patella femoral syndrome after ACL surgery

**Woodlandclown** · 05-30-2008, 11:01 AM

So - I believe I have this after having an ACL hamstring reconstruction and meniscus tear repair. Its pretty painful, especially after PT. Stepping up, down, squats with weights or leg presses cause the most pain. I mentioned this to the PT and this is what she seems to think it was--I did mention pain to my Dr. and he said he had the same pain and it lasted almost a year. I was thinking it had to do with the meniscus repair. i guess its caused by the weak quad, but yet everything i can do to strengthen the quad hurts my kneecap. In fact, I just searched online and found that you actually shouldnt do the stuff thats hurts--especially squats with weights. I have only been walking without aid of any crutches at all for about a week. Am I just being a baby to worry and it will go away? Maybe I should just buy a simple drug store knee brace with the hole in it when I am exercising? I'll ask my PT next week. I was just there today--I keep hoping I wont feel like this after. I have found online that biking with low resistance and high rpm is good, which i am doing. It just doesnt seem like it will get better if I keep doing things that hurt it. Ugh - after PT i can barely walk for the rest of the day, but then its better in the morning. I would like to be able to rehab everyday though. i guess i'll just stick to things that dont hurt on non pt days.

**drmark** · 05-30-2008, 11:45 AM

Patellofemoral syndrome occurs when the knee doesn't straighten out as much as the other side. Get that accomplished and it will go away. We put all our patients on prone hangs with weights from the get go.

**Woodlandclown** · 05-30-2008, 01:03 PM

Originally Posted by drmark

Patellofemoral syndrome occurs when the knee doesn't straighten out as much as the other side. Get that accomplished and it will go away. We put all our patients on prone hangs with weights from the get go.

Its straight, but not as straight as the other side. searching online it says its because of a week quad muscle--are you saying that isnt a cause? that would make more sense to me since my leg is shriveled. my extension hasnt been an issue. Maybe its just the meniscus then.

**drmark** · 05-30-2008, 04:34 PM

Straight is what the other side is. Without a knee that fully straightens out equal to the other side, patellofemoral syndrome, arthritis, and misery is the ievitable result.

**GoNads** · 05-30-2008, 05:19 PM

Taping for PFS helps alleviate some of the pain, ask your physio. its a temporary fix... I'm stuck taping for everything from skiing, to hockey, soccer running etc because the kneecap has subluxed so many times and there is so much scar tissue around the joint. It also makes the clicking go away.

**Vinman** · 05-30-2008, 06:45 PM

for PFS also look at other possibilities like tight hamstrings, tight patellar retinaculum, tight IT Band. Taping should be a temp fix and used to allow you to exercise with less/ or no pain and make getting stronger easier without irritating the PF joint.

**SponsoredByDuctTape** · 05-30-2008, 09:35 PM

I believe I have the same exact issue going on right now. The pain is because your patella is not tracking straight when you use the quad to straighten your leg, correct? My PT had me try to do some quad extensions for the first time the other day. All he did was put a roll under my knee, so the only weight was that of my foot/shoe. I did about 3 before I got that shooting pain right under the patella. He tried taping it, then I was able to do about 8 before the same thing started happening.

My problem is that I'm just not there yet with the therapy - my PT was really just testing my progress. He tells me it's because of the swelling. The patella is basically floating on fluid and banging on the femur. The lack of strength in the quad is preventing the patella from remaining in position during the extension. Basically, my PT said that I just have to hold off on those exercises for a while. He also mentioned that this type of pain is very common after knee surgery of almost any kind.

I'll admit to being completely ignorant of the medical definition for the term "patella femoral syndrome." I just told my PT "that hurts too much," and he said "OK, don't do that." That's about as far as the medical terms went. However, my repaired knee extension has been the same as my good knee for about a month. I think the issue in my case is just the swelling and weakness of the quad, and it sounds like you might have the same issue.

**whisky** · 06-01-2008, 11:21 AM

I have the same type of pain as well. It was terrible a few weeks ago but it has steadily improved. I've been doing VERY light extensions using BOTH legs. (10lbs) I support the weight with my good leg, only allowing my bad knee to do what's comfortable. A light stretch is all. If you attempt this make sure your knee is WARM before doing this. Again, do this very light.

