patellafemoral pain syndrome

belgium

diagnosed with above condition over 5 weeks ago,ive followed all the advice given by the physio including vmo and isometric exercises,also followed a strict stretching routine of the hamstring and itb,i can run and use all other non impact cv machines in the gym with no pain in fact i have no pain doing anything,however i got back on my bike on sat after 5 weeks off and within 20mins the pain in my knee was back as bad as before,im due to go to majorca in 4 weeks on a training camp,anyone out there got any magic cures or advice as im at my wits end

onabike

Is the knee inflammed at all?
If so any inflammation will inhibit the VMO muscle, therefore the excercises that strengthen the knee won't work.
If there's inflammation then sort that first ( ice, ultrasound whatever), and then start the excercises.

Also, deep massage of the ITB may help. If the ITB is tight it will pull the knee cap over. Stretching of the ITB is not really possible, but you can stretch the area where the ITB attatches to the hip, which helps a bit - google some excercises for that ( sorry i dont have the link to hand). Deep, painful massage, even self-massage raking your knuckles up and down the ITB may well loosen it up more than a stretch.

PFS can take a long time to resolves. A very long time. I had it bad for two years.
I'm not a physio, just learnt the hard way.

belgium

thanks for the reply,2 years sounds one hell of a long time,did it come and go or was it there all the time?
as far as mine goes theres no swelling and the pain has completely settled down apart from when im on the bike,apart from that i wouldnt even know i had a injury

onabike

Mine felt ok off the bike, but would cause problems 2 hours into the ride.
I think I had some tendinitis as well, so my case was a severe one. I had some inflammation around the knee as well as symptoms of PFS. Once I got the inflammation down the problems eased. I wish I'd gotten ultrasound quicker than I did.

Perhaps with some physio your problem will resolve fairly quickly. Can only guess. I still have symptoms of PFS now, but it's not limiting my riding at the moment.

Do you have the "movie - goers sign". This is when you find your knee feels sort of itchy and irritable after sitting for a long period of time e.g. at your desk or when driving or anything where the knee is kept bent. This sign can be an indicator of how severe your PFS is. I used to find after just twenty minutes sitting my knee felt itchy ( for want of a better word). I still get it now, but it takes much longer.

http://www.aafp.org/afp/991101ap/2012.html

Monty Dog

Don't forget the simple things like ice, cod liver oil, glucosamine and NSIADs (provided you can take them). Also try changing your bike position - dropping the saddle slightly, spinning and less seated climbing can help too.