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Author Topic: 18 Months of PFPS - Minimal Improvement  (Read 3409 times)

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Offline ddv33

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18 Months of PFPS - Minimal Improvement
« on: January 12, 2015, 09:18:31 PM »
This is a long post, but I wanted to get my experience with left knee pain out there.  Would love to get any perspectives, and just getting this written down may help me sort through the struggles I'm having. 

I am a 30 year-old male in San Francisco.

My Knee Pain Story

Summer 2013:
About 18 moths ago, I started experiencing left knee pain in the 1-2 days following athletic activities, which slowly increased.  This was during a period of time when I was participating in a number of sports/activities (recreational soccer, roller hockey, jogging, weights). 

I didn't do much to treat it the first 6 months (mistake), but I did somewhat reduce activity levels (no more jogging or soccer, but still roller hockey and weights). 

The knee doesn't significantly hurt while exercising, especially after warming it up. However, it progressed to having a lot of aching and stiffness afterward. Climbing and descending stairs will also hurt on days after activity. It is difficult to pinpoint the pain but it is generally middle of the knee under the patella.  The knee feels like it has more friction than the other one. Additionally, the knee often clicks, pops, or feels crunchy. 

The general soreness can be very distracting during the day, and the aching/hot/pressure sensation has kept me up many nights over the past 18 months. It is also uncomfortable to sit with my knee bent for more than a few minutes.  I feel like a 30 year old with a 60 year old knee.

Spring 2014:
I went to an orthopedic doctor, was prescribed with Patellofemoral Pain Syndrome, and referred to Physical Therapy.  I also got an MRI which was negative for structural damage (though they saw a minor Baker's cyst with fluid).

The Physical Therapist did a lot physical manipulations to "release adhesions" such as massage, cupping, and foam rolling.  Additionally, he had me doing quad and glute strengthening exercises.  He said I should continue playing roller hockey and doing some light jogging so I would "know where I am at" with my knee.

During this time (about 5 months) the condition didn't really worsen but also didn't improve.  It continued to hurt every night, and would feel inflamed in the days following activities.  I felt like I was in a perpetual cycle of irritating the joint and it never felt like I was healing.

October 2014:
Discouraged, last October ago I quit going to PT and found a different perspective on my condition.  I read "Save Yourself From Patellorfemoral Pain Syndrome" ebook, which promotes more rest and light exercises that don't irritate the joint.  I also quit participating in any sports or jogging, and haven't done these activities since.  I was very hopeful for this course of treatment, however the time commitment to healing is intimidating.

I rested my knee as much as possible for 3-4 weeks.  This included no knee loading exercise, avoiding stairs with the left leg, and trying to walk less than I used to.  I still walked 3,000-5,000 steps a day to get around in San Francisco.  The general aching pain seemed to reduce during this time, but never fully subsided.  After about 3 weeks, I (regrettably) went on a company hike that was fairly strenuous and this re-inflamed my knee in following days.  I felt like I was back to square one, only now my leg's muscles felt a bit weaker.   I was very frustrated and had trouble deciding whether I should go back to resting again, or try something else.

I went to another orthopedic doctor and took X-rays (negative), and he said I should strengthen my legs and do more PT after taking X-rays.  I started back on this strengthening path again and frequented the gym to do leg/hip strengthening (deadlift, kettlebells, squats, lunges).  I felt like maybe I should just get as strong as possible to mitigate my knee pain.

December 2014:
Not surprisingly, the pain/irritation increased following this period of weight training and PT exercise.  In December 2014, I read more online and became worried that I was just going to do more damage to make my condition permanent.  I read some materials from Dr. Scott Dye (cited in the Save Yourself ebook) and a blog called "Saving my Knees", and thought I would give the "resting" and "envelope of function" theory another try.  I started "resting" again on December 20. 

I also had an initial appointment with Dr. Dye, who had me get another MRI and Rosenberg X-Ray to see where I am at.  He also wants me to get a Bone Scan, which I am looking into how to do through my insurance.

