Advertisement - Hide this advert





Author Topic: Severe PFPS - can't straighten knee?  (Read 389 times)

0 Members and 1 Guest are viewing this topic.

Offline Bluebird87

  • MICROgeek (<20 posts)
  • *
  • Posts: 3
  • Liked: 0
Severe PFPS - can't straighten knee?
« on: September 12, 2018, 03:58:37 AM »
Hi all,

I have been experiencing debilitating bilateral knee pain for about 6 weeks. I have not been able to straighten my right knee while bearing weight (walking or standing), and the right quad muscle is barely activating. I'm 30 years old.

About 7 weeks ago, I noticed my knees were becoming progressively more sore each day with walking (I typically walk 14k steps per day). By the end of the week, the pain became sharp and prevented me from walking or standing comfortably. After resting for a week with no improvement, I went to a sports orthopedist who took x-rays (looked fine) and diagnosed me with PFPS. Told me it'll clear up in 6 weeks with physical therapy.

I went back to work still in pain, and by the end of the day, I could not bear any weight without constant sharp pain in both knees. I went back to the orthopedist and he sent me for an MRI of the right knee. It only showed mild lateral tilt and mild chondromalacia. He stuck with his diagnosis of PFPS and told me to start physical therapy.

I went for the physical therapy evaluation where they tested my strength. They asked me to do a straight leg raise. I could do it on my left leg with a little discomfort. My right leg however did not even come up off the table and it caused a sharp pain. The therapist was a little shocked and said he has 80 year old women who come in and can at least lift their leg off the table.

I went back to physical therapy for my first session a couple of days later. The therapist who did my evaluation was not there. Another therapist and an assistant told me to stretch and had me do exercises from their cookie-cutter runner's knee plan. Stupidly, I just tried to follow along. I told them each exercise was causing pain, and they told me to just try. They had me balancing on 1 leg for 10 seconds, 10 reps on each leg. This has now resulted in sharp medial knee pain which I didn't have before!

I cancelled my next PT appointment and have been resting at home for the past 3 weeks. I am taking fewer and fewer steps per day (between 1k and 2k), and the pain is not improving (and might actually be getting worse). It seems like there is some inflammation, but NSAIDs aren't helping and blood test is normal. I'm going to another orthopedist next week for a second opinion, but I have don't have much hope.

Has anyone with PFPS been unable to straighten their knee when weight-bearing? Has anyone been physically unable to do a straight leg raise? Even trying to do a quad set - I can see my quad muscles tighten on the left leg, but on the right leg, it looks like nothing is happening (and it hurts a lot). The left leg has now been getting worse, probably from overcompensating for my right. I'm worried and feel helpless.

Thank you in advance for any advice/insight.

Offline BusterCatLegs

  • Regular Poster
  • ***
  • Posts: 72
  • Liked: 4
Re: Severe PFPS - can't straighten knee?
« Reply #1 on: September 13, 2018, 11:22:14 PM »
Very sorry to hear this. It's a very familiar story for many of us. It is possible that you have fat pad impingement/irritation which I have had along with synovitis. Quads are also inhibited when you have knee pain so that may be causing issues as well.

 I suggest as a first step starting to read a lot of the threads here on this site. Check out the information on Dr. Dye on this site. Suspectdevice has a lot of great advice in my opinion.


I'd seriously reconsider going to PT right now. It could do more damage than good. At least take a look at the top threads on this particular section of the forum....

The big debate is that many doctors recommend PT but it has not helped a large group of us. Dr. Dye recommends rest basically. If I were you I would start icing 3 times a day and immediately go on an NSAID long term even though you may not notice that it is helping.

I've been dealing with pfps for about 6 months and although progress has been ultra slow it is getting better. I can now straighten my legs usually without sharp pain coming from fat pad region. Finally!

Offline BusterCatLegs

  • Regular Poster
  • ***
  • Posts: 72
  • Liked: 4
Re: Severe PFPS - can't straighten knee?
« Reply #2 on: September 13, 2018, 11:23:42 PM »
When you say you can't lift your one leg at all is this due to knee pain or physically you can't make it happen?

Offline Bluebird87

  • MICROgeek (<20 posts)
  • *
  • Posts: 3
  • Liked: 0
Re: Severe PFPS - can't straighten knee?
« Reply #3 on: September 14, 2018, 12:45:40 AM »
Thank you so much for the reply. I have done a little research on Dr. Dye's theories after reading some helpful threads on this forum.

Because I've been "resting" (1k-2k steps/day) for weeks without improvement, my family keeps telling me that resting is not working. But based on Dr. Dye's information, it would seem that I'm not resting enough. It's a tough decision to basically go on bedrest and not know if things will improve. And wonder if my legs will still know how to work! I worry about developing RSD (I have a bad habit of googling too much). It's so frustrating not knowing what the right answer is, and I think this is the conundrum we're all facing.

