patellofemoral pain syndrome - any hope?

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oprah Aug 2013 10:02am, 11 Aug 2013 210 posts	0 oprah Apart from the occasional odd knee twinge after a speed session, I've never really had any problems with my knees until this year. A couple of weeks before my spring marathon, my knee started to ache after long runs, but I figured I'd just push through and then rest after the race. Having missed that marathon due to illness, I carried on training for another month for a replacement race, when my knee just began aching all the time and I gave up. I have now taken 3 months off (well, I think I've run 5 miles in total in that time), and have seen two physios and a knee surgeon, who all said it's anterior knee pain and will die down. I've been doing all the stretches and exercises for my VMO and glut meds, twice a day, and taping it, but whenever I move on to load bearing activities like lunges and squats, the aching comes back and it is agonising. The surgeon said if it's not better in another 6 weeks or so to come back, but from what I've read, surgery doesn't look all that promising for this condition. Has anyone been through this and come out the other side successfully? I finally got a good for age place in London so would love to run that as my last marathon if possible, but not feeling optimistic given my current state. I would really like to move to triathlons and still be able to run once or twice a week, but right now, the only thing that doesn't aggravate it that much is swimming, which is fine but certainly not my first love.
FTM42 Aug 2013 5:18pm, 21 Aug 2013 33 posts	0 FTM42 Yikes! Looks similar to mine, so I'll hop on and see what transpires! Just had an x-ray but not hopeful it'll show anything. My right knee seizes up painfully after about half an hour of sitting down, which is a bind when you're driving your kids on holiday for 3 hours - an automatic gearbox is no help as it's my right knee! I put it down to being 49 and having been a runner since I was 18-ish. The knee's been getting worse in the last few months and I probably hastened it after a fall when I knocked myself out on a low tree branch ["run on soft trails", they said, to "take the impact off your knee", they said!] and probably came down on the bad knee. I find it's OK as long as I'm walking around, but running sends pain up inner kneecap and standing still or squatting just results in an embarrassing method for getting up again, which involves sticking my bum in the air and leaning on my hands! I'm doing the strengthening stuff for thighs too, but that hurts. Cycling also painful, on the down pedal as well as the up and my swimming style is breast-stroke - useless if you have gammy knees!! I have a rowing machine at home, but that hurts too. All I can offer right now is sympathy, so lets hope someone hops on this thread with an answer?!
FTM42 Aug 2013 5:21pm, 21 Aug 2013 34 posts	0 FTM42 btw - have you caught this thread? http://www.fetcheveryone.com/viewtopic.php?id=49461
Krissie Aug 2013 9:09am, 26 Aug 2013 94 posts	0 Krissie .....and yes there is hope! I got over it within a few months with a good physio program focusing on core and glutes. Still now if I let the gute exercises go I will start to get some left knee pain back. Need to stretch the glutes lots more too, the more strengthening I do or they just get tight and cause the same knee pain.
oprah Aug 2013 1:18pm, 26 Aug 2013 211 posts	0 oprah Thanks for the replies - I couldn't find any earlier threads ( though probably didn't look hard enough!). Sorry that anyone else has had to endure this, but glad to see there is hope. I had a tibial stress fracture a few years ago, and the advice for that was to not run if there was any sign of pain whatsoever, so that has been my mindset for all injuries. But, on my physio's advice, I tried a little cycling and then running 1 mile at a time, which was not pain free, but was more in the uncomfortable range rather than painful range. The weird and unexpected thing I have found is that the more I do, the more I seem to be able to handle and the less pain I am in. In the beginning with this injury, if I did anything, it would seize up for days, so it is definitely getting better. I also discovered I have comorbid ITBS, which I did not realise because my pain feels different to the way my husband describes his ITBS. Anyway, I have been doing clams for my glut meds for almost a year now because of other injuries, but I think I was doing them wrong before, so have started doing loads of those and another for my gluts, but then the ones I think are really helping are lying single leg lifts with foot turned out - lie down, turn right foot out and raise foot about 1.5 feet off the ground and hold for 3-5 seconds x 10 on each side straight single leg lifts - same as above, but with foot pointed at ceiling instead (doesn't seem as useful but probably can't hurt) Physio also gave me a long stretchy band to do knee tracking exercises with - strap the band around foot and then do leg extensions keeping knee as straight and stable as possible aligned over second toe. - when I first started with these my knee clicked on every single extension, which was causing pain, but since I've been doing the leg lift exercises this only happens about 20% of the time. This change corresponds exactly to when I started feeling less pain, so I really think these 3 exercises helped. I'm also supposed to do single and dual leg squats, lunges, and single leg heel raises. The squats hurt too much so I've switched to wall sits and that feels OK for now. Anyway, I just ran 5 miles mostly pain free, so that is progress! I am so happy - I had no idea it would take this long to settle down. And I am grateful for the injury for giving me the push I needed to try out triathlons (have been working on my swim all this time), and for getting some perspective.
RunningRach Nov 2013 7:35pm, 25 Nov 2013 81 posts	0 RunningRach I have suffered knee pain pretty much since I started running almost 3 years ago, which is slowly getting better (resting...then spent the summer having technique/form coaching, worked on cross training and strength work, LOTS of glute work) but my right knee just refuses to completely get better. I was wondering if anyone has ever tried a knee helix? bodyhelix.co.uk I was taping my knee for a while earlier in the year when marathon training. Have never used any kind of support (partly because couldn't find one to fit) and was curious.
Derby Tup Nov 2013 7:45pm, 25 Nov 2013 8,293 posts	0 Derby Tup I had a bad do in 2008 with both my knees. They were grinding and clunking and even standing up was painful if I'd been sat down for more than say 20 mins. I went to a good physio who explained my knees had largely siezed up plus my quads were wasted. They gave me three or four intense sessions of physio all around the knee area and encouraged me to do lots of lunges and squats. After maybe 10 or 12 weeks things cleared up. My advice is see the best physio you can find and hit any excercises they give you to do with the same energy and application as any other training you'd do. I seriously thought I wouldn't run again at one point but my knees are as good now approaching 50 as they've ever been. Good luck!
tom_craggs Nov 2013 7:48pm, 25 Nov 2013 2,425 posts	0 tom_craggs You have been doing all of the sensible things there oprah - might be time to go and see a really good physio (no disrespect to those that you have seen but in my experience there are very few doctors and physios I really trust in the UK when it comes to running injuries). Clifton Bradeley perhaps or Paul Hoborough in Twickenham (I have no reason to recommend them other than they are the best in the business in my opinion having fixed me and many of the runners I coach). Just being told it will go away isn't helping you clearly and as you are doing the correct exercises this might need a more in depth look at your biomechanics, posture and hip function.
tom_craggs Nov 2013 7:49pm, 25 Nov 2013 2,426 posts	0 tom_craggs Ha only just seen your second reply - so scrap that - sounds like you've nailed it! The exercises you have mentioned do take some time to really pay dividends.