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  1. #1
    Join Date
    Jan 2006
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    Carbondale
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    12,451

    Patellar Tendinitis

    I think I have some Petellar Tendinitis from riding like 35 miles my first weekend of really riding my bike this season (went to Moab).. how long does my dumb ass have to stay off the saddle now to let this heal? any recommendations? I'm doing the whole RICE thing and will stay off it for a little while. I guess this gives me a few days to send my fork to PUSH.
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  2. #2
    Join Date
    Sep 2010
    Location
    SW CO
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    5,582
    Check out today's MobilityWOD.

    Here's some random stuff off the top of my head, starting with the acute phase and moving to the maintenance/rehab phase.

    1) Deep friction massage.
    (Massage perpendicular to the direction the tendon runs). It's gonna hurt pretty badly at first, but it should stop hurting so bad after 5-10 minutes.

    2) Ice massage. Do this directly after the deep friction massage. 4 x numb per day until the acute period of inflammation is over. Easiest way is to fill up some dixie cups with water and put them in the freezer. After they're frozen, rip off half the paper and you've got the perfect ice-massage.

    3) Cold water immersion. Switch to this from ice massage after the acute phase, ie, when deep friction massage is no longer painful. This is really an awesome technique, and I've had it work for various ailments for me. The idea is to immerse the body part in cold water. You want the water cold enough so that the extremity flushes with blood and turns pink after 10 minutes, but not so cold it turns white. Keep it immersed for 30 minutes. The point here isn't anti-inflammation, but rather to bring tons of blood to the tendon so it'll heal. It works best for finger/hand injuries, but it is possible to do for a knee.

    We happen to have some thing like this laying around for summer parties. We also have a multi-level deck (one-step). I lay on my stomach on the top level and put the bucket on the lower level. With some towels for padding on either side of the bucket, I'm able to comfortably submerge my knee while it's bent at 10-15 degrees.

    4) Eccentric loading. Try one-legged, inclined eccentric squats. Find a good incline (board), and squat down with the bad leg. Squat as low as you can without tilting hips or sacrificing form. When you get to the end of your range, stand up on your good leg.

    Personally, I'd wait until I could do the eccentric loading without pain. But maybe I'm paranoid. I dealt with bad patellar tendonitis for 1.5 years that ultimately required a tendon debridement (during which they found a piece of bone that had ripped off the tibial tuberosity but never showed up on any scans).

    Just my $.02. Not a doc, and don't claim to be an expert on this shit. If you're really serious, you might also try rolling out and stretching your calves and IT band.
    Last edited by auvgeek; 05-01-2012 at 07:49 PM. Reason: clarity
    "Alpine rock and steep, deep powder are what I seek, and I will always find solace there." - Bean Bowers

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  3. #3
    Join Date
    Jan 2006
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    Danke, I'll give this stuff a try and reassess in a week or so and decide whether to go see a doc or not.
    www.dpsskis.com
    www.point6.com
    formerly an ambassador for a few others, but the ski industry is... interesting.
    Fukt: a very small amount of snow.

  4. #4
    Join Date
    Jan 2007
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    Upstate
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    9,656
    Personal experience is that there's nothing you can do except rest it.

    Also, PT is often the result of having the seat too high. I changed that this year and am free of pain.

  5. #5
    Join Date
    Sep 2010
    Location
    SW CO
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    5,582
    Here's an easy way to get your calf to loosen up.

    Honestly, I'm not sure what a doc is gonna do for you, besides prescribe PT (which may or may not help, depending on how good the therapist you see is). Other nonsurgical treatments include PRP, cortizone, or stem-cell injections, but I would highly doubt you need any of that.

    My story: Under-rotated front flip off cliff = backseat landing. Didn't hurt too bad and I skied the rest of the day, but it was never quite right afterwards. Took the rest of the season off, and ended up taking the next one off too cuz it still wasn't healed. X-ray and MRI were negative. And it turns out that nothing helped until the surgery where they found that bone shard lodged in the tendon. All of this is just to say that I've run the gamut, and the advice above is simply what I've read and been told can help a tendon heal quicker. All of that has worked for me in other tendon injuries, from fingers to other knee issues. I just started doing that cold-water immersion technique recently, and it's worked like a charm for everything I've tried thus far. (knock on wood!!)

    At least ski season is over, right?

    ETA: Do NOT try the eccentric loading (or any exercise) until you're confident you can do it pain free. Don't do anything to make it flare up again and prolong the recovery.
    Last edited by auvgeek; 05-01-2012 at 08:19 PM.
    "Alpine rock and steep, deep powder are what I seek, and I will always find solace there." - Bean Bowers

    photos

  6. #6
    Join Date
    Feb 2009
    Location
    On Vacation for the Duration
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    14,373
    Might not have been the same thing but after too much/too soon training on my Huffy Mtn bike mt knee cap swelled and hurt like a bitch. After 1 week of RICE with no change I went to the doc and he prescribed 6 Advil and heat. Swelling/pain gone on day 2.
    A few people feel the rain. Most people just get wet.

