Patello-femoral syndrome

[741]

Anyone have this condition? I think I'm going to take time off fencing to try treating it.

[Allen Evans]

This is a fairly common condition amoung fencers who don't cross train a great deal, don't stretch enough and who fence a lot. It's easy to fix through some simple exercises and close attention to cross training and stretching in the future. In very severe cases, it might require surgery, but I've never heard of anyone who didn't get results through some physical therapy and stretching.

As always, if you think you have an injury or problem SEEK THE ASSISTANCE AND ADVICE OF A PROFESSIONAL. I don't know how you arrived at your diagnosis, but the knee pain that is so often present in PTF dysfunction could also be the result of other injuries or conditions.

Allen Evans
Dominion Fencing

[mifencer]

This is a fairly common condition amoung fencers who don't cross train a great deal, don't stretch enough and who fence a lot. It's easy to fix through some simple exercises and close attention to cross training and stretching in the future. In very severe cases, it might require surgery, but I've never heard of anyone who didn't get results through some physical therapy and stretching.

Allen Evans
Dominion Fencing

Ok, since you described me -- what am I going to get? What are the symptoms?

[Allen Evans]

Please understand that I am not a doctor, and this is not medical advice. But I had a bout with Patellofemoral pain, as did one of my students. We both resolved it through exercise and stretching....I believe he consulted a doctor and a trainer. I know I did.

The most common symptom for fencers seems anterior knee pain that occurs with activity and is often very acute when going down flights of stairs or decesending a slope. When I sought treatment (for exactly these symptoms), the doctor was also interested if sitting for a long time bothered me as well, though I didn't experience this myself. One knee - my back knee - bothered me more than the other.

My doctor told me that this pain was due to unbalanced muscle development because of fencing, and this was causing a mis-alignment in the knee joint, which not only moves up and down, but is capable of some lateral motion as well. Research after the fact seems to indicate that this is just one of the causes of the pain, and the jury seems to be out on the exact mechanism: poorly fitting shoes, overuse, and poor mechanics in footwork might also contribute.

The trainer gave me a number of exercises to do, some stretches, and a warm up to follow, and the symptoms gradually went away. None of the therapy was particularly painful, and I usually did the exercises as part of my fencing warm up. I also curtailed my fencing for a few weeks, but never stopped fencing. That might have made the symptoms persist longer than they should have after I started the course of therapy (about 4 weeks).

With all that said, knee pain can come from a lot of different reasons, and it's best to have someone who is an expert check you out. Pain in the knee could be tendonitis, arthritus, or damage to ligiments and tendons.

Knees are tough to fix once they are "broken", and I do what I always do when I have a problem: consult an expert (or two) and take their advice. I would recommend the same.

Allen Evans
Dominion Fencing

[mifencer]

Thanks! And I know you're not giving out medical advice. I also wouldn't take medical advice from anyone in a forum either.

I've actually have had this problem. Go figure. I thought it was age!

Thanks again for the advice doc.

[741]

Evans: It was a doctor that diagnosed me with patello-femoral syndrome. All he said was that I can take pain-killers for it and to seek a physio for help.

Can you tell me what kind of stretches and exercises you used to make it better? This pain is really starting to annoy me.

[One and Only...]

Just as a note, I would strongly advice my fellow fencers to do at least some bodyweight strength training and stretching, particularly in the lower body, to even out muscle growth. Squats, one-legged squats, jump squats, lunges (the strength-training kind, not done in the same way as you might in a bout), and scissors can all be done without weights, and might help prevent such conditions as well as improve your fencing ability. I should know: I've certainly benefited.

As far as treating the disorder once you have it, I can't give very specific advice. Those exercises may or may not help after the fact, and while I believe they would, but I'm not willing to make that assertion because I speak only from experience and hold no medical degree.

[BrianH]

I had the same thing many years ago, diagnosed as the synonymous term chondromalacia. Physical therapy, acetominophen and cross-training helped. Good luck with it...it's usually curable by pretty conservative treatment.

