Patellofemoral pain

DeezNutz

Active member
Trusted Member
Hey @PhysLifter,
First of all, thanks providing this invaluable service to the board.

I’ve never had a real knee injury before, so I guess it was bound to happen with my sports and lifting background (not to mention I’m creeping up in age and still redline like a twenty year old). Any help in this would be more appreciated than you would know.

1) Nature of Injury:
I can’t pinpoint an exact movement or ‘fuck me’ moment but I believe it had to do with a ridiculous amount of Snatches in CrossFit. I cycle my training styles weekly and monthly based on goals.

Training background: I train in all types of styles from olympic lifting to more tradition strength and conditioning while also playing softball and flag football.

2) Symptoms:
I saw the doc today as there is an odd feeling beneath my knee cap. He told me it was a Patellofemoral strain and not to do any explosive movements (fuck) as well as reduce weight (double fuck) and stay away from squats (triple fuck) for at least six weeks.

The pain or uneasiness comes and goes. It’s an awkward strain directly below the knee cap and is only felt repeatedly when walking down stairs. In some occasions, when I’m walking, it pings me out of the blue.

3) Past History:
No history of injury in the area

4) What Makes It Worse or Better:
Ice makes it better as do knee wraps.
As I said, walking down stairs and in terms of training, any squat based Oly lift causes pain ( tried a couple days ago w/ no weight: squat clean, snatch)

5) Scans:
Should I ask for one? I don’t like putting a strain(no pun intended) on the medical system when people have bigger issues. Also, by the time I get in, I’m sure it’ll be a month.

6) Goals:
Get back into Oly lifting and CrossFit.

8) Medications:
Currently on TRT and just in the middle of transitioning from : TRT + 600 primo + 300 Tren/wk to TRT + 300 DHB/wk

My questions:
A. Could these symptoms point to something different than what my doc said?
B. What types of exercises can I do to maintain strength in my wheels while the tendon heals?
C. What types of movements should I stay away from?
D. Can any supplements or peptides aid in recovery?

You’re my second opinion here. If there’s any advice you can think of to help my recovery along it would be greatly appreciated!
 

Funnyman

Well-known member
Trusted Member
Well I do know when i went for phyio the guy said he makes good money from crossfit. He said don't ever do cross fit, or you will be back to see me.

My chiro I been seeing for the past month said cross fit is bad for the spinal cord and joints.

No ballistic training ever.

Guess it's time to slow down the rep tempo.

But I'm sure phsiolifter will say the same.
 

gondar1

I'm kind of a big deal in Japan
Trusted Member
Sorry to semi-derail, I have informally bet about a dozen people that they would be injured within the first 3 weeks when they join crossfit and I don't think I've lost yet. @Funnyman your post set my brain in motion on the subject, I thought of a new motto for crossfit business owners to adopt -

"Crossfit, give us three weeks and we'll give you something that you'll remember for the rest of your life"
 

DeezNutz

Active member
Trusted Member
Hahaha - thanks guys!

I knew I was going to take heat for CrossFit but I needed to paint a full picture for proper assessment.

I’ve been training this way at my own pace within my limits for a few years on and off and with strict form and have never had an injury. I understand your perspective though and will simply be adjusting/adapting the training philosophy into a new routine once healed.
 

biguglynewf

Moderator
Listen to your healthcare team.

Unless you remember something remarkable I doubt there is any significant tears or anything that require imaging. With both of my knee injuries there was definitive popping noise/feel.

Did the doc suggest a rehab plan or engage a physio? If not get to a good one that understands athletes.

You basically have runners knee if the doc is correct in his assessment. It can be agonizing. It is caused by a bunch of things. Overuse, getting old, drying out, etc. Ultimately though it is excessive wear because the patellar tendon is not tracking properly causing inflammation. A good physio will be able to diagnose the misalignment and get you doing exercises that will help the imbalance.
 

Goldenrod

Well-known member
Trusted Member
Per biguglynewf - dealing with basically the same as you for a few months. Found a good physiotherapist with knees and I’ve been working with him for just over a month. I’m up to body weight squats and not in pain/limping anymore. Baby steps - it’s frustrating but I’m making progress. I only go once a week as he shows me what to do and I do it at home each day.
Good luck
 

Goldenrod

Well-known member
Trusted Member
I meant to mention - my doctor day she would order a scope or MRI if no progress in a few months. I would try physio for a while and if not better - ask for a MRI.
Peptides - BP157 - I take 250 twice a day right at the injury site but it is not a miracle cure. It helps but physio helped much more.
 

Bagua

Moderator
I got nothing, unless you want advice from someone with two replaced knees and countless injuries.
 

DeezNutz

Active member
Trusted Member
Listen to your healthcare team.

Unless you remember something remarkable I doubt there is any significant tears or anything that require imaging. With both of my knee injuries there was definitive popping noise/feel.

