Patellofemoral Pain Syndrome | Diagnosis
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- čas přidán 1. 06. 2024
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Patellofemoral pain syndrome or PFPS typically refers to anterior knee pain usually occurring during activities such as running, squatting, or walking up and downstairs.
Patients of all age categories are affected and the condition can persist for multiple years in up to 60% of cases.
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This is not medical advice! The content is intended to be educational only for health professionals and students. If you are a patient, seek care of a health care professional.
I tore my Acl and cartilage 13 years ago and it completely messed up my knee for good. I get runners knee so easily
I am 20 and very active. My knee pain started from football and it wont get better. Been suffering for 15 months. I used to be so sad and even had panic attacks bcz of pain. I used to see all these utube videos , tried physio but nothing worked. Fast forward 2 yrs. I had my knee arthoscopy 5 months ago. Turned out I had patellor maltracking with lateral shift and also chondramalacia features. And now I can tell you this : it gets so much better after arthoscopy. I know the recovery is a long process cant run for now. But I am pain free. Waking up every morning feels so better. I had muscle loss bcz of 15months of noactivity preop. But exercise helps in regaining muscle too now.
So mannn this is my genuine advice to you : plz stop watching these videos. Go to a consultant and get an MRI. mri explains every thing. Get a arthoscopy if u have to especiaaaly if u are young and wana return to sports.
Lots of best wishes to you nomatter where u are. And if u waana ask plz ask freely. I am 2nd yr med student myself and I pretty much understand the knees anatomy myself
Lots of love ❤😊
I am happy for your recovery
I've been experiencing pain in my knees for almost 2 years probably because of weightlifting and jump rope. been to physiotherapists, had an mri of both knees and all the tests were negative. My knee pain is killing me and the doctors think there is nothing wrong with it, it's sad and I kinda feel hopeless atm.
Del I feel for you bro. I hope it gets better. How old r u btw?
I'm 20 🙃
Bro Getting it in ur 20 in hard. Just as u said , it makes u feel hopeless. Told ya , I remained in ur condition for 15 months. One after the other I changed so many doctors. I remember of the doc said its arthiritis and has no cure. He even said this arthritis would now travel my other joints as well . I was so depressed . I cried alot too. I would watch these utube videos all day long and be sad all the time.
But be strong bro. Believe me it gets better. Lots of best wishes ur way. Stay strong. I know u would come out of it one day
I appreciate it man, thanks a lot for the comfort!
this channel is just awesome
I have been doing physio for months on end, it has done absolutely nothing. Sick to death.
Hello!!! Great videos! And great job! But, what happened with all the subtitles? It looks like there is no more subtitles in any video.
Most of the subtitles are submitted by the community so pretty much anyone can add subtitles to our videos to help the viewers
Great video
What causes nociception? is there nociception on the patella bone??
HLP
I had this for almost 2 years is it still fully recover able or should i be worried
Same I have it and had it for 2 years and it won’t go away I play sports and I don’t know why to do
Doing an MRI or Arthroscopy (if you haven't will help. Sometimes surgery is needed
Lo ipkkpkkpppppppppk jo po
You have given an apt description of PFPS. I have just exact symptoms with same causal factor (too much internal rotation while sitting). My physio told it's early OA knee and prescribed some exercises alongwith weight reduction. My age is just 31. I am worried whether my pain will ever go away?
For any health-related questions, we would advise you to get in touch with our colleague from Yourphysio.online where you can find great information for patients. You can also book an online consultation in order to work on your problem!
How is it now
Has it gotten better? MRI can help determine if surgery is needed
Thankyou!! Al your videos are very helpful. I read people with PFPS have pain when they need to sit for a longer time with a flexed knee. Do you have an explanation why this causes pain?
- a physiotherapy student from the Netherlands :)
Hoi Demy! Dat horen we graag! With PFPS we don't see it too often, rather with patellar tendinopathy as tendons don't like compression which obviously occurs in flexion. The same would be an explanation for PFPS - the compressive forces between the patella and the intercondylar notch are higher than in extension.
