T Nation

Knee Tendinosis Advice, Tried All Options

Hi. I’m in desperate need of advice. Here’s my situation. I have had knee tendinitis which has turned into chronic tendinosis over the span of the last 9 years. It started very slowly back when I didn’t know much about proper training and did lots of leg extensions. It slowly got worse when I started complex movements (squats and deadlifts).

I admit that I have always fired my quads more than my posterior chain when doing those lifts. I’m doing a lot of exercises recommended by a physio right now to fix that. It became much worse when I started playing full contact football at 26. My body just wasn’t used to that much running, and I’m 6’1’’ 250lbs. Around that point I started trying to fix the problem, so I went to my GP, to a physio and an athletic therapist.

I received the full gamut of treatments (ice, ultrasound, electrical impulse treatment, all kinds of stretching, pushing my kneecap down with my thumbs for minutes at a time, etc). All of that did practically nothing. I also once received a cortisone injection, which did mostly nothing either. I consulted on many occasions with a orthopedist, who didn’t do much. I then went to see an anaesthesiologist (not sure of proper spelling in english) who started prolotherapy with me.

Of my two knees, one responded very well, the other not very much. He scolded me every time I saw him for the fact that I kept on squatting heavy despite the pain and treatments. Therefore I stopped all lower body training and followed the protocol outlined in an article found on T-Nation, “Straightforward knee rehab”. No offense to the author and I’m sure this worked for some people, but in my case I didn’t get much results, and the improved wall stretches actually created a partial tear in the upper portion of my right patellar tendon.

So I had a tendinosis in left patellar tendon just below the kneecap, and tear in the right one just on top of it. After many painful prolotherapy injections, the doc concluded we weren’t getting much results and recommended Platelet Rich Plasma. I had to fork the 350$ (yeah, I know, you guys in the US will say I shouldn’t complain since it’s twice as much in the US, but we’re not used to paying for health care in Canada…), and now, 4 months and some physio later, I am no better than before.

So the doc recommended we try “whole blood injections” instead of PRP, as he seems to get better results with this. But he made it very clear that this is the final frontier. He basically has no other tricks up his sleeve for me after this. So I am basically faced with the prospect of lifelong knee pain if this doesn’t work. No more heavy squat ever, and most important, I’ll never be able to squat in front of my 1 year old kid to play with him. And that is scary as hell.

The doc said the prognosis of untreated tendinosis would be arthrosis down the line, so I guess I’m looking at being an arthritic 45 year old 10 years from now, or something. As things stand now, I’m scheduled to have Whole Blood injection into the tendon this fall. I’m working at strengthening my core and stabilizer muscles throughout the core and pelvic area. I’m working on my ankles to better support my weight.

I’ve started doing ball squats against the wall, but those are already painful if I’m not careful to fire the posterior chain primarily. And I’m trying my damn best to lose weight to lessen the load on my knees. Even that’s a lot easier when you are able to use the caloric output of complex exercises. So at this point, I’m starting to consider Growth Hormones. My reasoning is that coupled with whole blood, this may dramatically increase my chances of healing properly.

I’d be lying if I said I had never thought about trying those simply for the muscular gains and weight loss, but it never was a SERIOUS consideration. The potential side effects worried me. But at this point, the muscle gain and weight loss would come distant second to being pain free again. Does anyone have any input on this? Anyone ever been in a similar situation? Can anyone give advice on injuries treatment, and GH as a part of this? Or simply about GH?

Believe me when I say I’m really desperate if I’m considering this option. If anyone has an alternative option (a science-based one preferably) to suggest, I’d be willing to try it…

I’ll be waiting for your input!

jf

Couple questions.

Have you had an MRI? I’m assuming you have since this has been such a long problem. What did it reveal if so?

Has anyone recommended to you eccentric single-leg squats on a slant board (physio or otherwise)?

Yes, I<ve had an MRI prior to my Platelet Rich Plasma injection, so that the anaesthesiologist would know exactly what he<s dealing with. It revealed tendinosis in lower left patellar tendon (as evidenced by some swelling and fiber disorganization), and tear in upper right tendon, as evidenced by the ruptured fibers.

I have been recommended eccentric training by the physio I have been seeing since the PRP injection. But she follows a strict rehab protocol as outlined in scientific articles given by the anaesthesiologist, and the eccentric training comes late in the rehab. She also thought I needed to strengthen my core and pelvic area first. But I<m lining up to try it soon. I have to admit I<m weary of all single leg stuff given my weight and weak tendons. I may start with eccentric slant squats with both legs, though. Worth considering I guess…

I meant I’m wary…although that could be considered a funny lapsus I guess…

ART

Saved my knees, even after 4 operations. (2 on each).

This is after trying EVERYTHING.

Cheers

Huh. Didn’t even know the term, but I looked it up and there’s a few people doing it here in town. Worth checking it out…

I’m still open to other inputs about this.

voodoo bands.

[quote]tork94 wrote:
voodoo bands.[/quote]
Isn’t that more for ‘itis’ issues than degenerative issues?

[quote]PB Andy wrote:

[quote]tork94 wrote:
voodoo bands.[/quote]
Isn’t that more for ‘itis’ issues than degenerative issues?[/quote]

It’s also a “band aid”, not a cure.

Once again, I knew nothing about the suggested method. I looked it up.

I’d say the 3 of you are right. It may be an option which would allow me to be pain free during workouts, so it may be worth it if it allows me at least that. However, it appears it IS only a band aid in cases of tendinitis or even worse tendinosis. And yes, I would need to find what actually causes my problem rather than band aid it. But this has been and ongoing question for years in my case. I’m wondering about endogenous levels of GH and also cortisols, among other things…

But once again, I’d say the voodoo bands may be worth checking out. Let’s hope the answers keep coming…

had it in left knee,
eccentric single leg squats with heel elevated
glute exercises,make sure the glute min and med are firing properly
roll the it band…
one or a combination of these worked for me dont know which,if i had to guess it say the glutes weren’t firing
best of luck

Yes, good advice. I’ll pull out the foam roller again I guess. I’ve been focusing on the glutes a lot, so I’d say that’s covered. Thanks again…

ok, so…roll IT band, eccentric squat with heel elevated, focus on firing glutes, ART, and if all those fail, voodoo bands. Good plan. Does anyone have any input on…supplements let’s say, to help in injury healing?

I would just buy voodoo bands (Voodoo X Bands which are thicker for the knees) and use them concurrently. They’ll last a lifetime and you can use them for other aches and pains.