kneetendonitis....

[Arvid]

So heres my story, ive been bothered by my left knee for a good 6 months now, and here comes the stupid part, it never hurt so much so i didnt think it was so serious, just thought it would probably go away with a little rest. So finally we were going on vacation for almost 2 months, so i thought ok great il rest for a few weeks initially and then im gone play tennis again. So i rest for a few weeks, but nothing has changed of course, thats when it starts to dawn on me that all this time ive been stupid not going to a doctor. Were in El Salvador right now, my wife is from here, so i go and see a doctor here, he gives me some anti inflammatory pills to take for a few days and a gel to apply to the knee, and when i see him i also find out what i have, kneetendonitis. I should explain that this is an injury that i didnt get from playing tennis, however if i hadnt played tennis all the time it probably would have gone away by itself after a few weeks, or i might not even have noticed it was there, when im not doing anything in particular i dont have any pain. So as soon as the pills where over i could feel that there was not differense what so ever. So i was supposed to see the doctor again, but things happened and its not gone work out to see him again, now were leaving from here in a weeks time, but were goind to new jersey, which means im not gone be back home to sweden where i live until the 27th to find a doctor where i live. I dont want to wait that long without doing anything, im dying to start playing tennis again, and just want to get rid of this thats been bothering me for so long, anyone has some good tips on what to do. Right now im trying to massage the knee twice a day, dont know if its any good to be honest but i have to do something. Thanks/Arvid

[Chas Tennis]

Where's the pain and how did it come about? Related to posture issue?

Patellar-femoral pain
http://www.aafp.org/afp/2007/0115/p194.html

Tendinitis (with inflammation) & Tendinosis (with defective healed tendon tissue)
http://tt.tennis-warehouse.com/showthread.php?t=442912

There are many TW threads on knee injuries.

[Arvid]

Originally Posted by Chas Tennis

Where's the pain and how did it come about? Related to posture issue?

Patellar-femoral pain
http://www.aafp.org/afp/2007/0115/p194.html

Tendinitis (with inflammation) & Tendinosis (with defective healed tendon tissue)
http://tt.tennis-warehouse.com/showthread.php?t=442912

There are many TW threads on knee injuries.

Thanks for the response. I have read the links you sent me but not indepth, will do that soon, but what i am beginning to understand though is that this is probably not gone be something that can be cured in a matter of a few weeks in some miracle way sadly....If someone has some exercise or something that helped them, please share. Some years ago i was weightlifting alot and started to feel some similar pain in both my knees. So i decided that before every workout i would start on the bicycle for 5 minutes, that completely cured the problem. I have not had the chance to use a bicycle to see if that would help unfortunately this time. Will try that in the future though as ive heard only good things about knees and bicycling...

[lobman]

For a less detailed but still appropriate discussion of knee pain go to Knee-Pain-Explained.com

[Lefty5]

Tendonitis does not get better with rest, its caused by over-use of imbalanced muscles. The only way out of tendonitis is to strengthen the muscles around the injury - exercise them slowly and correctly. Keep up your strengthening routine, even once you start playing again, and chances are it will go away forever.

[charliefedererer]

Sorry to hear you are having problems.

It can be exasperating that injuries take so long to improve.

But it sounds like a "go slow" approach until your return to Sweden and making a proper diagnosis is a good idea.


If you do decide to try a bike, really try to keep it to that 5 minute limit.

(After a brief warm up, the knee may actually feel much better - but you may pay for it the next day if you push it too much.)


The initial goal in rehab is just to get the joint moving through a normal range of motion.
There is no attempt at first to gain strength - that much stress unfortunately leads to more tendonitis.

The length of time and tension on the bike should be very gradually increased so the muscles/tendons can accomadate the increase in stress.



The reason bike exercise is usually well tolerated by the knee is that the knee is not bearing the body's weight.
But increase the tension and revs/minute too much and you can experience worse problems.
[Just do a quick google search on cycling and knee tendonitis to see how many cyclists suffer from knee tendonitis from over doing it.]



Lefty 5 has it right that knee tendonits can be caused from muscle imbalances/relative weakness of muscles in the leg or even up above the hip area. An overall strengthening program of the legs, core and muscles that connect the legs to the core is often the most effective way of preventing a recurrence. (And the squat may be the single best exercise for that - but only after you make significant progress from where you are.)


Good luck!

(Let us know how you are doing.)

[Arvid]

Originally Posted by charliefedererer

Sorry to hear you are having problems.

