Detailed guides to painful problems, treatments & more

All Archived Updates for:

The Complete Guide to Patellofemoral Pain Syndrome

This page lists all 127 updates for one book on, The Complete Guide to Patellofemoral Pain Syndrome For a more general summary of everything new around PainScience — recent updates for all articles, new articles, blog posts, and new study summaries, see What’s New on

  1. Jan 1, 2022 — Added sub-topic, ozone therapy — Added a discussion of ozone therapy, which just barely qualifies as a “regenerative” therapy, and my only advice is to avoid it, so it’s a minor addition here — but an interesting one.
  2. Sep 10, 2021 — New section, about plantaris hypertonia —
  3. Jul 26, 2021 — Proofreading — Top-to-bottom check for typos and other minor errors. They creep in over the years as I work on updates to the book. A good three dozen of the little buggers identified and fixed this time.
  4. Feb 4, 2021 — More and better, thermotherapy section — It’s not an important sub-topic for patellofemoral pain, but it certainly deserved more and better advice than I had previously offered. An obsolete point or two removed, and a more modern perspective added.
  5. Nov 14, 2020 — New sub-topic — Added discussion of the (rather silly) idea that prolotherapy is a form of regenerative medicine.
  6. Nov 14, 2020 — Major expansion — Added an introduction about regenerative medicine in general, a thorough discussion of autologous chondrocyte implantation, and some basic notes about stem cell therapy.
  7. Oct 28, 2020 — Upgraded — Substantial revision and modernization, with more attention given to skeptical concerns about icing.
  8. Sep 2, 2020 — Science update, introduction to exercise therapy — Added more about the rationale for exercise therapy, citing Fu.
  9. Jul 11, 2020 — Addition — Added osteochondritis dissecans to the list of other diagnoses to consider.
  10. Jul 6, 2020 — Minor addition, load management — Added “sex” to the list of activities that can involve potentially harmful knee stresses, depending on the position and, er, endurance.
  11. Jun 6, 2020 — Science update — Updated the discussion of inflammation with important perspective about more subtle types of inflammation in overuse injuries.
  12. May 4, 2020 — New content, orthotics chapter — A minor but nice addition of information (and a story) about heels and heel lifts.
  13. May 4, 2020 — Minor update, rest introduction — Added a couple small but good clarifications, and an amusing bit of perspective, in my never-ending quest to effectively explain the importance of rest.
  14. Jan 14, 2020 — New sub-topic, oral corticosteroids — Compared and contrasted oral and injected corticosteroids.
  15. Jan 6, 2020 — Added sub-topic, soft knee bracing — Expanded the scope of the section to include soft bracing as well as taping and strapping.
  16. Nov 6, 2019 — Expansion — Previously this chapter was just about massage in general and foam rolling in particular. I’ve widened the scope to address the underlying assumption that there’s a need to “loosen” the quads, and now cover both stretch and massage.
  17. Jul 31, 2019 — Minor addition, resting pitfalls — Added a brief discussion of an important principle: exercise is a pain-killer! Sometimes.
  18. Jul 31, 2019 — New section, evidence for resting —
  19. May 17, 2019 — New section, all about joint noise —
  20. Mar 16, 2019 — New section, minor new sub-topic: Is it possible to exercise to recovery while still in some pain? —
  21. Mar 16, 2019 — Edited, worst case scenarios with pushing through the pain — Just cleaned it up, clarified, made it less about runners exclusively.
  22. Jan 25, 2019 — New section, review of a popular video about “patellar release” —
  23. Jan 4, 2019 — Science update, regenerative medicine section — Added brief discussion of the poor state of evidence for stem cell therapy, citing Pas et al.
  24. Jan 4, 2019 — Minor addition, resting strategy — Added sidebar about crutches and canes.
  25. Jan 4, 2019 — Additions, differential diagnosis — After long neglect, I finally added some new points to this section, regarding tendinitis and infrapatellar fat pad impingement fat pad syndrome.
  26. Nov 10, 2018 — Editing, strength section — Just making the same points a bit more clearly.
  27. Oct 1, 2018 — Expanded, diagnosis section — Added discussion of plica syndrome.
  28. Sep 8, 2018 — Additions — More detailed summary of the troubles with meniscectomy.
  29. Jul 25, 2018 — New section — A new standard chapter for most tutorials summarizing several key concepts about placebo.
