Patellar Tendonitis

SuprSi

I've had patellar tendonitis below the knee cap of my left knee for over 2 years and have made very little progress healing it. I've been to various physios and tried all sorts of exercises, and although the tenderness of the tendon has improved, as soon as I do anything remotely stressful to it, like stair-climbing or even box jumps/burpees it starts acting up again.

Over the past 3 months I've been doing a fairly intensive leg routine of 4 sets of 15 reps (squats/deadlifts/seated leg press), gradually increasing the weight as I go along each week as advised by my last physio and I believe it's helping, but it's just so slow and I wanted to see if anyone else has had this injury and what they did to clear it up.

LuckyLloyd

It's a bollocks, simple as. I've had it since March, though note that you most likely have tendinosis rather than tendinitis at this stage technically speaking.

Mine is getting better more consistently, but it only takes one bad training session or too long a walk or period standing to flare it up for a few hours.

What helped me was eliminating all items of stress and irritation for an extended period; rehabbing and then trying to gradually reintroduce stuff back in and that has got me this far.

For example:

- dropped squats but hit deadlifting like a wild Russian bear instead;
- dropped running but hit rowing;
- dropped burpees, box jumps, skipping, olympic weightlifting movements and found other things to do be it pressing, rowing, kettlebell swings, etc;

Now, I had a trainer working this out for me weekly, but there is no reason why you can't keep working for a period while avoiding all movements that stress the patellar tendon.

================

So, you shouldn't be doing any of this right now imo:

as soon as I do anything remotely stressful to it, like stair-climbing or even box jumps/burpees it starts acting up again

and yeah:

but it's just so slow

it really is.

Also consider doing additional foam rolling and mobility work. Tight quads are a targeted nuclear weapon pointing right at your knee right now. Roll and stretch that ****.

The real lesson I learned is to not ignore joint pain ever again. :rolleyes:

Danye

SuprSi wrote: »

I've had patellar tendonitis below the knee cap of my left knee for over 2 years and have made very little progress healing it. I've been to various physios and tried all sorts of exercises, and although the tenderness of the tendon has improved, as soon as I do anything remotely stressful to it, like stair-climbing or even box jumps/burpees it starts acting up again.

Over the past 3 months I've been doing a fairly intensive leg routine of 4 sets of 15 reps (squats/deadlifts/seated leg press), gradually increasing the weight as I go along each week as advised by my last physio and I believe it's helping, but it's just so slow and I wanted to see if anyone else has had this injury and what they did to clear it up.

LuckyLloyd wrote: »

It's a bollocks, simple as. I've had it since March, though note that you most likely have tendinosis rather than tendinitis at this stage technically speaking.

Mine is getting better more consistently, but it only takes one bad training session or too long a walk or period standing to flare it up for a few hours.

What helped me was eliminating all items of stress and irritation for an extended period; rehabbing and then trying to gradually reintroduce stuff back in and that has got me this far.

For example:

- dropped squats but hit deadlifting like a wild Russian bear instead;
- dropped running but hit rowing;
- dropped burpees, box jumps, skipping, olympic weightlifting movements and found other things to do be it pressing, rowing, kettlebell swings, etc;

Now, I had a trainer working this out for me weekly, but there is no reason why you can't keep working for a period while avoiding all movements that stress the patellar tendon.

================

So, you shouldn't be doing any of this right now imo:



and yeah:



it really is.

Also consider doing additional foam rolling and mobility work. Tight quads are a targeted nuclear weapon pointing right at your knee right now. Roll and stretch that ****.

The real lesson I learned is to not ignore joint pain ever again. :rolleyes:

I've suffered with tendonitis in both my knees now for 12 months. At times it can be agony, although I'm glad to finally say I feel I've gotten over the worst of it.

I've tried all sorts of everything from accupuncture, dry needling, fascial stretch therapy to laser therapy and everything else in between. I'm not sure I could pinpoint one treatment that would help though. People seem to be a big fan of the laser treatment but I found him to be a chancer.

In anyway the tendonitis seemed to stem from a mobility / flexibility issue. So I started doing the De Franco's agile 8 daily and also used a hard roller and hockey ball to get in around the glutes, hips, IT band and quads. I also laid off any training that put any kind of stress on my knee.

If I could give any advice it would be to ease of the training (my biggest problem) get yourself to a good physio and see what they say and work from there.

I would also advise you to work on your mobility and flexibility in the key areas mentioned above and roll daily as well.

