Re: Re: Patella tendonitis

[Guest guest]

There's another couple of things here - good deep tissue massage/sports

therapist could help. They can go over the whole thing and find out which

muscles are strong, which are weak...and help you figure out what to do about it

also (if they're experienced in athletes).

My suggestions to clients with this condition is to avoid below parallel squat

until it sorts - also watch the tendency for IT band to be involved too

(sometimes this gets missed). Watch your foot spacing on machines if you are

actively working out otherwise... keep the knee warm - wear a wrap or something

loosely - when mine got cold, i was done for the day!

half squats or deadlift rack work can help even it out - sometimes the outside

hamstring is also involved in the mess.

Examine your form. Sometimes this whole drama starts from the positioning you're

in during your activity - this is also an opportunity to do workouts that focus

on other weak spots, head them off before they bite you.

the Phantom

aka Schaefer, CMT/RMT, competing powerlifter

Denver, Colorado, USA

Re: Patella tendonitis

>

> Dear members,

>

> approx 6 weeks ago i developed patella tendonitis, which came with the

prescription of rest, a sports persons/coach worst nightmare!

>

> I have rested my knee as much as humanly possible given the nature of my job,

however symptoms are still as severe as the first week. Does anyone have any

guidance researched or anecdotal (getting a bit desperate!) for more pro-active,

rehabilitative strategies?

>

There was some discussion on the goheavy forum recently. Here is a summary of

the replies:

Things to try:

1. Ice/heat contrast--ice w/compression and heat directly after usually feels

the best....try to do this as often as possible. 2-3x/day if you can

2. Foam roll the IT bands

3. Rest some but not too much--tendonitis issues usually don't resolve with rest

alone, you need to stress the area just enough to stimulate a proper healing

response. Stay away from power cleans/snatches because the tendons take the

brunt of the force during these partial knee flexion movements. Stay with the

deep knee bend activities.

4. Knock down the overall volume of training and take the extra time to warm-up

5. Don't use ibuprofen for more than 5-7 days consecutively. Ibuprofen is an

anti-inflammation drug and if used too much can actually decrease the healing

response to the affected area by depriving it of good blood flow, nutrients, O2,

etc......some inflammation can be good in this case! Tendons have poor blood

flow as it is, so decreasing it more would be detrimental to the healing

process. Here is an excerpt about Ibuprofen from a recent article I've read

published in 2009.......NSAIDs work by inhibiting the production of

prostaglandins, " substances that are involved in pain and also in the creation of

collagen. Collagen is the building block of most tissues. So fewer

prostaglandins mean less collagen, " which inhibits the healing of tissue and

bone injuries, " including the micro-tears and other trauma to muscles and

tissues that can occur after any strenuous workout or race.

6. Try supplementing MSM and glucosamine if you haven't already.

It's a process that WILL heal if you let it.

7. Tendonosis injuries are particularly frustrating because they aren't enough

to take you out completely, but IT IS THERE every time to go to train. The knee

wraps are a good idea. I've recently begun wearing them due to my own tendon

issues and they have helped keep things warm between sets

8. Eccentric work like step DOWNS is one of the few ways to actively strengthen

tendons while suffering from tendonitis.

9. If the tendinitis is chronic you might consider platelet rich plasma

injections (PRP). Also might help to wear a Chopat Jumpers Knee Strap.

=========================

Carruthers

Wakefield, UK

[Guest guest]

I was actually going to suggest water walking, not swimming. The water may help

with inflammation and you can do half squats hanging onto the side for balance

if necessary - plus you can do other exercises hanging onto the side or a kick

board.

I guess the other concern I had reading Mark's original plan was to make sure

you get sufficient rest. Rest cannot be overlooked in recovery and going from

all rest to none is not a good idea for healing.

My other comment is that my own knee had some similar issues - and I used the

full conventional deadlift to correct my problems. (Ok those who know me already

know I love to pull - but it was the right thing for my own knee in this, and I

had to stop squatting entirely for about a year to get this sorted. )

Just like training programs, rehab also requires you look at your own response

and adjust accordingly.

The Phantom

aka Schaefer, RMT/CMT, competing powerlifter

Denver, Colorado USA

Re: Patella tendonitis

Mark,

In have only limited experience with eccentric training for legs, but I have

found leg presses to be very easy to perform, pushing the weight with both legs

and lowering it with the affected leg.

Eccentric body weight squats sound terrific. But how are you going to do them in

real life? Remember, the idea is to stress the tendon in the lowering phase

Same with the deadlifts, putting the weight down slowly doesn't make this an

eccentric exercise.

Most people are quad dominant in riding their bike, so I would only recommend it

at medium speeds. Also running puts extra stress on the knees and the patella

tendon. How about swimming?

Regards,

Johan Bastiaansen

Hasselt, Belgium

>

> Thanks for all the replies, there was some excellent information given.

>

> Based on this I have put together I rehab programme, which will hopefully put

me back on track

>

> 5-10 min warm-up (bike)

>

> 5-10 min Glute/activation exercises

>

> 2 x 1 min eccentric body weigt squats on a vibration platform (30hz, low

resonance) this is repeated 2-3 times during the workout.

>

> 3 x10 eccentric squats

>

> 3 x 10 deadlift from knee height (emphasising increased lowering time)

>

> 3x 5 stiffed leg deadlift.

>

> + 2 upper body exercises (alternates across the sessions).

>

> 2 x 30s stretches for hamstrings, quads, hip flexors, glutes/IT band.

>

> After only a few sessions I feel there has been some improvement, but that

could well be the joy of doing some form of training.

>

> The session will be done three times per week, interspersed with some EMS work

on the quads and one session per week of cross friction massage.

>

>

> I would be interested to know what the group thinks of this programme, and

what aerobic exercise would be appropriate to supplement it. I have pretty much

ruled out most sports already, and would like to maintain some aerobic fitness,

rowing is problematic due to the degree of knee flexion, which leaves running

and cycling. Does anyone know if these would be contra-indicated or beneficial?

>

> Thanks

>

> Mark Helme

> Wakefield, UK.

>

>