**Woodlandclown** · 06-01-2008, 01:57 PM

Originally Posted by SponsoredByDuctTape

I believe I have the same exact issue going on right now. The pain is because your patella is not tracking straight when you use the quad to straighten your leg, correct? My PT had me try to do some quad extensions for the first time the other day. All he did was put a roll under my knee, so the only weight was that of my foot/shoe. I did about 3 before I got that shooting pain right under the patella. He tried taping it, then I was able to do about 8 before the same thing started happening.

My problem is that I'm just not there yet with the therapy - my PT was really just testing my progress. He tells me it's because of the swelling. The patella is basically floating on fluid and banging on the femur. The lack of strength in the quad is preventing the patella from remaining in position during the extension. Basically, my PT said that I just have to hold off on those exercises for a while. He also mentioned that this type of pain is very common after knee surgery of almost any kind.

I'll admit to being completely ignorant of the medical definition for the term "patella femoral syndrome." I just told my PT "that hurts too much," and he said "OK, don't do that." That's about as far as the medical terms went. However, my repaired knee extension has been the same as my good knee for about a month. I think the issue in my case is just the swelling and weakness of the quad, and it sounds like you might have the same issue.

yes - sounds similiar. also as vinman said, it could be tight hamstring. thats where the graft was from, so I am quite sure that isnt functioning properly yet. i am going to hold off a bit on stuff that hurts and work on the stuff that doesnt. one thing that doesbnt hurt is straight leg raises with 10lb ankle weights. at least its something that will help build up quad that doesnt hurt.

**pawel.acl** · 12-22-2015, 07:15 AM

Originally Posted by Woodlandclown

So - I believe I have this after having an ACL hamstring reconstruction and meniscus tear repair. Its pretty painful, especially after PT. Stepping up, down, squats with weights or leg presses cause the most pain. I mentioned this to the PT and this is what she seems to think it was--I did mention pain to my Dr. and he said he had the same pain and it lasted almost a year. I was thinking it had to do with the meniscus repair. i guess its caused by the weak quad, but yet everything i can do to strengthen the quad hurts my kneecap. In fact, I just searched online and found that you actually shouldnt do the stuff thats hurts--especially squats with weights. I have only been walking without aid of any crutches at all for about a week. Am I just being a baby to worry and it will go away? Maybe I should just buy a simple drug store knee brace with the hole in it when I am exercising? I'll ask my PT next week. I was just there today--I keep hoping I wont feel like this after. I have found online that biking with low resistance and high rpm is good, which i am doing. It just doesnt seem like it will get better if I keep doing things that hurt it. Ugh - after PT i can barely walk for the rest of the day, but then its better in the morning. I would like to be able to rehab everyday though. i guess i'll just stick to things that dont hurt on non pt days.

I know this thread is old, but I have the same issue here. I would like to ask how did you resolved that issue did it go by itself with time ?

P

**Woodlandclown** · 12-22-2015, 11:02 AM

It went away by itself with time. was about one year with pain and now I long ago distant memory. good luck!

**pawel.acl** · 12-22-2015, 12:03 PM

Originally Posted by Woodlandclown

It went away by itself with time. was about one year with pain and now I long ago distant memory. good luck!

thank you, will focus on the things I can do.

**spanky** · 01-09-2016, 05:08 PM

I'm still dealing with patellofemoral pain syndrome. I'm 16 months post-op from a patella auto-graft ACL reconstruction. I'm optimistic that the pain will continue to fade as time progresses. I've found that quad stretches, foam roller (IT-band especially) and overall stretching of all leg muscles helpful.

Thankfully, it doesn't bother me skiing.

**TeleMiriam** · 04-02-2016, 08:11 PM

I am 5 weeks post op - right ACL reconstruction hamstring autograft. I too have the same thing but it's pretty severe. I can't move my foot from gas pedal to the brake without excruciating pain. I am not driving - I tried to practice in the gararge and failed miserably. I'm quite upset and I'm not sure what to do. Tape doesn't really help.