The SPECIALIST'S OFFICE => Overuse problems of the knee (except Osgood Schlatter's) => Topic started by: countrygirl88 on April 30, 2008, 02:28:57 AM

Title: PFS
Post by: countrygirl88 on April 30, 2008, 02:28:57 AM
i posted this in the patellofemoral joint section, but i think it may fit better in here:

Hi, I'm 19 and a college student. I was diagnosed with patellofemoral pain syndrome back in january. problems started after ice skating back on december 18th. I have been ice skating daily since last year, however back in november i sprained my ankle, therefore i was only skating once a week. I also played roller hockey and i fell on my right knee a month before. the day after ice skating, i could not move my right knee, it was pretty much locked. After a couple weeks, my left knee started hurting as well. I went to see 4 different people about this. The health center on campus told me it was PFS, my chiropractor said there might be scar tissue, my doctor said there was fluid in there, and my orthopedic doctor took x-rays and determined that it was PFS. He gave me Zorprin (800mg aspirin) and told me to work up to doing 200 straight leg lifts in a row on both legs. The Zorprin worked for the pain for about 2 weeks, then all it was doing was making me really tired. So he gave me 600mg ibuprofin and, again, told me to get up to 200 leg lifts and come back in 6 weeks. However, the ibuprofin does nothing for the pain. They say doing non-impact cardio, like the bike and elliptical should be ok, but my knees swell a bit and turn red when i do. My next appointment with him is in june, which will make it 6 months. The pain hasn't really gotten better, it's really hard to walk up stairs (i basically have to lean on the railing and hobble up). He hasn't mentioned and MRI or anything, he thinks that my quads are just weak. However, my kneecaps have always tracked to the outside when i bend them, no matter how strong my quads. I think next time I go see him I'm going to ask him if there's anything else he can do...any suggestions? I'm really not keen on surgery, but if it'll help, that's great...I'm an active person, and I haven't been able to do anything these past 4 months because of the pain. The pain used to be all over and under my knee, but now it's mainly on the outsides, as if there's a tight muscle there (except, painful). I'm just kind of frustrated with my doctor, that he hasn't given me an MRI and he doesn't think physical therapy will help, just the leg lifts. Also, I don't think i will ever be able to get up to 200 leg lifts, it hurts just above my knee to do them.
Sorry for such a long post, but it's kind of a complicated thing, and I'm not sure what to do.

Title: Re: PFS
Post by: TwoBadKneesUSA on April 30, 2008, 02:47:24 AM

It sounds like you are pretty frusterated.  Unfortunately patellafemoral pain syndrome really doesn't tell you much more than you already know.  It hurts around the kneecap.  If your knees get hot after exercise, they are likely inflammed.  Try to ice them for 15-20 minutes.  My kneecaps have always tracked to the outside too.  I now have patellar arthritis that is only on the lateral (toward the outside) side.  Leg lifts are good, but you may have a deficient VMO (part of the quad muscles toward the inner part of your thigh).  Mine are and no matter how hard I try to work them and get them strong, they just don't hold the kneecap in place.  You may want to go see a different OS.  I know that MRI and x-ray won't really show much unless your kneecaps are really tilted.  It is a frusterating problem.  Use the RICE method and keep your quads, hamstrings, hip and glute muscles strong.  It can help.  Good luck.

I've had three lateral release sugeries to help correct the tightness and pull on the kneecap.  Unfortunately the last one did not work as well as it was hoped.  In any case see if you can try physical therapy.  Sometimes getting the correct instruction and muscles training will help the pain.


