After more than 4 years of suffering with PFPS, I've found that the single leg wall sit within the pain free range is by far the most important exercise for reducing pain. After completing about 5 sets of 30 sec holds, I then do single leg step downs from a slant board with a slow eccentric and tapping the opposite heel to the ground before starting the concentric rep. Currently, I'm doing 1 set of 15 with no weight, 1 set 12 holding a 10kg dumbbell and then 2 sets of 12 holding a 20kg dumbbell. I do both exercises every 3 days.
@gothops2632 it's a nightmare. I have patellarfemoral on one knee and tendinopathy on other. I am so fed up. It's just not getting better. I have been doing physio for 18 months. I got fermoral first (previously had 5 years ago and took a year of no exercising to heal), then I guess my other leg couldn't handle the extra load and the tendinopathy developed. It makes life so restless. Day to day chores are that much harder. It just nags at you whatever you do
Maryke, you say that foam rolling and massage doesn't change the structure of the tissues, it just decreases pain. Why then when you massage a person's tight muscle you can feel the muscle soften after some time? Does massage activate the parasympathetic nervous system thus signalling the muscles to let go of tension and relax?
From my personal experience, if you have pain at the patella, wall sits will definitely increase the pain . I agree with the progression from easy to hard but I wouldn't recommend that exercise for PFPS at the beginning , or when having a flared up knee.
@@SportsInjuryPhysio How would the exercises, dos and don’ts differ for someone who’s had a patella lateral release surgery in a past? I know there’s many variables to it but I thought I’d ask. Thanks so much!
Maybe a silly question but at what point would it be ok to return to barbell deadlifts / barbell squats? E.g. "you should be able to be pain free completely// you should be able to do wall sits for minutes straight 😂" just wondering if i can use deadlifts as a way to rehab e.g. light or slow, or whether theyre completely off the table for a while. Thank you x
Is it common to have had this and over a short period the injury changed to patella tendinopathy? I felt like I started with this injury where I couldn’t locate where exactly the pain was and it felt like it was changing where the pain was to all of a sudden just being in the one area around the patella which my physio eventually diagnosed me with patella tendinitis.
Yes - the patellar tendon and the kneecap works as a unit, so if one gets injured the other one often also get injured. It may be that the pain from the kneecap was initially the worst and therefor you didn't notice the tendon but then when the kneecap pain settled down, the tendon became the main issue.
What you start with and what you have to build back up to varies depending on: 1. Your current strength 2. Your knee's current tolerance to load 3. Your activity goals As a rough guide - if you can do 3x45 sec isometric, it is usually time to move on. And if you can do 3x15 free squats, it is usually time to move on. Your physio is best placed to help you progress it all at a sensible level because they will use their findings from the interview/assessment to help gauge your rehab loads.
Is Bone bruising top of shin but below knee cap a common symptom? Glute bridges,Planking, cycling seems bother my knee. Walking seems fine as long as not hilly.
Hello, I'm uncertain if you'l come across this comment, but I have a question I'd appreciate if you could address Firstly, thank you for providing such a detailed video and sharing your valuable knowledge. I've been experiencing pain in the back of my right knee for the past three weeks. The team physio advised a 7-day course of anti-inflammatory pills, which somewhat alleviated the back knee pain after 10 days. However, I started feeling discomfort in the knee next to the ligament. The physio mentioned that my patella had slightly shifted but assured me it's not a serious issue, and I should recover in about a month. I just came across your video and wanted to ask if I should proceed with the exercises you recommend. My knee doesn't click, but there's persistent pain on the inner side when I bend it, walk, or climb stairs. What exercises would you suggest to help me return to sports and overcome this pain?
You need to get your knee diagnosed properly. What you are describing sounds like you've injured something inside the knee (not patellofemoral pain syndrome) that has made it swell and that can cause the kneecap to sit a bit funny because it is being pushed by the excess fluid in the joint. So, the kneecap is likely not the issue. If your physio is unable to provide you a proper diagnosis of what the actual injury is, then you need to perhaps get a second opinion and have it assessed by someone else.
