have pain at rest, ie driving and prolonged sitting, and sometimes upon waking up in the morning.
I’m really at a loss here. Has anyone else had a tough case with this problem and have they had any success? I am a 26 year old male with no history of knee issues. I also never even ran that much when I did, rarely more than 10mi/week MAX. Any advice or suggestions would be greatly appreciated. Thank you
There is a podcast episode of The Physical Performance Show where he interviews a leading researcher on patellofemoral pain, you should check it out if you haven’t already
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Hi. I will check it out. Thanks!
Wall sits… lots of them throughout the day. Work on strengthening the vastus medialis oblique muscles. Did I mention wall sits?
I had terrible knee pain in both knees for a couple of years. Just tried to work through it. Could not sit very long without a lot of pain, driving for more then 20 minutes was unbearable. August of 2020, after Covid had just shut down the last of my races I knew I had a window of opportunity to put a serious PT effort in and hopefully solve the issue. My PT put me on the program, a lot of hours, but I was seeing gradual improvement. About 10 months after I started the program my day to day activities and my running were almost pain free. I have cut back on the time I spend on PT, but still do it, and I and pain free. I ran my 53rd marathon last week, which a year ago I had a lot of doubt I would ever run another one. Be patient, do what your PT tells you and you maybe able to come out of it like I have. Good luck!
I’m more than a few years removed from when I was given The patella femoral pain diagnosis. I did all sorts of stuff with nominal success in my first go around with two PTs who were convinced it was my IT band or flute weakness.
Then I sprained my ankle horribly, went to a PT and she said more or less, “your ankle will be fine in time but how long have you been recuperating from the quadricep injury?†I told her I didn’t know what she was talking about and she told me my right quad was weaker and tighter than my left by a fair margin and it had likely been injured and then lost strength. Within 2-3 weeks of strengthening it, my pain and discomfort went from bothersome to barely noticeable and after 6 weeks I considered myself recovered.
What I learned was some PTs chase the most likely cause to a symptom and others follow the clues. And ironically the person who found my problem wasn’t even looking. And to your issue- quad strengthening fixed my issues with PF pain.
Thanks for your reply, Jamie. I am having the same issues with driving and sitting. What was the key area your PT saw that was likely causing your pain?
If you were running <10 mpw, what are/were you doing for exercise other than that? Are you cycling? Are you overweight? Seems odd to get a running injury with such low volume.
I would do some cycling occasionally. Was not overweight. Maybe now 5-10 lbs per BMI chart due to inactivity. Remember though, you don’t even have to be a runner to get runner’s Knee.
Need more information. Where is your pain specifically? What brings it on, what makes it better? What in PT helped in the past? What has not helped? Prior history of injuries? History of back pain? What was the original cause of pain? What medication have you tried?
Hi Biker,
Pain is generally below kneecap or sides. It’s brought on by exercise, or any bending of the knee. prolonged sitting and driving tends to Aggravate it. PT has only ever helped somewhat. I’ve gotten conflicting info on what my problem is. Usually hip abduction and glut med exercises were helpful, along with scraping the knee with that silver knife- like Device.
Activity modification doesn’t help, nor does ART, acupuncture or orthotics.
No significant history of injuries. Although I did used to get an intermittent hip pain that went away after a couple years. No history of back pain.
I’m not entirely sure of the original cause. Could have been running but I didn’t even do that much so possibly but unsure. I have been told by multiple people that the way I walk is likely contributing to my pain. So might be my gait. I don’t have good dorsiflexion, and my feet are externally rotated.
Tried ice and all the typical NSAIDS. Doesn’t touch it. When it gets bad I have to take low grade painkillers.
Runless, your post about your PT is awesome they were able to help you get this straightened out. You were fortunate. My experience with a lot of PTs is they just seem to be following a guide book and not really thinking “outside the boxâ€, or what I call “making a differential diagnosisâ€. I’ve got a really good PT now, but I’ve had a lot of questionable ones too. It’s disappointing because some PTs can actually make your condition worse by not individualizing the treatment protocols. You sound like you had a good one.
Sorry, I am just seeing this reply. My PT pinpointed the pain at the top of my patella. He could move my patella around, dig under and find the sensitive areas. I did a lot of quad, and glute strengthening. Hip and ankle stretching. My PT is top notch, has helped me with a couple of issues. He refuses to give up and will keep working till he finds a path to recovery. Then the rest is up to the person to do their exercises. Hope this helps some.