Patella Tendonitis - Triathlon Week

10-26-2004, 04:25 PM

Hello All,
In my last two races of the season I had severe pain above my knee cap.
Since then, I've developed pain below my knee as well, with stiffness every
morning. My family doctor says it is patella tendonitis, and I need to rest,
no running or biking. She did recommend light strength training.
So here is my question, does anyone have experience with this? My goal
was to start building up my running miles this winter, and do a half
marathon in the spring, in preparation for my duathlon season. How long
should I wait before resuming training? Should I see a specialist?

Thanks in Advance,
Larry

10-26-2004, 09:14 PM

Were you running or cycling when it was hurting? Saddle position can help
if it was on the bike. Try high rep/ low weight leg extensions from the 45
degree to fully extended position. This was an exercise that a PT had given
me as a strengthening exercise for the inner most head of the quads, which
is often the culprit of patella tendonitis. A good PT should be able to
work you through this very common problem. Good luck.

AJ

"Larry Gray" <[Only registered and activated users can see links. ].com> wrote in message
news:s9Afd.55011$[Only registered and activated users can see links. ].com...
> Hello All,
> In my last two races of the season I had severe pain above my knee
cap.
> Since then, I've developed pain below my knee as well, with stiffness
every
> morning. My family doctor says it is patella tendonitis, and I need to
rest,
> no running or biking. She did recommend light strength training.
> So here is my question, does anyone have experience with this? My goal
> was to start building up my running miles this winter, and do a half
> marathon in the spring, in preparation for my duathlon season. How long
> should I wait before resuming training? Should I see a specialist?
>
> Thanks in Advance,
> Larry
>
>
>

10-27-2004, 06:09 AM

I suffered with a terrible case (both knees) about 10 years back. It
shut me down just a few weeks before the NYC marathon. I could run but
I could not walk, which is to say that after a mile or so of running
the pain would disappear, only to return after I'd cooled down. I was
miserable and looked even worse walking around the office. I went and
had my gait analyzed and the guys told me they were amazed I could
even walk upright with my screwed up skeletal structure. They made me
my first set of orthotics and after I recovered from the injury, I
started wearing them to run as well as in my cycling shoes.

Never had the problem again. In fact, that was the last tiny bit of
knee pain I ever had.

10-27-2004, 05:18 PM

Hello,
I didn't notice it on the bike, although my legs felt spent and I
couldn't push it. It started right on the run. Thanks for the advice, it
probably happened because I've neglected the weight room this year.

Thanks,
Larry

"A. J." <[Only registered and activated users can see links. ]> wrote in message
news:[Only registered and activated users can see links. ]...
> Were you running or cycling when it was hurting? Saddle position can help
> if it was on the bike. Try high rep/ low weight leg extensions from the
> 45
> degree to fully extended position. This was an exercise that a PT had
> given
> me as a strengthening exercise for the inner most head of the quads, which
> is often the culprit of patella tendonitis. A good PT should be able to
> work you through this very common problem. Good luck.
>
> AJ
>
> "Larry Gray" <[Only registered and activated users can see links. ].com> wrote in message
> news:s9Afd.55011$[Only registered and activated users can see links. ].com...
>> Hello All,
>> In my last two races of the season I had severe pain above my knee
> cap.
>> Since then, I've developed pain below my knee as well, with stiffness
> every
>> morning. My family doctor says it is patella tendonitis, and I need to
> rest,
>> no running or biking. She did recommend light strength training.
>> So here is my question, does anyone have experience with this? My
>> goal
>> was to start building up my running miles this winter, and do a half
>> marathon in the spring, in preparation for my duathlon season. How long
>> should I wait before resuming training? Should I see a specialist?
>>
>> Thanks in Advance,
>> Larry
>>
>>
>>
>
>

11-12-2004, 04:48 AM

"Larry Gray" <[Only registered and activated users can see links. ].com> wrote in message news:<s9Afd.55011$[Only registered and activated users can see links. ].com>.. .
> Hello All,
> In my last two races of the season I had severe pain above my knee cap.
> Since then, I've developed pain below my knee as well, with stiffness every
> morning. My family doctor says it is patella tendonitis, and I need to rest,
> no running or biking. She did recommend light strength training.
> So here is my question, does anyone have experience with this? My goal
> was to start building up my running miles this winter, and do a half
> marathon in the spring, in preparation for my duathlon season. How long
> should I wait before resuming training? Should I see a specialist?

Rest will probably help, but will not solve the problem. Leg
extension exercises will help (as mentioned by A.J.). Try turning
your toes out slightly as you do them in order to focus the effort on
the vastus medialis. Running often causes the v. medialis to become
weak relative to the v. lateralis, leading to knee pain. I also like
to do the exercise very slowly, particularly working the
eccentric/negative motion.

If your hamstrings are even slightly tight, try to work on stretching
them. Tight hamstrings will affect the rotation of the entire lower
extremity and alter the tracking of the kneecap, or so I've heard.

For instant relief, try running with a cho-pat strap (multiple
versions are available from roadrunner sports and other vendors).
Strap it around the patellar tendon (not too tight) and it pins the
tendon, effectively shortening it and moving its insertion closer to
the kneecap so that the kneecap can't track as far out of line. When
I had pain above my kneecap two years ago, I could tell the difference
the strap made within 60 seconds of putting it on or taking it off. I
haven't tried cycling with it, but it might help there as well. Ice
massage of the knee following workouts will also help relieve
inflammation, etc.

