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patella tendonitus

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  • Be interested to see how OP Kevin has got on here. I've been suffering from from similar knee pain for a year now. Mine came on shortly after coming back from being knocked off my bike, and damaging in the main my left foot. Since returning to cycling, though the pain was in my left knee, outer above the knee cap, and below on the inside.

    From before doing regular 120k+ rides, daily commuting to work by bike (70k round trip) and loads of hill walking, I was left in the stage where I got pain simply walking. I went to a physio nearly a year ago now, who diagnosed patella femoral syndrome, and I had accpuncture and physio, and was given stregthening exercises - squats, leg raises, scissors etc. which I followed religiously. Three months of this and also stopping cycling altogether, and I was in worse state than before. Practially permanent knee pain, worse from when sitting down I guess (desk job :( )

    I tried a chiropactor to see if it might be related to cycle accident and caused by hips, or ankle - no joy there. GP referred me to a orthopeadic knee specialist who recommended further rest. With no improvement at all, I started to resume light cycling, which was Ok for short distances, certainly no worse than resting.
    Going back to the knee specialist after no improvement, I had a MRI scan which has just now come back negative. He said simply that there is nothing structurally wrong and that I should try to resume my full cycling, which is ridiculous as I have knee pain simply from simply walking.

    An attempt to slightly increase the amount of cycling produced the inevitable increased knee pain again. So I'm back to square one again, except a few dollars poorer.

    I'm lost as what to do next. I've never had any knee pain before, but there's clearly some thing wrong and giving my the knee pain. It's not just cycling, walking's the same. The other noticeable symtom is regular clicking if I bend my knee.

    I'll probably have to bite the bullet and try another physio and hope for the best, but it's so infuriating. If I hadn't managed to keep active through increased sea kayaking this last year, I'd have gone stir crazy.
  • SOunds like cartilage problem - torn or burst or a chunk off. Get a new physio who's good at knees, sports injuries etc. Good luck!
  • SOunds like cartilage problem - torn or burst or a chunk off. Get a new physio who's good at knees, sports injuries etc. Good luck!

    Well, I haven't clue what the problem, but I'd have thought a cartidge problem would show up with the MRI scan I had. The specialist apparently found no problem with them, though there's loads of slides, they don't mean a great deal to unrained eye that's for sure.

    Certainly whatever it is rest isn't curing either again, this week it's worse than ever though I've done nothing sit a desk all day, though for longer hurs than usual has been busy there.

    Anyway you're right another physio I think, would be handy to know if others had similar experiences and that there is light at the end of the tunnel.
  • well a year on and no real progress, wiht hinsight the physio I saw last year didn't really understand cycling.

    I'm also considering orthotic inserts for my shoes based on "gait assessment" offered by Davenport House in Stockport, hoping that this may address some of the imbalance that has contributed to my tendonitis. Can give any comments or advice on this ?

    Many thanks

    Update: The guy at Davenport House had a good look at me last year, I didn't need inserts, but moving my cleat as far back as possible was advised to teke strain off my knee. This worked for me and since then I have been building up the cycling and the tendonitus has abated considerably
    I want to climb hills so badly;
    and I climb hills so badly
  • well a year on and no real progress, wiht hinsight the physio I saw last year didn't really understand cycling.

    I'm also considering orthotic inserts for my shoes based on "gait assessment" offered by Davenport House in Stockport, hoping that this may address some of the imbalance that has contributed to my tendonitis. Can give any comments or advice on this ?

    Many thanks

    Update: The guy at Davenport House had a good look at me last year, I didn't need inserts, but moving my cleat as far back as possible was advised to teke strain off my knee. This worked for me and since then I have been building up the cycling and the tendonitus has abated considerably

    Just out of interest, how far have your cleats been moved back, and now where do they sit in relation to the ball of your foot?

    Glad things are getting better.
  • Where to start on this subject...... Thing is my patella tendons have ruled my life for the last 2years. Believe me when i say be carefull with yours because if you feel like ruining your ability to do ANY sport you ignore the pain at your peril.

    2 yrs ago i was an active MTB rider and footballer. I had patella tendonitus in BOTH knees and although it was uncomfortable and sometimes downright painfull, i could manage the pain with Ibrprofen and a circuit training routine which i tailored to help my blatently obvious muscle imbalances. I visited my GP and the recommended physio for their recommendations (Pretty sueless tbh) and i went to see my local football club physio who basically said he had never seen anyone damage this tendon playing football as it was nearly an inch thick and i would need to be in a car crash to damage it badly. If i could handle the pain, i wouldnt cause to much damage.

    Thing is though, a tendon with tendonitus isnt the healthiest state for it to be in is it? With regards to the pain, it usually felt like someone was running a sharp knife along the tendon whilst exercising. Afterwards the knees would swell up on bad days but sometimes it didnt so dont take lack of swelling as a sign its getting better. The exercises i was doing were helping reduce the pain so i caried on with my sports. Oh, did i mention i have it in BOTH knees :-(

    So we fast forward another 6mths to December 2010. had a few weeks off with the weather and then returned to my first match early january. 10 mins into the game i go to clear a ball. I didnt even get close to kicking it. I was wearing a pair of Mcdavid knee supports designed for the job. Well my knee exploded on planting the standing foot. My injuy is something common in basket ball and american football. My patella tendon snapped completely below the knee cap. If you want an idea of what it looks like google image Ruptured Patella tendon. The forece through this tendon is upto 17 times your body weight and it went with enough force to rip the knee support off. My knee cap ended up closer to my testicles than my knee and i ended up eating grass in pain.

    I had the most amazing surgeon and i cant thank the hospital enough and after 10mths i have managed to do about 2500kms on my road bike, complete a sub 30min 10mile TT and 'win' a 60km charity ride. Thing is i still cant run. Biking is a mechanical movement and its where i feel i have a normal knee. The consultant basically said my knee is now completely different to what it was before the incident. Its in a different position, different leverage etc etc. My brain is having to learn new signals.

    The physio was based around things like core exercises, balance, squats and stretches. It all helped. A couple of basic ones which are absolute hell for me but wont be too hard for you

    1) Stand on a trampoline and stand on one leg. Now do mini squats for a few minutes (Easy). Now get a ball and start throwing it up and down at the same time. Vary the height and speed of the throws. The reason for the throwing etc is that its easy to do things conciously but by concentrating on somthing else you start to highlight weaknesses and you may find you lack strength.

    2) Just get in front of a mirror on one of them step boards wome used to use. Do a few dips on one leg and watch yourself in a mirror. Try to do it slowly and smoothly. Keeping a good straight line. My knees are so bad i end up looking like an irishman dancing a jig.

    The most important message i have after all of the above is the one i wish i knew 2 yrs ago. My 'other' knee is the best it has been for years and years. I havent had a single twinge from it since i snapped the other one. WHy is this? Because it has had a complete rest for a prolonged period and has benefitted from proper exercises. Every exercise they gave me for the injured knee i duplicated on the other leg. If i knee what i knew now and i had the tendonitus i would jack in and rest the knee for a very long time whilst doing whatever exercises i was prescribed.

    Unless you have badly torn your tendon or ruptured it there isnt really any surgical solution i have heard of.

    Hope this helps and i am not any kind of expert so please take anything i say as trying to help.
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