Patellar Tendonitis

I have just recovered from something similar. I went to PT for 5 weeks and it is 95% better. I was having left knee pain and trained through it for almost 5 months. We had just bought a stick shift car and using the clutch was so painful. My PCP referred me to PT and I thought for sure he would tell me to rest it. But he didnt. He felt my knee was sore from inadequate warm ups before running. He taught me stretching exercises and I am doing a lot of strenghthening exercises for my quads, hamstrings and calfs. He had me running still but only at 50% of my usual distance then we gradually increased it. Last week I did 2 longer runs 2 days in a row with no pain. Maybe you could see a PT or Sports medicine doctor? I had taken 2 weeks off running before going to PT and it really made no difference, possibly because I do a lot of activity at work, it seems in my case that the stretches were the biggest help. Good luck!

My knees have been balky for the last few years, and I've experienced exactly the kind of pain you describe. For the past 6 months I've been pain free and training consistently. While I'm certainly no doctor, here's what I think made the difference:

1) You've got to take some time off to deal with the ongoing inflammation/irritation. The ibuprofen (taken as prescribed) will help. One, or better yet, TWO WEEKS is the typical recommendation. If you're dying to blow off some steam during that period, I'd recommend swimming and other upper body regimens, as cycling can and does impact the patellar tendons.

2) Assuming that the break in training brings things under control, you've got to be committed to a GRADUAL resumption of training. Going back to the peak miles you're used to logging will almost invariably bring back the inflammation and pain.

3) Pre work-out stretching has got to become a habit. The ten minutes it takes to stretch properly could be the single most important time investment you make, if it's a lifetime of activity you'd like to enjoy. It's weird how muscles that don't seem involved (e.g., the hamstrings) impact the tracking of the knee.

4) Icepacks after a workout, whether there is pain or not, will make a big difference to controlling inflammation. I suggest one of the reusable "soft-packs" which are economical and mold nicely around the knee joint. Even 15 or 20 minutes of icing cna make a big difference.

5) Finally, don't be cheap about buying the right footwear and replacing them on a regular schedule.

These things are working for me (knock wood). I've just started training for my first marathon, so it will be interesting to see how my knees hold up to the increase in mileage. Right now, I'm pain free and enjoying my runs and bike rides more than ever. It's amazing what healthy joints add to a workout. Too easy to lose track of that, IM, until there is a problem.

Edited by Xan 2006-11-06 12:21 PM

I had the same pain starting in September and tried to train through it since I wanted to run a marathon in October. It got too bad to run, so I tried to rest it, hoping it would get better on its own. After abandoning my marathon plan and a month of barely any running, it was still bothering me and I went to the doctor last week. He told me it could be my shoes don't have enough arch support and/or my quads need strengthening. The doctor sent me to PT and I got similar advice from the physical therapist but she added that since my muscles are too tight, my hamstrings may not be relaxing fast enough and that may be stressing my quads and knee. Today she taped my knee to pull my patella into the spot my quads should put it and told me to try running. I just got back from a slow four mile run and it is still hurting.

So my short answer to your question is instead of time off, try to correct whatever is causing the stress. For me, I'm trying to improve my flexability and leg strength and hoping I'll be able to build up the mileage again for a spring marathon.

Unless you want to make a bad situation worse, take time off! Take as much time as it takes (sorry for the answer but this is not a 2wk, 10days, 1 month simple answer). The longer you continue to run and make it worse the longer it will take to recover. It's the off season now, start rehabing your knee. Quad strengthening (leg ext, legpress, squats) with just a slight bit of pain is the way to go. Stretch the quads and hip flexors for the front of the thigh, hamstrings and calves for posterior structures. Check into orthotics or have someone review mechanics, check leg length etc. but you still need to take time to heal and strengthen the patella tendon. As the inflammation process continues the chemicals produced become  a source of irritation and irreversible tissue damage (on a small scale but  can add up). Ice as well, keep the inflammation down. I hope adventurebear will read and add to this. I've treated patella tears, it ain't pretty and usually started with minor irritations over several months to years without formal treatment.

Sorry to rain on your training but for some reason mother nature likes to heal in 6 week blocks.  I'd take at least 6 weeks off.  PT will probably help and they may be able to tell you if there is some underlying biomechanical problem as well.  Is it worth having a crappy season and contunued pain to keep training with it?  Probab;y not.  You can probab;y aqua jog if you MUST run.  Sometimes you can even find a PT place with an underwater treadmill.