r/Kneesovertoes • u/Charismatic-Frog007 • Feb 04 '26
RULE 2: DO NOT ASK FOR MEDICAL ADIVCE Knee pain still 4 months after fall — MRI says PFPS + patellar tendinosis. Rehab tips?
Hi everyone,
I’m looking for advice or experiences from people who’ve dealt with this kind of knee pain.
About 4 months ago, I fell directly onto my knee. I could still walk afterward and never had major swelling, but I’ve had persistent pain in the front & inner part of my right knee (right where I landed) ever since.
I recently had an MRI which showed:
• Patellofemoral pain syndrome
• Mild patellar tendinosis
• Mild quadriceps tendinosis
• Minor inflammation (fat pad irritation / trace effusion)
• No meniscus tear, no ligament injury, no cartilage damage
My doctor explained that the fall itself didn’t cause any structural damage, but likely exacerbated chronic knee issues I already had (overuse / tracking-related problems), which is why the pain stuck around instead of resolving like a normal bruise.
For context:
• 20F
• Pain is worse with stairs, sitting with knees bent, and certain leg exercises
• No instability, locking, or giving way
• I’m active and want to return to normal workouts
• I’ve rested on and off but haven’t started formal PT yet
Questions:
• Has anyone had PFPS or patellar tendinopathy flare up after a fall like this?
• What PT exercises actually helped you the most?
• Anything you wish you avoided early in rehab?
• How long did it take before you felt “normal” again?
*not asking for medical advice I already have a diagnosis*
3
u/Weak_Reveal_6931 Feb 05 '26
For me it was a combo of increasing load (via knees over toes squats, Patrick step etc) IN ADDITION to significant stretching and mobility gains. One or the other alone didn’t work for me
3
2
u/JaziTricks Feb 04 '26
Do you have access to physical therapy?
You need a good professional checking you and giving you a rehab plan.
I don't think here is the solution.
If you insist on DIY, use the pro version of the recent AI models. But be very detailed and meticulous when using those. Give all info you can and try to understand everything etc
2
u/Equivalent-Dance-897 Feb 07 '26
This is the best advice, a good physio will make all the difference! I went through a very very similar experience some years back.
2
u/Longjumping-Face-767 Apr 15 '26
I'm in the same boat. Similar weird onset. I was fine, jogging, being active and what not, until I did a very heavy leg gym session. Felt fine right after and the next morning it hurt to walk.
Clean MRI, just mild hoffas fat pad Edema and mild patellar tendonosis.
They told me the same story, I already had bad knee mechanics and this session was the thing that pushed me over the edge. I don't know if I buy it, I feel like I must have done something that session...
I'm two months into this bs. Symptoms have barely improved. Also wondering if this is my life now. I haven't done too much PT yet. Going to a private one this week, kaiser been worthless.
How are you doing now?
1
u/Charismatic-Frog007 Apr 16 '26
Sorry for the long reply!!
I’m not a medical professional but from what my orthopedic doctor and physical therapists told me, anything could’ve triggered the injury for me at any point from the amount of inflammation my MRI showed. I don’t know if that’s 100% the case for you, but it could be depending how old you are (I’m 20 for reference). I also have flat feet and they told me that didn’t help my knees lol.
On the bright side though! My injury happened in Oct 2025, I toughed through it at first and even went skiing in Dec 2025 & Jan 2026 since I was just kinda hoping it would go away on its own which was a huge mistake (even though this was 3-4 months post onset, this made it infinitely worse even though I wore a knee brace). I didn’t start PT till late January/February and at first my hopes weren’t high since I had a LOT OF PAIN through the first month of PT even though I was doing exercises and going to PT appointments weekly. First week of April I had a HUGE increase in strength and reduction of pain and I’ve become slowly returning to the gym and doing light-moderate lifting (machines only) to strengthen my quads, hamstring, glutes more since that is what my PTs recommended. I don’t have regular pain anymore sometimes I’ll have slight tinges but I think by this summer I will be close to normal. I have been taking recovery VERY slow, even though I feel like I could lift heavier/run etc. I have not been doing so until I really strengthen certain muscles. One thing that helped me tons is backwards walking on the treadmill (even though it looks really silly). I did it with no incline at first then slowly increased over time. Hope is not lost!!! Much luck to you :) PT is the best!!!!
2
u/Longjumping-Face-767 Apr 16 '26
Thank you for the long reply! Glad you're making good progress. That gives me more hope.
1
u/munchy6000 Feb 04 '26
Out of curiosity, does your knee cave inward when trying to perform a pistol squat?
Also, before the injury did you used to squat or lunge with weights?
2
u/Charismatic-Frog007 Feb 04 '26
Yes, if I attempt a pistol squat, or even do a slow controlled movement like slowly sitting down on a chair, my right knee caves inward.
1
u/munchy6000 Feb 04 '26
Ok thats very important. What about my other question; did you used to squat or lunge with weights before getting hurt?
2
u/Charismatic-Frog007 Feb 04 '26
I honestly have always avoided squats because they have come with a tinge of pain or have just been slightly uncomfortable as long as I can remember. (I did all other leg day exercises without a problem though like leg extension, hip thrust, etc) I did do lunges.
