Diagnosis Explanation:

Patellofemoral Pain Syndrome (PFPS), also known as runner’s knee, is a common condition causing pain around or behind the kneecap (patella) due to overuse, muscle imbalances, or improper kneecap tracking. It is common in runners, cyclists, and athletes but can also affect people who perform repetitive knee bending, prolonged sitting, or stair climbing. Symptoms include dull, aching pain in the front of the knee, worsened by squatting, running, kneeling, or prolonged sitting.

Specific Work Modifications:

• If your job requires standing or walking: Use supportive footwear or orthotics and take breaks when needed.
• If your job involves lifting: Avoid deep squatting and twisting movements. Use proper lifting mechanics.
• If your job is desk-based: Keep the knee elevated when sitting and perform gentle stretches throughout the day.
• Avoid: Kneeling, deep squats, prolonged standing, excessive stair climbing, and repetitive knee stress.

Specific Activity Modifications:

• If you run or play sports: Reduce mileage and switch to low-impact activities like swimming or cycling.
• If you hike: Use trekking poles for support and avoid steep inclines.
• If you do weightlifting: Avoid deep squats, lunges, and leg presses. Focus on controlled, low-impact movements.
• Avoid: Jumping, running on hard surfaces, prolonged kneeling, and repetitive stress on the knee joint.

Recommended Supplements:

• Collagen Peptides – 10g daily for cartilage support.
• Glucosamine & Chondroitin – 1500mg/1200mg daily for joint health.
• Omega-3 Fatty Acids – 1000mg daily to reduce inflammation.
• Vitamin C – 500mg daily to promote collagen synthesis.
• Turmeric (Curcumin) – 500-1000mg daily for pain relief.

Recommended Nutrition and Hydration:

• Increase Omega-3 Intake (salmon, walnuts, flaxseeds) to reduce joint inflammation.
• Consume Collagen-Rich Foods (bone broth, citrus, tomatoes) to support cartilage repair.
• Eat Anti-Inflammatory Foods (leafy greens, berries, nuts, turmeric) to reduce swelling.
• Limit Processed Foods & Sugars to decrease joint inflammation.
• Hydration: Drink 8-10 cups of water daily to maintain joint lubrication and prevent stiffness.

Home Exercise Prescription (Rehabilitation for Patellofemoral Pain Syndrome)

Early Phase (0-2 Weeks, Reducing Pain & Swelling):

• RICE Protocol – Rest, Ice (15-20 min, 3x/day), Compression (brace if needed), Elevation.
• Quadriceps Sets – Tighten thigh muscles, hold for 5 seconds, repeat 10 reps, 3x/day.
• Heel Slides – Gently slide heel toward buttocks to improve mobility, 10 reps, 2x/day.
• Seated Knee Extensions – Slowly extend knee, hold for 5 seconds, repeat 10 reps, 2x/day.

Strengthening Phase (2-6 Weeks, Regaining Strength & Stability):

• Straight Leg Raises – Keep knee straight, lift leg, hold 5 seconds, repeat 10 reps, 2x/day.
• Clamshells (Hip Strengthening) – Lie on your side, open and close knees, 10 reps, 2x/day.
• Mini Squats (No Deep Bending) – Slight knee bends while keeping weight on heels, 10 reps, 2x/day.
• Glute Bridges – Lie on back, lift hips while keeping knees bent, 10 reps, 2x/day.

Advanced Phase (6+ Weeks, Improving Stability & Return to Activity):

• Step-Ups – Step onto a low platform, push through the heel, repeat 10 reps, 2x/day.
• Lateral Band Walks – Step sideways with a resistance band around thighs, 10 steps each way, 2x/day.
• Stationary Cycling – Low resistance for 10-15 minutes/day to maintain mobility.
• Balance Exercises – Stand on injured leg for 10-20 seconds, increase as tolerated.

Helpful Books:

1. The Knee Injury Bible: Everything You Need to Know About Knee Pain, Prevention, and Treatment – Kevin R. Stone, MD.
2. Heal Your Knees: How to Prevent Knee Surgery and What to Do If You Need It – Robert Klapper, MD, and Lynda Huey.

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.