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Quote from: kawi_girl on February 22, 2020, 05:50:35 PMHello! Thanks for your reply and I’m sorry about your struggles. Here is an update on my condition.So, the flare subsided after three days, and then started to feel a bit better. Shortly after that I had 4 days where I truly thought the injection had helped, yet then went right back to how I was before that.Currently, the right knee is more sore, ranging from a ‘full’ feeling with an inflamed feeling in the medial area, to a deep ache during flexing while weight bearing. The left knee (no injection) has slightly improved. This COULD be due to a new physio program I started at the end of January. Very conservative, and anything that hurts, even minimally, I say no to.I am starting to believe that the key to recovery is having a good PT that understands the envelope of function (yes I agree with dr. Dye) and you as a patient need to learn lots about knee function and give lots of feedback. Do NOT blindly trust anyone!If I take it easy, ice for 20 min 3times a day I can calm the right knee down again. Gentle yet short FAST walks seem ok (I still have to experiment on the length, I’m thinking start with 3 to 5 minutes, hoping to be able to try for 3 times a day, resting in between as a baseline)The latest news is I have decided to take 2 months of work to tackle this problem head on and with as much dedication as I can. This will start in March, I have one week left of work to go. PT work right now involve foam rolling, straight leg exercises, some stretches and a wall squat of maybe 15 to 20%, with a band, light loading yet no pain.I have a feeling it’s going to be a long journey....Yup, that's right. It is a long journey. I thought I was going to have to live with it forever, but thankfully I'm a lot better now after 7yrs.After 2 previous attempts to do the short local triathlons over the past 2 seasons which ended with bad flares, it's 3rd time lucky as I did the local race with no major repercussions last weekend (took me 70mins, which is 12mins slower than my best when I was about 45 just before this knee nightmare started, but I'll take it given I've only done about 25% of the training I once did this past year).Got 2nd place LOL! Not bad for a 56yo, and I was tussling with a 20-something year old, who only pipped me by 8 seconds (OK the really fast guy who would have beaten us both by 10mins got a flat tyre ). We exchanged places on the bike 4 times, and 2 times on the run, which made it the most fun race I've ever done.TBH, I only went at about 90-95% intensity as I didn't want to kill myself, but it was a big step forward. Still got a few knee tingles after, but nothing too drastic.
Hello! Thanks for your reply and I’m sorry about your struggles. Here is an update on my condition.So, the flare subsided after three days, and then started to feel a bit better. Shortly after that I had 4 days where I truly thought the injection had helped, yet then went right back to how I was before that.Currently, the right knee is more sore, ranging from a ‘full’ feeling with an inflamed feeling in the medial area, to a deep ache during flexing while weight bearing. The left knee (no injection) has slightly improved. This COULD be due to a new physio program I started at the end of January. Very conservative, and anything that hurts, even minimally, I say no to.I am starting to believe that the key to recovery is having a good PT that understands the envelope of function (yes I agree with dr. Dye) and you as a patient need to learn lots about knee function and give lots of feedback. Do NOT blindly trust anyone!If I take it easy, ice for 20 min 3times a day I can calm the right knee down again. Gentle yet short FAST walks seem ok (I still have to experiment on the length, I’m thinking start with 3 to 5 minutes, hoping to be able to try for 3 times a day, resting in between as a baseline)The latest news is I have decided to take 2 months of work to tackle this problem head on and with as much dedication as I can. This will start in March, I have one week left of work to go. PT work right now involve foam rolling, straight leg exercises, some stretches and a wall squat of maybe 15 to 20%, with a band, light loading yet no pain.I have a feeling it’s going to be a long journey....
