Causes and Treatment for Patellar Tendonitis
Patellar tendonitis, also known as jumper’s knee or movie knee, has slowed me down for a few years. For the first time in my 30 years of life, I have been forced to take things slow. No more hopping out of bed, eating a donut and running 6 miles or so. That is impossible. I’m old and my body hates me. I have patellar tendonitis in my left knee. According to a medical dictionary, tendinitis and tendonitis are different spellings with the same definition. I’m going to use tendonitis because the suffix –itis basically means “inflammation of” and we are talking about tendons. Tendonitis is the inflammation of a tendon. Patella is the kneecap.
Patellar tendonitis is inflammation of the tendons and tissues that surround the patella. It’s called jumper’s knee due to the common cause of patellar tendonitis being activities that require a lot of jumping or high impact on the knee. Patellar tendonitis is also referred to as movie knee because sitting with the knee bent for an extended duration (like when you’re in a movie theatre) can cause discomfort.
History of my knee problems
I have always been an active person. From little league through high school sports, I pursued athletic endeavors and pushed my body to the limit. College came and my athletic endeavors were slowed to the occasional pickup basketball game and having to fight off all the ladies with a stick. My body handled it like a champ with no stretching or nutrition required. By the time I was 20, exercising never entered my thoughts. Fast forward five years later (at 25 years of age) and I decide to get into shape by running. I was in the worse shape of my life. My physical appearance only confirmed the need to make a change. I never ran because I thought running just to run was a horribly boring way to spend a day. I had let myself go. Lacing up a pair of shoes and running out my front door fit my schedule and budget, so I started. It was hard. It turns out that years of no aerobic exercise coupled with cigarettes and booze is not an ideal training regimen. The silver lining was how hard it really was for me. My anger of not being as physically capable as I thought I should be far outweighed my preconceived notion of running being boring. I ran. I would occasionally run across a running magazine and read about regular Joes running 10 miles and freak-shows running ultra-marathons. I decided 10 miles was my goal. I had no schedule. I stretched only if I felt sore. I did not eat properly. But I ran. I started to enjoy running and a few months later I ran 10 miles. I was proud. Two days later, I felt great so I decided to run another 10 miles. Other people run a ridiculous amount of miles (I know because I read about them in glossy magazines). It turns out I wasn’t other people. Around mile 5, I felt uncomfortable but it wasn’t the first time. At mile 6, I thought my knee was disintegrating and hot bones were just flopping around in loose skin. I walked home in shame. I didn’t run for a couple of weeks. When I tried, I could not surpass one mile without extreme discomfort. I kept trying but the knee still hurt. I did not run for about a year. I would go to a gym and lift weights, occasionally swim and ride bike but none of it was consistent enough to really have any long-term benefits. After about a year of no high impact activities on my knees, I had an opportunity to go on a trip to hike Mount Elbert (highest peak of Rocky Mountains - elev. 14,440 ft), the La Sal Mountains and Arches National Park. I couldn’t pass it up. Day one we summit Mount Elbert. Coming down was an experience. Every step that I took would vibrate pain from my knee to my teeth. Step after step after step. A man with tendonitis knows that getting down from the mountain far outweighs the push up. While I was coming down from the mountain, I convinced myself that I had some serious knee problem. It was the only answer.
After the trip, I went to the doctor. I had gone to the doctor about a year earlier with the knee pain after the 20 miles in 3 days incident. He recommended stretching and prescribed me Diclofenac pills which are prescription strength non-steroidal anti-inflammatory agents (NSAIDs). It did not stop my discomfort after 2 weeks of taking a 75 milligram pill daily so I stopped taking them. On the second doctor visit he referred me to an orthopaedic center. The orthopaedic center performed x-rays which confirmed no bone spurs or abnormalities of my knee. I was a bit disappointed there was nothing really wrong with my knee. The amount of pain I felt convinced me there was something wrong. But alas, I am just a sissy. Or patellar tendonitis can hurt.