  30. Dec 4, 2017 — Science update — Cited and discussed Schandelmaier et al on low intensity pulse ultrasound for fracture/osteotomy healing.
  31. Nov 29, 2017 — Science update, surgery section — Cited Siemieniuk — the British Medical Journal strongly denouncing the common athroscopic surgeries.
  32. May 21, 2017 — Revision — Clarifications about the value of treating inflammation in principle.
  33. May 20, 2017 — Science update, steroid injections — Significant science upgrade based on McAlindon et al.
  34. Apr 8, 2017 — Upgrade — Shoes now have a section to themselves (orthotics discussed separately), and I made several improvements at the same time, mostly about spring-based shoes as a generic concept.
  35. Apr 8, 2017 — Major upgrade — Much more detail and modernized references. The entire section is now dedicated to orthotics (and shoes have their own section, also upgraded).
  36. Jan 14, 2017 — Major science update — I have reversed my position on vastus medialis isolation on the basis of new evidence.
  37. Aug 3, 2016 — Science update — More information and citations about ineffective knee surgeries for context.
  38. Jul 23, 2016 — Minor update — Cited van Gent 2007 on training volume and the “fine balance.”
  39. Jul 23, 2016 — Minor update — Cited van Gent 2007 for perspective.
  40. May 6, 2016 — Major update — Fully modernized risk and safety information about all over-the-counter analgesics.
  41. Apr 14, 2016 — Science update — Significant revision in light of (finally!) good new evidence about natural running and injury prevention.
  42. Jan 14, 2016 — Science update — Added a strong (and interesting) reference about surgical lavage and debridement.
  43. Dec 29, 2015 — Science update — Added citations to shore up efficacy, and evidence that taping tinkers with knee sensation.
  44. Nov 11, 2015 — Science update — Added more evidence showing no causal connection with hip weakness, plus related editing.
  45. Oct 26, 2015 — New section —
  46. Oct 1, 2015 — New links — Added links to several other relevant articles around the site, and most of those have been updated recently.
  47. Mar 10, 2015 — Science update — Added strong evidence from Freedman et al that Q-angles aren’t worth measuring.
  48. Feb 9, 2015 — Minor update — Added an interesting subsection about “fabella syndrome.”
  49. Dec 22, 2014 — Correction — Reduced confidence in the results of a major study of special footwear (Knapik, the subject of the last update). Later removed the reference altogether.
  50. Sep 23, 2014 — New section — A short new section, finally, on PRP injections. I’ve also published a more detailed free article about this.
  51. Aug 23, 2014 — Minor update — General editing, plus a stronger and clearer statement about targeting the vastus medialis.
  52. Aug 23, 2014 — Minor update — General editing and polish, now that the dust has settled from the 2nd edition launch.
  53. Aug 23, 2014 — Minor update — General editing and polish, now that the dust has settled from the 2nd edition launch.
  54. Jul 29, 2014 — Major update — Extensive revision for the 2nd edition.
  55. Jul 29, 2014 — Major update — Extensive revision for the 2nd edition.
  56. Jul 29, 2014 — New section — A new section for the 2nd edition.
  57. Jul 29, 2014 — New section — A new section for the 2nd edition.
  58. Jul 29, 2014 — New section — A new section for the 2nd edition.
  59. Jul 29, 2014 — New section — A new section for the 2nd edition.
  60. Jul 29, 2014 — Updated — Significant revision and expansion for the 2nd edition.
  61. Jul 29, 2014 — New edition — Major revision of the book with the help of, Tony Ingram, PT, MSo. The new edition has a few new sections, a strong new focus on the value of judicious exercise therapy, and updated and expanded citations for many key points. Read more about the 2nd edition.
  62. Dec 23, 2013 — Science update — Added another bad-news citation, and type of evidence.
  63. Nov 21, 2013 — Science update — Added a bad-news citation. Sorry about that.
  64. Nov 7, 2013 — New section — Intriguing new evidence of circulatory impairment in PFPS patients.
  65. Oct 24, 2013 — New section —
  66. Sep 20, 2013 — Science update — Added some science, to start building an evidence-based case for resting.
  67. Sep 20, 2013 — Science update — Another good news science update: more about how surprisingly well knees handle running.
  68. Aug 20, 2013 — Science update — Added a new study to the pile of evidence that abnormalities are common in healthy people and vice versa.
