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Author Topic: Patellar Tendonitis, Tendonosis, Tendonopathy  (Read 12482 times)

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Offline samlau21

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Patellar Tendonitis, Tendonosis, Tendonopathy
« on: June 14, 2012, 01:44:02 PM »
Hello,

I am a 22year old male who has been suffering with patellar tendonosis for 3years now! I think I have actually become obsessed with getting better and have read so much about the condition. At times  I have also been very depressed and felt like it is never going to get better.

How it began in 2009

It began by playing basketball too intently in the space of a few weeks and I had tendonitis in both patellar tendons. I never properly rested my right knee and subsequently kept reinjuring the tendon :(. I was 19 and very sporty (football, basketball, tennis) - I thought i was invinvible!

Getting better Summer 2011

Last Summer the knee got better and I strongly believe i was due to eccentric squats. It is so important to start with almost no weight and slowly increase the weight. I went from 2 legged squats to 1 leg squats with 25kg backpack on an incline board over a 6month period. I was cycling almost 25km a day and feeling good again. I was also playing football and tennis but being carefull.

Back to Square 1!

I was feeling so good again that I played basketball in Sept 11. My tendon the next day felt pain and I was limping around for a few weeks. The knee felt ok walking but I couldn't do any sports again or sit with it bent for long.

Back to Square 1 again!

One of the worst decisions was seeing Dr Ralph Rogers at the London Orphaepic clinic. I had some PRP injections into the tendon in Jan 2012 and I am sure it made me 10 times worse.

The swelling from the injections never went away and my hoffas fat pad was very infammed. The tendon and surrounding tissue would swell up everyday just from walking and i was painfull all the time. I put up with this for 5months before surgery!

Surgery

4 weeks ago I had open and arthroscopic surgery to remove a small bone spur and a decompression inflammed tissue at the inferior pole. The surgeon said that he reomved 1/3 of the tendon! He said that the bone spur was causing all of the tendon problems. Interestingly I had Osgood Schlatters when I was 14 and have an bone spur at the tibial tuiberosity (which does not cause any problems)

Recovery

I am now 4 weeks post op and have about 110degrees of ROM. I can walk without crutches but sill finding stairs difficult. The tendon and surrounding tissue is still quite swollen but I have already noticed that I can sit with the knee bent for longer without the same pain where the bone spur most have been pressing into the tendon.

At the moment I am still doing static quad work as the area is still too sore for even straight leg raises. I really am hoping I can get back to he sports I love in about 4-6months time.

I would love to hear from anyone else with this problem, the time it took to recover and the steps they took in physio for recovery.

If anyone out there is suffering from this then please ask any questions as I feel like I know everything!



Offline samlau21

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Re: Patellar Tendonitis, Tendonosis, Tendonopathy
« Reply #1 on: June 18, 2012, 02:21:33 PM »
My first post and no replies!

Offline knee2no

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Re: Patellar Tendonitis, Tendonosis, Tendonopathy
« Reply #2 on: June 18, 2012, 09:22:10 PM »
One of the worst decisions was seeing Dr Ralph Rogers at the London Orphaepic clinic. I had some PRP injections into the tendon in Jan 2012 and I am sure it made me 10 times worse.

I have a similar condition but declined the PRP. 
4 weeks is still quite early.  This surgery has a long recovery time and 4-6 months sounds faster than what I have been told.  Many athletes with this surgery are out for a year.   If you had success with the incline squats why did you not continue? 
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not", nor will I fail to call in my colleagues when the skills of another are needed.

Offline samlau21

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Re: Patellar Tendonitis, Tendonosis, Tendonopathy
« Reply #3 on: June 28, 2012, 02:18:44 PM »
Hi thanks for reply.

I did continue with the incline squats. But my condition worsened when I returned to sport.

I found out that I had a bone spur at the infrapetalla pole that was actually digging into the tendon when i bent my knee.

6 weeks post op and I already feel better than when I went into surgery. I can now sit with my knee bent without pain.

