Patella-Femoral Syndrome

just read what I posted on the other thread last week:

PFPS is an old friend of mine...I'm actually trying to come back from a very long bout right now. I've read just about everything and gotten every suggestion. what I've come to believe is that you can't completely know the best way to get rid of it unless you have a Physical Therapist evaluation. this is because PFPS can be caused by a number of things (although there is a pretty definite category--certain suggestions above may work but it depends on the nature of your problem).

in my case, it seemed that the main problem was weak/inflexible hips and inflexible hamstrings (although the injury wasn't actually catalyzed until I significantly overtrained). so I was put on a PT regimen (which I can perform independently) which works on correcting these. in my own experience, the best way to get over it (I wish I had realized this months ago) is to run just a little bit EVERY OTHER day for a while, and then slowly increase mileage.

however, you can't even begin this until the inflammation is gone (or nearly gone), so you may need some brief time off first. it's tricky though, because the longer you wait, the weaker certain already problematic muscles become, and can make the problem come back that much more quickly (although PT mitigates this somewhat...running is really the best form of strengthening running muscles, though, as long as they're not already too fatigued/weak to improve well). you have to find a balance between inflammation and muscle weakness.

How long does it usually take to get over PFS and return to more or less normal training?

(and I mean on average, I don't really want to hear the typical letsrun bragging about freak injuries that kept people out for 3 years).

After the pain goes away, how long do you wait before starting up again with light jogging?

How about the typical quad exercises targeting the VMO muscle, how long before those start having noticeable positive effects?

The modalities will be useless or do very little. You need rehab. Do quad strength, stretch the shit out of your IT band, and walk before you run.

Here is the answer I posted on an old topic, some of this should work for you:

Basically you need to work on your IT band (stretch it and use a foam roller to give it a hard massage a few times a day) and your inner quad (do 3 sets of 15 straight leg raises with your foot turned out so it targets the inner quad....do this 2-3 times per day). Take a hot bath once per day and ice it every night.

You should try not to run if it hurts as this will just cause inflammation which will knock the patella further out of alignment. When the pain goes away start running again but go slowly and run on soft/flat surfaces. You should also change your shoes and be aware about your alignment when running (think about if you are doing a squat and watching how your knee tracks in relation to your foot...the inside of your knee cap shouldn't track over your big toe, it should be in the middle/outside of your foot...same goes for when you run. Focusing on landing on the outside of your foot and pointing your foot slightly inward when landing can help this. Once your quad gets stronger and IT looser, your tracking will improve naturally but making a conscious effort at first can really help I've found.

I've had this problem a couple times. The first time it took a month to go away but after learning the causes and how to fix them I've been able to head it off at the pass without even stopping training.

superduperduperman wrote:

How long does it usually take to get over PFS and return to more or less normal training?

(and I mean on average, I don't really want to hear the typical letsrun bragging about freak injuries that kept people out for 3 years).

After the pain goes away, how long do you wait before starting up again with light jogging?

How about the typical quad exercises targeting the VMO muscle, how long before those start having noticeable positive effects?

There is no "usual"--it all depends on your rehab, the degree of inflammation you already have, and how fatigued your muscles are. Once I really figured out how to treat this injury, the last time I was coming back, I needed close to two weeks without running. Although, it may have been less had my muscles been less fatigued, which was making it easy for the pain to come back (I had tried to come back too fast and sort of fried myself) even after the inflammation had probably more or less disappeared. I have been gradually rebuilding in the month since without any major setbacks.

I am not sure about how long the exercises to take to have effect. I would assume about a week.

I've been using the foam roller for my IT band the last couple of days, and since I've been doing that my IT band actually feels like it's getting tighter.

It may not be, but at any rate it's sore now, and it wasn't before.

Is this normal?