- Pain in knee
- Discomfort in knee
- Excessive “knee popping”
At first, I only had pain in my left knee after performing some physical task. Running and playing basketball were the worse. While I was running or playing basketball, I would feel the pain right behind my kneecap. Typically, I would play through it and just be in pain for about a day then it would subside with a couple of days rest. Swelling in my knee has never been a major problem. Only after a long hard workout could I ever see swelling and those times the swelling was not always obvious. My knee would regularly ‘pop’ (gases of synovial fluid being released and/or tendon getting out-of-place and snapping back into place) when I bent my knee. Then the discomfort was constant. No longer just during physical activity. If I sat in a chair with my knee bent there was discomfort. If I walked to long – discomfort. If I tried to jump – discomfort. Being the coach/pitcher for my 9 year old’s softball team – discomfort. Car trips of almost any length – discomfort. Many nights the discomfort would keep me from sleep. I routinely got out of bed twice a night to do some squats and stretch my leg muscles to gain an iota of relief from the discomfort. So began the trial and error of figuring out how to make my body happy.
- Strengthen leg muscles
- Eat right
- Knee brace
Stretching is one area where I have gone from never doing it to being the most
flexible I have ever been which has greatly reduced my tendonitis discomfort. The newest information in stretching is the pros and cons of static stretching and dynamic stretching. Static stretching is the traditional stretching that we all remember from gym class or little league. You reach or extend as far as the given muscle will allow without pain and hold it for 10-15 seconds. Dynamic stretching is when the muscle being stretched is constantly in motion or dynamic. Static stretching will improve your flexibility more than dynamic stretching. Static stretching only if the muscles being stretched have been sufficiently warmed-up is recommended. Recently, stretching studies seem to be increasing (or at least publicized more) and there seems to be some new conclusions that static stretching may not be as good for you as previously thought. How and when you stretch is up to you. Just start stretching and some positions will immediately relieve the knee pain (keep doing them). Stretch every day. It doesn’t matter if you’re exercising or not, stretch. If you are exercising, stretching before and after is a most. Stretch every day.
Ice the inflamed area. A great method for icing the knee is to fill a 3 ounce paper Dixie cup with water and freeze it. Tear the bottom off of the frozen Dixie cup and rub the ice wherever it is sore. This ice massage reduces swelling and numbs the area for a bit of pain relief. Rubbing or massaging the knee with ice helps the cold penetrate your body and is more effective than just laying a bag of ice on your knee.
Strengthening leg muscles is one area I had never worked on before getting tendonitis. I have chicken legs. They are small and skinny but nonetheless they are a rewarding muscle group to work with. Work out your legs 2-3 days a week for 2 weeks and you will immediately feel stronger just walking up stairs or walking to the fridge. It is a good feeling and one of the keys to being able to be active without tendonitis slowing you down. Strengthening the hamstrings, quadriceps, calves, and muscles of the hip are the focus. A cable pulley system at a gym or a resistance band at home is enough to do all the exercises you need to get started.
Sleep. Fairly simple treatment is to sleep at least 7 hours especially if you are in your 30’s. No matter what, 7 to 9 hours of sleep is great for your body.
Rest is suggested by many to be the most effective form of treatment for tendonitis. The amount of rest will depend on the degree of pain or discomfort. One should never exercise if it causes pain. I did no high impact exercise for about a year then played a short and relaxed basketball game that left my knee in pain. I believe my condition to be severe and not the norm. If only minor discomfort exists then I have found that light exercise for a short period and a lot of stretching seems to ease my tendonitis discomfort.
Proper nutrition is a goal which all people should strive to achieve. It will help speed up recovery and make you healthier. Each body is different and needs/wants different foods. Become cognizant of what you eat and how you feel afterwards. My current ‘go to’ foods to make my mind and body feel better are apples, bananas, avocados, fruit smoothies, lentil soup, and risotto. Recognizing what foods make you tired and don’t sit well may be just as important as knowing what foods you are supposed to eat.
A knee brace has become a regular accessory in my daily garb. The knee brace I wear is an open patella neoprene brace. The relief it gives me is well worth the $15. I use the knee brace solely for relieving discomfort for periods when I will be sitting down or have my knee bent and static for long durations. I never wear a knee brace during workouts or exercise. From my experience, a knee brace during exercise will allow you to run longer but the next day the pain/discomfort is greater. I want to get my entire body in shape and I find value in naturally strengthening the weakest link of my body to gain a legit comprehensive level of fitness.
Having tendonitis is not the end of your physical activity. If you take the proper precautions and follow the treatments listed above, you will be able to gradually improve the degree and duration of impact your inflicted knee(s) can handle. The term gradual is significant. I have gone from not being able to complete 1 mile to being able to run 6 miles now without having to fight through knee pain or worry that my knee will be in pain the following day. Slow and steady wins the race. No surgery or fancy pills required. Solutions to tendonitis are here. Simple treatments managed by you and performed by you will end the pain of patellar tendonitis.