T Nation

Knee Pain

Hi, I’m sure you guys get your share of knee issues posted in this forum.

So it’s happened to me now! And I’m not sure what caused it… probably running on an uneven surface and inappropriate shoes.

The little tendon right below me left knee appears swollen and when I kneel down on the floor, it hurts when it has to bear weight. Also when I get up and straighten my legs, the same area right below the knee, hurts. Going up the stairs, or especially down the stairs hurts.

I started to feel this pain when I went running over 2 weeks ago. I run at the local park, where the gravel isn’t exactly very soft, the surface is a little uneven, and my running shoes have a thick sole, and the shoe itself has a slight arch and raised from the heel. I’m flat footed.

So I stopped running and it went away for a while, but thanks to another run last evening, the pain is now back, and my knee feels a bit unstable too.

What exactly do you call this type of injury and are there any long term ramifications? Once again, the tendon right below my left knee feels and looks swollen. Pain only when kneeling and getting back up. Going up/down the stairs. That’s when I gotta be extra careful.

So what do you folks recommend at the moment? Iboprufen, Paracetamol and RICE? I’m extremely frustrated at the moment, as I love running, and I know I won’t be doing that for quite a while. On top of that I got a squat workout tomorrow.

What kind of rehab exercises would you recommend? I shall be eagerly awaiting your feedback. Please help!

It’s called patellar tendonitis, and it’s likely from your squat workouts, but aggravated from running, though I’m not an expert when it comes to running.

It’s caused mainly from tight quads.

I would simply kneel and sit your butt on your heels for a few minutes a couple times a day and see if that gives relief.

I use a tensor bandage over my patellar to give relief, but they make patellar straps, I’ve seen them at pharmacies.

I’m willing to bet this is from the running, not the squat workouts. I had some pretty severe patellar tendonitis when I played basketball, probably due to the crazy amount of running and jumping.

I’m not a huge fan of anti inflammatory medication or RICE. Are you getting plenty of fish oil? If you aren’t, you should add it in. Keep that area (your knee) nice and warm during all activity, and flush some blood through your quads on your off days somehow. Of course, stretch as Larry has said. When I saw a physio about my pain back in the day, they also suggested it might be hip flexor caused, so stretch those out as well.

if is swollen and painful to the touch, then PLEASE refrain from intense physical activity until the swelling subsides. Myself, any many others in this forum have tried to play/lift through patella tendonitis and pretty much all of us regret it in the long run.

I would not suggest any NSAIDs or ice as they could delay, and in many cases cause incomplete healing.

Do lots of passive stretches, ride a stationary bike and keep it moving, but DO NOT irritate it further. It will only increase healing time and could possibly make it not completely heal at all, increasing the chance that you will be dealing with something like this for a very long time, if not forever in some way.

Once the swelling is lower, continue to increase mobility and work on stability of the knee by working on your hamstring and glute (esp glute-med) strengh and do some extra work for the VMO (peterson step-ups, poliquin step-ups, side step-ups, light stationary lunges etc…)

Eccentric focused exercises are excellent for increasing tendon/ligament strength. For the first little while, all the exercises i listed above should be done with SLOW eccentrics (3-5 seconds)

There is the possibility that your knee will be fine without taking these precautions, but myself and many others wish we could go back in time and deal with it right away instead of hoping it goes away on its own.

^^^^^^^^^^^^what he said…had your symptoms a while back and the above tratments/mbility ect worked.although i had it for over a year if you catch it early you should be able to clear it up in a few weeks/month, best of luck

Thanks so much for the feedback guys!

Quick question: poliquin step ups and side step ups… how exactly do you do them? I am familiar with Peterson step ups and hear they’re great for strengthening the muscles and tendons around the knee.

It is definitely the running, as I had been pushing my luck for a while; the surface is uneven and I finally payed the price. Something was telling me to stop running there, but I ignored my instincts almost completely. I’ve never had knee pain after a leg workout.

BTW, the area where I iced it has red marks all over! It’s kind of like… I “infra redded” the region, and now I know where the swelling is! The tendon below the left knee is swollen, and just a while back I noticed a sack like swelling on the left side of that tendon as well. The inside is a bit swollen… red marks and all.

So NO icing or RICE, roger that. Cut out NSAIDS, affirmative! They don’t seem to be making much of a difference. So stationary bike, rehab work with the exercises you folks recommended and adequate rest. I suppose I’ll have to ditch my heavy squat workout today and just opt for a light one. Arrrgh… not happy!

How about leg extensions and curls… will the help? Shin cable pulls? Seated calve raises?

I really appreciate the feedback…glad I posted!

FYI: the pain is particularly fixated in the knee area when I get up from a chair and about to straighten my legs. Going down the stairs is a pain, need to place my foot carefully.

And yes, there is definitely pain in the tendon right below the knee, when I apply pressure on it.

Fish oils… no. I’ll start em ASAP. How many grams a day?

Sorry I keep posting multiple times. This just came to mind.

the poliquin step-up is basicly a peterson step up, only you put something extra under your heal so you dont have to worry so much about balance and can just focus on the movement instead of having to force yourself high on your toes.

side step-ups: start with the box fairly low and zero weight, stand with a box at your side (goal is a box at the height where your thigh is parallel to the floor) place the working leg on the box and with as little assistance as possible from your “rest” leg drive on to the box, and then attempt to lower under control. if you cant lower ALL the way down under control and cant get up without cheeting, lower the weight or lower the box height.

As far as ice goes, IF you have EXTREME swelling, or pain, some short ice massage sessions are acceptable, but if swelling isnt greatly effecting your everyday life then resist the icing.

Definitely NO leg extentions as they place A LOT of stress on even a healthy knee (for most people), hamstring curls will probably be a very good idea as long as they are not painful for you. the cable leg pulls and calf raises should be fine, but if they irritate the knee, then DONT do them.

Fish oils imo should be very high, at least for the short term. I would suggest up to 45g/day (get the liquid and have 3 Tablespoons/day for the first 2 weeks) then you can probably move down to 5-15g/day. although many people get great results with less then that.

any other questions? good luck, please let up know how everything works out.

[quote]Sepulnation wrote:
Fish oils… no. I’ll start em ASAP. How many grams a day?

Sorry I keep posting multiple times. This just came to mind. [/quote]

I’m at like 9g daily. Can probably go higher than that. Start with just a few grams, though.

great stuff in this thread

Excellent Feedback tork94!

Thanks for the response. My internet connection had been out of order, and then my PCs mobo and power supply had died. So here I am at last, all issues resolved.

The knee is better. But I can still see and feel a small tendon swollen right under the knee area. Knelling on the floor, and getting back up can be painful. Other than going up/down the stairs, squatting up or down on the john is OK. But I practice caution.

It is getting better, but only the next leg workout will tell. I did sprint intervals for a short while on the treadmill today BTW. At 20 km/h, 2 deg incline. Feels great. No post workout fatigue.

But I ain’t pushing my luck yet. Heavy squats will have to wait.

good to hear, keep the leg work heavy on the eccentric side to avoid further irritation and to continue to strengthen the tendon. good work so far

Hi Sepulnation,

I’ve read the problem you face. I have the same knee pain especially walking down from the stairs. It appears after my squat days and it is now effecting my daily life. Did you solve your problem? Your tread is and old tread so maybe you can add something to previous comments. Do you still have the knee pain?

Thank you for your help