Because most PFS is misdiagnosed and is actually referred pain from the Lumbar spine or a knee derangement, two things which can be fixed completely within 2-3 visits using the McKenzie method.
Physiotutors, you guys never talk about the McKenzie method and are thus perpetuating a lot of myths and misdiagnosis by putting emphasis on Orhtopaedic Special Tests which have been shown to be mostly unreliable. I appreciate that you always show the data and studies it is based on, but please have a look at the McKenzie method. For instance, about 50% of hips stem from reffered Lx pain and another large proportion of joint problems are local derangements which can be fixed with a single repeated movement in a matter of seconds if only you applied the McKenzie method. A recent study showed that 29% of patients awaiting RC shoulder surgery are actually Cervical derangement while 38 percent are shoulder derangement (both correctible within 2-3 sessions with a single repeated movement). Please take a look at those studies which you can all find on the Reference list of the McKenzie Insitute website. The fact that you didn't even mention that knee pain with sustained sitting could come from the Lumbar spine clearly shows that you should look at the new studies coming out. Thanks.
Which myths and misdiagnosis are
we perpetuating? Our goal is to shine light on different tests and their reliability and validity. A lot of them are not very strong, still useful.
Now you are throwing around with numbers without any evidence. Can you provide evidence for your claims?
How is cervical derangement assessed? Has this been proven in studies as reliable and valid? Don't think so.
To our knowledge there is no study at the moment (at least that we are aware of on Pubmed) which have proven the effectiveness of the McKenzie method. Could you please provide links to high-quality studies?
In our experience it can be a good method for acute pain and radicular syndrome in patients which react positively with centralization of symptoms.
Regarding the knee...again, which high-quality studies show that localized knee pain can come from the lumbar spine?
Please don't refer us to a webpage which is highly biased!
The way you wrote this comment only let's us assume that you are a McKenzie practitioner yourself and you are either trying to use our channel as advertisment or you got stuck on the modality rollercoster.
Again - evidence? Don't spread myths without backing them up with high-quality research!
I have a question,normally PFS covers lateral deviation of the patella... but is it possible that it will be medially deviated too? because the pain that I feel during weight bearing activities happen on the medial aspect of my left knee :( is it because of my VMO ?
Hey, do you still suffer from this exhausting strange and weird pain and does the pain regulate during the day ? Other question, do you also have a (not) funny feeling in your left knee in the morning because of pfps ? And maybe most important because i too feel it medial, with stairs and so on its a bit everywhere but never lateral. So: do you feel the patella move a little bit when standing up from a chair or couch ? So a little deviation, and on itself not painful but sometime after it gets irritated. Please comment and if a little bit confusing you can send me a an email if you dont mind. I will give it to you if you want too 🙂
I am going to a other fysio because this started because of the exercises from the previous and now really frustrated every day about it.
I never can talk about it with anyone who has the same anoying knee pain
@@KevinBoels89 I started walking every other day to help with my symptoms, the targeted exercises by the PT didnt seem to help. I noticed that eventually my pain subsided, now I only feel crepitations on my knee but almost no pain when climbing up the stairs, I can also run now but not 100% yet. And yes, when I was still symptomatic theres this prolonged subtle pain and heaviness on my knee when I am about to sleep or when I just woke up. Walking did so much for me, my PFS started appearing due to the lockdown, as I was very active before the oandemic hit reaching 10,000 steps or more a day
Hey guys is there a differential diagnosis for this signs ? Because I had a patient who had pain with squatting in her anterior knee , pain with stepping up stairs however she had pain with full extension as well. Thanks guys
Certainly. PFPS is included as possible diagnosis only if all other pathologies have been excluded. Think meniscus or fatpad especially with extension pain
I had gotten it during a dance including fast squats. I can no longer squat without excruciating pain.