It can be exasperating that injuries take so long to improve.

But it sounds like a "go slow" approach until your return to Sweden and making a proper diagnosis is a good idea.


If you do decide to try a bike, really try to keep it to that 5 minute limit.

(After a brief warm up, the knee may actually feel much better - but you may pay for it the next day if you push it too much.)


The initial goal in rehab is just to get the joint moving through a normal range of motion.
There is no attempt at first to gain strength - that much stress unfortunately leads to more tendonitis.

The length of time and tension on the bike should be very gradually increased so the muscles/tendons can accomadate the increase in stress.



The reason bike exercise is usually well tolerated by the knee is that the knee is not bearing the body's weight.
But increase the tension and revs/minute too much and you can experience worse problems.
[Just do a quick google search on cycling and knee tendonitis to see how many cyclists suffer from knee tendonitis from over doing it.]



Lefty 5 has it right that knee tendonits can be caused from muscle imbalances/relative weakness of muscles in the leg or even up above the hip area. An overall strengthening program of the legs, core and muscles that connect the legs to the core is often the most effective way of preventing a recurrence. (And the squat may be the single best exercise for that - but only after you make significant progress from where you are.)


Good luck!

(Let us know how you are doing.)

Thanks so much for youre answer! Right now and for the next few weeks cycling wont be an option anyways. I came across some physio exercises on the internet that ive been doing, also applying ice on the knee, however i have to say that i have felt more sore after starting with these exercises, which leads to my question, at this stage is pain (or soreness wouldnt really call it pain cause its not strong) always something bad? Or is it possible that these physio exercises will help me eventually even if it makes me feel more sore right now? //Arvid

[Chas Tennis]

Originally Posted by Arvid

........................ I came across some physio exercises on the internet that ive been doing, also applying ice on the knee, however i have to say that i have felt more sore after starting with these exercises, which leads to my question, at this stage is pain (or soreness wouldnt really call it pain cause its not strong) always something bad? Or is it possible that these physio exercises will help me eventually even if it makes me feel more sore right now? //Arvid

Any details on the 'kneetendonitis' diagnosis? Where is the pain? Front knee cap area or other? Did the Dr tell you which tendon or joint might be involved in the pain especially since there are two very different joints in the knee area, the patellar-femoral joint and the knee joint. Did the Dr that you saw recommend any exercises or stretches to you?

I have read that cartilage does not have any/many? nerves. When my meniscus was torn I stopped tennis, after just a few weeks my knee felt great, no pain, much smoother motion than when I was playing tennis. I'm sure that I still had a torn meniscus at that point.

I believe, but am not certain, that many knee pains appear only when adjacent tissue or bones that have nerves, unlike cartilage, become involved in the injury maybe through inflammation. I guess, but don't know, that cartilage damage could occur and it would not be apparent by pain. ??

[Chas Tennis]

Not recommending any stretch while possibly injured until a Dr clears you for it.

In some people a tight/short rectus femorus might cause pain under the knee cap.
http://www.mrtherapy.com/articles/article3.html

WARNING - hip flexor stretches might cause stress and injury to the lower back.

A tight rectus femorus might also contribute to anterior pelvic tilt. I don't know the incidence of some degree of anterior pelvic tilt in the population but I believe that it is a common characteristic of the posture of middle age and older people.

Anterior Pelvic Tilt

[Arvid]

Originally Posted by Chas Tennis

Any details on the 'kneetendonitis' diagnosis? Where is the pain? Front knee cap area or other? Did the Dr tell you which tendon or joint might be involved in the pain especially since there are two very different joints in the knee area, the patellar-femoral joint and the knee joint. Did the Dr that you saw recommend any exercises or stretches to you?

I have read that cartilage does not have any/many? nerves. When my meniscus was torn I stopped tennis, after just a few weeks my knee felt great, no pain, much smoother motion than when I was playing tennis. I'm sure that I still had a torn meniscus at that point.

I believe, but am not certain, that many knee pains appear only when adjacent tissue or bones that have nerves, unlike cartilage, become involved in the injury maybe through inflammation. I guess, but don't know, that cartilage damage could occur and it would not be apparent by pain. ??

Well i dont think theres anything physically wrong with my knee accept for an inflammation, i got the injury from running up stairs and tend to crying babies, not from playing tennis, however it was sustained due to me continuing with the tennis despite the soreness. The only thing that hurts is the patellar tendon if that helps? I didnt get any closer diagnosis then that. I did not get any exercises or anything like that from this doctor, the exercises im doing right now are things i saw on the internet that had to do with knee tendonitis....

