T Nation

Tendinitis, How Can I Train Legs?

I’m pretty sure I have tendinitis…I’ve had pain near the patella of my knee (mostly right above and on the outside of the leg on the perimeter of the patella) for a few weeks, and it’s not really getting better.

I still want to train, but I think it would be counter-productive to be doing squats or anything knee-intensive. I’ve heard foam rolling and single-leg exercises plus increased vitamin/fish oil intake would help a great deal. How do you guys train through knee problems, and how should I go about correcting the issue I have?

I have patellar tendonitis in my left knee, and it hasn’t changed my leg workouts, I just have to ensure a proper warmup, something you should do anyways. Maybe yours in more severe, but it’s harder to give these kinds of suggestions on the internet with the little info you gave.

When you say you have pain on the outside of the leg can you be a bit more specific, if its patellar tendinitis you should only have pain in your patellar tendon right under your kneecap. Also, does the pain get worse with things like leg extensions and squats or anything else that stresses the patellar tendon such as going up or down stairs. For tendinitis, basically what you want to do is ice it for 15 minutes as often as you can hourly.

You don’t really want to stress the tendon as its trying to heal, meaning ideally you would need to take a layoff from leg work for at least a week and see what that does for you in terms of pain decreasing or not. Another thing is it’v very important to properly warmup as PF_89 said and you should really look into doing some quad stretches and direct soft tissue work on the tendon itself when you feel it’s healed enough to hand it.

Lemme know if that helps you there but in the end, if it doesn’t go away in about 2-3 weeks at worst I would definitely see a Physical Therapist or Doctor to do a quick evaluation. I have one year left in PT school so you don’t think im some jerk just spewing non-sense on the internet. Cheers mate and hope that you get it taken care of.

tendonitis is an overuse injury, stressing the affected tendons will make it worse.

I learned the hard way.

Proper warm-up, proper stretching are a given. I’ve had pain on the outside of my left knee ever since i can remember. I wear an ace brace that i got from a walgreens whenever i work legs and have no pain during or after my session. Might be worth a try. You get what you pay for when it comes to braces, so don’t be cheap for the sake of being cheap.

Sounds like it could be worth a trip to the doctor. If you have good health insurance…

[quote]acelement wrote:
I’m pretty sure I have tendinitis…I’ve had pain near the patella of my knee (mostly right above and on the outside of the leg on the perimeter of the patella) for a few weeks, and it’s not really getting better.

I still want to train, but I think it would be counter-productive to be doing squats or anything knee-intensive. I’ve heard foam rolling and single-leg exercises plus increased vitamin/fish oil intake would help a great deal. How do you guys train through knee problems, and how should I go about correcting the issue I have?[/quote]

That’s not tendonitis. That’s an IT band problem. Foam roll it.

[quote]acelement wrote:
I’m pretty sure I have tendinitis…I’ve had pain near the patella of my knee (mostly right above and on the outside of the leg on the perimeter of the patella) for a few weeks, and it’s not really getting better.

I still want to train, but I think it would be counter-productive to be doing squats or anything knee-intensive. I’ve heard foam rolling and single-leg exercises plus increased vitamin/fish oil intake would help a great deal. How do you guys train through knee problems, and how should I go about correcting the issue I have?[/quote]

it could be an IT band problem like the other poster said…i had this a few years ago myself. stretching it will fix the issue…however there are different ways to stretch it and you just have to find out which one works best for you…

about the IT band:

stretches:
http://www.rice.edu/~jenky/sports/itband.html

http://www.drkiper.com/ITBand.html

http://www.drpribut.com/sports/spitb.html

Neither of those stretches worked for me but I did find another version of the side stretch that did work for me…Basically I stood on a stair or something with a little height with my “hurt” leg. Then with my other foot I would try and touch the floor which was of course lower than my hurt leg. This would give me a great stretch in my hip and on my IT band. I would also slowly bend my hurt leg a little up and down like mini single leg squats. This felt like a better stretch to me but I’m not sure if it really did anything. After doing these stretches my problem went away and it hasn’t returned yet.

I hope this helps…these stretches are worth a shot.

I like using these bands for my tendonitis:

[quote]DaBeard wrote:
When you say you have pain on the outside of the leg can you be a bit more specific, if its patellar tendinitis you should only have pain in your patellar tendon right under your kneecap. Also, does the pain get worse with things like leg extensions and squats or anything else that stresses the patellar tendon such as going up or down stairs. For tendinitis, basically what you want to do is ice it for 15 minutes as often as you can hourly.