SuprSi

LuckyLloyd wrote: »

- dropped squats but hit deadlifting like a wild Russian bear instead;
- dropped running but hit rowing;
- dropped burpees, box jumps, skipping, olympic weightlifting movements and found other things to do be it pressing, rowing, kettlebell swings, etc;


Also consider doing additional foam rolling and mobility work. Tight quads are a targeted nuclear weapon pointing right at your knee right now. Roll and stretch that ****.

Danye wrote: »

In anyway the tendonitis seemed to stem from a mobility / flexibility issue. So I started doing the De Franco's agile 8 daily and also used a hard roller and hockey ball to get in around the glutes, hips, IT band and quads. I also laid off any training that put any kind of stress on my knee.

If I could give any advice it would be to ease of the training (my biggest problem) get yourself to a good physio and see what they say and work from there.

I would also advise you to work on your mobility and flexibility in the key areas mentioned above and roll daily as well.

Thanks both, that's some really good advice. I've been frustrated as I've found myself a bit bored of the cross-trainer and tried to mix it up a little with burpees and the like, but I see what you're saying about adding non-impact exercises in like the kettlebell and rowing. I'll also check out that Agile 8 program, so thanks for recommending it.

I just need to be careful as all it can take is a little sprint or jump after the dog on the beach for it to flare up again! I have found that wearing a strap helps a lot, though whether this is just a temporary thing or will help in the long run I can't be sure;

http://www.physioroom.com/product.php?cid=3113&pid=39352&pn=PhysioRoom.com_Elite_Jumpers_Knee_Patella_Strap

LuckyLloyd

SuprSi wrote: »

I just need to be careful as all it can take is a little sprint or jump after the dog on the beach for it to flare up again! I have found that wearing a strap helps a lot, though whether this is just a temporary thing or will help in the long run I can't be sure;

http://www.physioroom.com/product.php?cid=3113&pid=39352&pn=PhysioRoom.com_Elite_Jumpers_Knee_Patella_Strap

A strap is a good thing to wear. Not sure if it's a good idea while training, but for the general working day it can only help.

You have to accept you're hurt and avoid **** like the above as annoying as it is!! You should be taking the lift, avoiding the routine 15 minute walk, looking for a chair in the pub, sitting on the outside of the row in the cinema, etc, etc. You can still exercise once it's non aggravating movement - but you can't just do all the things you used to in your day to day activities.

That is a real drag, people won't understand but you have to suck it up and adjust your day to day to compensate or it isn't going to start improving.

Best of luck.

MD1990

i have it as well
mine is okay running & sprinting
but it flares up when doing Squats & plyometrics
im going to see Anthony Geogheghan to see if he can get it too fully heal as i have made good progress in the last month

SuprSi

What have you done to make good progress?

MD1990

LuckyLloyd wrote: »

It's a bollocks, simple as. I've had it since March, though note that you most likely have tendinosis rather than tendinitis at this stage technically speaking.

Mine is getting better more consistently, but it only takes one bad training session or too long a walk or period standing to flare it up for a few hours.

What helped me was eliminating all items of stress and irritation for an extended period; rehabbing and then trying to gradually reintroduce stuff back in and that has got me this far.

For example:

- dropped squats but hit deadlifting like a wild Russian bear instead;
- dropped running but hit rowing;
- dropped burpees, box jumps, skipping, olympic weightlifting movements and found other things to do be it pressing, rowing, kettlebell swings, etc;

Now, I had a trainer working this out for me weekly, but there is no reason why you can't keep working for a period while avoiding all movements that stress the patellar tendon.

================

So, you shouldn't be doing any of this right now imo:



and yeah:



it really is.

Also consider doing additional foam rolling and mobility work. Tight quads are a targeted nuclear weapon pointing right at your knee right now. Roll and stretch that ****.

The real lesson I learned is to not ignore joint pain ever again. :rolleyes:

is yours gone completley now?

MD1990

SuprSi wrote: »

What have you done to make good progress?

stopped Squatting & doing plyometrics that aggravate the tendon
stretching & foam rolling daily
been doing Deadlifts & TKE's for leg strength
eating plenty of protein & talking Glucosamine supplement

SuprSi

What are TKE's?

MD1990

SuprSi wrote: »

What are TKE's?

calfmuscle

use some kineso tape to support your knee cap. Its easy to do. It acts like s staple but with more give and less friction.

