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Old 11-30-2011, 12:43 AM   #1
Stephanie Schwab
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Just diagnosed with Patellafemoral Pain Syndrome

So I am relatively new to CF, started On Ramp the first week of September. I love it and have had a great experience. I am about 70 pounds overweight.

About three weeks ago after a particularly challenging week of WODs I started having severe knee pain in the front of my knee that was especially awful getting up and down from sitting and going up and down stairs. It has not gotten better even after a break from CF and doing all the traditional stuff (ice, advil, evelation, foam rolling, stretching, etc). It did not help at all I spent five days in a cabin that had three flights of stairs for a family renunion, it was like torture.

Anyways, I finally saw a dr. today and she diagnosed me with Patellafemoral Pain Syndrome. I told her I started CF and she told me when you start exercising it is common for the outer thigh to develop quicker than the inner thigh and cause an imbalance. She also said I have abnormally loose knee caps. She recommonded exercises to to strengthen the innner thighs. She said in two weeks I could start slowly excerising again. And she said once you have this its very hard to get rid of and it comes back easily

So I am just wondering if anyone has any advice/info for me, especially about the inner thighs being weaker than the outer thighs. Is that common when starting CF? The dr. did not mention my quads or hamstrings. I had done a lot of research on knee pain, etc. when I first felt pain because I don't have health insurance so I was trying to avoid the dr. I can't see a physical therapist due to financial constraints/ no ins.

Needlessly to say I am incredibly discouraged. Being so new to CF and finally seeing progress in my fitness, weight, etc. and having it all have to stop for awhile. Its horrible. I can still go and work around it but any slight bend in the knees really hurts. Any advice is appreciated.

stephanie
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Old 11-30-2011, 04:25 AM   #2
Chris Cooper
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Re: Just diagnosed with Patellafemoral Pain Syndrome

Good morning;
Essentially, what you're experiencing is an imbalance around the knee (quad dominance.) Back in the old days, we called this, "Jumper's Knee." Your best solution (and fastest) is to strengthen your hamstrings with deadlifts, good mornings, GHR...and lay off work that emphasizes more knee extension.
As you become more proficient, you'll recruit more force from the hips, and less from the knees. It's not a common injury in CrossFit, but it IS common among the new-to-exercise population in general.
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Old 11-30-2011, 06:48 AM   #3
Ian Nigh
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Re: Just diagnosed with Patellafemoral Pain Syndrome

"Patellafemoral Pain Syndrome", isn't that just another name for "my knee hurts"?

Seriously some of these ortho docs need a serious wake-up call. I recommend you watch the video series entitled "A new language to Diagnose" by Kelly Starrett on the CF Journal: http://journal.crossfit.com/search.p...agnose&x=0&y=0 (WFS but I believe you need a membership to view).

This is a great place to start and will hopefully get you on the road to resolve your issues in a short time.
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Old 11-30-2011, 07:58 AM   #4
Renata Speranza
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Re: Just diagnosed with Patellafemoral Pain Syndrome

Hi Stephanie

I am sorry to hear that your knees still are not getting any better!!!

Keep on rolling over the foam roller and the ball and as was mentioned before, strengthen the muscles around. And I hope that it really get's better soon!!

Big hugs
Reni
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Old 11-30-2011, 08:49 AM   #5
Steven Low
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Re: Just diagnosed with Patellafemoral Pain Syndrome

wfs
http://www.eatmoveimprove.com/2009/1...-dysfunctions/

Mobility/strengthening/etc. corrections on page 4
__________________
Posts are NOT medical, training, nutrition info
Bodyweight Article, Overcoming Gravity Book
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Old 11-30-2011, 10:52 PM   #6
Michael Ko
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Re: Just diagnosed with Patellafemoral Pain Syndrome