(I've been dealing with this for almost 25 years and it's only been the last 5 that are driving me nuts.)
Title: Re: PFS
Post by: countrygirl88 on April 30, 2008, 03:00:04 AM
Wow, to me, 25 years is a looong time to have this. 4 1/2 months is long to me, but I'm a rather active person, and I'd like to get back to what I normally do as soon as possible...Apparently the x-ray he took showed enough evidence of PFS. I did go to physical therapy once a couple weeks after i hurt my knee. she gave me a list of exercises to do to strengthen/stretch my quads and hamstrings, and told me to do them 3x a day...I did them as she told me, and it was actually after a couple weeks of that that my left knee started hurting. I don't know if the exercises caused my left knee to hurt or if it was just overcompensation. I was thinking about going back to that physical therapist once summer starts, maybe going regularily will help? Thanks for the advice. I've been asking my friends and family to bend their knees so I can compare theirs to mine, haha
Title: Re: PFS
Post by: TwoBadKneesUSA on May 01, 2008, 06:00:33 PM

It might not hurt to consult with a therapist.  There are some exercises that can make the pain worse if they are not done correctly.  I personally refuse to do short arc quad sets (this is the one where you put a towel under the knee and straighted it out).  Those hit the most painful spot for me.  I don't do squats too much either.  It would be a good idea to make sure you are doing them all correctly.

I was a fairly active person too, until I got a job with a looooong commute. Then things kind of slowed way down for me.  I try to do what I can that will not make the pain worse, but I keep the knee moving. 

At this point I don't compare anymore ;D.  My kneecaps don't even match each other anymore.  I can say that at least they do still work (sort of).

Take care, good luck.

Title: Re: PFS
Post by: countrygirl88 on May 02, 2008, 06:27:04 PM
I'm starting to think that it's something else, though....the type and place of pain has changed, and it's near impossible to walk up stairs, i always thing my knees are going to give out (going up stairs used to be fine, and it was going downstairs that killed, but now its the opposite). When i go to my appointment in june i'm going to ask for an mri (or if there's anything else he can do for it), and depending on how it goes, i may find another doctor to see
Title: Re: PFS
Post by: TwoBadKneesUSA on May 02, 2008, 06:28:39 PM
A fresh set of eyes may not be a bad idea.  Take care.
Title: Re: PFS
Post by: countrygirl88 on May 11, 2008, 04:04:42 PM
i've started to notice that when i'm on my feet for a while (knee supports or no knee supports), the next day it feels like i pulled both my hamstrings...It's happened twice already. I'm thinking maybe they're just tight, since i havent been to the gym at all (even ellipticals and the exercise bike make them act up), and i havent been stretching at all. Would stretching them help, or could it be something else?
Title: Re: PFS
Post by: TwoBadKneesUSA on May 12, 2008, 02:54:53 PM
It's quite possible the hamstrings are tight.  Streach them carefully.  Mine get sore if I don't streach them regularly.
Title: Re: PFS
Post by: countrygirl88 on May 13, 2008, 12:44:37 AM
alright, thanks...I'll post here again once I go for my next OS appt and find out more.

Also, whoever's e-mail is coto2, you e-mailed me and I tried replying twice, but it sent it back saying it couldnt deliver it.
Title: Re: PFS
Post by: countrygirl88 on May 26, 2008, 12:22:43 PM
well, after my knee sleeves that I had been wearing didn't seem to be helping all that much, I went to Dick's to look around for something else, and I found patella straps that said they are designed to relieve pain due to PFS and overuse I bought them, put them on, and once they were adjusted the right way, there was pretty much no pain yay! I might see if I can do some running or light biking with these, since it seems like they take the pressure off your knees.
I'm also going to start going to a physical therapist this week, so I'm going to talk to her about this. Then I just gotta wait till the 13th for my appointment to see if he does anything or if I'm gonna have to go see another doctor. Apparently the one I'm going to now specializes in knee and hip replacements, so he's gotta know something about knees, right? But I know there's another OS at the same place who specializes in knees, shoulders, ankles and feet, and also in sports medicine, so I'm thinking he might know more about my specific injury. Well, we'll see
Title: Re: PFS
Post by: countrygirl88 on May 28, 2008, 11:06:02 PM
i don't know if people read this, but i have another update