Quote from: SuspectDevice on February 24, 2020, 04:22:41 AMQuote from: kawi_girl on February 22, 2020, 05:50:35 PMHello! Thanks for your reply and I’m sorry about your struggles. Here is an update on my condition.So, the flare subsided after three days, and then started to feel a bit better. Shortly after that I had 4 days where I truly thought the injection had helped, yet then went right back to how I was before that.Currently, the right knee is more sore, ranging from a ‘full’ feeling with an inflamed feeling in the medial area, to a deep ache during flexing while weight bearing. The left knee (no injection) has slightly improved. This COULD be due to a new physio program I started at the end of January. Very conservative, and anything that hurts, even minimally, I say no to.I am starting to believe that the key to recovery is having a good PT that understands the envelope of function (yes I agree with dr. Dye) and you as a patient need to learn lots about knee function and give lots of feedback. Do NOT blindly trust anyone!If I take it easy, ice for 20 min 3times a day I can calm the right knee down again. Gentle yet short FAST walks seem ok (I still have to experiment on the length, I’m thinking start with 3 to 5 minutes, hoping to be able to try for 3 times a day, resting in between as a baseline)The latest news is I have decided to take 2 months of work to tackle this problem head on and with as much dedication as I can. This will start in March, I have one week left of work to go. PT work right now involve foam rolling, straight leg exercises, some stretches and a wall squat of maybe 15 to 20%, with a band, light loading yet no pain.I have a feeling it’s going to be a long journey....Yup, that's right. It is a long journey. I thought I was going to have to live with it forever, but thankfully I'm a lot better now after 7yrs.After 2 previous attempts to do the short local triathlons over the past 2 seasons which ended with bad flares, it's 3rd time lucky as I did the local race with no major repercussions last weekend (took me 70mins, which is 12mins slower than my best when I was about 45 just before this knee nightmare started, but I'll take it given I've only done about 25% of the training I once did this past year).Got 2nd place LOL! Not bad for a 56yo, and I was tussling with a 20-something year old, who only pipped me by 8 seconds (OK the really fast guy who would have beaten us both by 10mins got a flat tyre ). We exchanged places on the bike 4 times, and 2 times on the run, which made it the most fun race I've ever done.TBH, I only went at about 90-95% intensity as I didn't want to kill myself, but it was a big step forward. Still got a few knee tingles after, but nothing too drastic.It took 7 years for you to get better?? Then it's going to be a very long journey for me.I have been struggling with this for past 6 months and knee pain throughout the day and night. What helps you in your case to get better? I am going to PT for past 4 months. Doing strengthening and stretching exercises. Started foam rolling 2 days back. Did 3 sessions of aggressive dry needling and one needling session for scar tissue in the same knee. PT said I need a couple more dry needling sessions.I don't know how to proceed further to get better. I get the burning pain right above the knee and lateral side. It burns whenever I bend the knee or stretch my legs straight. So it's difficult for me to sit down and lie down. It's 3 am here and am up because of the pain. I have to move around and sleep back again. I do ice my knee sometimes. Not everyday. I don't need a magical thing to work on, but is would be great if I really know what's going on and what should be done. PT and the doctors also not sure and telling me to focus on strengthening. Since I didn't injure anywhere, they say I got the pain and patella maltracking because of weak muscles. That causes some inflammation in my knee now. I have even changed to a new proper fitting shoe now. I was wearing an unfitted shoe and walked with that for a month for 2to 3 miles a day. After that, the burning pain started. It's the same level of pain till today. It's been more than 6 months.What should be the next best step to do?
Quote from: Userhere123 on February 24, 2020, 09:25:01 AMQuote from: SuspectDevice on February 24, 2020, 04:22:41 AMQuote from: kawi_girl on February 22, 2020, 05:50:35 PMHello! Thanks for your reply and I’m sorry about your struggles. Here is an update on my condition.So, the flare subsided after three days, and then started to feel a bit better. Shortly after that I had 4 days where I truly thought the injection had helped, yet then went right back to how I was before that.Currently, the right knee is more sore, ranging from a ‘full’ feeling with an inflamed feeling in the medial area, to a deep ache during flexing while weight bearing. The left knee (no injection) has slightly improved. This COULD be due to a new physio program I started at the end of January. Very conservative, and anything that hurts, even minimally, I say no to.I am starting to believe that the key to recovery is having a good PT that understands the envelope of function (yes I agree with dr. Dye) and you as a patient need to learn lots about knee function and give lots of feedback. Do NOT blindly trust anyone!If I take it easy, ice for 20 min 3times a day I can calm the right knee down again. Gentle yet short FAST walks seem ok (I still have to experiment on the length, I’m thinking start with 3 to 5 minutes, hoping to be able to try for 3 times a day, resting in between as a baseline)The latest news is I have decided to take 2 months of work to tackle this problem head on and with as much dedication as I can. This will start in March, I have one week left of work to go. PT work right now involve foam rolling, straight leg exercises, some