Total rest seems baffling to me...

[kawi_girl]

Hello! I have been suffering from PFP for over a year now, started in the right knee and in the last month the left has joined the party.  My story is on the general page. (Over a year and frustrated)

What I don’t I understand, is this total rest idea. All your other muscles get weak, and it doesn’t address the maltracking issue at all, which I would think just returns once you start moving again.

I have been wondering about orthotics lately.

Anyone had success with total rest first? Or orthotics?

[vickster]

Orthotics could help if you require them, ie if your feet have some sort of deformity to correct. Get gait and feet assessed by a podiatrist 

[SuspectDevice]

I'm of the opinion that the mal-tracking thing is over-diagnosed by maybe 80% or more.  And the muscle strengthening they get you to do to fix this non-existent problem just inflames the knees more.

Total rest is almost impossible if you have responsibilities, unless you can afford to do what Richard Bedard did and really jump off the mouse wheel for 12mths.  And even then, total rest is not what he did.

I never did total rest, but had to stop all the things I loved exercise-wise except easy flat walking and swimming without kicking.  But these were enough to keep some leg strength & aerobic fitness until things settled enough to get back into gym strength work, and even then I avoided quad work but focused on hips/hammies/glutes/stomach/lower back/calves.

I'm of the opinion my PFS was brought on by putting too much stress on my knees (triathlon), when all the supporting muscles were not strong enough....and I had a coach who prescribed strength work, but only really for the core, not the other important leg muscles.  So my quads became too strong relative to the other muscles = too much knee stress.

[kawi_girl]

I'm of the opinion that the mal-tracking thing is over-diagnosed by maybe 80% or more.  And the muscle strengthening they get you to do to fix this non-existent problem just inflames the knees more.

Total rest is almost impossible if you have responsibilities, unless you can afford to do what Richard Bedard did and really jump off the mouse wheel for 12mths.  And even then, total rest is not what he did.

I never did total rest, but had to stop all the things I loved exercise-wise except easy flat walking and swimming without kicking.  But these were enough to keep some leg strength & aerobic fitness until things settled enough to get back into gym strength work, and even then I avoided quad work but focused on hips/hammies/glutes/stomach/lower back/calves.

I'm of the opinion my PFS was brought on by putting too much stress on my knees (triathlon), when all the supporting muscles were not strong enough....and I had a coach who prescribed strength work, but only really for the core, not the other important leg muscles.  So my quads became too strong relative to the other muscles = too much knee stress.

That makes more sense, thank you. I’m still trying to go to work, and I’m on and off my feet for that. So I guess total rest is trying to do only work and nothing else (which is what I’m doing currently due to pain)
I am seeing a new PT on Friday at a clinic with plenty of experience-I am sure that I’ll be their most cynical patient! I’m willing to put in the work if it makes sense to me-heck, even if it doesn’t at first as I’m desperate.
I have heard that the whole mal-tracking theory is bogus and that your kneecap is meant to be able to move around very freely. The pain makes no sense at all.

[SuspectDevice]

I'm of the opinion that the mal-tracking thing is over-diagnosed by maybe 80% or more.  And the muscle strengthening they get you to do to fix this non-existent problem just inflames the knees more.

Total rest is almost impossible if you have responsibilities, unless you can afford to do what Richard Bedard did and really jump off the mouse wheel for 12mths.  And even then, total rest is not what he did.

I never did total rest, but had to stop all the things I loved exercise-wise except easy flat walking and swimming without kicking.  But these were enough to keep some leg strength & aerobic fitness until things settled enough to get back into gym strength work, and even then I avoided quad work but focused on hips/hammies/glutes/stomach/lower back/calves.

I'm of the opinion my PFS was brought on by putting too much stress on my knees (triathlon), when all the supporting muscles were not strong enough....and I had a coach who prescribed strength work, but only really for the core, not the other important leg muscles.  So my quads became too strong relative to the other muscles = too much knee stress.

