Patellar Tendinitis
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I’m coming off a base block and heading into a strength block. In my first workout I got a twinge on my patellar tendon and now it’s remained a small niggle. As I read recovery exercises and stretches (hip flexors etc) I tried weighted leg extensions (lowering/eccentric) on my unhealthy leg. I’ve not seen much change over 2 weeks. Anyone have any experience or black magic tricks?
I do hero’s pose for 5 minutes in the morning when I roll out of bed, and at evening to keep my knee pain to a minimum. You know your body best, so a couple of modifications that can help: closed knee child’s pose, sitting with a towel between your heels and glutes, or using your hands to bear some of your weight. I sit in toe pose for 2 minutes after to counter the stretch on my ankles. The other one that helps my personal knee pain is sitting in a yogi squat, again work-up to 5 minutes. Nose breathe to help release all the muscles around your knee joint, and help you get through the discomfort of the poses.
I had my oldest daughter, a former D1 athlete (wow just realized she graduated 4 years ago) do this over the last 3 weeks and the tweak is gone from her knee.
If you think these stretching exercises may help you, give them a try twice daily for 2-3 weeks. Scan your body if you do, you know yourself best. Whatever you do I hope the niggle goes away.
I just started the strength training phase of the 24 week plan. Hope your training is going well Ryan.
Note I am a yoga practitioner and instructor, not a medical professional. Just offering up what works for my knees.
Hi Ryan
Great question. Tendon adaptations, in general, are very slow, and 2 weeks will not be enough to make a lot of difference.
Things I would recommend looking at in this “acute” stage – isometric holds. There are a variety of ways to achieve this – iso-lunges, wall sits, seated leg extensions, isometric leg presses etc – you can google these. Isometric holds are quite useful early on, as they reduce pain, and trigger some of the necessary adaptations in the tendon structure; holds are usually in the 20-40s range. There is some evidence now that taking a collagen/Vit C supplement 30-6- mins before these exercises can promote more rapid healing (look up Baar et al, UC Davis’ work).
Isometrics can be done daily. After this I would usually progress to some sort of heavy eccentric or eccentric/concentric work. The weight should ultimately be challenging – 3-5 rep max. These are challenging and should NOT be done daily – 2-3 times per week is good.
I love the Spanish Squat for patellar tendons – look it up.
The final part of the equation is to introduce more explosive work – box jumps, box drops, drop squats – plyometrics basically. Again – these can be very challenging – 1-2 times weekly max.
Hope that helps – a good therapist will be able to check your form, do a biomechanical assessment, add in some additional manual therapy/modalities and confirm the diagnosis.
LCB – thank you for the response. My physical therapist had me work on mobility and it has made a difference!
Dr. Reed,
Thanks for the thorough reply. I met with Pete Dickinson from world cup physio and he watched my movement and thinks my muscles are tight and that I’m a squat dominant athlete and need to work on my locomotion; improving and utilizing deadlift motions and hip-hinging through my gait. I’ll absolutely work in your suggestions to my recovery. Going forward I’ll work in a good isometric building block to strengthen the tendons and joint. Thank you very much for your input.
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