Did the doc suggest a rehab plan or engage a physio? If not get to a good one that understands athletes.

You basically have runners knee if the doc is correct in his assessment. It can be agonizing. It is caused by a bunch of things. Overuse, getting old, drying out, etc. Ultimately though it is excessive wear because the patellar tendon is not tracking properly causing inflammation. A good physio will be able to diagnose the misalignment and get you doing exercises that will help the imbalance.
Thanks @biguglynewf and all the others who've chimed in.

You elaborated on what my doctor said regarding the patellar not tracking properly. He was pretty vague in his description of the issue (as I probably was) and sent out a referral but said it would be a couple weeks until they get ahold of me. @TheOldGuy sent me a physiotherapist in my area that I'll be contacting today. I don't like the idea of not being in control of the rehab timeline.
 

PhysLifter

Active member
Trusted Member
Hey @PhysLifter,
First of all, thanks providing this invaluable service to the board.

I’ve never had a real knee injury before, so I guess it was bound to happen with my sports and lifting background (not to mention I’m creeping up in age and still redline like a twenty year old). Any help in this would be more appreciated than you would know.

1) Nature of Injury:
I can’t pinpoint an exact movement or ‘fuck me’ moment but I believe it had to do with a ridiculous amount of Snatches in CrossFit. I cycle my training styles weekly and monthly based on goals.

Training background: I train in all types of styles from olympic lifting to more tradition strength and conditioning while also playing softball and flag football.

2) Symptoms:
I saw the doc today as there is an odd feeling beneath my knee cap. He told me it was a Patellofemoral strain and not to do any explosive movements (fuck) as well as reduce weight (double fuck) and stay away from squats (triple fuck) for at least six weeks.

The pain or uneasiness comes and goes. It’s an awkward strain directly below the knee cap and is only felt repeatedly when walking down stairs. In some occasions, when I’m walking, it pings me out of the blue.

3) Past History:
No history of injury in the area

4) What Makes It Worse or Better:
Ice makes it better as do knee wraps.
As I said, walking down stairs and in terms of training, any squat based Oly lift causes pain ( tried a couple days ago w/ no weight: squat clean, snatch)

5) Scans:
Should I ask for one? I don’t like putting a strain(no pun intended) on the medical system when people have bigger issues. Also, by the time I get in, I’m sure it’ll be a month.

6) Goals:
Get back into Oly lifting and CrossFit.

8) Medications:
Currently on TRT and just in the middle of transitioning from : TRT + 600 primo + 300 Tren/wk to TRT + 300 DHB/wk

My questions:
A. Could these symptoms point to something different than what my doc said?
B. What types of exercises can I do to maintain strength in my wheels while the tendon heals?
C. What types of movements should I stay away from?
D. Can any supplements or peptides aid in recovery?

You’re my second opinion here. If there’s any advice you can think of to help my recovery along it would be greatly appreciated!
Lots of great info here!! Let's get right to work!

Typically when you descend/go down objects pain usually represents joint or inert tissue. Not muscular because you are in a rested state of use and the joints take on all the load. When you go up stairs, contract, and you have pain, that's usually where the patellafemoral issue comes into play.

There is though the bursa sac that sits under the patella, and through significant loading activities can aggravate the hell out of it. An easy way to diagnose that is to push straight down on the knee and if it hurts then yes, or cup your knee cap above with the webspace of your hand, block it from moving up, then try to do a static hard contraction into the floor without the knee cap moving. If it hurts, it's bursa. If it doesn't hurt, likely joint space (given you said squats and descents of stairs hurt again).

At this point ice is a good analgesic but you want more heat on the tissue to heal it. I would also avoid all large loading, focus on simple leg split squats, extensions, some pressing to rep out without ZERO or MINIMAL discomfort. That is different than pain.

I used TB500 to help with my tendonitis. I injected straight into the tissue but I have no idea if that helped at all or caused another type of inflammatory reaction which made it heal. I do know TB500 did accelerate healing significantly but I still had to train smart.

A good physio will pick that up fast, tape it, treat it, get you back on the right track fast especially if there are a few lagging muscles contributing to those issues that may come back up again in a future time. You may only need an assessment and a follow up or two at the max.

No xrays/mri needed. You aren't surgical, there are no fractures or tumours, and knowing that you may have arthritis or "Degenerative Changes" amounts to nothing than a waste of time on the system plus you exposed to unnecessary radiation.
 

DeezNutz

Active member
Trusted Member
Many thanks for this @PhysLifter.
No pain when pushing straight down the knee, nor when I cup the knee and do a static contraction. Right now I'm staying away from the gym until I get an assessment. Great to hear that no xrays/mri are needed.

I'm going to look into TB500 a little more as what I have read up until this point has been conflicting in nature.

I'll keep you updated.
 
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