That makes more sense, thank you. I’m still trying to go to work, and I’m on and off my feet for that. So I guess total rest is trying to do only work and nothing else (which is what I’m doing currently due to pain)
I am seeing a new PT on Friday at a clinic with plenty of experience-I am sure that I’ll be their most cynical patient! I’m willing to put in the work if it makes sense to me-heck, even if it doesn’t at first as I’m desperate.
I have heard that the whole mal-tracking theory is bogus and that your kneecap is meant to be able to move around very freely. The pain makes no sense at all.

Sadly, for many of us, the only certainty is that there is no certainty to solving chronic knee pain.  It is a long road of trial and error, but keep the faith as you can get massive improvements, and some like Richard Bedard get full recovery.
I'd not claim full recovery for myself, but I'm a lot lot better than 5 yrs ago, though I doubt I'll ever return to doing Ironman/Half Ironman triathlon training/racing.....and I'm not sure I want to even if I could, it was such an all-consuming past-time I now realise.

[Aly0108]

I agree, total rest helped me also, for few years. I was able to walk , to stay a long period. Last week I decided to do a massage to my hamstring and hip. My knees started to be swelling again. I didn’t nothing for knees, I don’t understand why massage made things worse ? Maybe I changed biomechanics of muscles? Also stretching is not good, I see.
Please any idea? Now I have to start again.

[kawi_girl]

Hi Aly0108,
First off let me say how very sorry I am to hear that your knee issues flared up again like they did. Was there anything else that possibly triggered this (super long walk, on your feet for an extended period of time that you weren’t accustomed to?)
It is puzzling why massage like that would have set things off. Was the massage really aggressive? Is it possible you are having referred pain in what is a delicate part of your body (your knees)? All I can hope for you at this point is that you were far enough along with your healing that you will recover from this quicker than previously, are you able to rest and ice?
I know this knee stuff is extremely frustrating. I myself had a good cry today, I’m not going to lie. I was thinking about all the activities I loved and can no longer do. They gave me such joy! Now I feel that I have to pull it together and redefine myself. Some days are just hard.

[Aly0108]

I found my PFS cause, I went to see an orthopaedic specialist. In five years nobody said me I have lateral pelvis tilt on left side , or left high pelvis. It is crazy. I don’t know how I have to fix it. I think I have short leg, internal rotation of femur and tibia exterior rotation. It is big misery to fix.  A lot monies for PTs, sports do too, etc and  nothing. 

[kawi_girl]

What about custom orthotics combined with the right exercises? I know that orthotics are often not a fix for PFP yet there are some cases that might be the exception. If you do go that route, I’d advise to go to someone who specializes in making these, and takes at least an hour to assess you.

[Aly0108]

What about custom orthotics combined with the right exercises? I know that orthotics are often not a fix for PFP yet there are some cases that might be the exception. If you do go that route, I’d advise to go to someone who specializes in making these, and takes at least an hour to assess you.

Hi

I don’t understand why my knees are bad and stiff ? One year ago I open my restaurant, my knees were well until now when I closed my restaurant du this quarantine. And my knees started again to be painful and swollen.
I will try to take Celebrex to see how it will work with inflammation.
My pain is laterally of my patella, I think fat pad inflammation again.
I don’t do nothing to make it worse.

I don’t understand really my knees.

[BusterCatLegs]

I did total rest for a while and looking back I assume I would have gotten better without doing that but at the time I was lost and scared and in so much pain from walking that I just didn't know what to do. So that's what I did!

I probably paid for it with muscle weakness and maybe even other issues...my legs feel really strange a lot of the time and it took me a long time to start using the back muscles in my legs again properly. Pushing through the back leg and out the heel has been a major issue for me and sometimes I wonder if ligaments or tendons are permanently changed or altered in a way that they won't be normal for a very long time...

Stretching every single day has been very important for me as much as I can tolerate. Which at times was barely anything! Also massage and rolling out the legs with a tiger stick was helpful.