Brian

[Achilles]

I also had the same problem. Like everybody said, crosstraining, weight lifting, and stretching will fix it.

[Zilverzmurfen]

Lately I've experienced the same symptoms described. I have now joined a gym in order to do some additional crosstraining/weightlifting.

To me it hurts most (althought it's not an 'acute' pain) when I rise after having been seated for a while, or walking down stairs. Walking down stairs is the worst actually, that hurts a bit...

741:
How is your 'treatment' with this coming on?

[Mauler]

I've been in the process of recovery for the past couple of months. Mine was a rather acute case, compunded by other conditions and a lengthy period of heavy abuse and neglect. After a month of receiving acupuncture and massage therapy three times a week, my knees have improved drastically. Now I run a couple of miles every day and soak in hot bath afterwards. But I still have problems putting any load on my back knee while it's bent (i.e. stairs). I also have to pay a close attention not to put any twisting load on it.

[BrianH]

My pain has come back to haunt me since I posted here last month. Same symptoms. Cause this time: being stupid. I was very vigorous last weekend with sunny spring weather, and ended up running stair laps on concrete stairs over and over and over. I'm afraid I'm a bit old to be doing that, after a lifetime of enthusiastically beating up my legs with fencing, basketball, volleyball and running.

I am no longer a young man. There: I've admitted it. In public.

Good luck with the pain, ZZ.

Rest, Ice, Compression, Elevation (RICE). If it hurts, don't do it for a week (the doc told me six weeks, but hey...no fencing for six weeks? C'est imposible pour moi.) Anti-inflammatories. Red wine if you're not taking acetominphen.

[howtobrew]

Okay, this doesn't sound like what I have been experiencing...(is that good or bad??)

I have been having a gritty discomfort underneath my right kneecap. (right handed). It doesn't bother me when I am fencing or moving, mostly after sitting a while. I guess I am somewhat relieved to read that my symptoms don't include descending stairs.

Course with my luck you guys will immediately reply that my symptoms are indicative of prostate problems....

[Bayou Bum]

I gave up running because of knee problems and took up cycling. I now ride 20-30 miles a day and have completed several century rides. The point is ... I have found cycling easy on the knees and it has strengthened them for fencing as well.

Just watch out for crazy drivers.

[BrianH]

I've heard of other people switching from running to riding for the same reasons...including the epee champion Schmidt from Germany....with great success. It's probably a terrific idea, if you can avoid dogs and crazy drivers.

[JEC]

741,

As I have indicated in other threads, you should consult a sports medicine physician, typically an orthopedist with additional training in this area. Your doctor could then recommend a physical therapist that does sports rehabilitation. As a physician, I can tell you this is the best route to get best care. I have had two knee surgeries and I am still fencing two to three times a week. The link below is from an internet textbook of medicine. I was an editor and author of some articles in my area of expertise, which is not sports medicine.

http://www.emedicine.com/pmr/topic101.htm

Best regards (from NAC-Denver),

JEC

[sabreur]

Along with seeing your doctor, cross-training, stretching, etc., you might take a look at:

http://www.cho-pat.com/

I wear a "dual action knee wrap" on each leg. Several years ago I had pretty nasty p-f problems, particularly with my right (front) knee. I took about a month off, then came back and worked hard on stretching and balancing hamstrings and quads--I haven't had any problems since.

MR

[Zilverzmurfen]

I wear a "dual action knee wrap" on each leg. Several years ago I had pretty nasty p-f problems, particularly with my right (front) knee. I took about a month off, then came back and worked hard on stretching and balancing hamstrings and quads--I haven't had any problems since.

Yep, I wear these from Rehband

• Knee Support
  and
• Knee Support with free patella.

At the moment I'm not very eager to take time off from fencing as I have competitions coming up that I want to do. My pain isn't 'acute' yet so I take it easy during fencing.

I am aware of the unbalance between my quadriceps and 'hamstrings' sooo.....working on it.

Thanks for all links and tips, everyone!