Patellar Tendonitis
Tendonitis of the knees is a common problem with athletes, especially in sports like motocross and snow skiing. It is characterized by a sharp stabbing or burning pain, around or under the patella (knee cap). In addition, it is characteristic to hear a crackling or popping noise during knee movement. Patellar tendonitis lingers for weeks or months and sometimes years. The older you get the more likely you will develop it in one form or another.
Tendonitis is a state of inflammation and irritation that exists in the tendon of a muscle. It is often considered an over use injury. The tendon has a poor blood supply in comparison to the muscle, so it receives less of a supply of oxygen and nutrients. When a tendon becomes injured or over stressed it also becomes inflamed. Inflammation is the enemy here, because the inflammation will slow the ability of the tendon to heal. The severity of the inflammation correlates with the amount of pain one experiences. Often one can pinpoint the area of pain and while pushing on it with a thumb or finger feel a ropey or nodular sensation in the tendon or the muscle-tendon transition.
The best things you can do on your own to take care of this situation are rest, ice, non-steroidal anti-inflammatory (ibuprofen), stretch and change your exercise habits. Rest is an important starting point. If possible take a couple weeks off of all activity. Ice should be considered your best friend. Use it 3 to 4 times a day for 15 minutes at a time. I prefer to use herbal anti-inflammatory because they have little or no side effects. A few suggestions are Boswella Serrata, Bromelain, Echinacea or Black Current Seed Oil.
Stretching the quad muscles will also help stretch the tendons around the knee. Stretching should be performed 2-3 times through the day. In addition you will want to avoid acid producing foods. Coffee, refined sugar, processed foods, excessive red meat are the most common and make up at least 75% of the average diet. Eat more acid buffering foods like vegetables (preferably raw or as close to raw as possible), green leafy lettuce, fruits, white meats like fish, lamb and poultry, red meats in moderation, eggs, good fats like olive oil, flax seed oil, sesame seed oil, apple cider vinegar, water, green and black teas.
Current research suggests that eccentric weight training can help improve the healing rate of tendonitis. Eccentric means elongating the muscle while maintaining a contraction. The best way to do eccentric contraction work is with a machine. The two exercises of choice for the knee are the knee extension and the leg press.
Starting with knee extension you will want to use a light weight that you can handle very easily using one leg. Then using both legs lift the weight until your legs are straight out. You are now in the starting position for an eccentric contraction. Next, use only one leg resisting against the weight as you lower the leg down. Do this slowly for 3 sets of 30 reps. Increase the number of reps each session until you get up to 3 sets of 100 reps. From here start adding weight but do it in small increments. The idea here is to work the leg with as little stress as possible. Working the tendon eccentrically with low weight/high reps helps stretch the tendon without re-injuring it. This helps reduce the amount of inflammation in the tendon and increases the blood supply. The combination helps induce the healing process.
Next, apply this same principle to the leg press. Push with both legs and retract with one leg. In the beginning, do not bend the knee more than 45 degrees during the retraction movement. After a couple of weeks let the knee bend to 90 degrees during retraction. Don't add weight until you are comfortable bending the knee to 90 degrees.
After exercise reduce inflammation by stretching and icing. When you get home take half an hour for a 15-minute session of stretching and a 15-minute session of icing.
Try to work out like this every other day and expect 10 to 12 weeks to reduce the pain and crackling sound to a minimal range. Ice your knees down for 15 minutes after every exercise session including running, walking even after a day at work.
It is always wise to seek the advice of a professional when dealing with an injury. If you are an athlete chances are at one point in your career you are going get tendonitis. If it gets bad enough it can be career ending. So learn to spend the extra time and take good care of your body, especially if you have had serious injuries. Like the old saying, "An once of prevention is worth a pound of cure".
See you out at the track!
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