13 Wrong Treatments You Might Be Doing To Worsen Your Patellofemoral Pain Syndrome

Treating patellofemoral pain syndrome can be so confusing because there’s so many treatments out there that actually make the knee pain worse, I’m going to tell you 13 commonly done treatments. And these are often recommended by healthcare professionals that will make your patellofemoral pain syndrome in your knee worse.

Number one, quad sets. This exercise is when you are sitting down or lying down, maybe with your legs up, your leg is straight like this, and you’re trying to contract your thigh muscle, you’re trying to tighten this thigh muscle as hard as possible to work this muscle out. This is called a quad set. Sometimes you’ll hold it sometimes we’ll just squeeze and let it go squeezing let it go.

Either way, this is not a good exercise, because this exercise is focused on getting more strength through the quad muscle on the front of the thigh here, which is actually what makes the whole knee problem starts when you have over dominant quad muscles on the front of your thigh. When they’re too strong, though they attach to the kneecap here, and it pushes the kneecap down against your thigh bone, which rubs it way too much and causes patellofemoral pain syndrome.

It rubs a cartilage on the back of the kneecap and on the end of the thigh bone right here. And it makes the cartilage rubs so hard and so much that it irritates the cartilage and overtime can set you up for serious problems like knee arthritis, and other knee problems that you don’t want to deal with long term. So doing any sort of quad related exercise, especially those quad sets that I just showed you are not a good idea.

Another exercise that is a sneaky quad exercise is straight leg raises. This one is so often done in physical therapy. Usually, you’re lying down like so. And then you’re picking up your leg straight. Just like this.

People are told to do this all day long in physical therapy. And the goal by the physical therapist is usually to work out the muscles exhaustively in the leg in an effort to strengthen everything around the knee without paying attention to the muscle imbalance.

But when you’re picking up your leg like this, one of the muscles that runs right down the front of your thigh. It’s a quad muscle. It’s called the rectus femoris muscle, it attaches to the kneecap and if you’re strengthening that muscle, you’re compressing your kneecap down against your thigh bone further, making the whole root problem the muscle imbalance worse.

Number three is wall squats. Squats like this with your back against the wall are very often recommended by all kinds of healthcare professionals for treating kneecap pain. But in reality, it makes your quads work tremendously. So it is not a good idea to be doing this exercise if you have patellofemoral pain syndrome.

And there’s really no good way to make this exercise, not use your quads, you have to use your quads, no matter where you put your legs, it just is very quad dominant. Because some exercises as you’ll see, I’m going to talk about them. You can modify them to make them not so quad dominant in the front. But this is one that is just straight up quads.

Number four step ups. Stepping up and stepping down by doing aerobics type exercises, or even just using stairs like climbing up stairs, in an effort to make your quad muscles stronger are a bad idea. Many times, you don’t even get told what muscles are working.

You’re not even sure what muscles are supposed to work, you’re just told to go up and down stairs or steps and it’s supposed to help your patellofemoral pain syndrome. But if you find that you’re using your quad muscles quite a bit when using any sort of step up or a stair, it’s going to feed into that quad muscle imbalance and put more pressure on your kneecap making your patellofemoral pain syndrome worse.

Number five adductor exercises. These are exercises where you’re pushing your knees together to squeeze together and cause your groin muscles on the inside of your thighs to work. They are often done with a pillow or a ball between your knees.

You you’ll probably lie down on your back, put the ball or the pillow between your knees and then squeeze it like so sometimes people will hold it and you’ll feel the muscles that run from the inside part of the part of your knee here all the way to the groin area, those muscles will tighten up.

Getting more strength in these muscles is rarely ever needed. Because how often do you really need to squeeze your thighs together in normal everyday activities like walking, running, jumping, bending down, usually your legs go out and you need more strength going out rather than going in.