Same.
Did 400 squats for Boxing.
Are U still in pain?
Same :(
Can i train upper Body doing pushups, planks, pull ups etc. while recovering from pfps
Absolutely
Regarding PFS, could a strength imbalance between the hamstrings/glutes and the quadriceps be a culprit for chronic anterior knee pain?
In my experience, I never had knee pain in my life from running before I started weightlifting. When I started weightlifting, I did squats (pain free and with good form) but skipped a bit too often on deadlifts, and became possibly even more quad dominant while neglecting the posterior chain. Thats when I felt knee pain after my usual runs that never gave me pain before. I ruled out overtraining, and assume, that it might be caused by said imbalance, since runners often talk about quad dominance being a culprit for runners knee.
Doc told me I had relatively tight quads that pulled on my patella while running. Also I feel that glute activation relieves the tightness in my knees atleast for a while.
Would like to hear your professional opinion on that!
No evidence for that according to our knowledge.
PFPS is often the result of overload on the knee due to increase in training volume. Could make sense that weightlifting and running together sensitized your knee.
Hey Guys! Do you include in PFPS Hoffa fat pad inflamation? In that case, do you recomend similar treatments?
Thanks! hope this 2018 comes with a lot of knowledge and joy for you!
Hi Matias, we believe the basis (hip strengthening) is the same but it has to be managed a bit differently - avoid end-range extension and possibly apply taping on the base of the patella..
Have a look at this paper: www.coreconcepts.com.sg/wp-content/uploads/Clinic-Newsletter-2011-10.pdf
Physiotutors
Genios! Your quick, consistent and selfless answers are inspiring. Thanks and good life!
You have a brother in Argentina :)
Did you heal ?
How did you recover?
I developed PFPS in one knee during heavy squats a month ago and I've been going to PT. They're having me increase my very poor femoral internal rotation (less than 30 deg before stretching, less on the injured side), cortisone patches and slowly increase the loading of the squats but it gets more painful as I increase. They didn't see any evidence of patellar maltracking and taping seems to provide no relief once it's aggravated. I really want to lift pain-free again, are there other options I should talk to my PT about? Started megadosing omega 3's hoping it'll do some good and quell any inflammation left in the knee, I am really feeling desperate! Squats are fundamental to my sport (olympic weightlifting) !
Sorry to hear that! Both of us have had a series of PFPS and know how lengthy it can be. We are both equally enthusiastic about weightlifting/BB and dealing with it has been a challenge at times. Realize that you don't have to quit any specific activity. Key is to make appropriate modifications that don't aggravate your symptoms. If that means decreasing squatting depth, lowering the weight, choosing a different exercise, etc.
Working on hip strength in isolation has done well for us. We have posted about three example rehab protocols for PFPS here on this channel which you could check out and discuss with your PT.
thanks, I'll have a look, you mean the video specifically strengthening the glute med through isolation? I'll talk to my PT about this today. What would having a weak glute med do for my squats? Cause an excessive Q-angle while squatting and resulting in PFPS? I don't have excessive femoral internal rotation/knocked knees, quite the opposite, I have very good ER and can squat low with my knees and toes in the same plane. My VMO's are also sizeable from years of heavy front squats and my dorsiflexion is way above average according to my PT. How can poor IR cause PFPS? It's something I don't understand.
Technique is one thing. Research suggests that an increased q-angle or knee valgus might be a risk factor for the development of PFPS, which is why they came up with strengthening exercises for the glute medius and external rotators.
At the same time, research shows that people who train those muscles become pain-free, BUT did not reduce the Q-angle or knee valgus - pretty weird, hé? But for that reason, work the external rotators and abductors of the hip, even if you technique seems fine.
I'd claim that we both have a pretty decent technique in the squat, but we both have developed PFPS.
We'd therefore suggest you to look more into your acute:chronic workload, rapid increases of volumen, changes of exercises etc. The best solution is to decrease your weight and find an intensity+volume that let's you squat without pain.
