How do i treat patellofemoral pain syndrome?

Question

i have patellofemoral pain syndrome, i was told that without physical therapy it becomes more difficult to treat, problem is i have no insurance nor money to afford such things so can anyone suggest a routine of daily exercises or something like that i could do? (im a pretty active person, i exercise over 2 hours a day in sanshou and kung fu as well as various over exercises if that helps your answer at all)

Answer 1

PFPS is frequently treated with combination of NSAIDs (like Motrin, Alleve), ice, rest and physical therapy.  Your source is correct, the longer this goes, the longer it is to treat. The good news is that many of the treatments, through physical therapy, are ones that you can do on your own, such as stretching techniques. I know you don't have insurance, but I would encourage you to go to the physical therapist at least once. They can then demonstrate the most common stretches and give some ideas of a modified routine you can do at home. I would be upfront about the insurance issue and let them know that while you would like to come to PT, you just can't afford it and you are looking for a one time consultation on things that you can do on your own.  Give their recommendations a few months, and try to tone down the workout schedule, and if things don't improve, you may have to consider getting professional PT on a more regular basis.

Answer 2

hello -ens_imp is right, in that you should really go and see a physio at least once, as they will be able to check you out, assess you biomechanically, and help you with a programme to get rid of the pain.

I am very active and had severe PFPS for years -however I saw EIGHT different physios during that period, seven of whom gave me the same treatment and the same lame exercises to get rid of the problem, which did not work at all. So if you do decide to see someone, see a specialist sports physio who also has knowledge of trigger points, as these may be a contributing factor to your pain.

In the meantime though, I can suggest some things that may help or even get rid of it.

The vast majority of the time, PFPS is a muscular / biomechanical issue -there is most likely nothing wrong with you knee joint at all. Very basically, what happens is that your quads muscles on the outside and/or front of your thigh get very tight, and end up shortening. As a result, they then pull on the tissue that attaches to your knee, causing pain.

So, the first thing you should do is stretch your quads properly -not the usual standing stretch, do this one regularly throughout the day, and make it a part of each warm up/warm down: http://www.fitsugar.com/1626823

As your PFPS doesn't sound too crippling -you've been able to stay active -this alone may do the trick -though it will take a few weeks. However, your quads may also have seriously tightened in some areas of the muscle, and you may have knots of muscle tissue, or some trigger points (points of constantly contracting muscle fibres that cause pain). If so, simply stretching will not necessarily get rid of these. To do so, you need to physically break them down. So to start with, just sit with your leg out straight, and have a a feel all over the muscle bulk of your quads -from hip to knee -to see if there any obvious lumps or very tender points (other than bruises). Using some baby oil or similar helps a lot.  If there are, then stick your elbow/knuckles into them or get someone else to do it and massage them away. You can also use one of these to lie on and roll up and down your  quads -I can highly recommend one: https://www.physique.co.uk/dolc_product....

Another thing to look for is a flicker response in the muscle -this is when you press a lump or sore point in the muscle, and it causes it to involuntarily spasm in the local area. This is probably a trigger point and must be destroyed! massage/roll it away.

This is all quite sadistic as it can hurt a lot, but it will feel good afterwards -though if you are leaving bruises, you are doing it too hard. Again, only do this to MUSCLE tissue, not too near your knee joint. If there are knots, and they have been there a while, be aware that it can take a long time to get rid of them.

You also need to stretch all other associated muscle groups regularly -hamstrings, calves, glutes are all vital -though I imagine you already do so through kung fu. Also add in this one as well: http://www.easyvigour.net.nz/fitness/h_T...

Other than stretching, you should also try and get the smaller quads muscle on the inside of your thigh working a bit better. (That's the VMO -this one here: http://www.sports-injury-info.com/image-...

The best way to do this is sitting on a chair with both legs bent. Then, if you are working on your left leg, place your right hand on the inside of your left knee over this muscle. Then push very slowly against your right hand with your left knee and resist with your right hand (i.e. an isometric exercise). It takes a lot of practice, but the idea is to get this VMO muscle firing before the quads on the outside of your thigh. Do it very slowly and gently, so you can feel a slight contracting in the muscle, and then build it up to a stronger, controlled contraction. You should also place your left hand on the muscle on the outside of your thigh to check that it is not firing first -try and keep it as relaxed as possible. It may also help if you think of pushing your left heel sideways against the resistance of the ground -sort of like you are side-footing a football. Anyway, experiment with it.

You can then move onto things like step ups and step downs, making sure your glutes and your VMO are firing well. do everything in a slow controlled manner.

All this may hopefully help -though the final thing you would need to look at is why you quads are so tight. it may just be because you are very active and haven't given your quads enough attention, as most people do. or it may be a biomechanical issue, whereby your quads are having to do too much work on a daily basis. The usual reason for this is weak gluteal muscles -so it would probably also be worth getting those strong and firing really well while standing, walking, running, and throughout your kung fu practice.

Anyway, hope this helps! know how annoying it can be, so good luck.

Answer 3

you can't beat simple physicla therapy like using a massage sandals.

it cost you about £25 and you can practise every day at home.

you can find out more how it works

http://www.healthy-step.com

Answer 4

I have a similar sort of problem.  The best thing to do if you can't have physiotherapy is to exercise for around half an hour everyday doing quad stengthening and hamstring and calf stretches.  It is best to avoid exercises that put a lot of impact of your knees, I would probably try and avoid doing kung fo as that can make it worse.  Exercises that are easier on the knees, which also strengthen the legs are cross-training and using stationary bikes.  Also, try to get good footwear that has a lot of cushioning and support, a high arch is good.  And wear supports while exercising.