Patella Tendonitis

I was diagnosed as having Patella Tendonitis 15 months ago by a consultant here in Saudi Arabia. I was given a steroid injection followed by 12 sessions of physio. I restarted training after some 3 months and was okay about 5 months when the problem re-occured. I carried on running which didn't seem to bad but eventually the pain got unbearable, walking up and down stairs was the very painful.
I stopped running and went back to see the consultant who gave me a second steroid injection and 12 sessions of physio again. This time it was only 1
week before the pain came back. I again carried on running and still am today some 3 weeks since re-starting running.
I am now worried I may have to give up running which I love and cannot imagine my life without running.
The consultant told me to run every other day and forget competive running, needless to say I have not taken his advice.
I really do want to have another steroid injection as I think it is not working for me.
I normally run 50 miles a week which includes 2 track sessions, 1 steady run,3 easy runs and a long run.
Can anyone help me please.
Roy

Roy, it seems that you are a dedicated runner which is a good thing. However, sometimes a little too much enthusiasm can be damaging rather than productive. I myself, maybe like you, am a believer in active recovery-rightly or wrongly. I have decided to lessen my training load and I have dropped down a group in my club training sessions. I wouldn't reccommend doing two track sessions a week as this can be very damaging to the knees at the best of times let alone when you're already injured. I would say that the rest of your schedule looks good although I would cut down on the long run to maybe another easy run. I am also like you in that competetive racing is still very much on the agenda so I can't criticise anyone who wants to compete with this injury. For me this injury is a time to maintain my fitness/running level not to improve it until this gets better. I don't know if you have read the other forum discussions about tendonitis but many of the forumites are running with this injury using a patella strap. I'm gonna get one tomorrow off my physio. They apparently are very good although results vary. Whatever you decide to do good luck and i hope your injury can finally be cured.

Hi Roy,

The problem is that the tendonitis is being cleared up each time it re-occurs, but has the physio corrected the cause of the tendonitis in the first place. If the cause is not irradicated then it will keep re-occuring.

Tendonitis of the patella in my case occured as a results of patellar femoral syndrome. This occured in my case due to pronation, quadricep muscle imbalance, one leg shorter than the other and weaker SI joint stability muscles on my right.

I would find a physio that can properly instruct you on your biomechanics to ensure that you a running properly and don't need orthotics. They may give you exercises to strengthen the weaker side to rebalance.

Please get it sorted properly else you will keep struggling as I have also.

For about two years I had patella tendinitis really really bad, like after a run I could hardly walk without pain.

Went to physio, spent money on shoes, nothing really worked, untill I tried barefoot / forefoot running.

Instead of landing on the heel with the foot out in front, I started landing on the forefoot with the foot under my body, knee bent.

This helped out big time.. I still have some pain, but its nothing like what I used to have, and I think its due to my form still not quite right.

Have a look at www.runningbarefoot.org, and www.posetech.com.

Try going for a wee run in bare feet, making sure you land on the balls of your feet, knees bent, letting your calfs and the arch of the feet absorb the impact ( and also release that impact energy again, as the foot goes behind you ).

You need shorter strides, dont land with the feet out in front of you.. thats heel strike material. Land with the feet under your body.

The problem with running this way is that you need to run barefoot ( which is actually really nice on most surfaces ), or find some 'racing flats', ones WITHOUT cushioning, and WITHOUT the wedge shaped heel, and WITHOUT all that pronation control and all the other crap. This is because landing on the ball of the foot requires room under your heel for your calf and foot arch to act as suspension spring, absorbing the energy and releasing it again.

I suspect I have patellar Tendinitis. I used to run about 8-10 miles 3 times per week. I was suffering from pain in my knees while running, and the following day when sitting bent legged, or walking up and down stairs. I went to my GP and she diagnosed me as having a fluid sac on cartaliage under my kneecap and told me to stop running for 6 months and take some ant-inflammatory painkillers. I did this, and now after buying some new running trainers, am trying to get back into running, I started doing 3 miles 3 times per week, and have gradually increased it to 6 miles 3 times per week. My knee was okay at first, but now it has started hurting again. It's bearable, so I was considering just keeping running at my current mileage and hoping it doesnt get any worse. I dont know if this has been caused by increasing the mileage and speed too quickly or whether it is something else.
I havent been to see any specialists, as I am worried it might cost hundreds of pounds for treatment. If I go to my GP again she will probably just tell me stop running again which I really dont want to do. Anyone know what I should do?

i have just been diagnosed with patella tendon strain in my left knee. there is no waiting list for physio where I live and the local physio is a sports specialist. I have got into London Marathon this year - what are my chances of actually competing. I was previously running 20 miles a week plus cycling (both road and off road). I intend to concentrate on road cycling to maintain my fitness levels, and hope that with some rest I may be able to resume my training for the marathon.

Kim, the problem with the tendons in the body is that they heal very slowly. Unfortunately, being deadly honest with you it won't get better unless you sort out the route cause of the problem which in most cases is the patella tracking wrongly across the knee. When I was diagosed with patella tendonitis it didn't get better until I saw a physio who in a matter of weeks got me back to running in comptitions although you have to select the races you choose very carefully. Because the inner quads tend to be weaker than the outer quads it might be that you need some strengthening exercise to realign you knee cap. Let me know what you decide as you have my utmost sympathy as I know how painfull this is. Oh and by the way good idea with the cycling. Good luck.

Hi Kim,

My wife Louise has had this problem for a couple of years, she wears a knee support which was recomended by our Phsyio, if she runs without it she get pain. But with it she can run and did the FLM last year (Second time), the support works y lifting the patella and somehow it aleviates the rubbing. She still gets some discomfort, but it is a workaround. But like Gav said you may want to get the route of the problem sorted as well.

