Anyone ever had Patello-Femoral Syndrome ?

[FredGavioes]

so i got hurt playing soccer back in october, and i thought i had hurt my ACL.

i got this freecare plan, which it takes months for u to have an appointment. but i finally had one last week, in which my doctor told me i have Patello-Femoral Syndrome . i asked about acl and he said it was fine. he said that the only way i could get fully recovered if i was to do Physical therapy . he made me another appointment for me in june, so i could learn the stuff, and do the exercises at my house. two months is so far away, i want to start something by miself. but i cant seem to find any website that tells me about it, anyone ever heard of PFS???

[taocpa]

http://familydoctor.org/479.xml

[servotron]

I had this when I was playing hockey and soccer in the late 80's in high school. I saw a sports doctor, and they gave me a list of easy exercises to do, what it came down to was quad-building exercises and some ligament training/strengthening, one of which was holding my kneecap with some tension and pushing down on it while I flex my quad and resist the movement.. hard to explain but it GRINDED against the bone which was no fun, so I didn't do it very often.....

Eventually I grew out of PFD, and have no problems with my knees (at age 31)

[Martininho]

so i got hurt playing soccer back in october, and i thought i had hurt my ACL.

i got this freecare plan, which it takes months for u to have an appointment. but i finally had one last week, in which my doctor told me i have Patello-Femoral Syndrome . i asked about acl and he said it was fine. he said that the only way i could get fully recovered if i was to do Physical therapy . he made me another appointment for me in june, so i could learn the stuff, and do the exercises at my house. two months is so far away, i want to start something by miself. but i cant seem to find any website that tells me about it, anyone ever heard of PFS???

Is the doctor you saw an Orthopaedic specialist, or general practioner?

How did your doctor assess the knee? Physical exam only? MRI?

P-F syndrome is also known as Chondromalacia. I suffered from it when recovering from my first ACL reconstruction (late 70's, medieval compared to today). Do the work, and be patient. The condition can worsen, making it difficult to climb stairs, and even walking after sitting for prolonged periods can be extremely painful. I suggest the MRI to help reveal any soft-tissue damage that may not be as easily diagnosed in a physical exam only.

[Toon Lad]

You need to spend about 15 minutes a day on a stationary bike, not much resistance. Do knee lifts on a gym machine, lots of reps at low weight. Lie down with a rolled towel under your knee and tighten your quads so that you press the towel down. About 30 of those. If you can't do anything else, do the bike. It's been a long time, but those are the things I remember.

[FredGavioes]

damn guys, im doing all this stuff. but my knee cant seem to recover, how long does it take? summer is here and i wannap lay soccer so bad. i can jog no problem, but if i run and make a suddenly turn to the right, i feel lil bit of pain on my knee. u guys think i should avoid soccer for now?

[supersoft]

your mileage may vary but my experience has not been good ...

played soccer and was a goalie in hockey too (may be relevant or not). after college i certainly slowed down and became more the weekend warrior. in summer 2002 i developed iliotibial band syndrome (ITBS) which is kinda like tendonitis. both knees. i mostly overcame it, tried to do more stretching and strengthening, but would have flare-ups occasionally.

then a bit over a year ago something became much more serious, without any acute injury. pain didn't go away after days, light weight work only made it worse, swelling, couldn't walk really. went for mri on both knees - the radiologist mentioned possible serious problem with the meniscus, which could lead to osteoarthritis, necrosis ... lots of bad sounding things.

but they have a way of saying every bad possible thing to cover their asses. when i went to the orthopedist - yes i got the mris first - he read the radiologist report and said baaaah. did his tests and says "you have chondromalacia aka pfs." surgery isn't indicated, go do physical therapy.

after months of that things were better but not good. i can play casual soccer for maybe 40 minutes before the knees go. then need four days to recover. i don't have full strength to kick the ball. i really don't even bother playing any more. i fear the radiologist was right.

the extra thing in my case, which may be in yours too, is a meniscus problem. my right medial meniscus (the inside one) looks to have largely worn away. not from any acute injury that caused a tear, just from ... time, body mechanics, lack of help from supporting muscles (esp VMO) to prevent the pounding of the joints.

for rehab, definitely DO NOT do leg extensions. even the bike is bad, with any kind of resistance it is terrible. i really don't know what injury toon lad was recovering from but it's not what they recommend for pfs. you don't want lots of reps. you maybe want a leg extension at low weight where you hold it for 20 seconds at a time. there are ways to strengthen the quads without sending all the weight through the patellar tendon like a leg extension does.

first question - are you bowlegged? i didn't know it but i am slightly. stand up, put your feet together, and see if there is a gap between the inside of your knees. for me it's about 1-1/2 inches. not huge but it may be a factor in causing more pressure and pain medially.

next question would be how old you are? i'm thirty which i'm told is quite young for my meniscus to have just worn out. if you've done all the strengthening but still have pain you may have a meniscus tear - surgery is probably the way to go. but if your meniscus is just wearing through then they can't do anything good ... yet.

nicky weaver of man city actually got a meniscus transplant from a corpse, after two years of unsuccessful rehabbing, just so he could get back into playing condition. i think he has to be on immuno-suppresant drugs (like with an organ transplant) so that his body doesn't reject it.

i've got some hopes pinned on stem cell research and biotechnology to come along with something to heal meniscus, but that's probably 10 years away, maybe. else i'm facing knee replacement in the future. those only last about 15-20 years, then you do it again. so i'm just inactive now, trying not to do more damage to the cartilage, trying to stall an eventual knee replacement.

i really hope my story doesn't ring too many bells. but if it does the future may suck.