  7. #7
    Join Date
    Jan 2007
    Posts
    45
    I am enduring my 3rd episode of Perellar Tendinitis (I'm 50+).

    My experience is that resting and staying off it never works. Now, you want to be pain free, but you want to treat the problem without incurring pain.

    When my knee was hurting while climbing stairs, my knee pain was related to mountain biking and a tight IT band. You need to get a black foam roller and roll your It band 3 times a day (30 stokes up and down the leg each session).

    I also had to get a strap and stretch my hamstrings. Goto youtube, look up hamstring stretches and do a bunch of stretches daily after a 5 minute leg warm up.

    WHen my knee hurt while running, I solved the problem with glute and hamstring stretches.

    Right now, my knee is hurting and this is related to Jumper's knee. The VMO muscle in my quad muscle is well developed but weak. I have a lot of squats and single leg squats in my future... that and a bunch of stretching...

    My recommendation is light rides when pain free. Lots of Ice, but no R, I (ibuprofen) or E. Lots of stretches; hamstring, glute, IT band and hip flexors. As you recover, do some 2 legged and then single legged squats (really deep, butt touching heels). Start with no weight with 30 reps. Progress gently from there.

  8. #8
    Join Date
    Jan 2006
    Location
    Carbondale
    Posts
    12,451
    Thanks everyone...
    www.dpsskis.com
    www.point6.com
    formerly an ambassador for a few others, but the ski industry is... interesting.
    Fukt: a very small amount of snow.

  9. #9
    Join Date
    Aug 2006
    Location
    SFCA
    Posts
    1,354
    I just went in for an MRI today, 10 months after whacking myself on a surf trip. Pain has been merely annoying, until three days ago. Last night, after playing 9 holes(golf, sicko), I couldn't walk. ~50% Tear in my patellar tendon. Scheduling surgery tomorrow. Dreading trying to work the next seven days...
    "Yo!! Brentley! Ya wanna get faded before work?"

  10. #10
    Join Date
    Aug 2018
    Posts
    1,262
    Quote Originally Posted by auvgeek View Post
    Check out today's MobilityWOD.

    Here's some random stuff off the top of my head, starting with the acute phase and moving to the maintenance/rehab phase.

    1) Deep friction massage.
    (Massage perpendicular to the direction the tendon runs). It's gonna hurt pretty badly at first, but it should stop hurting so bad after 5-10 minutes.

    2) Ice massage. Do this directly after the deep friction massage. 4 x numb per day until the acute period of inflammation is over. Easiest way is to fill up some dixie cups with water and put them in the freezer. After they're frozen, rip off half the paper and you've got the perfect ice-massage.

    3) Cold water immersion. Switch to this from ice massage after the acute phase, ie, when deep friction massage is no longer painful. This is really an awesome technique, and I've had it work for various ailments for me. The idea is to immerse the body part in cold water. You want the water cold enough so that the extremity flushes with blood and turns pink after 10 minutes, but not so cold it turns white. Keep it immersed for 30 minutes. The point here isn't anti-inflammation, but rather to bring tons of blood to the tendon so it'll heal. It works best for finger/hand injuries, but it is possible to do for a knee.

    We happen to have some thing like this laying around for summer parties. We also have a multi-level deck (one-step). I lay on my stomach on the top level and put the bucket on the lower level. With some towels for padding on either side of the bucket, I'm able to comfortably submerge my knee while it's bent at 10-15 degrees.

    4) Eccentric loading. Try one-legged, inclined eccentric squats. Find a good incline (board), and squat down with the bad leg. Squat as low as you can without tilting hips or sacrificing form. When you get to the end of your range, stand up on your good leg.

    Personally, I'd wait until I could do the eccentric loading without pain. But maybe I'm paranoid. I dealt with bad patellar tendonitis for 1.5 years that ultimately required a tendon debridement (during which they found a piece of bone that had ripped off the tibial tuberosity but never showed up on any scans).

    Just my $.02. Not a doc, and don't claim to be an expert on this shit. If you're really serious, you might also try rolling out and stretching your calves and IT band.
    I have had this shit since I was 16. I have done all the conservative stuff. Finished a round of PT this summer. Worked on hip strength and leg flexibility. Should still lose more weight, but that is easily said and harder to do.

    I can get it to a dull ache but it is never gone.

    Anyone tried PRP or surgical repair? Both were put on the table by my ortho last spring.
    "Let's be careful out there."

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