Patellar Tendonitis.... Suggestions?

[miami]

Has anyone delt with patellar tendonitis before? Both myself and a buddy of mine are out with similar issues with our knees.

I've been told to take a week off... but I don't want to take that many zeros.

All input is welcome.

[solobip]

If you do not rest it and take some type of anti-inflammatory meds, you will take a lot more zeros than you want, after a great deal of pain and crying. I had a bout a few years ago, thought I would never hike again, incredably painful. Took some joint supplements and eventually recovered and now with regular exercise and losing weight, feel better than 100%. Address it.

[LDog]

I just went to see an orthopedic specialist today about some pain I was having on the inside of my knee. He poked, prodded, did some stress tests, and ruled out either torn meniscus or ligaments. Instead, he said I had tendonitus. He called for rest, ice, advil, and lots of stretching - quads, hamstrings, calfs, IT bands, and hip abductors. He didn't rule out the hike, but questioned me on pack weight, how many miles I thought I'd be pushing, and whether I'd be using hiking poles ...

[Wise Old Owl]

Miami before anyone should answer factors such as age weight medication need to be addressed

[miami]

30yrs/ 200lbs (6'-3" tall). Medications include Vit I (for 2 days before I got off) and a regular regiment of Multi Vit, fish oil, probiotics, immune globulin, CoQ10 (cellular energy), Traumeric by orthomolecular(turmeric w/ quercitin, rutin, and bromelaine; all natural anti-inflam)... I just bought some glucosamine w/ chondroitin (containing skullcap) and started taking a "soft tissue recovery pack" by orthomolecular (natural anti-inflam and tissue repair) as of two days ago when I got off the trail.

I also just picked up a pretty serious looking knee brace today with bottom and outside stabalizers for the kneecap.

[Blissful]

Hope you got is checked by a sports md.

A huge bulky knee brace might not be the solution. Hence the md.

I fixed my issues with a cho pat duo knoee brace and cut my miles and food weight (that is, resupplied more often).

[miami]

I saw a sports md today and will be seeing a PT tomorrow morning. The md is where I got the brace from.

[miami]

Base weight is roughly 24lbs. Typically carry 2L or less water in my pack. Food is roughly 1.5lbs per full trail day. I use poles, boots, and superfeet.

[psnipes]

Stretch your quads frequently.

[Hooch]

Without a doubt, the best thing you can do for your knee right now is rest it and take anti-inflammatories as needed. A week's rest will do you good. I understand you may not want to take that many zero days, but better now than having to get off the trail completely. Doctors have extensive training for a reason.

[smoothsailin]

One exercise that helps me is to have a board on a slant and do a few squats.

[smoothsailin]

and custom insoles. I had mine made by a dr who casts both feet. Having proper foot alignment is key to walking without pain.

[Snowleopard]

You are already seeing a doctor and PT, so do what they say.

The preventive measures are exercises to strengthen quadriceps and hamstring muscles. Unbalanced strength of this pair of muscle causes some knee problems. Stretches might help too. Do this BEFORE you have knee problems. Once you have knee problems, see a doctor before there is permanent damage.

[burger]

Stretch your quads frequently.

That's bad advise. For kneecap issues, your quads need to be strengthened and kept reasonably tight to keep your kneecap aligned. Some PTs will tell you to not stretch your quads at all.

What you should be stretching is your hamstrings and calf muscles. I'm sure your PT will tell you this.

[miami]

So, it looks like everyone from the othopedic md, physical therpist, current and former athletes, long distance runners, and thru-hikers are telling me to lay off for at least a week. I have another PT appointment on Monday with a different PT that specializes in long distance running to get their input as well.

The MD and PT confirmed my suspisions that I primarily have a patellar tendonitis issue, as opposed to an irritation under the kneecap that is common due to poor tracking. However, I also have a slightly outturned foot on the same leg (due to a childhood injury), which may or may not be complicating things. Thus the additional PT appointment.

PT is recommending the following stretches and strengthening excercises: PRIMARY: Straight Leg Raise phase 2 (15-20/set x 3 sets), Hip Abduction side-lying (15-20/set x 3 sets), Bent Knee Lift prone (15-20/ set x 3 sets), Hamstring Stretch standing or supine (hold 30 seconds, repeat 3x), Hip Internal Rotation resisted (15-20/set x 3 sets), Calf Stretch (hold for 30 seconds, repeat 3x), Quadriceps Stretch (hold for 30 seconds, repeat 3x), Iliotibal Band/ Abductors (hold 30 seconds, repeat 3x). SECONDARY: IT Band Stretch and Proformist Stretch.

If anyone has any questions about this, I have been pretty well schooled at this point... lol.

[littlebird2012]

Hey man! This is my first post and I normally read these topics without commenting but I HAD to add a little advice. I have a very similar condition to you called runner's knee and my knees acted up the most when I was running-- I found out that it was because I heel-strike when I run and this also wound up effecting my hiking-- I'd just get this tingling feeling around my knees and over time it started to hurt. I wound up starting barefoot running and walking barefoot in general and it helped a great deal, although what I would recommend is something called "the pose method" that can be used for running or walking. You can learn more about it here:
http://posetech.com/
What it advocates is really targeting the function of the knee: flexion. Too many people believe that to walk or run, you have to extend your leg or straighten it when in reality, walking is allowing your weight to fall forward and your natural springs (joints) flexing and gently taking the weight. It's worked wonders for me and I went from not being able to walk long-distance without my knees hurting to being absolutely pain-free. I hope some of the principles on the website help you out! I had physical therapy and it did mildly help-- nothing wrong with the exercises you're doing as long as you keep fromm doing any leg press or knee extension exercises. definitely pay attention to the pose drills, they have done WONDERS for me and it is all on the site.

[pdcolelli42]

Good thing you saw a PT. I don't think I had tendonitis but rather poor tracking due to the muscle above the knee cap not being strong enough to keep it aligned properly. When the PT looked at it he noticed the right leg's muscle was smaller than the left due to the injury and me favoring one leg. Anyway long story short he gave me all sorts of exercises to do to strengthen the supporting muscles. I still have a lot more to do in the next 16 days before I leave but my knee(s) are already feeling much stronger.

Do what the PT says. Mine really knows his stuff and hopefully you can trust your PT like I do mine. I also saw someone posted strengthen the muscles before you hike. I totally agree, wish I knew that sooner than a month before my thru.