Patella Tendonitis, keep runni

I have suffered the above for about two months now. I stopped running and did some quad strengthening exersizes. I recently visited my long term physio who is great, but he advised me not to stop running and that I should keep the area moving, stop the risk of further atrophy and accompany the running with stretches, lunges and other strengthening exersizes. When I run I have to say I dont really feel the knee, but when I am sitting down I notice it continues to be very tender at he bottom of the knee cap and I keep wondering whether to continue running is providing further aggrevation to it? Unfortunately I can only visit my physio 3 weekly at present. Anyone got any thoughts?

Hi Simon,

Have a look at this: http://www.mayoclinic.com/health/pat...initis/DS00625

Stopping/continuing running is a personal decision; if it was me I would stop but try to keep fit with a "patter routine" and swimming - I would also stretch all muscle groups around the hip/knee/ankle, and do eccentric quads exercises as long as these were not painful - for example single leg squats, concentrating on the down phase; going down over 4-5 seconds, not letting the heel come up.

Good luck.

Simon,


I can only give you the benefit of my experience. Nineteen months ago I underwent a procedure on my knee called a micro fracture. When I received my report from the consultant about a month later it mentioned the fact that I also suffered from "Patella Tendonitis", he said the pain was probably being masked by the more serious problem with the knee. I took 4 months off then back very steady, ie low mileage 12\14 miles per week, which I never exceed even now.

At times the pain was pretty sharp, but I continued running, hell at my age I've not a lot to loose. Most of my runs are now almost pain free, in fact I have days with no pain. I did the Stretton Skyline mid September and never had a moments discomfort, and nothing subsequently. So there is hope you may recover as I did, just go easy on the miles, and stick with the excersizes.

Good Luck.

Thanks Mike and John........I am really hoping I never get to the surgery stage of things, but strangely John I seem to run pain free the tenderness is most apparent when I am sitting at my desk or on a bus or something similar?

Simon

Simon, I had a summer of this after the Three peaks fell race in 2008. The pain was always worst after getting out of a chair, or similar. Eventually after around three months I went to a good local physio who said my knees were extremely inflexible and my quads were weak. I incorporated squats into my trains (loads of them) plus did I did regular lunges and it cleared over six to eight weeks. Keeping the knees warm helped. I think you have to really get stuck into any strengthening exercises. Really attack them and think of surgery as the very last resort. I got quite down for a while and thought I'd never run again but my knees were the best they'd ever been afterwards and I get no pain from them now. Good luck! Andrew

Hi Simon

We are in the same boat.I think my problem was just overuse - borrowdale, steel fell and howtown inside a week not a good plan. I've laid off the running and done a lot of cycling (which keeps the knees mobile but doesn't put sudden stresses onto the tendon) and also done eccentric contractions initially with both legs together and latterly with single leg.These work by standing, toes down, on an incline of about 30 degrees ( a plank on the bottom step of the stairs) and doing a very slow squat till your knees reach about 40 degrees. This is the eccentric contraction as your quads are contracting although at the time they are actually getting longer! then stand up as fast as you like and repeat. I started with eight reps three times daily and worked up to twenty with both legs then went back to ten reps with each leg singly and again built up to twenty. this has definitely helped and although, like you, I don't really notice much pain when running I now have no pain doing anything else either. Altogether it has taken about four weeks to get back to this position. Hope this helps.

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Originally Posted by mykind

Hi Simon

We are in the same boat.I think my problem was just overuse - borrowdale, steel fell and howtown inside a week not a good plan. I've laid off the running and done a lot of cycling (which keeps the knees mobile but doesn't put sudden stresses onto the tendon) and also done eccentric contractions initially with both legs together and latterly with single leg.These work by standing, toes down, on an incline of about 30 degrees ( a plank on the bottom step of the stairs) and doing a very slow squat till your knees reach about 40 degrees. This is the eccentric contraction as your quads are contracting although at the time they are actually getting longer! then stand up as fast as you like and repeat. I started with eight reps three times daily and worked up to twenty with both legs then went back to ten reps with each leg singly and again built up to twenty. this has definitely helped and although, like you, I don't really notice much pain when running I now have no pain doing anything else either. Altogether it has taken about four weeks to get back to this position. Hope this helps.

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Interesting. What is the thinking behind doing it on an incline?

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Originally Posted by Corniceman

Thanks Mike and John........I am really hoping I never get to the surgery stage of things, but strangely John I seem to run pain free the tenderness is most apparent when I am sitting at my desk or on a bus or something similar?

Simon

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Simon, similar problems here. Have little or no pain running, but can struggle after sitting for a while, driving, pushing a shopping trolley (!?) etc.
Have had this on and off for years and I have come to the conclusion that this is related to:
a. overuse and particularly anything that will cause an imbalance in muscle e.g. cycling.
b. weak and/or inflexible calfs, quads
c. bad luck that my body is so bio-mechanically rubbish!

Symptoms are usually eleviated by ice and massage and keeping active though maybe at a lower level if the pain is not too bad. Any sharp pain and its ice and rest for a while with a gradual return. Ibuprofen if particularly bad.
A patella band I also find helps.

Prevention:
Basically everything else people have eluded to i.e. strengthening (esp. vastus medialus) and stretching. Also learn what your limits are (though keeping to them is the big problem for me!)

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Originally Posted by Mike T

Interesting. What is the thinking behind doing it on an incline?

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The idea here is to stop the calf muscle making any significant contribution towards the control of the slow squat. flat footed squats can allow the calf to influence the rate of descent and thus make the whole thing less effective - I think!

I can see that on a flat surface the tension in the calf as the knee bends would tend to make the quads do less work.

A further couple of points on squats:

1/ do not let the knee(s) bend in towards each other - you should be able to just see the side of your big toe as you look down the inner side of your knee

2/ it is the initial taking up of tension that particularly strengthens tendons, so if going lower is difficult/painful, even those first few degrees of bend are beneficial.