Pain at Tibial Tuberosity

Im hoping some of you fellow T-Nation readers can help me out here. Ive been dealing with regular knee pain at the tibial tuberosity for about a year or so now and it isnt getting better. Doctors/P.T. cant give me a straight answer on what it is and how to treat it. ruled out patellar tendonitis since it really doesnt hurt anywhere along the tendon itself.Just where it inserts on the tibia.

Pain gets worse after activities like squatting, walking a long time, basketball which i play tons of, and just about anything that requires me to be on my feet for a long period of time. Tried resting before and its helped but the pain returned, have used ice and pre activity stretching modalities but still no long term answer. Anyone experience this before. Oooo and I doubt its Osgood-Schlatter syndrome given that im 21 yrs old already

[quote]Brooklyyyn wrote:
Im hoping some of you fellow T-Nation readers can help me out here. Ive been dealing with regular knee pain at the tibial tuberosity for about a year or so now and it isnt getting better. Doctors/P.T. cant give me a straight answer on what it is and how to treat it. ruled out patellar tendonitis since it really doesnt hurt anywhere along the tendon itself. Just where it inserts on the tibia. Pain gets worse after activities like squatting, walking a long time, basketball which i play tons of, and just about anything that requires me to be on my feet for a long period of time. Tried resting before and its helped but the pain returned, have used ice and pre activity stretching modalities but still no long term answer. Anyone experience this before. Oooo and I doubt its Osgood-Schlatter syndrome given that im 21 yrs old already[/quote]

You know I had some REALLY bad tendon pain in that same area although, on the outside of the knee, for years and the same activities that you describe caused me a ton of pain as well. I ended up getting a steroid injection into the tendon and the inflammation disappeared and hasn’t bothered me since.

You might ask your doctor about Patello-femoral syndrome.

ART, I’m sure it’s a soft tissue area. By and large most people suck at soft tissue work, or even acknowledging it.

My advice would be to rest and ice it for a little while again, like a week or so…just stay away from training for that time being. After that, you need to start focusing on knee-stability work in the gym. Work on strengthening your glute medius (lateral band walking, bridging w/ leg extension). Also, slowly and progressively work on single leg work, you need some time off from the bilateral work until you move past the unilateral imbalances. A lot of knee pain, as I’ve seen as a trainer, has been caused by knee tracking issues in movements like squats, deadlifts, lunges, etc.

When I have clients with those tracking issues (some noticeable, some not so much), I follow this protocol with them and 95% of the time my clients return without any sort of knee pain and we go back to squats, DLs, etc. without anymore problems.

Great exercises in addition to the ones I said before for the glute medius: single-leg squats/deadlifts (progress them slowly), single-leg leg presses, reverse lunges ONLY (if deciding to lunge), progress into BW lateral lunging, hip mobility work, ankle mobility work, bridge and plank progressions.

Good luck!

x3 on the foam rolling/soft tissue work as well

Active release therapy is worth pursuing. It’s painful but you may be fixed up in a session of two. Look into it.

[quote]bushidobadboy wrote:
OK so you have pain ant the tenoperiosteal junction (literally where the tendon meets the periosteum on the surface of the bone) This is usually caused by a mild but constant pull on that area caused by tight quads in combination with prolonged bent-knee positioning.

Do you sit at a desk? Do you often sit for long periods with bent knees? Does this make the pain noticeably worse?

Would you say that the area is hot/warm and inflammed or just inflamed with no heat (‘boggy’ feeling) or just painful with no percptible heat or inflammation?

What you can do: Straighten the legs when sitting. Use a pouffe when sitting at home on the couch, etc. to straighten the legs.

Use contrast therapy on the area - cold, heat, cold, heat, cold, etc always finishing on cold. Apply for 5-10 minutes per contrast, depending on what brings relief. It’s a superficial structure so it will feel the cold/heat and respond quickly.

Ice massage after exercise.

Strip the quads down towards the knee, to reduce tension on the patella ligamant.

Asses your ITB for tightness. Basically, if you srip it or rub it hard or foam roll it, is is excessively tight/painfull? If so, it could be pulling on the patella, contributing to the overall tension on the patella ligament.

BBB[/quote]

Bumping thread because this works wonderfully. I had exact same issues as described by OP and within a week of applying everything BBB said, I was able to start squatting again (minor discomfort) within a week and squatting heavy 2 weeks after that. I stretched quads in between sets to keep irritation down and although I continue to do it, there is little to no pain/discomfort at all.

I also no longer need my neoprene sleeves but still use them just to keep them warm in case.

I honestly thought I was going to have this nagging issue forever and now its almost totally gone. Happy happy. Btw I squat 4-8 times a week if that relevant to anyone. This coupled with desk job and sitting in classes probably made my quads/hip flexors unbearably tight.