Patellar tendinitis - recovery and management

cruff

Background - used to be fat (almost 20 years) then dropped a load of weight very quickly a few years back when I finally decided to do something about it - mainly running with a bit of cycling. After a while, bought a 'real' bike and really enjoyed it, so started cycling more and more until I realised I was actually pretty good at it and began taking it a bit more seriously. Now put in about 10000km a year - a mixture of fast(ish) shorter rides, commutes and longer more leisurely rides with mates and the odd sportive.

This year I had a bad off in April (broken wrist, broken jaw, lost two front teeth (Stybar Style!) and superficial Road rash) but then waa able to ride the Mallorca 312 with a splint, so I heal pretty well in general. However, in hindsight, I think that's where my trouble started. When I unpacked my bike I didn't raise the seat post high enough and rode the sportive on a saddle that was about 3cm too low. I started to get pain in my knee but dealt with it before bowing out at 230km. However this quickly cleared up so I didn't think anything more of it. Since then I've ridden Chase The Sun with no pain and done countless commutes, fast solo rides, taster crit races and longer training rides without issues.

Until I did London to Paris in 24 hours. English side was fine, but literally 30km out from Calais on the French side my knee started to hurt again. Couldn't find a group to travel at my pace, so rule 5ed it and trialled the last 270km on my todd. Nothing wrong with bike setup this time. Didn't ride for about a week, then did 100km the following weekend and was in serious pain for four or five days afterward. Since then it's been a battle trying to get ANY riding in without being in pain for days after. The day go day pain will subside, but then as soon as I get on the bike it hurts again and is worse for the following couple of days.

I've been to a physio who has diagnosed it as the start of patellar tendinitis - brought on by a chronic lack of strength in my left glute (apparently very common with cyclists) and given me exercises, stretches and foam roller work for my quads (ye gods that is painful!). I'm doing these religiously and haven't ridden now for nearly a week (after I did a quick 20km at the weekend and it flared up again).

Has anybody else been in a similar position? If soso, how did you manage your pain? Did you leave it a set period of time 'pain free' before riding again? Did your knee pain ever resolve itself?

I'm petrified I'm going to end up having to give up the bike because of this...

gaffer_slow

worthwhile perhaps looking into a bike fit. specifically re: knee tracking while peddling.

I have found that cleat wedges (if you use clips shoes pedals) helped

CornishInitBey

Suffered with the same after 4 days continuous riding in and around Calpe last November on a rented road bike, left me in excruciating pain where I could barely turn a pedal back to the hotel.

Visited a recommended physio, who also confirmed i had symptoms of PT. Resulted me in having a professional bike fit and a good (but brutal pain wise) course of physio with said physio, stretching out tight hamstrings and glutes. During this time I was able to ride at the same intensity with a Patella band for a number of months but now its surplus to requirements!

Recommend you attending a good local physio and grabbing yourself a professional bike fit.

cruff

Thanks all for the above advice. The physio I'm seeing has been very helpful (although bloody expensive!) and given me a load of exercises to do. Some of then do seem a bit silly but the theory behind them is sound, so going to persist with them. Foam roller exercises are bloody painful!

Have stayed off the bike - going to leave it at least two weeks completely pain free before getting back on. Also looking at a bike fit (another painful bout of open wallet surgery) to sort out any niggling issues with my setup.

Thanks again for all the help

Eag1E

I have suffered badly with this, as previously suggested ensure you get a good bike fit, otherwise you may be wasting your time and reoccurrence will be around the corner.

Tendons take a long time to heal, it took me about 6 months to get over it. The standard treatment for PT is eccentric exercises on a wedge. See http://physiofoam.co.uk/ for the wedge I used. Plenty of exercise examples on the web\youtube.

Hth.

cruff

Back on the bike, slowly but surely. Two weeks pain free and lots of exercises (oxoman is spot on - some of them are truly odd!) and already starting to feel the difference. One thing that looked deceptively simple but is, in fact, incredibly difficult and painful is the Glute Clamshell (basically, lie on the floor sideways with both knees bent and your pelvis straight, then slowly lift your top knee out to 90 degrees, hold for ten seconds and slowly contract). After a minute of those it's agony - I apparently have extremely weak hip flexors as well as an almost non-existent left glute complex