  69. Jul 9, 2013 — Science update — A particularly “good news” science update about how running is, counterintuitively, actually pretty good for joints — not hard on them.
  70. Jun 5, 2013 — Minor update — Added a reader anecdote about stretching the IT band helping her anterior knee pain.
  71. May 2, 2013 — Minor update — Apt aging joints humour added, via comedian Louis CK.
  72. Mar 29, 2013 — Minor update — Upgraded risk and safety information about Voltaren Gel.
  73. Dec 18, 2012 — Science update — The writing was on the wall, but a new comprehensive review of knee lube jobs has confirmed that knee lube jobs are all washed. The section now reflects that.
  74. Dec 5, 2012 — Science update — Two new studies of the connection between knee pain and the inner thigh muscles, showing … modest correlations of dubious significance.
  75. Nov 24, 2012 — Minor update — Some customizing of “brain wrangling” for patellofemoral pain syndrome.
  76. Nov 20, 2012 — Science update — Weak but interesting new evidence on natural running and injury prevention.
  77. Nov 16, 2012 — Major update — Greatly expanded. Now offers a comprehensive summary of all treatment options: the good, the bad and the ugly.
  78. Nov 16, 2012 — New section — New standard section I’m introducing to most of the tutorials to “manage expectations.” Too many readers assume there’s going to be a specific miracle treatment plan.
  79. Nov 15, 2012 — New section — An important new section created as a direct response to reader demand.
  80. Nov 13, 2012 — Medium update — Added a few paragraphs about foam rolling and trying to “elongate” the IT band.
  81. Oct 28, 2012 — Science update — A minor but interesting new item about high heels.
  82. Sep 29, 2012 — New section —
  83. May 14, 2012 — Minor update — Another nice swimming update: I added some excellent perspective from an experienced competitive swimmer.
  84. May 4, 2012 — Minor update — Very simple swimming tip added. Hat tip to reader Eric C.
  85. Mar 8, 2012 — Updated — Answered some common reader concerns about planning.
  86. Feb 23, 2012 — Updated — Bone scans and the reason for getting them are now described much more thoroughly. Added some new science confirming that many PFPS knees are “hot.”
  87. Feb 23, 2012 — Major update — Expanded and heavily edited. In particular, the concept of a “diagnosis of exclusion” is now explained thoroughly.
  88. Dec 30, 2011 — New section —
  89. Dec 13, 2011 — New section — Not a beefy update: just a few quick thoughts about heat.
  90. Dec 13, 2011 — Minor update — Addressed some common fears about the threat of getting out of shape while resting.
  91. Sep 28, 2011 — Minor update — Added reference to Kong et al, about the effect of shoe wear.
  92. Aug 22, 2011 — New section — Expanded the section so much that it’s effectively new. It was just a single paragraph about orthotics. Now it is a much more thorough discussion of orthotics, shoes, and impact reduction.
  93. Jul 29, 2011 — Minor update — Added a reference about the poor overall quality of online information about common injuries. See Starman.
  94. Jul 8, 2011 — Minor update — Added an item about swimming to the “activities that may strain the knee” chart.
  95. Jun 21, 2011 — Major update — Major improvements to the table of contents, and the display of information about updates like this one. Sections now have numbers for easier reference and bookmarking. The structure of the document has really been cleaned up in general, making it significantly easier for me to update the tutorial — which will translate into more good content for readers. Care for more detail? Really? Here’s the full announcement.
  96. Mar 20, 2011 — New section — Finally, long overdue, a new section on this topic (for all the running injury tutorials, in fact).
  97. Feb 8, 2011 — Important new info — Where’s the fire? Recently I published a major new article about repetitive strain injuries, in which I explain that these injuries are rarely actually inflamed. Instead of being “on fire,” excessively stressed tissues tend to break down without inflammation — a kind of rot. For the full scoop on inflammation and repetitive strain injuries, see: Repetitive Strain Injuries Tutorial: Five surprising and important facts about repetitive strain injuries like carpal tunnel syndrome, tendinitis, or iliotibial band syndrome.
  98. Dec 2, 2010 — New section — New short section for both this book and the iliotibial band syndrome book covering potentially confusing alternative diagnoses, such as popliteal artery entrapment syndrome (PAES).
  99. Sep 29, 2010 — Minor update — Added some data on the incidence of PFPS in cyclists.
  100. Aug 6, 2010 — New cover — At last! E-book finally has a “cover.”
  101. Jul 27, 2010 — New section —
  102. Jul 8, 2010 — Major improvements — Substantial changes related to new science summarized in Am I wrong? An update on the conventional wisdom.