Plus, the muscles that make your thighs go inwards, tend to work together with the front of the thigh muscles. So when those muscles contract together, it just feeds into the compression that you’re already putting on your kneecap. So you don’t want to be doing these adductor exercises. You’re better off doing exercises where you push your knees outwards and make these muscles work more than these muscles.

Number six quad stretches. Quad stretches live like this, there’s different ways to do it, people will usually stand, grab their foot and bring their foot towards the bottom like this. And they get a big stretch on the front of the thigh.

And other way people will do it as they’ll put their foot up on a chair or somewhere like this, and then sit back into it, or they’ll slide their knee behind them and get a little bit of a hip flexor, in addition to the quad. So like on that one, I felt it right here on the front of my thigh.

These stretches, they’re not super bad, but they’re also not the best use of your time. Let me tell you why. If you have dominant quads already, they’re going to tend to be a little bit shorter, stronger, muscles tend to be shorter. That’s how when you work out and you firm up and you tone up, the muscle feels a little tighter and stiffer, because the muscles shortens just a tiny bit.

So if it’s a shorter muscle, hearing your thigh, and then you go to bend all the way, you’re going to put some more stretch through an already shortened muscle and compress the knee joints. Now, it’s in rare occasions only that I find that people tell me that it hurts when they bend their knee all the way.

That means that that cartilage is very irritated, if that’s you, you should not be stretching to get pain relief from your patellofemoral pain syndrome, you need to avoid it. Now the only time I tell people go ahead and stretch for this kind of a problem is if you stretch very lightly, on a scale of zero to 10.

10, meaning the most intense stretch you’ve ever gone through, you need to stay at like a one or two at the very most three intensity of stretch. And even then there’s way better exercises way better activities that you could be doing to help your patella femoral pain problem. Stretching is really one of the lowest level things that you could be doing.

Number seven is resting too long. This is a recommendation given by doctors often whenever you go to the doctor with patellofemoral pain syndrome, especially if you’re more of the athlete or you’re the active individual, you’re always on your feet doing stuff around the house or you’d like to go exercise at the gym or the park, the doctor is going to ask well, how much are you walking? How much are you running? How much time are you doing with this sport.

And as soon as you say you know, an hour a day or whatever it might be because you’re the more active individual, that doctor, especially if they’re not an active person, they’re going to say, Oh, that’s too much, you need to rest. That’s why your knee hurts. That’s why you’re running into patellofemoral pain problems. And yeah, in some circumstances, it can be that you just did too much too soon. And maybe you don’t have a muscle imbalance.

But if you do have a muscle imbalance, which is usually the case with patellofemoral pain syndrome, rest is okay. Only at the beginning while you’re getting that inflammation in the knee joint to come down. But once your knee is feeling better, people tend to want to go back to doing physical activity than the one that they were doing before.

They want to be active again, if you don’t fix that muscle imbalance, and you just rest indefinitely, then you’re going to always have that muscle imbalance there and it’s just going to get worse over time. So rest Yeah, a little bit, but then eventually you need to get on to the right kind of exercises so that you can address the root problem.

If you want to learn which exercises are best for your patellofemoral pain syndrome. Then I want to encourage you to learn more about our 28 Day knee health and wellness boost program. You can find more details about it down in the description below.

Number eight hamstring stretches. These muscles are the ones that are on the back of your thigh right here. And very often people will put their foot up on a stool and a chair somewhere where they can get their foot up like this and then lean into it like so and they feel a stretch anywhere in this area.

I feel it most right behind my knee. Some people will feel it in the middle of the thigh back here and some people up by the bottom are here by the glute muscles. That whole area is where your hamstrings live in your body.

These muscles are intended to guide the movement of your knee and they usually get tight because they’re not being helped out by other muscles or they’re the hamstrings are having to take over they’re compensating for weakness in other muscles, usually the glute muscles. So stretching might buy you some short term relief but it’s not going to solve the root problem.

You’ve got to fix that muscle imbalance which goes back to usually strengthening the glutes sometimes it’s other core muscles. Sometimes it’s foot muscles as well that need to be addressed. In order to get that hamstring flexibility again, stretching the hamstring tends to add compression to the knee joint.