Other considerations are choice of shoes, age of shoes, orthotics,
etc. Overpronation can cause either of these types of knee pain, so
you might want to consult a running specialty store or a PT if you're
not sure about your shoes or your biomechanical tendencies.

If you don't have major biomechanical problems to resolve, patellar
tendinitis is a pretty routine running injury, so you should be able
to work through the problem on your own without seeing a specialist.
If you do need to consult a doctor, I wouldn't rely on a general
practitioner unless the person is also a veteran runner and familiar
with running injuries. The average member of my running club seems to
have more experience with common running injuries than the average GP.
On the other hand, the right specialist or PT can often work wonders.

As far as how long to rest, this is the perfect time of the season for
a break. On the other hand, I often find that not running causes me
to stiffen up so that my symptoms get worse. Some injuries won't heal
without complete rest while others seem to need some exercise to work
their way out. On balance, I would give the strengthening and
stretching exercises a head start for a couple of weeks and then start
with a bit of jogging or relaxed spinning depending on how the knee
feels.

Good luck,
Jason Blank

11-12-2004, 04:03 PM

Hello,
Thanks for the reply. Rest and leg extensions have helped. I've seen the
straps advertised. Are they safe?

Thanks,
Larry

<[Only registered and activated users can see links. ]> wrote in message
news:aa301aab.0411120348.788e8de0@posting.google.c om...
> "Larry Gray" <[Only registered and activated users can see links. ].com> wrote in message
> news:<s9Afd.55011$[Only registered and activated users can see links. ].com>.. .
>> Hello All,
>> In my last two races of the season I had severe pain above my knee
>> cap.
>> Since then, I've developed pain below my knee as well, with stiffness
>> every
>> morning. My family doctor says it is patella tendonitis, and I need to
>> rest,
>> no running or biking. She did recommend light strength training.
>> So here is my question, does anyone have experience with this? My
>> goal
>> was to start building up my running miles this winter, and do a half
>> marathon in the spring, in preparation for my duathlon season. How long
>> should I wait before resuming training? Should I see a specialist?
>
> Rest will probably help, but will not solve the problem. Leg
> extension exercises will help (as mentioned by A.J.). Try turning
> your toes out slightly as you do them in order to focus the effort on
> the vastus medialis. Running often causes the v. medialis to become
> weak relative to the v. lateralis, leading to knee pain. I also like
> to do the exercise very slowly, particularly working the
> eccentric/negative motion.
>
> If your hamstrings are even slightly tight, try to work on stretching
> them. Tight hamstrings will affect the rotation of the entire lower
> extremity and alter the tracking of the kneecap, or so I've heard.
>
> For instant relief, try running with a cho-pat strap (multiple
> versions are available from roadrunner sports and other vendors).
> Strap it around the patellar tendon (not too tight) and it pins the
> tendon, effectively shortening it and moving its insertion closer to
> the kneecap so that the kneecap can't track as far out of line. When
> I had pain above my kneecap two years ago, I could tell the difference
> the strap made within 60 seconds of putting it on or taking it off. I
> haven't tried cycling with it, but it might help there as well. Ice
> massage of the knee following workouts will also help relieve
> inflammation, etc.
>
> Other considerations are choice of shoes, age of shoes, orthotics,
> etc. Overpronation can cause either of these types of knee pain, so
> you might want to consult a running specialty store or a PT if you're
> not sure about your shoes or your biomechanical tendencies.
>
> If you don't have major biomechanical problems to resolve, patellar
> tendinitis is a pretty routine running injury, so you should be able
> to work through the problem on your own without seeing a specialist.
> If you do need to consult a doctor, I wouldn't rely on a general
> practitioner unless the person is also a veteran runner and familiar
> with running injuries. The average member of my running club seems to
> have more experience with common running injuries than the average GP.
> On the other hand, the right specialist or PT can often work wonders.
>
> As far as how long to rest, this is the perfect time of the season for
> a break. On the other hand, I often find that not running causes me
> to stiffen up so that my symptoms get worse. Some injuries won't heal
> without complete rest while others seem to need some exercise to work
> their way out. On balance, I would give the strengthening and
> stretching exercises a head start for a couple of weeks and then start
> with a bit of jogging or relaxed spinning depending on how the knee
> feels.
>
> Good luck,
> Jason Blank

11-21-2004, 06:18 PM

<[Only registered and activated users can see links. ]> wrote in message
news:aa301aab.0411120348.788e8de0@posting.google.c om...
> "Larry Gray" <[Only registered and activated users can see links. ].com> wrote in message
> news:<s9Afd.55011$[Only registered and activated users can see links. ].com>.. .
<<snip>>

> If your hamstrings are even slightly tight, try to work on stretching
> them. Tight hamstrings will affect the rotation of the entire lower
> extremity and alter the tracking of the kneecap, or so I've heard.
>

<<snip>>
> Jason Blank

I found this a helpful contribution. I have had tight hamstrings since I
was a teen, with no symptoms (discomfort).

Some factors related to my knee pain:

* It is bearable, compared to my PF experience.
* It subsides after a mile, even on cold days.
* I have never been fond of stretching.

Since reading this I have experimented with basic hamstring stretching,
sometimes after warming up, sometimes not.

It seems to make a difference in that I can "get down to business" earlier
in my run workouts

Thanks for the contribution. It never occured to me that the problem could
be on the other side of my leg!.

RR

12-04-2004, 04:11 PM

Great information on patella tendonitis, but is that really the
problem? I've got a similar injury, but it's still just above my
kneecap, not below it. I thought petella tendontis cause pain below
the kneecap.

-sTeve-O