Mr. Lowe has got it right. The link he posted has a picture with a skeleton with the words "femoral internal rotation or hip adduction, knee valgus, and ankle eversion". Those 3 things are some of the most common causes for any overuse syndrome in the lower extremity. Patellofemoral joint pain is usually cause by mechanical faults with walking, steps, squats. The knee will bend sidewards towards the middle or called "knee valgus" but the root of it is usually weakness in the glut medius (outer hip) or poor hip awareness and/or ankle eversion/fallen arches/foot pronation, etc. Often times, tightness in the IT band/TFL/glut med will develop so using the foam roll is part of the solution. Making sure you have good lower extremity alignment is what keeps the pain from coming back. Think about aligning the patella over the middle toe with any functional movement. (ie. stairs, squats, deadlift, overhead squat, etc)

The idea of having an imbalance of medial muscles in the thigh or quad is old school thought. It hasn't been phased out of rehab medicine yet. Someone will probably argue me about this.

I wouldn't worry about the loose patella if you haven't had a dislocation. It doesn't matter because when the quadricep is active, its going to pull the patellar and quad tendon so hard, it's not going to move sideways.
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Old 12-01-2011, 12:36 PM   #7
Troy Peterson
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Re: Just diagnosed with Patellafemoral Pain Syndrome

Quote:
Originally Posted by Michael Ko View Post
Often times, tightness in the IT band/TFL/glut med will develop so using the foam roll is part of the solution. Making sure you have good lower extremity alignment is what keeps the pain from coming back. Think about aligning the patella over the middle toe with any functional movement. (ie. stairs, squats, deadlift, overhead squat, etc)

The idea of having an imbalance of medial muscles in the thigh or quad is old school thought. It hasn't been phased out of rehab medicine yet. Someone will probably argue me about this.

I wouldn't worry about the loose patella if you haven't had a dislocation. It doesn't matter because when the quadricep is active, its going to pull the patellar and quad tendon so hard, it's not going to move sideways.
This is good advice - as a fellow knee pain sufferer (I've heard all the names over the years)....nothing has helped me as much as focusing on some areas where I was (and still am) lacking in mobility.

Areas? glute, psoas, TFL, hamstring. Those were problem areas for me which I've figured out after viewing MWods and researching and talking to a knowledgeable PT/trainer.

traditional stretching, foam roller and lacrosse balls are your friends. I have lax balls at work & home and use daily. Stretch after each workout (hamstring, psoas, hip). Occasionally also stretch calves (which haven't been a problem).

Improving mobility is simple, cost effective, shouldn't get you hurt and is something you can start today. Get back into CF/scaled workouts that don't hurt your joints.
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Old 01-09-2012, 07:35 AM   #8
John Redshaw
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Re: Just diagnosed with Patellafemoral Pain Syndrome

Check these out on MobilityWod.com.

Episode 59: Upstream and Downstream (knee-itis). And the Bear, Episode 107/365: A Friend Calls With Knee “itis” Below the Patella, Episode 237/365: Heel Cord Love, Episode 253/365: Knee Pain Case Study, Episode 267/365: MobRx for Lound, Creaky Knees, Episode 281/365: Runner’s Legs and Hip Extension, Episode 305/365: Solving Problems With The Tunnel: The Foot Strike
There are several others that hit aspects of knee pain do a search using knee.
Also go to the CrossFit Journal Kelly has a 3 part series “Solving Knee Problems” and “Ready State and Injury”

I think Kelly's videos are the best self treatment/preventative tool. And its free.
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Old 01-12-2012, 10:06 AM   #9
Greg van den Dries
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Re: Just diagnosed with Patellafemoral Pain Syndrome

Quote:
Originally Posted by Steven Low View Post
wfs
http://www.eatmoveimprove.com/2009/1...-dysfunctions/

Mobility/strengthening/etc. corrections on page 4
Steph,

Steve's diagrams and recommendations are spot-on. As you get stronger, hopefully this pain will dissipate. Working on HS, Glutes, etc will certainly help.

Since knee pain is hard to diagnose over the net, it is impossible to give a highly accurate recommendation but i can offer you this.

We treat many athletes that suffer from runner's knee or PFS with Rocktape. The application is simple and I'd be happy to send you a free sample so you can see if it might work for you. Send me your mailing address to: admin at rocktape dot com.

Hope it helps and take it easy until your body tells you it's time to go harder.
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