And although it’s not as direct as quad stretching, because the quads attached to the kneecap here, the hamstrings do not attach the kneecap they come from behind it attached to the sides of the shin bone. It does add compression is and is overall a negative thing to be doing for the knee joints.

Your time is much better spent at flipping that muscle and balance so that the pressures are normalized in your knee joint and you take that compression off the kneecap right here.

Number nine, pointing your toes and knees directly forward. When walking stair climbing, doing any activity and exercise. It’s not a good idea a lot of people don’t realize this they just kind of pick it up at some point or another, whether they’re in high school sports or they work out with a trainer.

Maybe they see it online, they think that your toes need to be pointed directly forward, whenever you’re walking or doing anything. In reality, you should have your toes angled out slightly. And here’s why. When you point your toes forward, your glute muscles are less likely to work. And your quad muscles are more likely to work.

So try this experiment right now stand up, point your toes straight forward, tighten up your butt muscles back here. And you probably feel them work. If not, you have a big muscle imbalance. But you probably feel your quads wanting to work to now do this point your toes out. A comfortable amount doesn’t have to be all the way you could go all the way if you want.

Now tighten your glutes, you should find here that your glutes tend to tighten better than when your toes were forward. And then you can even try pointing your toes inward just to take it to the other extreme and try tightening your glutes there. They don’t work as good as when you have your toes slightly pointed out.

So here’s the thing, if you point your toes out a bit, all the time when you’re walking all the time when you’re exercising, and it doesn’t have to be extreme like Charlie Chaplin, it can just be a moderate a comfortable amount, then you’re presetting your glutes to tend to work better. And it’s setting you up to take some pressures off your knee for the long term.

Now it’s a small, it’s a small tweak, it’s a small motion. But think about this, if you go walk 10,000 steps that several miles, and every single step or 80 or 90% of the steps your toes are pointed out. That is tremendously less pressure through your knee joint over time, that’s going to extend how much time you could spend on your feet before your knee starts to bother you.

And gradually you reduce the irritation. And you’re training the glute muscles to work properly. As long as you can activate them, you have to be able to activate them so that you can take care of this patellofemoral pain syndrome for the long term. And you’re preventing yourself from getting into worse issues like meniscus injuries, cartilage injuries, and of course, knee osteoarthritis.

Number 10 playing through pain. If you have patellofemoral pain syndrome, this is bad on so many levels. If you’re a runner, for instance, or you do any type of running sports like soccer, football, jumping sports, as well, volleyball, any of those sports, soccer, any of those, if your knee hurts, and you just play through it, you’re irritating your cartilage.

Further, it’s just like, if you already hurt if you have a wound on your skin here, and then you get something on top of it, you put your hand on top of it and you rub it what’s going to hurt, right? Why would you do that? It’s the same thing on the inside of your knee joint, your cartilage on the back of your kneecap is hurt.

It’s irritated, it doesn’t, it’s not ready to take on all the forces you’re about to put through it. Or it could be the cartilage on your thigh bone here too. And then you go run or you do jumping activities and you rub it further, you’re making it worse, it just makes sense to do that.

The problem that people run into is the body is amazing. And it has the ability to turn off pain at certain times. And cartilage is a very durable tissue and it can take quite a bit of pressure. And it kind of shuts off pain if it’s not too bad. Once you start to run, it kind of goes away, it feels better. But then comes the pain afterwards.

If you have that pain, that just intensifies. After you stop exercise, that’s a serious situation where you should not be doing a whole lot of exercise. Or you need to modify your exercise need to fix something about how you’re doing it.

Either change the exercise, reduce it, reduce the intensity. And if you tried all that then you do need to stop for a short time while the inflammation goes down in your knee so that you can begin to do the right exercise and eventually get back to that sport or that activity that you like to do.