stretches and a wall squat of maybe 15 to 20%, with a band, light loading yet no pain.I have a feeling it’s going to be a long journey....Yup, that's right. It is a long journey. I thought I was going to have to live with it forever, but thankfully I'm a lot better now after 7yrs.After 2 previous attempts to do the short local triathlons over the past 2 seasons which ended with bad flares, it's 3rd time lucky as I did the local race with no major repercussions last weekend (took me 70mins, which is 12mins slower than my best when I was about 45 just before this knee nightmare started, but I'll take it given I've only done about 25% of the training I once did this past year).Got 2nd place LOL! Not bad for a 56yo, and I was tussling with a 20-something year old, who only pipped me by 8 seconds (OK the really fast guy who would have beaten us both by 10mins got a flat tyre ). We exchanged places on the bike 4 times, and 2 times on the run, which made it the most fun race I've ever done.TBH, I only went at about 90-95% intensity as I didn't want to kill myself, but it was a big step forward. Still got a few knee tingles after, but nothing too drastic.It took 7 years for you to get better?? Then it's going to be a very long journey for me.I have been struggling with this for past 6 months and knee pain throughout the day and night. What helps you in your case to get better? I am going to PT for past 4 months. Doing strengthening and stretching exercises. Started foam rolling 2 days back. Did 3 sessions of aggressive dry needling and one needling session for scar tissue in the same knee. PT said I need a couple more dry needling sessions.I don't know how to proceed further to get better. I get the burning pain right above the knee and lateral side. It burns whenever I bend the knee or stretch my legs straight. So it's difficult for me to sit down and lie down. It's 3 am here and am up because of the pain. I have to move around and sleep back again. I do ice my knee sometimes. Not everyday. I don't need a magical thing to work on, but is would be great if I really know what's going on and what should be done. PT and the doctors also not sure and telling me to focus on strengthening. Since I didn't injure anywhere, they say I got the pain and patella maltracking because of weak muscles. That causes some inflammation in my knee now. I have even changed to a new proper fitting shoe now. I was wearing an unfitted shoe and walked with that for a month for 2to 3 miles a day. After that, the burning pain started. It's the same level of pain till today. It's been more than 6 months.What should be the next best step to do?Yes, 7 years. Re-read the personal message I sent you and you'll know why. Basically because:1. I got bad advice from the experts esp re quad strengthening which only made things worse as it continued to overload my knee joints - my joints were the problem, not my quad muscles/VMO;2. Because I was stupid and kept trying to return to my fitness program and overloaded my knees before the joints had settled.But something you said above about the location of your pain & burning (above knee and lateral side) makes me wonder if what you have is different to PFPS? My pain was directly under the kneecap, and moved about a bit, but definitely not above the knee or lateral.Your pain has me wondering if your problem is a tight ilio-tibial band - which is a much easier issue to solve than PFPS (and I define true PFPS as Dr Dyes loss of tissue homeostasis = chronic inflammation of the synovial lining).I had bad ilio-tibial band pain for about 2 months many years ago (before my PFPS) and the solution was rest and stretching the ITB band. Once it has settled, strengthening the supporting muscles (glutes/hips/hammies/calves/core/lower back) is also recommended.
SuspectDevice:Congrats on the 2nd place finish! A win if you ask me. You have fought back hard, I’ve been reading your story. Oh how I long for a good cardio session :'(Userhere123:Ah, pain. Mine is crazy. The most consistent is a burning or ‘inflamed’ feeling on the medial side of my right knee. My left knee is also involved yet not as bad. I fluctuate from feeling ok with just an awareness that things aren’t all well, to a deep ache in my knee (s), almost like it’s deep in the bone. Sometimes walking quickly helps, sometimes not. Hurts more to completely straighten, yet surprisingly flexed not as much. Although that, too, can vary.Dry needling. Be careful, many studies do not support that it helps. I’ve had a bit done on my IT band as well as foam rolling. You get to a point that you try many different modalities in hopes that something will work though, I get that! Here’s some reading that you should have a look at: www.jospt.org. Look for volume 49, September 2019. Lots about the latest research on PFP. (That’s through the Journal of OrthopaedicAnd Sports Physical Therapy) Also have a look at globalsportmatters.comSome interesting info on how to treat this problem. I don’t know if it’s all correct yet there are a few different approaches out there, just look for the common thread. And I do support ‘active rest’ as well. Enough initially to calm things down, yet not too much that your joints get no action. I am actually about to take some time off work to give the resting part a good, honest try. It’s a fine line. Inform yourself as much as you can, don’t just trust your PT completely.Good luck!Holy cow, forgive me I did not see that last post of yours until after I posted this. I agree with SuspectDevice in that your problem does not seem to fit PFPS. One never knows as we all present a bit differently, plus I’m learning that PFP is more a blanket term for anterior knee pain that doesn’t fit into another category...yet perhaps you need a second or third opinion. I still stand by the ‘arm yourself with knowledge’ idea.