With the straight leg raise, when I try tightening the quad and lifting the leg, the sharp pain under my kneecap becomes very severe. Sitting upright on the floor, I think I could physically lift the leg an inch or two for a second, but I'd be feeling the effects of it for days. At my PT evaluation, he had me try it while laying down, and it felt impossible. Maybe because my core is weak too?

I'm glad to hear you're on an upward trend! You mentioned you can straighten your legs now without sharp pain. Do you mean standing or stretching your legs out in front of you? I've always had tight hamstrings, and every day I try to sit on the floor and stretch them for a minute, but I feel like that might be causing pain too. When you rested, did you stop stretching as well?

Thanks again for the advice and for sharing your story. I find it very helpful to hear what others are experiencing and which strategies have been effective for them. I hope I can figure out what's effective for me and share it too!

Offline Strongknees

  • MINIgeek (20-50 posts)
  • **
  • Posts: 21
  • Liked: 3
Re: Severe PFPS - can't straighten knee?
« Reply #4 on: October 09, 2018, 11:24:21 PM »
Hi Bluebird,

Anybupdates on your progress? I too have PFPS, probably fat lad impongement!

Offline Bluebird87

  • MICROgeek (<20 posts)
  • *
  • Posts: 3
  • Liked: 0
Re: Severe PFPS - can't straighten knee?
« Reply #5 on: October 19, 2018, 04:03:19 AM »
Hi Strongknees,

Unfortunately, I haven't made much progress. Within the last week or two, I'm noticing a little bit of improvement. But I'm still basically house-bound, only able to walk around 2,000 steps a day with some pain. Right knee still doesn't straighten when walking.

About a month ago, I had a second opinion with another orthopedist, who referred me to a rheumatologist. The rheumatologist ordered pretty much every blood test and an MRI with contrast (hoping it might show something that the previous MRI without contrast didn't show). Once again, the MRI only showed mild chondromalacia. The MRI report stated no synovitis and no effusion. Every blood test came back negative. She gave me a 6-day oral corticosteroid pack to try (in case it was being caused by some kind of virus), but I don't think it had much of an impact.

I went back to the orthopedist this week to follow-up and let him know that it was not anything rheumatic. He reviewed the MRI with contrast and said he saw that the cartilage was inflamed on the medial side of the kneecap, which is exactly where I'm feeling the sharp pain. He was surprised that I haven't been able to go to work (long commute, standing on public transportation) and I haven't been able to drive (extremely painful to press on the brakes with right knee). He seemed very genuine and wasn't doubting what I was saying, but said that what the MRI shows isn't matching up with the severity of the symptoms I'm experiencing. He wants me to try 4 weeks of physical therapy and Celebrex. If there is no improvement, he would do cortisone injections. He was very optimistic about my prognosis, but we'll see.

Last week, for a stretch of about 4 days, I was walking noticeably better and without nearly as much pain. I still couldn't completely straighten the right knee, and I could still only muster about 2,500 steps though. Nonetheless, it was a little shocking and I thought maybe I was finally headed in the right direction. But then I was working on something stressful and didn't notice that for about 15 minutes, I was nervously bouncing my legs up and down. So the next morning they were feeling a bit worse, and then later that day I had the orthopedist appointment where they manipulated my knees. So now I seem to have lost some of that progress. The improvement was probably just a function of time/rest, but it also coincided with me beginning to take liquid turmeric. Could be a coincidence (since nothing has worked for me so far - meloxicam, glucosamine, chondroitin), but just wanted to throw it out there.

Even though I don't have much hope that physical therapy will improve anything, I'm feeling desperate at this point and like I have nothing to lose. I will be more assertive this time in letting them know when something is painful or if I don't think I can do it. I would also like them to try kinesio taping. I need to go back to work. I feel like life is just passing me by, being trapped in my house alone and not able to walk or stand without pain (sometimes my "walking" is more like shuffling).

BusterCatLegs - I'm so sorry I never replied to your message! I truly appreciate your willingness to share and help me :) Have to do my 20 posts.

Offline Strongknees

  • MINIgeek (20-50 posts)
  • **
  • Posts: 21
  • Liked: 3
Re: Severe PFPS - can't straighten knee?
« Reply #6 on: October 19, 2018, 10:41:49 AM »
Hi Bluebird, I am sorry to her you haven't made much progress.
I think at the beginning it will be a lot of trial and error to see what works for you.
You don't mention Ice? I feel ice helps, although don't do any exercise afterwards because you might not feel if it is hurting you or not.
I am sending you a PM as well.
Be strong.















support