The original publication date of this tutorial has been lost, but I think it was in 2004. It remained quite rudimentary until 2007, when significant upgrades began. This change log was started in May ’07, along with many major improvements. As you can see, the tutorial has been updated many times since, and remains a live document.
A major feature of my tutorials is that I actively update them as new science and information becomes available. Unlike regular books, and even ebooks — which can be obsolete by the time they are published, and can go years between editions — this tutorial is updated at least once every three months and often much more. I also log updates, making it easy for readers to see what’s changed. This tutorial has gotten 47 major and minor updates worth logging since I started logging carefully in late 2009, and countless more minor tweaks and touch-ups.
Science update (Dec 23 '13, section #2.11) — Added another bad-news citation, and type of evidence. See section #2.11, What about pronating?
Science update (Nov 21 '13, section #7.18) — Added a bad-news citation. Sorry about that. See section #7.18, Taping and strapping.
New section (Nov 7 '13, section #3.8) — Intriguing new evidence of circulatory impairment in PFPS patients. See section #3.8, Like getting blood from a bone.
New section (Oct 24 '13, section #5.3) — No notes. Just a new section. See section #5.3, “Maybe you’re just not built for running”.
Science update (Sep 20 '13, section #6.1) — Added some science, to start building an evidence-based case for resting. See section #6.1, The art of rest: the challenge and the opportunity for patients who have supposedly “tried everything”.
Science update (Sep 20 '13, section #2.2) — Another good news science update: more about how surprisingly well knees handle running. See section #2.2, Assault on the conventional wisdom about patellofemoral pain syndrome.
Science update (Aug 20 '13, section #2.5) — Added a new study to the pile of evidence that abnormalities are common in healthy people and vice versa. See section #2.5, Patellofemoral Tracking Syndrome.
Science update (Jul 9 '13, section #2.2) — A particularly “good news” science update about how running is, counterintuitively, actually pretty good for joints — not hard on them. See section #2.2, Assault on the conventional wisdom about patellofemoral pain syndrome.
Minor update (Jun 5 '13, section #2.10) — Added a reader anecdote about stretching the IT band helping her anterior knee pain. See section #2.10, Tight IT bands.
Minor update (May 2 '13, section #2.2) — Apt aging joints humour added, via comedian Louis CK. See section #2.2, Assault on the conventional wisdom about patellofemoral pain syndrome.
Minor update (Mar 29 '13, section #7.6) — Upgraded risk and safety information about Voltaren Gel. See section #7.6, You and “vitamin I”: anti-inflammatory meds, especially Voltaren® Gel.
Science update (Dec 18 '12, section #7.19) — 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. See section #7.19, Should you get a lube job? Artifical synovial fluid injections.
Science update (Dec 5 '12, section #2.13) — Two new studies of the connection between knee pain and the inner thigh muscles, showing … modest correlations of dubious significance. See section #2.13, Weak and uncoordinated muscles, perhaps?
Science update (Nov 20 '12, section #7.11) — Weak but interesting new evidence on natural running and injury prevention. See section #7.11, Should you run naked? On faddish running styles and running shoes (or the lack thereof).
New section (Nov 16 '12, section #7.1) — 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. See section #7.1, So what’s the plan?
Major update (Nov 16 '12, section #7) — Greatly expanded. Now offers a comprehensive summary of all treatment options: the good, the bad and the ugly. See section #7, Other Treatments: What else can you do about PFPS?
New section (Nov 15 '12, section #8) — An important new section created as a direct response to reader demand. See section #8, Now what?: An action-oriented summary of recommendations.
Medium update (Nov 13 '12, section #7.14) — Added a few paragraphs about foam rolling and trying to “elongate” the IT band. See section #7.14, Quadriceps massage.
Science update (Oct 28 '12, section #7.10) — A minor but interesting new item about high heels. See section #7.10, Orthotics and shoes.
Minor update (May 14 '12, section #6.1) — Another nice swimming update: I added some excellent perspective from an experienced competitive swimmer. See section #6.1, The art of rest: the challenge and the opportunity for patients who have supposedly “tried everything”.
Minor update (May 4 '12, section #6.1) — Very simple swimming tip added. Hat tip to reader Eric C. See section #6.1, The art of rest: the challenge and the opportunity for patients who have supposedly “tried everything”.
Updated (Mar 8 '12, section #6.8) — Answered some common reader concerns about planning. See section #6.8, Jan’s Phase I: Preparation (July and August).
Updated (Feb 23 '12, section #4.4) — 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.” See section #4.4, Hot kneecaps! Should you get an x-ray, MRI, or bone scan?