SuspectDevice, thanks for chiming in on my thread, you seem to have learned a lot about PFPS through your long journey to heal and I appreciate your comments. In your own threads, you mention sitting and dangling your legs. What does that help,with, and how?Today I officially begin my attempt at active rest. I have taken a leave of absence from work for 2 months. Don’t know if my previous level of activity is in my future yet I have to try this.
Quote from: kawi_girl on February 29, 2020, 03:00:52 PMSuspectDevice, thanks for chiming in on my thread, you seem to have learned a lot about PFPS through your long journey to heal and I appreciate your comments. In your own threads, you mention sitting and dangling your legs. What does that help,with, and how?Today I officially begin my attempt at active rest. I have taken a leave of absence from work for 2 months. Don’t know if my previous level of activity is in my future yet I have to try this.It's just a gentle way of moving the knees without over-taxing them - it's not just dangling them, but also very gently swinging the lower legs back and forth, thus working the knees. Richard Bedard also talks about how knee movement improves the quality of the synovial fluid in the joint, which helps lubricate the joint and reduce pain. I still find my knees get stiff and a little bit sore/tingly, and doing these 'knee swingers' helps loosen things up.
Quote from: SuspectDevice on February 29, 2020, 09:21:19 PMQuote from: kawi_girl on February 29, 2020, 03:00:52 PMSuspectDevice, thanks for chiming in on my thread, you seem to have learned a lot about PFPS through your long journey to heal and I appreciate your comments. In your own threads, you mention sitting and dangling your legs. What does that help,with, and how?Today I officially begin my attempt at active rest. I have taken a leave of absence from work for 2 months. Don’t know if my previous level of activity is in my future yet I have to try this.It's just a gentle way of moving the knees without over-taxing them - it's not just dangling them, but also very gently swinging the lower legs back and forth, thus working the knees. Richard Bedard also talks about how knee movement improves the quality of the synovial fluid in the joint, which helps lubricate the joint and reduce pain. I still find my knees get stiff and a little bit sore/tingly, and doing these 'knee swingers' helps loosen things up.Thank you! That makes sense to me and I will try this. How many times a day would you do this, and for how long each time? I imagine that the answer depends on the person, I was just wondering about a general starting point.
Read the book in one sitting (well, I did get up and walk around every so often...part of my plan)So, the skeptic in me is asking, if this is really the way to heal (lots of time, patience, gentle movement over exercises that support knee and hip muscles) why haven’t more PT’s got on this bandwagon? Now, the book did make sense to me and I agree with a lot of it.It’s just that if the evidence points that the “traditional “ way of treating PFP is not working well, wouldn’t you, as a PT, keep looking for the answer, in the same way that medicine has developed over time?I am doing some prescribed stretches and strengthening movements, yet no aggressive quad strengthening, it’s more for glute and hip right now. Some quad setting and some patella mobilizations. Lying down with my knees up is still more comfortable, yet I’m afraid I’m doing too much of that now, and should be walking more.Any one experiencing their own doubts regarding what they are trying?
Yes, I have the same experience. All the health care professionals I’ve asked so far about Dr. Dye’s theory have not even heard of him! I’ve even read the latest research on PFPS from a medical journal (2019) and while it is at least acknowledged that for exercises to focus on hip and knee strengthening (not the old quad strengthening babble)is the ‘best’ approach, nothing is mentioned about rest for the return to homeostasis.It makes me wonder why I’m even going to physio...yet I do have a good rapport with her and can at least get input from someone who is interested in my recovery. Guaranteed I’ll still be in recovery long after I’m done seeing her though! The second PT I saw did also acknowledge that PFP can be a very tricky problem. (I’m on my third and possibly last PT)So, when the studies say that certain exercises have helped, I don’t believe they ever mean cured. Just a reduction of pain.Makes me wonder if the body would just eventually heal on its on with no intervention other than scaling back activities.I’m the type of person that wants to feel as though I’m working towards something though, so that approach would not fit well with my personality.Have you also read anything by Doug Kelsey? Wonder if there are any helpful things in there.