went to my PT today, and she said i'll be able to start once i get a referral from my GP, and that shouldn't take long. I then told her about my OS, and even she thinks it's strange that he said PT won't help and that he didn't give me an MRI!
She gave me the names and numbers of a few good Orthopaedic doctors who specialize in sports medicine, so i'm going to make an appt asap...hopefully i can get this all sorted out!
i'm sure i've mentioned this already, but i just have this feeling that it's not PFS anymore...
this morning my knees, especially the left one were really hurting, and it was on the outsides and insides of them. i don't know why, i didn't do much waking yesterday..however, i did have my knees slightly bent at one point and i was moving my kneecaps and they were making a grinding sound. maybe that irritated them? my dog also ran full speed into my left knee friday, hitting it with her shoulder, but i don't think that's what caused it.
oh well, i'll update later, hopefully after my new OS appt!
Title: Re: PFS
Post by: believev on May 29, 2008, 02:44:39 PM
hi it sounds like u are having something similar to what i had.  The braces from sporting good store helped me for a bit then i started to get these aches all around my knee.  I think i shifted the way i walk or something which caused the slight discomfort that lead up to minor chrondomalacia or something,

ur grinding no ur knee sounds like chrondomalacia.  its not that big of a deal if it is, PT and Ice should fix most of it.
just remember knee takes months to heal not weeks

goodl uck
Title: Re: PFS
Post by: countrygirl88 on May 29, 2008, 03:08:33 PM
yeah, i don't know what to think anymore
i've got an appt with the new OS june 25th, which is a while away, but i'm going to my old OS appt that's scheduled for the 13th and if he doesn't do anything i'm just gonna ask for my x-rays and medical records to take to this new guy
and i'm trying not to be too impatient, but as of the 18th it will have been 6 months that my knees have been hurting, and it's frustrating to think that if i had started PT a while ago (aka if my OS had suggested PT), my knees could be better by now and what might be chondromalacia could have been prevented
but i'm starting PT tomorrow i think, so hopefully that will help
Title: Re: PFS
Post by: fawn2388 on June 01, 2008, 04:25:59 AM
Try having 8 plus years of constant pain in both knees. Stop running all together, it kills your knees. Really, just stop all activity for a while. I have to wait 3 months to see a detorotational specialist - if you hadn't attempted to continue to run just because your knee was feeling 'ok' would of equalivical good of PT. BTW Chondromalacia just doesn't develop over night, it's a long time before it does. And more than 6 months.
Title: Re: PFS
Post by: countrygirl88 on June 01, 2008, 05:07:56 AM
thanks for the advice, and yeah 8 years is a long time...let's just say i'm not the most patient person in the world...guess that comes with time...i've also never had something this bad that's kept me from normal activities for this long...a couple weeks used to be a long time for me
i'm not a runner, thank god, and i havent been on an elliptical or exercise bike since feburary
i haven't really been doing anything for the past few months, however i just started work, where i'm on my feet 8 hours a day...for now i'm only working 3 days a week, but in a few weeks it'll be bumped up to 5 days...i realize that i need to rest them, but i really need this job for gas, groceries, etc, so until it becomes unbearable i'm just gonna have to tough it out...if it's slow i can sit on a stool, which is a plus
my appt with my current OS is before i'll start working full-time, so we'll see
i'm hoping that PT will get rid of it, but the big question is, will it get rid of it permanently and i'll be able to go back to sports or will this be something that will flare up again once i stop PT and return to sports? guess there's no real way of knowing
but like i said, i know many people on here have had problems for way longer than me, i'm just not used to absolutely not being able to do stuff (normally i'd just tough out the pain)...i'm just new to this

oh i just read the post where i said i'd try running...thinking about that now, i don't think i'd get very far even if i tried...same with biking....guess i was feeling a little too hopeful after getting the straps
Title: Re: PFS
Post by: fawn2388 on June 01, 2008, 07:56:49 AM
I was working 12 hour shifts til I broke my left patella. And I was like 1 1/2 months PO right knee