From there on, you can increase the intensity again.
Thanks! My physio did the glute med test and found no signs of it being weak. It was definitely an acute event where I made slightly abrupt increase in volume from an inconsistent training week with a heavy weight. I think your suspicions are correct.
It feels better this week, 50% 3x10 with slow eccentrics was painless.
Hi Sir, I am a beginner to working out. I always had to wear knee braces to complete the 30 min workout sessions. Eventhough I was not active, my doctor told me I have Pettela syndrome and it cannot be cured. I am really frustrated, because I cannot work out like everyone. I cannot walk for long more than 30 min without braces. Is there anything to do to avoid knee pain forever when exercising ?
I do have the same problem.
My doctor suggested me physiotherapy exercises but the pain is still there for me .
Did you heal
How was youe condition?
I'd do MRI if haven't. An arthroscopy can help.
Can you have pfps in both knees?
For sure
I have it in both knee😓😓😓😓😓😓😓😢😢😢😢 and in my country there is no good doctors and no good healthcare
@@meftahmourad5860 how’s it going now have you recovered
@@meftahmourad5860 did you recover
@@asumandemirel5225 no brother not yet , i find that problem have a big process its not in the knee , its from the hips brother the hips is the problem of all injuries and all problems of our skelet , our spine and knees and ankles , when the hip is not in the right place the whole body get injuries and also the muscles stability ...
How Can I Contact you ?
I want to diganoise my injury.
I am feeling like I am having PF SYNDROME.
Yourphysio.online
Couldnot I consult without paying?
I am from Nepal
So help me please.
@@sushantgiri8564 hahaha Nepali momo
I have strong quads n strong glutes but after hiking for 6 miles I can’t walk anymore
Saaaaaame. My quads and glutes are super strong. This just came on and the only thing that changed was the addition of cardio on the elliptical. I’ve always hated cardio sooooo 🤬
PFPS is rest pain sir? The pain is from knee up to hip.
I still think i was misdiagnosed but they said i have PFPS. My pain is knee to ankle, rarely to the femur region
The words are over top the picture
I have had this for 8 years I have also got a bony area by my kneecap
I have the exact same thing
How does one treat pfps??
Combination of education, load management and graded exercise
We also have videos on exercise protocols with example exercises
Kunt u mij alstublieft helpen ik ben bijna 16 en heb al ongeveer een half jaar dit in het begin viel het best mee hoeveel pijn ik had maar de laatste tijd heb ik echt het gevoel dat ik dood ga echt serieus ik krijg meestal s’avonds heel veel pijn dat ik bijna niet kan opstaan en zitten soms huil ik heel de nacht door en slaap ik terwijl ik huil ik was naar de huisarts geweest hij zegt het gaat over of je moet sporten maar sporten doet nog meer pijn en de pijn ligt in / random mijn knie schijf en als ik daar zoveel pijn heb gaat het zelfs verder naar onder mijn voeten daar heb ik dan ook veel mijn alsof iemands e bijt en ook heel raar s’avonds krijg ik ook heel veel pijn aan mijn vingers (knokkels/duim) en heupen en rug sorry voor mijn lange verhaal maar ik heb echt hulp nodig ik ben echt bang en ik ga volgende week weer een afspraak maken want door die vorige heb ik nu nog veel meer pijn! 🥺😭😭😭🙏
IS pfps detected in MRI?
My MRI report: Normal knee joint
But it is painfull !!
I'd love to know this. My GP seems to thik I have pfps and wants me to see a physio. But also wants me to get an MRI.
No, pain cannot be detected on an MRI and changes in cartilage is not strongly associated with pain
If red flags are excluded and pfps suspected, MRI is not necessary and can have detrimental effects
@@Physiotutors Hi, what are detrimental effects of an MRI? Thank you 🙏
30 sec of add is way too long!!!
We don’t make the rules