Major update (Feb 23 '12, section #4.1) — Expanded and heavily edited. In particular, the concept of a “diagnosis of exclusion” is now explained thoroughly. See section #4.1, Eliminate other concerns.
New section (Dec 30 '11, section #7.23) — No notes. Just a new section. See section #7.23, What can a runner with knee pain do at the gym?
New section (Dec 13 '11, section #7.8) — Not a beefy update: just a few quick thoughts about heat. See section #7.8, Heat (very briefly).
Minor update (Dec 13 '11, section #6.3) — Addressed some common fears about the threat of getting out of shape while resting. See section #6.3, 1. Common Resting Pitfall No. 1: The runner’s natural stubbornness.
Minor update (Sep 28 '11, section #7.10) — Added reference to Kong et al, about the effect of shoe wear. See section #7.10, Orthotics and shoes.
New section (Aug 22 '11, section #7.10) — 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. In particular, it features a fairly enthusiastic endorsement of Oesh shoes. See section #7.10, Orthotics and shoes.
Minor update (Jul 29 '11, section #1) — Added a reference about the poor overall quality of online information about common injuries. See Starman. See section #1, Introduction.
Minor update (Jul 8 '11, section #6.1) — Added an item about swimming to the “activities that may strain the knee” chart. See section #6.1, The art of rest: the challenge and the opportunity for patients who have supposedly “tried everything”.
Major update (Jun 21 '11) — 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.
New section (Mar 20 '11, section #7.11) — Finally, long overdue, a new section on this topic (for all the running injury tutorials, in fact). See section #7.11, Should you run naked? On faddish running styles and running shoes (or the lack thereof).
Important new info (Feb 8 '11) — Where’s the fire? Recently I published a major new article about repetitive strain injuries (like patellar pain), 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. This significant fact of biology is not yet given proper attention in this tutorial, and it should be. I learned the science of this myself only just recently, and it is going to take me a while to revise all of the tutorials and articles that are affected by it. Meanwhile the new RSI article is available, free to all, and I have also mentioned and linked to it where necessary throughout all tutorials. 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.
New section (Dec 2 '10, section #4.7) — New short section for both this book and the iliotibial band syndrome book covering potentially confusing alternative diagnoses, such as politeal artery entrapment syndrome (PAES). See section #4.7, Other possible diagnoses and sources of diagnostic confusion.
New section (Nov 27 '10, section #1.5) — Brief new section — just a note, really, but quite important to some readers. See section #1.5, About patellofemoral pain in teens.
Minor update (Sep 29 '10, section #7.5) — Added some data on the incidence of PFPS in cyclists. See section #7.5, Treating for inflammation: is there any point?
New cover (Aug 6 '10) — At last! This e-book finally has a “cover.”
New section (Jul 27 '10, section #7.20) — No notes. Just a new section. See section #7.20, Glucosamine, chondroitin sulphate and other “nutraceuticals” have failed every large, fair test.
Major improvements (Jul 8 '10, section #3) — Substantial changes related to new science summarized in Am I wrong? An update on the conventional wisdom. See section #3, A Modern Perspective: Patellofemoral pain as “the itch you can’t scratch”.
Major improvements (Jul 8 '10, section #2.13) — Substantial changes related to new science summarized in Am I wrong? An update on the conventional wisdom. See section #2.13, Weak and uncoordinated muscles, perhaps?
Major improvements (Jul 8 '10, section #2.12) — Substantial changes related to new science summarized in Am I wrong? An update on the conventional wisdom. See section #2.12, Misc other possible biomechanical bogeymen.
New section (Jul 8 '10, section #2.3) — A flurry of substantive updates and re-writing today inspired by some new scientific papers. See section #2.3, Am I wrong? An update on the conventional wisdom.
New section (Jun 29 '10, section #7.9) — No notes. Just a new section. See section #7.9, Steroid injections are powerful, but where would you put the needle?
New section (Jun 14 '10, section #7.22) — No notes. Just a new section. See section #7.22, Prolotherapy is not relevant to patellofemoral pain syndrome.
Minor update (Apr 2 '10, section #7) — Miscellaneous upgrades, and a nice anecdote from a reader about a “boot cure.” See section #7, Other Treatments: What else can you do about PFPS?
Minor update (Apr 2 '10, section #6.1) — Added thoughts about the effect of elliptical machines on PFPS and some other minor updates. See section #6.1, The art of rest: the challenge and the opportunity for patients who have supposedly “tried everything”.
Older updates — Listed in a separate document, for anyone who cares to take a look.