I was unable to even do 1 straigt leg raise before the op, Now I am doing it each night without pain to regain leg strength.

Sam

Offline samlau21

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Re: Patellar Tendonitis, Tendonosis, Tendonopathy
« Reply #4 on: June 28, 2012, 02:22:25 PM »
Oh I forgot to say.

I am sure the bone spur grew as a result of tendontitis and inflammation. I also had Osgood Schlatters when I was younger and have large bone spurs at the tibial tuberosity (that don't bother me).

The body seems to grow bone when you have inflammation in a tendon which made my condition 10 times worse so I had to have the bone out in surgery.

Have you tried eccentric squats? I thoroughly recommend it and be really carefull not to ramp up the wieght too quickly.

Sam

Offline kneepaincure

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Re: Patellar Tendonitis, Tendonosis, Tendonopathy
« Reply #5 on: July 22, 2012, 05:31:43 PM »
@samlau21: As a fellow sufferer of patellar tendonitis, could you tell me how they diagnosed the bone spur? Was it an X-ray or CT?

Hope your recovery is going well!!
Have had tilted kneecaps for many years, and occasional patellar tendinitis.

Offline samlau21

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Re: Patellar Tendonitis, Tendonosis, Tendonopathy
« Reply #6 on: July 26, 2012, 02:17:16 PM »
Hi,

2 surgeons and 2 radiographers missed the bone spur. I found i myself looking at my MRI images and showed the surgeon on he day of surgery. He then said that it definietly needed to come out! I will try and post an image of it later.

How long have you had tendonitis? I hope you can heal quickly but you must be patient with this condition. I made mine 10times worse by continuing to play basketball and football (initially i felt fine after warming up)

My knee is progressing well since the sugery so I am so glad I went for it. 9 weeks post op and I am doing leg extensions and straight leg raises with a 2.5kg ankle weight. I hope to start cycling and eccentric squats in abou 4 weeks time.

Offline kneepaincure

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Re: Patellar Tendonitis, Tendonosis, Tendonopathy
« Reply #7 on: July 26, 2012, 02:28:04 PM »
Wow, the surgeons didn't spot it on the MRI? That's pretty surprising.

I've had this on and off for 3 years now. And it's hard to be patient, but it's the only way. I've been doing eccentric exercises for about 3 weeks now, and while my knees feel less stiff, the pain is not gone yet. I have stopped running for now until this goes away.
Have had tilted kneecaps for many years, and occasional patellar tendinitis.

Offline knee2no

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Re: Patellar Tendonitis, Tendonosis, Tendonopathy
« Reply #8 on: July 26, 2012, 09:53:00 PM »
Were you able to feel the spur on outside of your knee by pressing on the tendon?

Not surprised the radiologist missed this I do not feel this is a field of much expertise.   
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not", nor will I fail to call in my colleagues when the skills of another are needed.

Offline samlau21

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Re: Patellar Tendonitis, Tendonosis, Tendonopathy
« Reply #9 on: July 27, 2012, 02:27:50 PM »
Keep up the eccentric squats. I moved slowly from 2 leg, hen to one leg. Built myself a slant board and then added 0.5pounds extra to a backpack each week. After 5-6months it was feeling good again.

Tbh a bone spur never occured to me. I remember the tendon feeling good again apart from a very deep portion where I could feel pain. I could press firmly on the tendon with no pain, but as soon as i bent my knee i could start feeling a pain.

Not only did 2 surgeons not notice the bone spur but i had ultra-sound guided autologous blood injections where another doctor did not notice it!




Offline Thorxes

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Re: Patellar Tendonitis, Tendonosis, Tendonopathy
« Reply #10 on: August 07, 2012, 09:02:34 PM »
I have a similar issue with my knees.

I've recently started doing the eccentric squats along with some glute and hamstring exercises. Before that I had decided to take off as much activity as possible, so my knees were feeling pretty good. But then I started the squats.....so here's my question:

When you started the eccentric squats, how did your knees feel for the first couple of weeks?