@SportsInjuryPhysio Yes you're absolutely right but the problem is that i can't spend more money on physios because im a fresh graduate searching for a job. Its really frustrating specifically because i did not get a proper answer about the cause of my knee pain
Hey thankyou for the video, I definitely learned alot, this will help me live my life more enjoyably, also I was looking for Brody's progressive rehab for runners knee but wasnt able to find it, do you happen to know the name?
Glad you found the video helpful! Here's Brody's website. If you don't find the runner's knee rehab programme there, you should be able to contact him via the website. runsmarter.online/
@@SportsInjuryPhysio Awesome thankyou for the quick reply, sorry last question last night I iced my knee and it seems to hurt much more now, do you know if icing can aggravate it more sometimes?
My capacity is so low that I think I found my current now at wall sits at 30 degrees. This causes no pain and returns to baseline quickly. I tried working within some pain but the next day it would be more sore.
I sometimes find that the kneecap does better if you do movements rather than isometric holds - so using a high chair or box that can limit the movement to what is comfortable to you, going up and down rather than doing the isometric hold might be better tolerated.
That's difficult to answer because it really depends on what is causing your flare-up. Patellofemoral pain syndrome usually don't cause pain when you're lying down, so you may want to discuss that with your physio and check what is going on.
What baseline pain can you start with? I feel it walking down the stairs. I ran an ultra and an 18 mile mountain race within 3 weeks of each other. I had knee pain before the ultra but once i warmed up it never returned. But doing another tough race so soon i felt the sore knees the entire race. They didn't make me hold back but i didnt like it. I had to walk sideways down stairs for a week or so lol. Now, the pain is there but i just notice it on the stairs. I haven't run in a week and the pain is improving. I can do full squats and everything but i feel it. I also have no idea what a level 4 feels like. I could be sensitive or not sensitive to pain. I was thinking of doing zone 1&2 flat trail walk/runs to see how it goes but i dont know when to start? Do i keep waiting until theres no pain? Is it good of the tendon starts sore and smoothes out or is that bad? I always thought that was from crap built up in it. I dont mind paying to chat with someone too. Just need a little guidance so i can get on the correct path
It sounds like you have quite a few questions! I can recommend my colleagues Kevin and Steph to help with this. They can assess it for your and provide you with a rehab plan and training advice via video call. You can read more about how the online consultations work here: www.sports-injury-physio.com/
Can you get this from an injury of deep bending to tie shoe; I think im dealing with the his for the past 5 months since this incident, I also heard a sound at the time.
It is more likely that you have torn something like your meniscus but I am obviously just speculating - get it checked by a physiotherapist - they will be able to diagnose it.
Could restricted ankle or hip mobility cause PFPS? I think that I have restricted ankle mobility and as I go into a deep squat my knees cave in and that cause PFPS.
If you are loading your knees in a position where they move in excessively, then yes, that can irritate the kneecap. Placing something under your heels (rolled up towel or weight plates) to lift them, can help you squat lower while maintaining better form.
It can react really well to finding the correct mix of activities. A lot of my patients who have arthritis find that if they cycle on a regular basis it makes a huge difference because the movement helps to feed the joint. Some of the runners I've treated has found that if they cut some of their running sessions and switched it out for cycling it helped them run pain free and perform better. I've shared some more tips in this video th-cam.com/video/HGmbqtDYyvo/w-d-xo.html
After more than 4 years of suffering with PFPS, I've found that the single leg wall sit within the pain free range is by far the most important exercise for reducing pain.
After completing about 5 sets of 30 sec holds, I then do single leg step downs from a slant board with a slow eccentric and tapping the opposite heel to the ground before starting the concentric rep.
Currently, I'm doing 1 set of 15 with no weight, 1 set 12 holding a 10kg dumbbell and then 2 sets of 12 holding a 20kg dumbbell.
I do both exercises every 3 days.
How is your pain? I'm also a sufferer for 4 years. Have you been able to recover? have you changed anything? thanks
@WillhHall As long as I do my wall sits at least a couple of times a week, I'm ok. If I neglect the wall sits my pain returns.