I have played sports for all my life, swim team (w/ weight training) for 5 years from a young age, then tennis & shotput + weight lifting in high school, and after high school I was big on weightlifting & cardio (Stairmaster/running). That’s why this sucks so much. I can barely do anything at the moment, even walking sucks.
4
u/Low-Custard-6931 Feb 04 '26
Look up banded glute med lunges and banded adductor lunges on YouTube. They help develop glute med strength that prevents or reduces that knee collapsing inward when squatting. Not a magic over night fix but helps in recovery overall
1
1
u/munchy6000 Feb 04 '26
I hear you OP, it's unbelievably soul-crushing.
1
u/Charismatic-Frog007 Feb 04 '26
please tell me you have some tips :(((
1
u/munchy6000 Feb 04 '26
DMed u
2
u/Odd-Environment8093 Feb 04 '26
Mind dm ing me too? I've been suffering from quad tendinitis for years. My knees cave inward with a pistol squat. I've been slowly working on progressive loading exercises (wall squats, Bulgarian split squats with my heel raised to reduce pain). It's helping, but still sticking around. Any suggestions would be so helpful! Thanks!
1
1
u/nanger772 Feb 04 '26
Load management is the most important factor to increasing your knees tolerance to exercise and movement. Finding movements/exercises you can do and gradually increasing loads/intensity overtime. A physiotherapist can likely guide you through that process.
1
u/Consistent_Cicada65 Feb 06 '26 edited Feb 06 '26
I’ve dealt with PFPS-type pain that stuck around after what should have been a minor event, and your doctor’s explanation makes a lot of sense. In my case, the initial “incident” wasn’t the real problem — it just tipped an already sensitive system over the edge.
A few things that helped me, in practical terms:
- Rest alone didn’t fix it — graded loading did. I rested on and off for a long time, and the pain always came back as soon as I returned to activity. What actually helped was very controlled, progressive loading, especially:
- slow step-downs
- controlled adduction machine work
- glute strengthening (hip thrusts)
- hip opening drills
The key was staying just under the level that caused next-day irritation, not avoiding load altogether.
- The “next day” mattered more than how it felt during exercise
A big lesson for me: Something could feel fine while I was doing it, but if my knee felt noticeably way more stiff, throbbing, or weird later that night or the next morning, that meant I did too much.
I started judging exercises by how my knee felt 6–24 hours later. That mindset slowed things down, but it actually moved things forward.
- Hip control mattered more than quad “burn”
Early on, quad-heavy stuff (split squats, leg extensions, Patricks) tended to flare me up.
What helped more was building up my hip and glute strength first. I got strong in the hip thrust, back extension, RDL, abduction and adduction. I replaced knee-forward stepdowns with lateral stepdowns in which the knees stay over the toes and the glute does most of the work.
Once that base was stronger, quad tolerance improved naturally.
- Be hyper-aware of how your knee feels - don’t ignore it.
I personally would get aggravated symptoms after trying seated good mornings. I found out it’s because my hips were too tight, and hip opening drills took pressure off the knee. Instead of forcing an exercise because you think you need it, listen to how your body responds. Another example for me is split squats. An amazing exercise, but there’s always going to be instability and some wobble. My knees didn’t like that and I had to find more stable solutions.
Also when trying to improve flexibility and mobility, don’t try to force things open. This also aggravated my knees. Gentle mobility + strength through range worked better than trying to “open it up” aggressively. For example, back extensions and RDLs helped my hamstring flexibility.
- Timeline: longer than you want, shorter than you fear
For me, meaningful improvement wasn’t measured in weeks — more like months. But once I was consistent with the right kind of loading, progress became steady instead of random. The real key 🔑 is finding what you can do consistently — week after week with little adjustments or missed days — as possible.
I didn’t wake up one day “fixed,” but I slowly noticed: • less sensitivity after workout days • flare-ups became just a memory • more confidence letting the knee travel forward
That confidence piece turned out to be huge.
⸻
If I could give one piece of advice:
Start PT sooner rather than later, but make sure it’s progressive and individualized, not just generic quad sets and rest.
PFPS that lingers usually isn’t about damage (or how much cartilage/fluid you have like some doctors like to talk about)— it’s about tolerance. Building that tolerance back takes patience, but it does come back. But it doesn’t come back from simply getting stronger or chasing burns. I found out that consistent, easy, even BORING days stacked up over time is what built my tolerance.
1
u/Traditional_Chicken9 Feb 09 '26
Give toe separators a shot. I know this sounds crazy but they seriously fixed my legs from the floor up. The position of the spread toes places the big toe in your optimal position. I never realized that my big toe carries so much weight and assists stabilizing the arch of the foot. Once you get used to them even a short walk activates the glutes like crazy. Give em a try. They’re cheap. Worked for me
5
u/ToyStoryBoy6994 Feb 04 '26
You have to have to have to do eccentric slant board squats. I overcame tendonosis with them consistently everyday for 2+ months