Best of Luck.


Nick.

I've just been diagnosed with this in my right knee, and referred to a physio. Only been doing 10 - 20 miles running per week, on good weeks that is. Done an awful lot of road cycling though to keep fitness up, and am thoroughly enjoying it, to the point where I may shift allegiance and take to cycling competitively, easing off on the competitive running (for a while at least).
Knee is particularly bad this week, so no cycling OR running, and apart from a rigid stretching regime I'm bored out of my brains and stuffing myself with food!!

What a laugh.

Fellow runners who are suffering from Patella Tendonitis, you have my utmost sympathy. My GP and Orthopaedic consultant diagnosed my left knee three years ago! I have had steroid injections twice (never again, so painful that I was in tears!!), ultra-sound, physiotherapy and acupuncture but unfortunately my knee did not response to the aforementioned treatments and the condition has become ‘chronic’! Basically I have been told not to have surgery by three doctors, as there is a 70% chance that the knee would get much worse. I miss running dearly as my body is conditioned for exercise and without it I feel very depressed! Three years of patella tendonitis is unbearable and the pain is constantly evident and never seems to decrease to a point where I feel a bit happy. So the bottom line is that I have to live with it! To put how much pain I am experiencing in perspective, I have been off work since March 2004 and can’t drive my Porsche 944 turbo!! So I hope all you fellow sufferers a speedy recovery and best wishes.

I have been out with this injury for 6 months, but I'm hoping to start some gentle running again in a couple of weeks. Some people have mentioned knee supports. Can anyone recommend a good one?

I developed this in my left knee as I built up the mileage prior to FLM this year. I bought a strap from my local sports shop and this helped to reduce the pain while running but when I took the strap off, I still felt pain while going down stairs or while driving in town (lots of clutch work. At the FLM Expo I got my knee cap "strapped" in a horseshoe shape with some titanium tape by a company called Phiten (www.phiten.co.uk). It's expensive but for me was nothing short of a miracle. I put some on both knees, under my straps (I'd decided on a second, right knee strap as a preventative, given the marathon distance. I won't say the FLM was painless (my thighs were stiff as a board on Monday) but I didn't feel so much as a tweak from either patella right through the race, and what's more, they haven't hurt since, not even when the thigh pain made me crawl backwards on hands and knees to get downstairs! My legs have recovered from the race now and I'm back to running this week and still no knee trouble (though I'm keeping the titanium tape handy just in case).
The straps I used are about an inch wide around the back with a wider, padded panel that rests over the patellar tendon. Made of neoprene with velcro fastenings. Don't be tempted by the "Cho Pat" strap - it's for a different condition called Chondromalacia - flaking of the under surface of the patella.
As a (now non-practicing) osteopath, I agree with the other forumites who say fix the musculo-skeletal imbalances first, particularly the quads, to maintain good tracking of the patella but sometimes a bit of outside help is worth it. I know why the strapping helps. I've no idea how the titanium works but it did for me, and I'm a confirmed cynic and sceptic.

wow, this thread started a long long time ago. well the patella pain suffering i've experienced pales in comparison to some of the stories on here. i'll certainly make sure my condition doesn't become chronic.

here's a good patella tendonitis rehab program i've come across. i've been doing knee dips for about four months now and my knee's much better these days. think i'll move onto using weights soon.

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thanks for all your responses. I stopped running for 4 weeks and have been having ultrasound twice a week which has helped. I have, over the last 3 weeks, started running again, and managed 11 miles (over 3 runs) 2weeks ago. However, my knee is aching significantly again, obviously when I run, but also climbing stairs and driving (and also as a passenger in a car.) the physio is recommending continuing running but find the surface that most suits me - running cross country and on muddy tracks through woods appears to be the best. I did try running on the canal bank but that was as painful as roads, which could possibly be due to trying to run at speed, which you are not always doing when running through woods.

When not running I did find road cycling a good alternative, but you do need to allow at least three times the time you would spend on a run.

I intend to try a couple of trail/off road runs this summer, probably up to 8 miles in duration (so fingers crossed!)

Thanks Susan & John... the rehab program looks good so I'll give that a try.
I was about to buy a "Cho Pat" strap, as it appears on many web sites for patella tendinitis, but will now hold fire following Susan's advice. The titanium tape looks interesting, I think I'll give that a go, but I'm still confused about the plethora of knee supports/straps that are available.

Cho-Pat worked for me. If anyone wants to buy a Large for £5 (I am med and bought a large buy mistake) let me know.

the cho-pat is often recommended for patella tendonitis amongst other things.

personally i'm wondering whether changing to a midfoot strike will help my knees and running in general. typically i've managed to injure my foot now so that's my number 1 injury. my knee didn't twinge at all when running this morning so that's pleasing.

I HAVE HAD THIS FOR OVER A YEAR AS A VERY COMPETATIVE RUNNER IT WAS AT FIRST HELL BUT AS AN EX CYCLIST GOT ON MY BIKE FOR SIX MONTHS JUST DONT DO TO MUCH TO SOON HOPE FULL TO BE AT THE WIBBLEY WOOBLY LOG JOG IN AUG AS FIRST RACE IN OVER 16 MONTHS ONLY UP TO 2 MILES TWICE A WEEK BUT THERE IS ALWAYS HOPE

UP TO 3 MILES TWICE A WEEK & STILL ON THE BIKE WILL BE AT WIBBLY WOBBLY LOG JOG ON 5TH AUG WITH LUCK THERE IS ALWAYS HOPE