This will help to reduce the excessive movement of the patella, reduce friction on the tendon while your exercising. It won't cure you but is a nice aid for training while you wait for the problem to resolve.

sorry Im on my phone so can't link!

nice_guy80

as a former sufferer of this, I tried all remedies

specific strength and conditioning program = got me 60% results - but flexion was very sore

rest - no real improvement

acupuncture - nope
physio - nope

so eventually went to GP, then knee surgeon, got MRI, got surgery

and it turned out not to be tendonitis
but a fold in the meniscus that was rubbing on the back of the patella tendon everytime I bent it to move/land/squat/jump

knee is 95% now. lot of strength and conditioning work went into it either side of the surgery. great job

Ryder

Its a bit like alcoholism, you're never cured. Have had it for about 4 years. Not sure what caused it, but running first then cycling was sore. It got so bad that every time I came back from cycling, I had to hobble around for a day afterwards.

4 years later, I'm 95% better. Still get twinges but when I look back to what it was, its nothing now. Stretches, and core work are important. Foam rolling of ITB was a life saver - immediate cure. My VMO on that side is smaller so have been doing some conditioning work on this.....wall squats while contracting the adductors and also some leg raises over my foam roller. Google YouTube for vmo exercises

bernconng

I was diagnosed with patellar tendonitis just two weeks ago. I work in a hospital and I'm on my feet all day.
The physio gave me orthotic arch supports hopefully that will help. Have done some accupuncture but haven,t seen any improvement.
I consider myself a very active person with two very busy children I'm worried my knee is going to take a long time to heal.

SuprSi

I just wanted to bring this up again as my physio has recommended I try extracorporeal shockwave therapy. Has anyone tried it? They are just starting to offer it here and, looking online it seems to really help in most cases;

http://ajs.sagepub.com/content/35/6/972

It'll all be covered by my health insurance and although my knee has improved of late I still can't get rid of the tenderness, despite resting it completely for nearly 3 weeks a while ago.

Danye

SuprSi wrote: »

I just wanted to bring this up again as my physio has recommended I try extracorporeal shockwave therapy. Has anyone tried it? They are just starting to offer it here and, looking online it seems to really help in most cases;

http://ajs.sagepub.com/content/35/6/972

It'll all be covered by my health insurance and although my knee has improved of late I still can't get rid of the tenderness, despite resting it completely for nearly 3 weeks a while ago.

I tried shockwave therapy, not sure what kind or how many different types there are but personally I seen no benefit.

My knees actually flared up pretty badly again a few weeks ago so decided to go to another physio who was recommend.

Delighted I did. He was the first physio who explained to me what was happening, why it was happening and how it was going to be fixed.

Basically my glutes were not working and my quads were quite weak. Because of this my knees where working a lot harder than they should of hence the reason for the pain.

After about 3 or 4 weeks of doing his rehab my knees feel about 70% better which is great. As with a lot of injuries the actual area of pain is not were the problem is. This was an issue I had with all the other physio's and physical therapists I dealt with. They where trying to rid the pain of the tendons as opposed to finding how and why the pain was appearing there.

I could pass you on the physio details if you like?

SuprSi

Thanks, though I'm not living in Ireland so couldn't go to him. Still, it sounds like you got what you needed. I've been told something similar, that my glutes are weak and overall my legs lack strength, the problem is that even if I gradually increase the amount of weight I use, I can only get so far before my knee flares up again. I'm wondering if I need something to assist in the strength training, which was where this shockwave therapy came in.

Danye

SuprSi wrote: »

Thanks, though I'm not living in Ireland so couldn't go to him. Still, it sounds like you got what you needed. I've been told something similar, that my glutes are weak and overall my legs lack strength, the problem is that even if I gradually increase the amount of weight I use, I can only get so far before my knee flares up again. I'm wondering if I need something to assist in the strength training, which was where this shockwave therapy came in.

Oh right.

Well maybe give it a shot? I'm sure it would do now harm combining the two other than the cost.

Let us know how it goes.

Danye

SuprSi wrote: »

Thanks, though I'm not living in Ireland so couldn't go to him. Still, it sounds like you got what you needed. I've been told something similar, that my glutes are weak and overall my legs lack strength, the problem is that even if I gradually increase the amount of weight I use, I can only get so far before my knee flares up again. I'm wondering if I need something to assist in the strength training, which was where this shockwave therapy came in.

Also actually just to add, that make sure your form is perfect when doing your rehab. At the start my form would wain towards the end of a set and my knees would actually hurt a bit. As soon as I corrected the pain eased dramatically.

Maybe when you start to add weight your form could be suffering? It's a quite common thing to happen in my experience.

Big_G

I've had it about 4 years and I'm convinced its a symptom of a movement disorder. I find running and front squats set it off the most. My knee pain is mainly on the left and is due to a poorly rehabbed old ankle injury and results in my my knee tracking inward to avoid pain in the ankle, particularly when fatigued. I've worked hard on having good technique, but as with anything that requires conscious control, as soon as fatigue sets in technique goes out the window.