What about full recovery?
@@Adam9306 I have not recovered fully, unfortunately. It's something I need to consistently work on
@gothops2632 it's a nightmare. I have patellarfemoral on one knee and tendinopathy on other. I am so fed up. It's just not getting better. I have been doing physio for 18 months. I got fermoral first (previously had 5 years ago and took a year of no exercising to heal), then I guess my other leg couldn't handle the extra load and the tendinopathy developed. It makes life so restless. Day to day chores are that much harder. It just nags at you whatever you do
This video helped clear up a few misconceptions that I had regarding PFPS. Thank you for the information.
Glad it helped!
Maryke, you say that foam rolling and massage doesn't change the structure of the tissues, it just decreases pain.
Why then when you massage a person's tight muscle you can feel the muscle soften after some time?
Does massage activate the parasympathetic nervous system thus signalling the muscles to let go of tension and relax?
From my personal experience, if you have pain at the patella, wall sits will definitely increase the pain
. I agree with the progression from easy to hard but I wouldn't recommend that exercise for PFPS at the beginning , or when having a flared up knee.
This is excellent! Thank you so much for posting these. I’m a huge fan of your channel!
You're very welcome!
@@SportsInjuryPhysio How would the exercises, dos and don’ts differ for someone who’s had a patella lateral release surgery in a past? I know there’s many variables to it but I thought I’d ask. Thanks so much!
This is such a great video and discussion with so much value!! Thank you.
Maybe a silly question but at what point would it be ok to return to barbell deadlifts / barbell squats? E.g. "you should be able to be pain free completely// you should be able to do wall sits for minutes straight 😂" just wondering if i can use deadlifts as a way to rehab e.g. light or slow, or whether theyre completely off the table for a while. Thank you x
Thank you so much, this is a big help!
Glad it helped!
Is it common to have had this and over a short period the injury changed to patella tendinopathy? I felt like I started with this injury where I couldn’t locate where exactly the pain was and it felt like it was changing where the pain was to all of a sudden just being in the one area around the patella which my physio eventually diagnosed me with patella tendinitis.
Yes - the patellar tendon and the kneecap works as a unit, so if one gets injured the other one often also get injured. It may be that the pain from the kneecap was initially the worst and therefor you didn't notice the tendon but then when the kneecap pain settled down, the tendon became the main issue.
I am sorry if I missed it but did how many seconds and/or how many repetitions/sets one should do the wall sit and the bodyweight squat? Thanks
What you start with and what you have to build back up to varies depending on:
1. Your current strength
2. Your knee's current tolerance to load
3. Your activity goals
As a rough guide - if you can do 3x45 sec isometric, it is usually time to move on. And if you can do 3x15 free squats, it is usually time to move on.
Your physio is best placed to help you progress it all at a sensible level because they will use their findings from the interview/assessment to help gauge your rehab loads.
great video, thank you
Is Bone bruising top of shin but below knee cap a common symptom? Glute bridges,Planking, cycling seems bother my knee. Walking seems fine as long as not hilly.
Hello, I'm uncertain if you'l come across this
comment, but I have a question I'd appreciate if
you could address
Firstly, thank you for providing such a detailed
video and sharing your valuable knowledge.
I've been experiencing pain in the back of my right knee for the past three weeks. The team physio advised a 7-day course of anti-inflammatory pills, which somewhat alleviated the back knee pain after 10 days. However, I started feeling discomfort in the knee next to the ligament. The physio mentioned that my patella had slightly shifted but assured me it's not a serious issue, and I should recover in about a month. I just came across your video and wanted to ask if I should proceed with the exercises you recommend. My knee doesn't click, but there's persistent pain on the inner side when I bend it, walk, or climb stairs. What exercises would you suggest to help me return to sports and overcome this pain?
You need to get your knee diagnosed properly. What you are describing sounds like you've injured something inside the knee (not patellofemoral pain syndrome) that has made it swell and that can cause the kneecap to sit a bit funny because it is being pushed by the excess fluid in the joint. So, the kneecap is likely not the issue. If your physio is unable to provide you a proper diagnosis of what the actual injury is, then you need to perhaps get a second opinion and have it assessed by someone else.