But playing through it in the short term is a huge no no, taking medication, pain medication to go play through it. Not a good idea. And there’s situations where you might even be doing a good exercise and exercise that is helpful for you. For instance, our 28 Day Knee Health and Wellness boosts program has tons of exercises.

Some of those might hurt you. If you’re too irritated in your knee joint. It’s just like if your skin was open a normal pressure that you can take without any issues. Well, it’s going to hurt if your skin is open. If you’re healing. You’re not ready you need to heal first, then you can take that pressure, no problem. So don’t play through pain. It’s just not a good idea.

Number 11 biking or cycling. The reason why biking cycling is not a good idea. For the most part. It’s not a good idea. There are exceptions. It tends to be a quad dominant activity, especially if you’re one of those intense cyclists that has the clip-on shoes and the whole ghosts which I’ve been there myself, you tend to be locked into a certain movement and it’s hard to deviate from that movement because of the shape of the bike is going to make you use your quads quite a bit.

 And even though it’s less pressure on your knee joint than walking, hiking, or running, or any sort of jumping activities, you’re still training yourself into the imbalance, and you’re going to cause worse knee problems later on, it just may feel better to do that exercise in the short term than if you go do some more impactful activity like running, but you’re still feeding into the long term problem by working out your quads quite a bit.

Now, cycling is very commonly done in physical therapy clinics. In fact, most physical therapists will start out their sessions with patients like that, they’ll say, Hey, come on back, hop on the bike for 10 minutes, and then we’ll get going on the rest of your treatment, there’s no attention paid to which muscles you’re actually biking with.

And biking can be a good thing, if you’re using your glute muscles, which in order to do that, you have to be very conscious about your how you’re moving. And you might need to open your knees a bit in order to get your glutes to work better and try to shut off your quads.

But if you’re if you just can’t get your quads to shut down and make your glutes work more during the cycling exercise, than it is not going to be a good thing for you to do overall.

Number 12 walking. On the same thread as cycling and biking. If you’re walking using your quads too much, then you’re going to feed into this muscle imbalance problem. And it’s only going to compress the kneecap against your thigh bone worse and worse as time goes on.

The trick is you can train yourself to use your glutes more during walking than your quads. And that toes out thing that I talked about earlier matters a lot when walking. Because if you can keep those toes out slightly, and think about using your glutes properly when you’re walking.

Which I’ve got a video for you, that shows you exactly how to walk using your glutes so that you can reduce how much you’re using your quads and take pressure off your knee joint, it’s in the description below.

It’s called does walking help knee pain, go check that out so that you can begin to walk in a way that’s helpful for your patellofemoral pain syndrome. Rather than harming it, you’ve got to reduce how much quad you’re putting into your walking pattern, then it can become helpful for you.

But if there’s no attention paid to what muscles you’re using, when you’re on the treadmill, or when you’re walking at home or at the park or at the store, then you’re probably feeding into your patellofemoral pain syndrome gradually over time.

Number 13, the final one is swimming. Swimming is often seen as the holy grail for knee problems because it takes pressure off your knee joint you jump in the water; the buoyancy of the water just takes weight off and it’s seen as something that reduces the pressures in your knee joints. And it often feels great to get in the water.

You mean you feel the cool water, it’s just a different sensation, it might actually help your knee problem quite a bit in the short term. The problem comes when you start to kick in the water. How are you kicking are using your quads quite a bit.

You’re supposed to be using your glutes and if you’re not using your glutes if your glute muscles your butt muscles are not getting tired when you’re kicking in the water, then you got to be using your quads there’s that’s just the main way it’s going to happen.

And if you’re using your quads a lot that means you’re building the strength in the quads which is going to compress the kneecap against the thigh bone and set you up for worse patellofemoral pain syndrome as time goes on.

Hope this video was helpful for you. Please give us a thumbs up if you thought it was helpful and share it with somebody who needs to hear this. And don’t forget to subscribe if you haven’t yet in terms of notifications. I’ll see you in the next video. Bye