MD - I understand where your PT is going with this but it may not be the right way for you to start. Make sure that when you see the PT you give very clear feedback about how you felt after the session. Eg: my back started to hurt an hour later and didn't stop hurting until I took advil a few hours after that. Be as specific as you can. If you are specific the PT will take this info and use it to mold a program that works for you. If they're any good they will. If you are not specific, it may come across as whining (not that it should but unfortunately sometimes PTs can be presumptuous and I hate to say it but especially if you're a little bigger and they think that you're not used to exercise). I personally prefer to start people on a stretching progam for the hips first and maybe with some strengthening of the inner thigh isometrically before I start in on leg presses, thigh push outs or knee extensions. In fact I never give knee extensions as an exercise for patellofemoral pain. I also like to add some deep tissue massage to release the lateral quad/thigh.

I really like taping techniques for this type of problem.

Here's how I might approach this with your PT. Poke around your quad and outer thigh area and see if you can find some knots. Point these out to your PT and politely ask if they think that deep tissue massage might help that. As for the hip stretches, I would say something like, "My hips seem really tight, could this be contributing to the problem. Would it help for me to stretch them?"

I'm laying this out in this way because some PTs feel threatened when a patient comes in and suggests a different approach. I don't personally think that there is anything wrong with this and I appreciate it when my patients put their thoughts out there, regardless of if it's positive or negative. But I am confident in myself and my work. Someone not as confident will not react well and instead of keeping a nice understanding repore and taking action to adapt a program as needed, they may start to rationalize why the treatment may not be going well by finding blame elsewhere.

Please realize that I'm not saying the treatment they have started with is bad. It may be very appropriate. I just think that you need to give some feedback and ask about some other options. It could be that your PT is planning to add these things in that I have suggested, they just couldn't get to it today.

Finally, your back pain may have something to do with your knee pain and if it persists it should be evaluated by the PT.

Knott will likely add some foot stuff to this.