Question - Patella Tendonitis Issue

by Peter
(Cork, Ireland)

I have been trying to get rid of patella tendonitis in my left knee for 7 months now.


It started in my left and I noticed this when running and doing my thai boxing training warm up. any pressure on the knee seemed to build up to a funny feeling that just niggled at me rather than hardcore pain.

After a few potential fights were canceled I approached a physical therapist.

I went through 4 months of deep massage, ultra sound massage and was advised to use bio freeze. Just into the new year I felt the problem was still there and had also spread to my right knee.

I have gone for an injection 5 weeks ago and the specialist injected tricylisone from the cortisone family. This seemed to work and I rested completely for a further 4 weeks.

I tried a light run on flat ground and very slow and had no real problem, a week later I returned to thai boxing, did a steady run and then trained the session involving pad work with kicks.

The next day I felt that familiar pain again when going up and down stairs, but in the right knee mainly, and the left knee didn't feel far away from it.

My herapist, who i saw again last week, has now diagnosed I have torn quads.

I find this frustrating as why on earth could he not have checked my quads 7 months, two injections and 1,000 euro before hand!!!!!

When I run its not far or fast and I have a brand new pair of gel filled Asics runners. I wear gel filled insoles in my day to day footwear. I stretch my hamstrings in the evening and morning even if I am not training.

I have had no treatment on the right knee at all apart from the injection, the pain has reduced since he massaged my quads.

Do yo have any advice? Would surgery be extreme at this stage?

Thanks
Pete

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Mar 18, 2008
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Mobility is the key...
by: Bart - SII

It sounds like you have had a frustrating time. Patellar tendonitis can be an extremely annoying injury, especially because there are so many factors that can contribute to its cause.

I can't comment specifically on your current situation because I cannot evaluate you. But it seems odd that you could all of a sudden developed torn quads with as little activity that you have done in the last few weeks.

There is an underlying mechanical cause to your problem. The key is finding that cause. Injections will help your symptoms, but they will not take care of the underlying problem...so when the medication wears off, you are still left with a painful knee.

The most overlooked component for treating patellar tendonitis that I have found is mobility in the lower back. Specifically, the ability to bend side to side. The soft tissue in the lower back becomes tight, restricting this motion, and then your hips cannot accommodate as they need to. Since your hips and back are not moving, your knee moves more than it should side to side during activities, and this increases the stress on the patellar tendon.

I would recommend talking to your therapist about lower back mobility, especially lateral trunk flexion, as well as talking about eccentric strengthening exercises for the hip abductors and external rotators. These are the muscles that control where the knee goes during activity.

I have some information on this topic in the rehab section of the website - Patella Femoral Rehab - Improving Mobility - I know you don't have PFS, but the concepts are the same. There are a couple of exercises there that may help.

Talk with your therapist. Sometimes to treat the knee you have to unfocus on the knee and refocus on another area that may be causing the problem - like the hip and back.

I hope this helps - please comment back with any other questions.

Mar 19, 2008
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stretches
by: Anonymous

yor dead right, so frustrated its unreal. I will try the stretching you have suggested and let you know how it goes.

Pete

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