[Chas Tennis]

Patellar Tendinosis or patellar tendinopathy - very specific location, correct?
https://www.google.com/search?q=pate...w=1320&bih=722
Tendinosis -
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1122566/
Effectiveness of tendinosis treatments -
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2505250/

What is the root cause of your injury? Acute injury, tight muscles, other? You should be able to go up and down stairs with babies...... If the cause were tight muscles, the cause is probably still there and it could be worse as it depends on your lifestyle and current activity level. Most injured people don't deal with underlying posture issues or find physicians who have the specific knowledge to diagnose posture issues.

I had anterior pelvic tilt for many years, despite a lot of tennis, and did not know it. 5 weeks of stretching the rectus femorus and it went away.

I don't know much about this website or patellar tendinosis but it says anterior pelvic tilt can lead to patellar tendinitis due to tight muscles. Consider this cause as just one possibility until you can confirm a diagnosis and find a cause. Be sure to look at the great video, the 1st one, on the anterior pelvic tilt page. Very entertaining presentation and descriptions. Conditioning stretches that are designed to lengthen a healthy tendon - especially the advanced stretches on this website - may farther injure injured tendons so wait until you can see a Dr.

http://www.fix-knee-pain.com/injurie...ee-tendonitis/

http://www.fix-knee-pain.com/basic-p...r-pelvic-tilt/

[2ndServe]

I've got the jumpers knee, every time I take a split step there's pain underneath the knee. Those jumper's knee straps do help a little.

[Arvid]

Originally Posted by Chas Tennis

Patellar Tendinosis or patellar tendinopathy - very specific location, correct?
https://www.google.com/search?q=pate...w=1320&bih=722
Tendinosis -
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1122566/
Effectiveness of tendinosis treatments -
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2505250/

What is the root cause of your injury? Acute injury, tight muscles, other? You should be able to go up and down stairs with babies...... If the cause were tight muscles, the cause is probably still there and it could be worse as it depends on your lifestyle and current activity level. Most injured people don't deal with underlying posture issues or find physicians who have the specific knowledge to diagnose posture issues.

I had anterior pelvic tilt for many years, despite a lot of tennis, and did not know it. 5 weeks of stretching the rectus femorus and it went away.

I don't know much about this website or patellar tendinosis but it says anterior pelvic tilt can lead to patellar tendinitis due to tight muscles. Consider this cause as just one possibility until you can confirm a diagnosis and find a cause. Be sure to look at the great video, the 1st one, on the anterior pelvic tilt page. Very entertaining presentation and descriptions. Conditioning stretches that are designed to lengthen a healthy tendon - especially the advanced stretches on this website - may farther injure injured tendons so wait until you can see a Dr.

http://www.fix-knee-pain.com/injurie...ee-tendonitis/

http://www.fix-knee-pain.com/basic-p...r-pelvic-tilt/

Thanks for the website, great stuff, im gone try some exercises right away. I dont think that my tendonitis has anything to do with hip anterior pelvic tilt. Im pretty sure this is how i got my tendonitis, i was typically in the evenings sitting infront of the computor or tv, the babies would start crying on the second floor, i would then take some very explosive jumps up the stairs to tend to the babies quickly without any kind of warmup of course. Had i not played tennis for a few weeks after i started feeling the sympthom to beginn with i might not have had any more problems. But as things are now ive had an inflamed tendon for well over 6 months now and i realise this is not gone be easy, but im willing to try just about anything. I have heard about massage, anyone know it its good, i tryed a little myself but it only seemed to make things worse, dont know if i did it right though. Cortison shot? Heard pros and cons about that, anyone? //Arvid

[Chas Tennis]

Sitting with the trunk at 90 deg to the femur takes forces off the rectus femorus and tends to allow it to shorten, long term or short term.

My son-in-law, a software engineer, tested his posture for a tight rectus femorus. He could comfortably do the standing quad stretch with his pelvis tilted back from straight, no problem.

This website provided has a simple 5 minute test specifically for the rectus femorus and flexibility in this area. Lying on a table, etc. Do you pass that test?

The Thomas test
http://www.fix-knee-pain.com/basic-p...r-pelvic-tilt/

I'm not familiar with this test. I show tight rectus femorus on the standing quad test as on the other site, the test that my son-in-law breezes through. I wish someone had told me about this posture issue many years ago.......did it contribute to my knee injuries?........