It has been about 3.5 weeks since I started "resting" my knee again.  The only activity I use my knee for now is walking.  I avoid using my left leg for hills and stairs as much as possible.  I definitely feel like my left leg is now weaker than the right, but my hope is that this rest will help heal the joint first before slowly building back strength. 

At this point, the pain during resting and sitting with my knee bent is still there, thought slightly lessened.  I still have the clicking and "frictiony" feeling under my kneecap.  I don't know how much longer I should keep resting and introducing gentle exercises.  In the back of my mind, I fear there is too much "junk" in my knee for it to ever heal without surgery. But then I read surgery has poor outcomes. 

My next planned step is to get another appointment with Dr Dye, so he can review my most recent X-ray and MRI and advise how to proceed.   I may also get a bone scan that he requested if I can manage this through my insurance.

Overall I still have little sense for the outlook and what is truly the best treatment.  I am still optimistic, but do worry if I will ever be able participate in athletic sports or have pain-free days in my knee again.

Things I am currently doing:
Resting: Avoiding load bearing movements with knee bent, including stairs.
Ice: 1-2 times a day
Stretching: Hips, hamstrings, quads
Light exercises: Clamshells, straight leg raises, walking
Foam Rolling

Offline SuspectDevice

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Re: 18 Months of PFPS - Minimal Improvement
« Reply #1 on: January 19, 2015, 08:39:28 PM »
Your symptoms & experiences to date sound almost identical to mine - except mine has been going on for approaching 3 years, and is in both knees.

I'm keen to hear how you go with Dr Dye and what the various x-rays show.  Keep posting on your progress as it may have useful information for many of us on here.

L Medial menisectomy 2012
PFPS both knees 2012-2017
Pre-CRPS diagnosed 2014 (I think this was crap)
2017 - 90+% cured via Dr Dye's research
2018 - MTB crash, busted collarbone & ribs - easy compared to knees!
2021 - ride 3x/week, swim 2x/week, gym 2x/week, short runs 2x/week, back to short races

Offline torpspot

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Re: 18 Months of PFPS - Minimal Improvement
« Reply #2 on: April 14, 2015, 08:15:36 AM »
Our pain is identical. Please keep the forum posted on your experience. Best of luck to you!

Offline Silkncardcrafts

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Re: 18 Months of PFPS - Minimal Improvement
« Reply #3 on: April 14, 2015, 09:15:39 AM »
Don't completely rest. Gentle exercise such as riding on an exercise bike is one of the best exercises for PF problems.

I'd ask about getting some CT scans too.
11/1996 - RK LR
07/1997 - LK LR
11/1998 - LK MPFL Reco
12/2005 - RK LR Repair
07/2006 - LK MPFL Repair
11/2006 - LK LR Repair
22/05/08 - LK Trochleoplasty
11/02/10 - RK Trochleoplasty
07/03/11 - RK Chrondroplasty

Offline willrunagain

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Re: 18 Months of PFPS - Minimal Improvement
« Reply #4 on: April 15, 2015, 05:10:09 PM »
I was misdiagnosed with runner's knee (pfps) and after 7 months I sought a second opinion.  I had an MRI at 4 months which read "no chondromalacia."  Boy was that radiologist wrong.  My new OS told me upon 15 minutes of physical examination that I had cartilage damage on the back of my kneecap.  I agreed to a scope and sure enough, there was a 2cm pothole in the cartilage behind my patella. 

MRI's are notoriously bad at identifying articular cartilage damage.  If you have been battling with pfps for that long chances are you have permanent cartilage damage somewhere in your knee joint.  The best way to find out is to get it scoped.  There are options to repair articular cartilage, so it is not necessarily an end to an active lifestyle, but it does require an extensive surgery (ie oats, carticel, denovo).

Offline Louisamith

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Re: 18 Months of PFPS - Minimal Improvement
« Reply #5 on: November 12, 2021, 10:49:19 PM »
Do you have any updates on this? I have these exact symptoms