  103. Jul 8, 2010 — Major improvements — Substantial changes related to new science summarized in Am I wrong? An update on the conventional wisdom.
  104. Jul 8, 2010 — Major improvements — Substantial changes related to new science summarized in Am I wrong? An update on the conventional wisdom.
  105. Jul 8, 2010 — New section — A flurry of substantive updates and re-writing today inspired by some new scientific papers.
  106. Jun 29, 2010 — New section —
  107. Jun 14, 2010 — New section —
  108. Apr 2, 2010 — Minor update — Miscellaneous upgrades, and a nice anecdote from a reader
  109. Apr 2, 2010 — Minor update — Added thoughts about the effect of and some other minor updates.
  110. Nov 30, 2009 — Another new section, practically on top of the last one, , along with a substantial new article offering more detail about ultrasound in general, Does Ultrasound Therapy Work?. I put a considerable amount of research into this topic, and so there are also 34 new records in the bibliography for ultrasound.
  111. Nov 27, 2009 — Updated the tutorial this morning with a new section, “
  112. Nov 20, 2009 — Added much more discussion of the study of patellar alignment assessment originally added back in June, in the section .
  113. Jun 30, 2009 — Added information about an interesting reference to a study showing that clinicians can’t agree on patellar tracking syndrome diagnoses (poor inter-rater reliability) — which I always knew, but it’s nice to see some strong scientific evidence of it.
  114. May 21, 2009 — New section: “
  115. Apr 1, 2009 — The visual design of the site was upgraded over the past several days. Although this is not an update to the content of this tutorial, it is nevertheless a significant upgrade for all of them — like publishing new editions of books with better typesetting and layout. The new design is even cleaner and reader-friendly; it now looks that good in most web browsers; and pages load as much as 50% faster. Many under-the-hood improvements will make it much easier for me to improve tutorial content. The tutorials are now well-oiled machines of digital publishing goodness, vastly superior to the low-production values of most eBooks. More information about the upgrade is published on the front page.
  116. Mar 18, 2009 — Major restructuring and editing of several sections related to therapies based on the assumption of a tracking problem. See the new section, “.” Particularly noteworthy was the addition of important new evidence from a 2008 paper in American Journal of Sports Medicine showing that a combination of strengthening, stretching and coordination exercises were ineffective at preventing patellofemoral pain syndrome.
  117. Feb 3, 2009 — Added a small new section about Traumeel, a popular but questionable remedy that I often get asked about. See the section, “,” or the free article, Does Arnica Gel Work for Pain?.
  118. Sep 18, 2008 — The New England Journal of Medicine just published two fascinating new papers about knee pain, knee osteoarthritis, and knee surgery. I was really pleased to see these papers, because they provide clear and definite scientific support for many key points I’ve made in this tutorial. Kirkley et al’s paper about surgery for osteoarthritis and Englund et al’s fascinating findings about torn menisci have been added to the tutorial.
  119. Jun 23, 2008 — Added some evidence to the pile concerning alleged knee pain differences between men and women.
  120. Apr 14, 2008 — Added information about taping to the section “.”
  121. Jan 10, 2008 — Revised the first several sections quite thoroughly to make them more clear and readable.
  122. Aug 7, 2007 — Polishing more or less complete.
  123. Jul 21, 2007 — Addition of several new sections, a table of contents (finally), and several new images and pull quotes to make it nicer and clearer to read.
  124. Jul 10, 2007 — Release of major new version of the article, almost three times as long. All traces of “structuralism” have been removed. Much more detailed and useful exploration of the causes of PFPS has been added, as well as many vital new sections of self-treatment. Many more improvements to the document are due over the next couple weeks as this version gets polished.
  125. May 23, 2007 — Expanded several of the introductory sections, added the humourous “graphical definition” of PFPS, and expanded the explanation of patellofemoral tracking syndrome and added the “wide hips” diagram. Added detailed treatment section on , with numerous new footnotes. More major changes are due shortly.
  126. May 22, 2007 — Added section to aid readers in determining the difference between these similar conditions.
  127. May 21, 2007 — Major changes underway working towards a full revision. Started by converting footnotes to new database-driven format. You can now link from footnotes to the database for more complete information about references.