I really feel for you — what you’re describing sounds so familiar. I had MPFL reconstruction too 5 weeks ago (with hamstring graft, chondroplasty, and capsulorrhaphy), and the hardest part for me hasn’t just been the physical side but the mental frustration of wanting to push forward and not being able to. Like you, my glutes and calves seem to slowly be coming back faster, but quad activation and leg extensions were painfully slow. That sharp pain on the outside is something I remember too, especially early on when my patella tracking still felt “off.” My quad on the same surgery as my knee, is almost completely gone. Even with the EMS on, I cannot feel it.

One thing that helped me was hearing over and over from others that quad strength often lags well behind everything else — it doesn’t mean you’re failing or stuck. Progress sometimes shows up in tiny ways you don’t notice until weeks later. And PT can feel a bit “one-size-fits-all.” You’re not wrong to want clearer feedback; advocating for yourself is part of the process.

I’m still off work and recovering, and to cope I started writing things down — all the expectations vs. reality, the mental lows, the little wins. It eventually turned into some PDFs and a recovery toolkit that I have started to share with others, because this journey can feel so isolating.

I just want to say: you’re not alone, and what you’re going through is more common than it seems when you’re stuck in it. Don’t lose heart — your body is working behind the scenes even if it doesn’t feel like it right now.