Mobility and tissue conditioning helps a lot (quads hip flexors ITBs ankle dorsiflection). Reprogramming motor patterns is very difficult and takes time.

I'll update as soon as I figure out how to do this .

SuprSi

So this morning I went into the gym and did some squats with just a 20kg barbell. I moved very slowly, focusing on form and I noticed that as I get near to the 90 degree angle on the squat (the lowest I go) my knees wobble very slightly from side to side. It's a very minor movement, but I wonder if this is part of my problem?

I'm going to spend some time with just the barbell trying to get rid of that wobble to see if it helps. I also tried some linear leg presses and but as I'm sitting down things were much more stable.

Danye

SuprSi wrote: »

So this morning I went into the gym and did some squats with just a 20kg barbell. I moved very slowly, focusing on form and I noticed that as I get near to the 90 degree angle on the squat (the lowest I go) my knees wobble very slightly from side to side. It's a very minor movement, but I wonder if this is part of my problem?

I'm going to spend some time with just the barbell trying to get rid of that wobble to see if it helps. I also tried some linear leg presses and but as I'm sitting down things were much more stable.

Why do you only go to 90 degrees with your squat as a matter of interest? Is it a conscious decision or a mobility reason?

What is your rehab routine as a matter of interest?

Burkatron

SuprSi wrote: »

I've been told something similar, that my glutes are weak and overall my legs lack strength, the problem is that even if I gradually increase the amount of weight I use, I can only get so far before my knee flares up again.

This is part if your problem, you're focusing on weight training! You need to knock it in the head for a while strengthen the specific muscles that are weak & stretch the muscles that are tight! At a guess (without seeing you) if your glutes & quads are weak your abs & hamstrings are inhibiting them & these need to be stretched! When strengthening do resistant band & bodyweight work till the pain is bareable majority of the time!

SuprSi

Danye wrote: »

Why do you only go to 90 degrees with your squat as a matter of interest? Is it a conscious decision or a mobility reason?

What is your rehab routine as a matter of interest?

This is directly from my physio;

This program involves three sessions per week with three key exercises. These exercises are:
Squats
Seated leg press
Hack Squats

You should complete four sets of each exercise with 2-3 minutes rest between sets.
The program lasts a total of 12 weeks. The number of repetitions are:
15 repetitions maximum (RM) during week one
12 RM weeks 2-3
10 RM weeks 4-5
8 RM weeks 6-8
6 RM weeks 9-12
During each exercise you should not go below 90 degrees of knee flexion at any time.
It is also suggested that you count 3 seconds for both the lower (eccentric) and raise (concentric) phase of each exercise. This means that each individual repetition will take a total of six seconds.

The problem I have is that once I get to a certain point, my knee starts acting up and at this point (and from others experience in this thread) it sounds like a form thing.

I also do a lot of sometimes very uncomfortable foam rolling.

Burkatron wrote: »

This is part if your problem, you're focusing on weight training! You need to knock it in the head for a while strengthen the specific muscles that are weak & stretch the muscles that are tight! At a guess (without seeing you) if your glutes & quads are weak your abs & hamstrings are inhibiting them & these need to be stretched! When strengthening do resistant band & bodyweight work till the pain is bareable majority of the time!

You have a point, my legs, particularly my hams are very tight. I also haven't done a huge amount of work on my abs, so this is something that needs addressing too.

Thanks for the feedback!

Burkatron

SuprSi wrote: »

This is directly from my physio;



The problem I have is that once I get to a certain point, my knee starts acting up and at this point (and from others experience in this thread) it sounds like a form thing.

I also do a lot of sometimes very uncomfortable foam rolling.



You have a point, my legs, particularly my hams are very tight. I also haven't done a huge amount of work on my abs, so this is something that needs addressing too.

Thanks for the feedback!

A) Has your Physio looked at your form & corrected it?? Do you know how to brace your knees to stop them traveling forward? Physio should show you this C) Has your Physio told you NEVER to go below 90/paralell or is it just at the moment?

If the answer to A) is yes &/or C) is no go find a new Physio!

Here's (one of) Kelly Starret's take on it!
http://www.youtube.com/watch?v=ydoRfEXvmU8

MD1990

ive made huge progress with my knee last 3 months
its pretty much 95% now
the key is to do one-legged eccentric squats 3x15,twice a day
have your foot slanted at an angle so that your using your knee more so it strengthens.
but stop if u have any pain at all
Deep Squats were a big help in strengthening it as well