I pay for, college, gas, car insurance, and everything else... in one of the most expensive states... Mass. If you want to know patient trying adding ankle twists in. I've come the sumrise that I can't so sports... at 20 years old. PFS just has flairs... I've had maltracking issues inmy left knee for a really long time and it has good tiems and bad times... you kinda gotta learn to roll to punches as I've learned the real hard way.
Title: Re: PFS
Post by: countrygirl88 on June 01, 2008, 02:38:13 PM
wow, that really sucks
i'm hoping for the best, but like you said, i guess i should prepare for the worst
i hear swimming's a good non-impact exercise for your knees, but i'm thinking i'd have to stick to the front crawl, since it seems like bending my knees repeatedly, no matter how much weight on them, irritates them
have you tried swimming? if so, does it help (or at least provide exercise)?
Title: Re: PFS
Post by: fawn2388 on June 01, 2008, 06:31:07 PM
PFS goes away with rest... believe me. And I did for like 2 weeks but than killed my left knee.
Title: Re: PFS
Post by: countrygirl88 on June 05, 2008, 04:36:19 PM
well i went to my first PT appt yesterday, and she said i have pretty much no quad muscles and that it will take a while to build them up again
i'm still gonna see if i can get an MRI, just to rule anything else out, but if that's my only problem, im not too worried
Title: Re: PFS
Post by: TwoBadKneesUSA on June 05, 2008, 05:00:36 PM
Hey glad you got to PT and have something you can do about the problem.  I know if your quads are weak it makes it more likely for your kneecaps to maltrack.  I will say you need to be very diligent about the PT at home as well as at your appointments.

Swimming is good for you but there is one stroke they say folks with knee pain should not do, but I cannot remember it. 

I don't think it will hurt to get an MRI, but it may not show much of anything.  It did not show my chrondromalacia at all.

Good luck.
Title: Re: PFS
Post by: fawn2388 on June 06, 2008, 01:34:19 AM
Weak quads is your answer. That causes maltracking issues.
Title: Re: PFS
Post by: countrygirl88 on June 26, 2008, 02:24:30 PM
well, just thought i'd write an update
started PT at the beginning of june, going twice a week...starting yesterday i'm done in her rooms (when i'd have to make appts. and pay more) and i'm just in her gym now and i can go whenever i want.

i noticed a real improvement in the first week, and they're getting better every week. They aren't 100% yet, but i didn't expect that to happen very soon. i was actually surprised at how fast i saw improvement, since my PT said it could take up to 6 months.

i've joined a real gym, so i do the bike, treadmill, and some of the machines there at the weights she told me...hopefully they'll be good enough at the end of summer that i can just go to the gym at school and keep the strength up...but if worse comes to worse, i can just find a PT out there.

thanks for your comments everyone, and while i doubt this is the end of my knee problems, i sure won't take my knees for granted anymore
Title: Re: PFS
Post by: TwoBadKneesUSA on June 26, 2008, 04:03:03 PM
Hey there!

Glad the PT is working out for you.  Keep it up!

Title: Re: PFS
Post by: countrygirl88 on June 26, 2008, 04:20:06 PM

i forgot to mention, i went to my OS on the 13th, and i told him that my knees had been getting worse, but when i came home from school i started PT and it was really helping. well then he gave me a therapy order to continue PT.

but see, the funny thing is, it was my pediatrician who gave me the referral to OS was the one against PT. My mom says he was covering his a**, especially since he's a really good OS in the area. i still think i went to the wrong OS here, though. the one i was going to specializes in knee and hip replacements. by the time i realized that there was another doctor there who specializes in knees and sports medicine, it was too late. oh well, i just have another follow-up appt in july, and then if i have any more problems, i'm finding another doctor
Title: Re: PFS
Post by: fawn2388 on June 28, 2008, 03:17:46 AM
Weak or unbalanced quads does that, PT does work a lot of wonders, and I think you'll just fine.