You don’t really want to stress the tendon as its trying to heal, meaning ideally you would need to take a layoff from leg work for at least a week and see what that does for you in terms of pain decreasing or not. Another thing is it’v very important to properly warmup as PF_89 said and you should really look into doing some quad stretches and direct soft tissue work on the tendon itself when you feel it’s healed enough to hand it.

Lemme know if that helps you there but in the end, if it doesn’t go away in about 2-3 weeks at worst I would definitely see a Physical Therapist or Doctor to do a quick evaluation. I have one year left in PT school so you don’t think im some jerk just spewing non-sense on the internet. Cheers mate and hope that you get it taken care of.[/quote]

So after a bit more research I’m quite certain it’s not patellar tendinitis. I’m pretty sure its Quadriceps Tendinitis because its mostly above the patella and on the outside of the patella (outside being away from the body), but NOT on the side of the leg where the IT is. Actually, I have some discomfort right now and its actually on the inner part of my leg, but still ABOVE and AROUND the perimeter of the patella. I do remember thinking I have weak hip abductor muscles because my knee (particularly my right) always instinctively moves inward on heavy sets, and I have to force myself to maintain neutral knee alignment.

Another reason it leads me to believe it’s QT is that it usually only bothers me when I’ve been sitting for a while or my knee is bent when sleeping on my side at night. It doesn’t hurt to do squats or leg extensions, but I get this sense of weakness/my knee is going to pop when attempting those exercises, like I’m going to hurt myself if I continue (despite there being on pain). Sleeping with my leg straight and fully extended does not agitate my knee, its only when its been bent for a while (such as sleeping or sitting) does the irritation come back.

I read up on eccentric loading for tendinitis as an aid to recovery, along with NSAIDs and Ice/Fish oil to minimize inflammation.

Does all of this information help?

That helps quite a bit, basically you can have one of two things, QT as you said is a possibility. The other is PatelloFemoral Pain sydrome (PFPS), whose signs and symptoms are exactly as you said. Pain with the knee flexed for a while in sitting or in bed. The location of the pain on top of and outside of the periphery of the patella is a very common site.

The one piece of evidence going against the QT at this point is the fact that you don’t have pain with leg extensions or squats, which should naturally put a lot of stress on it causing pain if it were inflammed. Back to the PFPS, it can be caused by a million things under the sun and one of the main reasons is muscular imbalances around the hips, knee or foot.

You really did your homework and im impressed because weak hip abductors are a very common clinical cause of PFPS. Work on unilateral leg work like Bulgarian squats, lunges and so on. Lemme know if this helps and if there is anything else you thought of that you could give as more info. Basically the more I know about the signs and symptoms, the more I can narrow down the problem.

[quote]DaBeard wrote:
That helps quite a bit, basically you can have one of two things, QT as you said is a possibility. The other is PatelloFemoral Pain sydrome (PFPS), whose signs and symptoms are exactly as you said.

Pain with the knee flexed for a while in sitting or in bed. The location of the pain on top of and outside of the periphery of the patella is a very common site.

The one piece of evidence going against the QT at this point is the fact that you don’t have pain with leg extensions or squats, which should naturally put a lot of stress on it causing pain if it were inflammed. Back to the PFPS, it can be caused by a million things under the sun and one of the main reasons is muscular imbalances around the hips, knee or foot.

You really did your homework and im impressed because weak hip abductors are a very common clinical cause of PFPS. Work on unilateral leg work like Bulgarian squats, lunges and so on. Lemme know if this helps and if there is anything else you thought of that you could give as more info. Basically the more I know about the signs and symptoms, the more I can narrow down the problem. [/quote]

Thanks for the help DaBeard!

I tried to do unilateral exercises and my leg was just not liking it. Like I said, it’s not because it was pain, its just that my knee felt weak, as if it was going to give out or something.

Maybe I should start w/ machines, and especially work on my hip abductors to really strengthen them? I think foam rolling will certainly help a bit.

Work on the foam rolling on the entire IT band and strengthen the hip abductors. If you have a hip station, that would be a good place to start. Do you ever get the feeling of your knee buckling when doing other things besides weight training, because that is really indicative of any of a number of ligaments being either very lax or at the worst torn, especially the ACL. I honestly don’t think it would hurt to see a doc if you have that option.