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Author Topic: How to handle PFS pain flairs  (Read 1122 times)

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Offline reader278

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How to handle PFS pain flairs
« on: November 03, 2019, 08:49:55 PM »
For those with patellofemoral syndrome, how do you handle the inevitable pain flairs when they come on. Do you continue to go to work (ie. sitting all day), continue to exercise etc. Or do you rest until it goes away? Or something in between? I have a hard time knowing what to do during flairs. I don't want to rest altogether because being bed bound=loss of muscle mass and is just so depressing. What's the best strategy?

Offline Brandon123

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Re: How to handle PFS pain flairs
« Reply #1 on: November 04, 2019, 09:47:18 AM »
I probably have more things going on than patellofemoral syndrome, but my response to pain flairs is your "something in between"-alternative. That is, resting as much as I can, while still trying to go about my daily business to the extent that it is possible without creating even more pain/symptoms. Finding that balance is difficult but key.
RK sharp pain while running, diagnosis chondromalacia patellae 6/09
RK arthroscopic chondroplasty 9/09
RK rehab, recovery, 90% normal, started running again -> back to square one 5/15
RK diagnosis patellofemoral arthritis + LK diagnosis chondromalacia patellae 8/15 -> conservative treatment

Offline Dave33

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Re: How to handle PFS pain flairs
« Reply #2 on: November 05, 2019, 03:32:26 AM »
That's actually a great question. There's advocates on pretty much the polar opposite; some will say do as little as functionally possible, and some will advise doing as much as possible in the envelope of function.

What I generally have done for the last ten years, is do nothing for a day or two, get frustrated, then do too much, aggregate it further, get angry, depressed and completely sedentary for a month or two, and then start the cycle over again next flare up. I'd advise against this, heh.

I don't think there really is a right answer, it's mostly experimentation with so many unique variables in your injury as per type, location, etc. I'm not a pill popper by nature, but I'll generally take ibruprofen for 2-3 days during flareups, and it seems to help calm things down. I find that the mental state during these times are almost as difficult to manage as the physical.

good luck.


Offline SuspectDevice

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Re: How to handle PFS pain flairs
« Reply #3 on: December 28, 2019, 07:51:40 PM »
Depends on how you define PFS?

This entire issue of PFS has a major diagnostic weakness IMO, and that is the experts usually don't ask enough questions about the nature of the pain in the anterior knee.

If it is the Dr Scott Dye type of pain (loss of tissue homeostasis = chronic synovial inflammation = main symptom is a diffuse burning across front of knee, mostly under kneecap, but also a general aching and knee stiffness), which incidentally I think is massively under-diagnosed because the experts rarely ask enough about the type of pain you have then for me what works is:
    backing off what aggravates
    TENS machine for 45mins a night relaxing on the couch with legs out straight
    Ice for 15-20 mins
    If still bad, anti-inflam meds (used to be Celebrex but now just Advil/Nurofen)
    Sitting with knees out on a box under my desk at work, not bent
    Sitting on table and doing gentle knee swingers including 5mins before/after activity

If is is PFS caused by cartilage damage (mostly the cartilage on the back of the kneecap - chondromalacia patella), recognised by more of a sharp catching pain on certain movements, not the constant, diffuse, incredibly depressing burning then:

All of the above plus avoiding the movements which cause the sharp catching pain, esp stairs
« Last Edit: December 28, 2019, 07:55:31 PM by SuspectDevice »
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!
2020 - ride 3x/week, swim 2x/week, gym 2x/week, aiming to get back to short triathlons















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