Right now the pain ramped back up since I had been doing practically nothing for 3 weeks. But this pain, while pretty big in magnitude, isn't as sharp or as concentrated as the pain I was having before. Somehow, when standing from a sitting position, I feel as though the knee and tendon is stronger, but it still hurts.

This reminds of how a muscle hurts a day or two after working out. But this isn't a muscle, and I have no idea what the tendon/knee is supposed to feel like with the eccentric squats. Any info would be appreciated. <3

Offline samlau21

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Re: Patellar Tendonitis, Tendonosis, Tendonopathy
« Reply #11 on: August 08, 2012, 09:43:15 AM »
This is a tricky one. I remember when I first started doing squats that there was some pain. But the pain was not sharp and the knee felt stronger when i woke up. i think it is better to do these exercises jus before bed so the tendon has time to rest and build as you sleep.

I think there may be a small amount of pain sometimes, but as soon as this goes over the threshold then you have probably done too much and should give it a rest for a few days. Some people say that you should squat with pain, I tried this and it made me much worse so I wouldn't advocate it.

I would start off very light. Support yourself by holding onto some chairs or something and by lowering youself down during the two legged squat. Only when you have done this comfortably for a few weeks and can feel an improvement each day should you move onto a higher weight.

Hope this helps,

Sam

Offline Dr_Refaat

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Re: Patellar Tendonitis, Tendonosis, Tendonopathy
« Reply #12 on: May 04, 2013, 01:32:12 AM »
Sorry to hear about your suffer


Our orthopedic team use a new strategy which is "Stem cell therapy in treatment of  Patellar tendonitis is a degenerative process.

Stem cell therapy depends on replacement of damaged part with a new one to completely end the problem and pain In Shaa Allah.

Contact us for free consult at


http://stem.md/

Offline Fred Wilkins

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Re: Patellar Tendonitis, Tendonosis, Tendonopathy
« Reply #13 on: September 01, 2014, 05:26:23 PM »
Hey everyone,

Is anyone still active on this thread?  If not, i'll start a new one but need some help on mine!

Many thanks

Fred

Offline slenkar

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Re: Patellar Tendonitis, Tendonosis, Tendonopathy
« Reply #14 on: October 05, 2015, 08:28:28 PM »
I had the same injury and I realised that walking up the stairs puts strain on that tendon, it prevents it from healing.

 

All I did was avoid walking up stairs for a few weeks and it healed - mostly

 

You just have to walk upstairs using your good leg or just crawl up the stairs for a couple of weeks

Offline John42

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Re: Patellar Tendonitis, Tendonosis, Tendonopathy
« Reply #15 on: October 06, 2015, 07:15:04 AM »
Hi Slenkar

Did you rupture your patella tendon, if so when?

I assume that you had an operation to repair the ruptured tendon, but how long ago ?

Did you have any physio and if so what ROM Range of movement do you have today?

Which country/town do you live in?

You should be looking at the webpage ruptured patella tendon/ surgery for answers.

JohnK/ Manchester UK
Ruptured Patella Tendon January 9 2003
Slipped on black ice.  Manchester UK

Complete Ruptured Tendon

Offline Clarkey

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Re: Patellar Tendonitis, Tendonosis, Tendonopathy
« Reply #16 on: February 02, 2016, 05:34:41 PM »
Hello,

I am a 22year old male who has been suffering with patellar tendonosis for 3years now! I think I have actually become obsessed with getting better and have read so much about the condition. At times  I have also been very depressed and felt like it is never going to get better.

How it began in 2009

It began by playing basketball too intently in the space of a few weeks and I had tendonitis in both patellar tendons. I never properly rested my right knee and subsequently kept reinjuring the tendon :(. I was 19 and very sporty (football, basketball, tennis) - I thought i was invinvible!

Getting better Summer 2011

Last Summer the knee got better and I strongly believe i was due to eccentric squats. It is so important to start with almost no weight and slowly increase the weight. I went from 2 legged squats to 1 leg squats with 25kg backpack on an incline board over a 6month period. I was cycling almost 25km a day and feeling good again. I was also playing football and tennis but being carefull.