[FredGavioes]

thanks man for your reply, i feel sorry for you, it sucks not being able to do something you love. that kid that watches all CL, Libertadores, plays only soccer on ps2, computer, play on the city's team. i am this kid.

since october i havent been the same.

about ur first question, i believe im not bowlegged, i just did ur test, and it shows normal. i dont feel pain all the time, only if i force my knee, i can feel something a little bit on the outside of my right knee. not something that i would screaming about, but you can tell it is not right. and whenever i stretch and bent my knee, i feel something like moving on the outside, i did the test with my left one and this didnt happened.


i am 22 years old, had this injury when i was 21. ive been doing rehab since march, doctor said that if my state dont change til 15 june, hes gonna take an mri, and see if there is a problem.

freecare sucks, it takes a longe time for you to have someone to help you.

[Toon Lad]

I had runner's knee, which I thought was the same as pfs. My kneecap basically slipped out of its track. I was running again in about 3 months. Sounds like you have something worse. Let us know what happens. Good luck.

[Martininho]

for rehab, definitely DO NOT do leg extensions. even the bike is bad, with any kind of resistance it is terrible. i really don't know what injury toon lad was recovering from but it's not what they recommend for pfs. you don't want lots of reps. you maybe want a leg extension at low weight where you hold it for 20 seconds at a time. there are ways to strengthen the quads without sending all the weight through the patellar tendon like a leg extension does.

i've got some hopes pinned on stem cell research and biotechnology to come along with something to heal meniscus, but that's probably 10 years away, maybe. else i'm facing knee replacement in the future. those only last about 15-20 years, then you do it again. so i'm just inactive now, trying not to do more damage to the cartilage, trying to stall an eventual knee replacement.

i really hope my story doesn't ring too many bells. but if it does the future may suck.

Some good news. First, I agree that one should avoid leg extensions as you would the plague. The tendency is for most people to work to full extension in order to fully work the muscle. Unfortunately, it also creates tremendous stress on the back of the kneecap, and can therefore lead to chondromalacia, tendonitis, etc. - A better routine is to use a combination of the following:

Squats - first, minimize or even eliminate sessions that train for strength (high weight, low reps). Instead, use a combination of static movements, like a Smith rack where you can safely spot yourself. I wouldn't recommend putting more than your body weight on the bar. Instead, focus on strict form and higher reps per set.

Squats II - using a free bar, do comparatively light weight for a high number of reps, with minimal rest between sets. If available, there are classes (bodypump, group power) that employ this kind of training for the overall body. Excellent for the aging athlete and/or one who has to deal with a history of injury.

Lunges - static and dynamic. Dynamic lunges should not only incorporate front and back (stepping forward/backward rather than straight up/down), but lateral movements as well with hand weights. These will engage the smaller muscle groups as the body attempts to maintain balance, and will help provide stability and your sense of balance (which goes away appallingly fast if not trained).

You may also try the lateral "slide boards", that simulate speed skating movements. Again, these also engage the smaller muscles due to the dynamic nature, and also provide aerobic training that is difficult to achieve with weight training.

Strict form is critical to success and avoiding injury (don't lock knees, don't sacrifice form to use excessive weight, use a mirror to provide visual feedback on correctness of form, etc.). Properly done, you can develop adequate strength without undue joint stress. Further these exercises develop power and muscle endurance, both of which tend to be more helpful for a footballer than raw strength.

On the medical front, improvements in imaging and surgical techniques are enabling surgeons to perform "microsurgeries" that provide small corrections to joint imbalances. Far less invasive, can provide excellent relief, and reduce the likelihood of later joint replacements.

Consider also the possibility of supplements, such as a mix of glucosamine, chondrytin, and MSM for joint support. I personally was able to reduce my use of NSAIDS (such as ibuprofen) by about 75%.

Cycling can also be helpful, but it's important not to use too high a gear ratio (I still tend to make that mistake), as the repetitive movement can cause tendonitis and aggravate already existing issues in the joint.

Good luck, don't give up, and please be patient with yourself (advice that I would have also found hard to accept at 20-21).

[Bolivianfuego]

I dont know if its similar or not, but i for the longest time thought i had tendonitis on my patella tendon, come to find out a couple months back after an MRI that i had torn it a little off the bone, thus the pain ive felt for like 2 years now! LOL


Finally got the surgery done 2 weeks ago, and i finally got strenth back when i tighten my thigh muscles as i used to feel pain and alot of the muscle has been gone as a result apparently. Maybe you got that?

[keane10]

My only suggestions are first check to see if you're flatfooted and need orthodics. That cured all of my problems. Second, to strengthen/stay in shape avoid weight bearing activities. Do a lot of bike riding.