T Nation

Patello Femoral Tendinosis

Since I ve been dealing with this injury for almost 5 years, Im looking if someone can help with some tips or ideas to solve my problem for once and for all.
As almost everyone on this site Im a fitness fanatic and also a sportsmen, I play rugby at a second division team in Argentina, but this injury y driving my crazy.

For the last 2 years, after an entire year out of practice visiting my physio once a week, I was better and playing rugby, strength training and every thing else pain free. But last couple of weeks the pain poped up again and its worst than ever.
I ve been foam rolling every time I work out for the last year, I try to strech as much as posible (I still can improve a lot) do my dynamic warm ups with mobility work and actiivation drills.

I think my problem with the knee is that I have little to no quad development altought a train on a regular basis. I lack VMO development and also Im pretty sure quad overall strength, but it seems everuthing I do has no effect. Its like running in circles if I train to hard Im in pain but if i dont train Im getting worst.
Has anyone a tip or idea to help change my condition??

Have you been evaluated by a physician? MRIs done? Do you have a formal diagnosis or were you just told it was patello femoral tendinosis?

What has your rehab looked like and how was it progressed through that year timeframe?

Yes levelheaded, I have been evaluated by many physicians, have done many MRI, and the diagnosis was patello femoral tendinosis. The tissue in the tendon had changed as it was thicker than and more dense than normal.
My rehab consisted on magnetotherapy, massages and mobilization of the surrounding tissues, and finally 10 minutes of tecatherapy. I worked on the gym strengthening my quads and hamstring, but I think I mostly had no pain becuase I spent almost a year and a half without doing any painfull activities such as running, jumping or squatting.
thanks for your answer

I am pretty unfamiliar with magnetotherapy and espeacially tecar therapy. From what I have read, the results from those seem to be similar to some of the modalities used in the US.

One thing that I see lacking is glute work and/or activation drills. I see that you worked on strengthening the quads and hamstrings in the gym. Did they ever go through proper activation drills of the glutes/hips? Any ROM/mobility assessments performed for the hips? How about ROM/mobility at the ankles?

Here is a great article that may be of help to you: http://articles.elitefts.com/articles/rehabilitation/solving-anterior-knee-pain/

Levelheaded, in every warm up I use some activation drills such as hip lifts or bridges, side lying clams and band lateral walks. I ve never been through any good ROM mobility assessments for the hips, but I also do in my warm ups mobility drills for the hips and ankles.

I might be tight and the hips or ankles, but Im pretty sure thats not the end of it, I still think my lack of quad development and other issues are holding my down.
Great article from elitefts, I had already read it, thanks anyway.