Can tendinopathy cause this much pain? What's a comfy patellar tendon strap?

[jenny1000]

Hi, I've had pain for 9 years (I'm 22) which has worsened to the point where I can only stand for 5-10 minutes.  The pain is constant and is in the middle of the patellar tendon, and I need codeine or tramadol every 4 hours for it to be bearable.  I saw 8 NHS surgeons who found nothing wrong, 2 private surgeons said I had patella alta/slightly twisted bones/flat feet/inflamed fat pad and initially recommended a TTT but then said the pain is hugely exaggerated and I should just strengthen up and wait.  I strengthed my leg muscles, pain still got worse.

Just saw Mr. Wilson at Hampshire knee who thinks I have a severe case of tendinopathy.  I didn't do much sport when I was younger so I don't know what the cause is.  He recommended an ultrasound scan to confirm the diagnosis (had xray/CT/ and an MRI which didn't show it) then 3 sessions of shockwave treatment.  If that doesn't work, PRP injections and possibly dry needling, and as a last resort surgery.  Could just tendinosis cause this much pain or could there be something else going on?  My kneecaps maltrack which you can see when I bend my knees but would this cause pain around the kneecaps which I don't really have?  I'm also on max dose of gabapentin in case there was some nerve pain, which hasn't helped at all.

I bought a patella tendon strap yesterday, just a cheap one from a pharmacy, but after about 2 hours it's really uncomfortable as it digs in around the back and sides of my knee so much.  Which is a more comfortable one?  And how much should I wear it, all the time or when I have to do more standing up at work etc?  I get the impression most people wear it for sport but I am unable to do any sport.

Sorry this was long, thanks in advance.

[knee2no]

Is your patellar tendon thicker?  This usually shows up on the MRI.  Have you had the shock wave therapy and did it make any difference? I dont find those straps particularly comfortable at all!

[jenny1000]

It looked normal on the MRI but apparently they can miss it sometimes.  I'm having an ultrasound tomorrow then starting the shockwave therapy next thursday - I'll let you know if it helps.  Have you heard much about how successful it is?  There doesn't seem to be much online.  It's £570 for 3 treatments so it better do something!  I'm glad it's not just me - I couldn't even wear it for long enough to see if it makes a difference, and I had massive red imprints all around my knee from it!

[emergRN]

You could also try taping.  I have a strap, but I found it uncomfortable.  A PT showed me how to do the taping for patellar tendonitis, and it really helped.  I would suggest making an appointment with a physio and get them to show you how to do it.  The tape is a bit pricey, but it is cheaper than having to go to a physio every two days to have the tape reapplied.

W

[knee2no]

I tape myself for tendinitis.  I experimented and found what made me feel better.  I did not know there was a specific method to tape for tendinitis?  PT have told me about the mcConnell taping for patella problems but never for tendinitis.  Could you explain? 

[knee2no]

jenny- how was the shockwave and do you think it helps?

[ALRunner]

The scientific evidence on shockwave is highly questionable; it's lacking and not at all convincing. That said, I have come upon some who swear by it in their own case, including it solving their long term tendinosis. If it were up to me I would pay the 570 prior to getting surgery. Here in the US it's not covered by insurance and the cost is $2500+.