Back to Square 1!

I was feeling so good again that I played basketball in Sept 11. My tendon the next day felt pain and I was limping around for a few weeks. The knee felt ok walking but I couldn't do any sports again or sit with it bent for long.

Back to Square 1 again!

One of the worst decisions was seeing Dr Ralph Rogers at the London Orphaepic clinic. I had some PRP injections into the tendon in Jan 2012 and I am sure it made me 10 times worse.

The swelling from the injections never went away and my hoffas fat pad was very infammed. The tendon and surrounding tissue would swell up everyday just from walking and i was painfull all the time. I put up with this for 5months before surgery!

Surgery

4 weeks ago I had open and arthroscopic surgery to remove a small bone spur and a decompression inflammed tissue at the inferior pole. The surgeon said that he reomved 1/3 of the tendon! He said that the bone spur was causing all of the tendon problems. Interestingly I had Osgood Schlatters when I was 14 and have an bone spur at the tibial tuiberosity (which does not cause any problems)

Recovery

I am now 4 weeks post op and have about 110degrees of ROM. I can walk without crutches but sill finding stairs difficult. The tendon and surrounding tissue is still quite swollen but I have already noticed that I can sit with the knee bent for longer without the same pain where the bone spur most have been pressing into the tendon.

At the moment I am still doing static quad work as the area is still too sore for even straight leg raises. I really am hoping I can get back to he sports I love in about 4-6months time.

I would love to hear from anyone else with this problem, the time it took to recover and the steps they took in physio for recovery.

If anyone out there is suffering from this then please ask any questions as I feel like I know everything!

The original poster of this topic of discussion sounds like a very similar scenario that I am finding myself in right now! Those that have already been following my post-op diary will know that I have been through two scopes#1 plica removal and fat pad trimming. Scope#2 AIR surgery to remove scar tissue behind the patella tendon.

My latest MRI scan shows a few areas that could be of a potential concern if there are no further improvements after 3 cortisone injections in 2015. One out of the three was US guided that showed up fluid around the patella tendon confirming Runner Knee or Patella Tendonitis!

MRI scan shows fat pad and patella tendon inflammation and spurs!

I have been doing PT and stretching exercises for a while now without seeing any benefits, the 3 cortisone injections have not made much difference that could potentially cause articulate cartilage deterioration!

PRP injections has been suggested and if you goggle it will see plenty of web links that highlight that PRP injections are beneficial for patients with patella tendonitis. However there are other links that say to stay away from it altogether!

Mr Charles Willis-Owen a UK based OS located south of London has done extensive research on PRP injections for inflammation of the patella tendon saying the following quote. 

PRP (platelet-rich-plasma) injections have been shown in large metastudies to be of no benefit for patellar tendinitis. 

http://www.kneeguru.co.uk/KNEEnotes/specialists/knee-surgeon/dr-mr-charles-willis-owen

There are other way to try and resolve patella tendonitis by trying out all the conservative methods of treatment.

1.   Physiotherapy
2.   Cortisone injections
3.   PRP Injection (does not work)
4.   Extracorporeal shock wave therapy (ESWT)
5.   Surgery

Link below is NHS based that mentions ESWT so assuming it is available that I could possibly try out before resorting to surgical intervention.

http://www.nhs.uk/Conditions/Tendonitis/Pages/Treatment.aspx

Surgery

Surgery may be an option for some tendon injuries, but this is often only considered as a last resort because it's not always effective and carries a risk of complications such as wound infections, scarring and rupturing of the affected tendon.

Surgery can be used to:

•remove the damaged section of tendon

•remove lumps or deposits that have formed on the tendon

•encourage the tendon to heal

•repair ruptured tendons


Has anyone been through Extracorporeal shock wave therapy (ESWT). Was it a success or failure, that can be done on the NHS, that's a cheaper and safer option to be going for before considering surgery.

[email protected]
« Last Edit: February 02, 2016, 05:42:58 PM by Clarkey »
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming