Patellar tendonitis = can't squat / press /etc

[Tri Girl]

I have patellar tendonitis in BOTH knees (marathon runner & triathlete).

Today I was doing a leg workout which included squats and leg presses, but the pain in both knees was such that I had to cut the workout short. The thing is, strong quads help alleviate the problem of patellar tendonitis, but the p.t. keeps me from doing some of those exercises! It's a catch 22.

Any suggestions for training, avoiding more injury, etc?

Race season is coming up, training is in full swing, and I can't let this get in my way.

Thanks

 

[big4life]

Is your therapist one who works with athletes on a regular basis? I know several who work with just rehabbing the average non-athlete from injury and their approach is always more cautious than the ones who work with athletes.

You're right about needing to strengthen the quads to help the patella tendon.

What is he/she doing to treat you?

 

[coolcolj]

I would do stepups and bulgarian splisquats instead for rehab

 

[supreme]

Did your P.T. check the aligmnet of your pelvis?? You may have a lower crossed and or pronation distortion syndrome which can lead to patellar tedonitis.

How is the tightness of your I.T band?? are your quads evenly developed incomparison to the VMO?? how is your hamstring strength & flex?? Low back flex?

All of these things need to be checked and made sure the are balanced. If there is an anterior rotation on the pelvis (common in women runners), the the femurs naturally internally roatate pulling the patella out of aligment. Can also occur if IT band is too tight or external hip rotators weak & adductor too tight.

I train several marathoners & these things are quite common, many times you need to look not where the pain is but what is the cause of it. Treat the source, not the symptom.

Get a new P.T. that is also a strength & conditioning specialist

S

 

[Nico Cujo]

I used to have it bad in both knees. Try stretching and applying ice after your workouts.

 

[delldell2]

Did your P.T. check the aligmnet of your pelvis?? You may have a lower crossed and or pronation distortion syndrome which can lead to patellar tedonitis.

How is the tightness of your I.T band?? are your quads evenly developed incomparison to the VMO?? how is your hamstring strength & flex?? Low back flex?

All of these things need to be checked and made sure the are balanced. If there is an anterior rotation on the pelvis (common in women runners), the the femurs naturally internally roatate pulling the patella out of aligment. Can also occur if IT band is too tight or external hip rotators weak & adductor too tight.

I train several marathoners & these things are quite common, many times you need to look not where the pain is but what is the cause of it. Treat the source, not the symptom.

Get a new P.T. that is also a strength & conditioning specialist

S

What's anterior rotation of the pelvis? And how can I check if my IT band is tight.

The reason I'm asking is my VMO and hamstrings are fine, but my knees point inwards some and it aggravates my knees. I think it starts from my hip. Something is weak up there. I also have lordosis.

What would your recommend?

 

[Tri Girl]

d'oh. I caused some serious confusion. My abbreviation of p.t. was for Patellar Tendonitis, not Physical Therapist. :|

Supreme - I have not had such things checked, however, I do see a chiropractor who is always adjusting my pelvis so I'd assume that my "alignment" is off. IT Band is alright, I stretch that out as much as possible. Without a therapist, how can I check the other things you mentioned? My hamstring flexibility is awesome... at least I think it's good that I can pretty much lay my elbows on the floor when I touch my toes. My hip adductors always feel tight, no matter how much I stretch.

CoolColJ - what are splisquats and how do I do them?

 

[delldell2]

split squats are lunges, without moving your back leg. just up and down, no step. Bulgarian ssq are where you put your back leg up on a bench and go up and down.
For step-ups, do peterson step-ups. Look it up on google. Basically the bench is behind you, and step up with your heel up at first.

 

[BodybuildingUniverse]

Man I JUST read a good article in Outside on this. They recommended low energy shock wave therapy for these type of injuries. Sounds strange but ask your doc. Most athletes were back running with no pain after 3 treatments. Hope this helps.

 

[big4life]

d'oh. I caused some serious confusion. My abbreviation of p.t. was for Patellar Tendonitis, not Physical Therapist. :|

That's cool, I get confused easy.


Since you're not seeing a physical therapist, you might want to look into one. Like I said, find one who specializes in working with athletes. They will be able to come up with different things that might help, and things that might be contributing to your problem.

Good luck.

 

[supreme]

O.k.

I'm off to the gym when I get back I''ll put up some info & some links that should be helpful.

Also, Shock Wave kicks ass! - I have a female maranthoner in her mid forties, had pronation distortion & lower crossed that lead to plantar fascitis. We implemented a corrective exercise & stretching program. made progress but slow, got orthotics, not much better.

Stuck with the exercise program, added in 3 shock wave treatments. She's back to running 3-6 miles/ day from 0 with almost no pain. Getting better evey week & insurance covereed the whole treatment.

S

 

[bigstve12]

all tendinitis is, is inflammation...let them rest and heal. dont do anything that aggravates the pain. Its hard to stay out of the game, but by doing so you'll stay in it longer....make sense?

Supreme is right on with his questions. Many overpronation problems in the ankle lead to knee problems...how's your gait? If your chiro is any good he should be able to help you with that. In the meantime try supplementing with some antiinflammatorys.

PS Ever do an ironman??

 

[supreme]

Yep,

bigstve12 is right on the inflammation, To help control it you can use high dose anti-oxidants, fish oils, flax oil and reduce red meat consumption and of course REST!

The best book (or one of them) that detail the correct diet & supplements to control inflammation is "Beat arthritis" by Dr. Michael Colgan. Arthritis is an inflammatory condition just like tendonitis - only different location.

Thats also a possibility to your condition, many endurance athletes show signs of arthritis in their early 30's due to the extreme milleage they do, especially if their form is off & the joints out of alignment - its like driving a car with bad alignment, you wear the bodies tissue & joints out faster.

The info on knees, ant. rotation etc. is coming - just its bookmarked on my other computer. I'll post it when I'm at work.

S

 

[b fold the truth]

Have you tried using Icy-Hot, Aleve, Ice, knee sleves, athletic tape, etc...?

I'm not sure if strengthening the quads is going to be the answer to this...

B True

 

[bigstve12]

I used to have consistent joint pain and a few cases of biceps tendonitis....i added flaxseed and other varieties of omega 3...i have been trouble free for about a month now. I highly reccomend it. Bromelean is also a good anti inflammatory if taken on an empty stomach daily.

 

[LATINLOVER]

go to a sports store and buy a bracelet for jumpers knee(p.tendonitis 0crondomalacia,etc. wear it when you are walking,cardio ,or workingon your legs. Also very important when doing any leg exercises try putting 75%of your strenth from your heels and 25%from toes;it will keep you patelle out of so much pressure(ex.leg press,squats)and stay away from hack squats or any ex. were your knees go over you toes. apply everything you got from all of us and good luck.

 

[Tri Girl]

I've got a few knee braces I wear. I ran a marathon wearing one which seemed to help - at least during the race it did. Ironically, the knees hurt more now. And I am aware that taking time off is the best remedy, it's just really HARD to sit still.

I recently discovered ibuprofin (sp?) gel which seriously takes care of any pain

I take an EFA three times a day.

And I have not yet done an ironman, tho this season I'm doing a sprint, 3 olympics, and one 1/2 ironman.

 

[LATINLOVER]

good luck and remember R.I.C.E (rest,ice,compression,elevation)
good luck.
p.s remember it is not the big bracelets their the thin ones.

 

[supreme]

Tri-girl did you read the post I put up for knee, pelvic & back pain. Several really good knee articles.

As you unfortunately found out the OTC braces are worthless and cause more harm then good. Braces like that are usually too weak provide any real support and if they do work; they only treat the symptom and not the cause.

As you are aware you need to treat the inflammation and re-algin the whole kinetic chain, not just the patella.

I will post more info as I retrieve it

S

 

[eric2420]

Supreme (and everyone else!)- I have a lot of the same problems but cant seem to find anyone who can correctly diagnose what the real problems/weaknesses are. I have had a tracking issue/quad tendinitis for almost two years in my left knee that i can't get to go away. I have done every rehab excercise and stretched almost an hour a day but i think it has something to do with weak hip rotators/flexors but i feel like when trying to build them up, i cheat (unintentionally) by tilting my pelvis in a way that keeps the muscles i need to build from being used (because they're weak). My hips feel extremely tight almost all the time and I have been having aches in my low back/sacrum area for whatever reason. I feel sure that its all connected to a pelvis/hip issue but its proving too complicated for me to fix on my own even with an hour or two a day devoted to it. I played sec college basketball and am trying desparatley to get down to south america to play pro/semi pro beach volleyball by the end of the year but i am about to completely lose my mind and go crazy because of how frustrating this left knee issue is. I had cartilage cleaned out from under my patella in June but that proved to not help anything and I guess I am considering a lateral release but i really dont want to have another surgery on it and let everthing atrophy even more. how do i find someone in Atlanta that can scientifically isolate all muscles and tendons and measure exactly where I am weak, tight, and have asymmetries? I will do anything including getting on a plane to go see a specialist but I feel a bit lost as none of the "best" therapists or orthos i have talked with have told me anything that has really worked. Sorry for the long rambling post. Any advice FROM ANYONE would be greatly appreciated - I joined this forum so I could respond to your posts. Thanks everyone in advance for your help!!

 

[BLAZAY]

I have patellar tendonitis in BOTH knees (marathon runner & triathlete).

Today I was doing a leg workout which included squats and leg presses, but the pain in both knees was such that I had to cut the workout short. The thing is, strong quads help alleviate the problem of patellar tendonitis, but the p.t. keeps me from doing some of those exercises! It's a catch 22.

Any suggestions for training, avoiding more injury, etc?

Race season is coming up, training is in full swing, and I can't let this get in my way.

Thanks

I cannot stress anymore what tendonitis is. any form of tendonitis. tendonitis is a inflammation of your joints/tendons. Inflammation means "fire". What do you fight with fire? ICE!!!! Iv'e been battling tendonitis in my wrists for years now and the first time it wouldn't go away. After a week of icing it for like 10-20 mins a day, 2 times a day, it went away for 6 months. Came back, repeated the process and was gone in 3 days. Best of luck to you..