@SportsInjuryPhysio Yes you're absolutely right but the problem is that i can't spend more money on physios because im a fresh graduate searching for a job. Its really frustrating specifically because i did not get a proper answer about the cause of my knee pain
Just looking for some clarification. Does baseline mean how it felt the past day before you did rehab or cardio exercises?
Yes, so if you think of your pain levels that you normally have had in the last few days (say over the last week) when you don't exercise.
Hey thankyou for the video, I definitely learned alot, this will help me live my life more enjoyably, also I was looking for Brody's progressive rehab for runners knee but wasnt able to find it, do you happen to know the name?
Glad you found the video helpful!
Here's Brody's website. If you don't find the runner's knee rehab programme there, you should be able to contact him via the website.
runsmarter.online/
@@SportsInjuryPhysio Awesome thankyou for the quick reply, sorry last question last night I iced my knee and it seems to hurt much more now, do you know if icing can aggravate it more sometimes?
My capacity is so low that I think I found my current now at wall sits at 30 degrees. This causes no pain and returns to baseline quickly. I tried working within some pain but the next day it would be more sore.
I sometimes find that the kneecap does better if you do movements rather than isometric holds - so using a high chair or box that can limit the movement to what is comfortable to you, going up and down rather than doing the isometric hold might be better tolerated.
@@SportsInjuryPhysio thanks wall already thinking of doing squats with three cushions on top of a chair to limit depth after wallsits
If the flair ups are bad.. then what do I do about having flare ups when I’m just laying down?
That's difficult to answer because it really depends on what is causing your flare-up. Patellofemoral pain syndrome usually don't cause pain when you're lying down, so you may want to discuss that with your physio and check what is going on.
What baseline pain can you start with? I feel it walking down the stairs. I ran an ultra and an 18 mile mountain race within 3 weeks of each other. I had knee pain before the ultra but once i warmed up it never returned. But doing another tough race so soon i felt the sore knees the entire race. They didn't make me hold back but i didnt like it. I had to walk sideways down stairs for a week or so lol. Now, the pain is there but i just notice it on the stairs. I haven't run in a week and the pain is improving. I can do full squats and everything but i feel it. I also have no idea what a level 4 feels like. I could be sensitive or not sensitive to pain. I was thinking of doing zone 1&2 flat trail walk/runs to see how it goes but i dont know when to start? Do i keep waiting until theres no pain? Is it good of the tendon starts sore and smoothes out or is that bad? I always thought that was from crap built up in it. I dont mind paying to chat with someone too. Just need a little guidance so i can get on the correct path
It sounds like you have quite a few questions! I can recommend my colleagues Kevin and Steph to help with this. They can assess it for your and provide you with a rehab plan and training advice via video call. You can read more about how the online consultations work here: www.sports-injury-physio.com/
Can you get this from an injury of deep bending to tie shoe; I think im dealing with the his for the past 5 months since this incident, I also heard a sound at the time.
It is more likely that you have torn something like your meniscus but I am obviously just speculating - get it checked by a physiotherapist - they will be able to diagnose it.
Could restricted ankle or hip mobility cause PFPS? I think that I have restricted ankle mobility and as I go into a deep squat my knees cave in and that cause PFPS.
If you are loading your knees in a position where they move in excessively, then yes, that can irritate the kneecap. Placing something under your heels (rolled up towel or weight plates) to lift them, can help you squat lower while maintaining better form.
Arthritis in my knee what do I do
It can react really well to finding the correct mix of activities. A lot of my patients who have arthritis find that if they cycle on a regular basis it makes a huge difference because the movement helps to feed the joint. Some of the runners I've treated has found that if they cut some of their running sessions and switched it out for cycling it helped them run pain free and perform better. I've shared some more tips in this video th-cam.com/video/HGmbqtDYyvo/w-d-xo.html
🙏🙏🙏