>Health and Nutrition>Intermittent Patellar Tendonitis?
Is it possible to have intermittent patellar tendonitis? Can biking aggravate or cause patellar tendonitis? Can biking cause or aggravate IT band issues?
I started having knee pain about 2 weeks ago after a long day (45 miles biking, 12 miles running). My knees hurt while biking, but not while running. My left knee always bothers me a little bit when I am biking (it snaps and cracks a fair bit when I start out), but this was in both knees and more noticeable.
My knees (especially my left knee) hurt while biking that next week and also while walking downhill/down stairs. My legs were tight before runs, but always felt better after the first 3-4 miles. The knee pain always disappeared after my muscles loosened up. I also realized that I was able to completely alleviate the pain in my knee by stretching and rolling out my quads, hamstrings, and calves. Because of this I continued with my regularly scheduled runs.
Last week I cut out biking entirely and only ran 4-5 miles a couple times. I noticed that my knees were swollen after one run, but were not painful. However, my left knee was painful while walking the rest of the day, and was stiff when I woke up the next morning. All of the pain and swelling is below my kneecap and on the outside of the knee.
Despite being stiff Saturday, I decided to complete my scheduled 16 mile long run on Sunday (yesterday). I felt very stiff the first three miles (no knee pain, but the muscle that runs across my shin was very tight and may have been pulling on the patella tendon) but felt great after that. I ended up running closer to 20 miles because I got lost. I noticed my knees were swollen around 2 hours and 45 mins. They also were a little tender while running downhill. I tried not to “brake” while running downhills and that helped. I finished the final 30 mins of my run (had to get home) and iced.
I took today off of running and biked a very slow and easy 4 miles. My left knee bothered me the entire time (both above and below the knee). The only place I am sore today is in my right quad and this makes me worry that I was subconsciously compensating for my left knee.
Does this sound like Patellar tendonitis (runner’s knee)? I worry somewhat that it could be related to my IT band. I am ok with experimenting with my running if it is Patellar tendonitis, but I will not mess with IT band issues. I have had Patellar tendonitis before and have continued to run through it. The athletic trainer always said that as long as I didn't limp, I couldn't make it worse by running on it. It just wouldn't heal until I rested. Typically when I have had tendentious it gets better throughout a run, not worse.
I am training for a 50K in September, but am a complete novice to that distance (I'm more of a 5K runner). What is the best way to deal with this issue? Should I try mini-runs multiple times a day? Just take a week off completely?
I am a young (20 something) female runner. I ran in HS and college. I am fairly new to biking, I just started covering longer distances a couple months ago and now bike ~40 miles/week.
Sorry this is so long!! Thanks for your help/experiences/advice!!
The Mildest Nihilist
OK, I don't know anything about Patellar Tendonitis other than that I have been dealing with it myself since April, and it's frustrating! I'm getting the sense that it's got a whole bunch of different, but similar, causes related to the hips, quads, IT band, etc.
For me, I mostly only feel my knee when I'm running. But if I've irritated it by running, then I'll feel it for the rest of the day during other activities, particularly going down stairs or other exercise. It does swell some, but it hurts when it swells- both in the same spot, just at the bottom of my kneecap, slightly towards the outside.
I tried biking a bit while I was trying to get past it by not running for a while, and the only time it hurt while biking was when I stood on the pedals to go up a hill. But I'm sure it would hurt if I went out when it was already irritated.
As far as intermittent, yes, progress seems to be of the two steps forward, one step back variety. And yes, I can run through it, but I think you can only run on it to a point before you do risk doing some damage to the tendon, or at least having the injury hang on for longer than it should.
Best of luck to you!
PRs: 5K: 25:35 / 10K: 53:03 / 10mi: 1:26:15 / HM: 1:55:02 / FM: 4:50:35
Wow. Your experience sounds very similar to mine. Thanks for your response.
Have you had success with anything like stretching, rest. etc...?
I started with rest and that seemed to help, but wasn't enough to fix it. Right now I am in PT and we are doing a ton of strengthening exercises for the hips, glutes, and quads, plus just a little bit of calf stuff. At home, I do my assigned exercises and have also started single-leg decline squats. Plus I do a lot of rolling with a roller and tennis ball, and stretch my quads and hip flexors. I find that I can run with my kneecap taped into position. Otherwise I'm really limited in mileage.
I have periodic patellar tendinitis, too, and it manifests similarly to yours. Things that seem to affect it:
I used one of the compression strap gizmos last summer (when it was especially bad) and found some relief. Something like this one.
“Everything you need is already inside.” -- Bill Bowerman
Thanks for your suggestions Zelanie and Clive F.
I will work on strengthening exercises and start single leg decline squats. Thanks for the link Zelanie. The photo of the damaged tendon is scary! I already know quite a few hip strengthening exercises, but am not familiar with many exercises that strengthen your quads. Would you mind sharing what you have been doing to strengthen your quads?
I will also experiment with run duration, frequency, form and shoes. I rotate shoes and now that I think about it my knee (while running) has only ever hurt while running in my older pair of shoes... I also notice that I can decrease my knee pain if I consciously focus on my form.
Its always encouraging to talk to other runners about what has been successful
Will run for scenery.
It seems there are many different causes of knee pain, so the best thing (if possible) is find a really competent specialist and have them examine you. But that may involve too much $$$.
So the next best thing, I guess, is work at strengthening just about everything from the jawbone down and see what helps !
In my case, running downhill would set off a round of knee pain that would force me to stop running for a week, or 2, or 12.... What seemed to be the magic bullet for me was strengthening my quads. In particular, the one that ends just above and toward the inside of the kneecap. Aparently running strengthens the muscles & "stuff" that pull the kneecap towards the outside, but not the medial quadriceps, at least not as much.
The exercise that made it possible for me to run again was leg extensions. That's a standard gym machine where you sit and put a bar across your shins and raise your leg until it's straight out in front of you. The most important thing is to keep the weight light and move your leg slowly. If you go fast, the other stronger quad muscles set the weight in motion and you just "coast" through the final part.
Anyway, in my case this one thing made all the difference. I've run (and raced hard!) down hills with no pain. Very recently I had a touch of knee pain come back after a run, but I think it's b/c I've neglected the gym since my last race a monrh ago.
Anyway, this may not be the exact solution to your problem, but the point is that there are things that make many types of knee pain go away. So don't be discouraged ! Keep searching!
Oh also, it seems odd (to me) that bicycling would cause knee pain. Are you sure your bike is set up right for you (seat height, crank length, etc.) ? It's just that I always thought of myself as someone with "bad knees", but biking never hurt at all.
jjs22, Running downhill definitely seems to aggravate my knees the most. In fact, they even hurt while walking down stairs at this point. I tried the leg extensions and they don't hurt my knees so I will continue doing them. Hopefully that will help!
I stopped biking and took 5 days entirely off of running Both knees are very stiff while walking, and I don't want to push it too much. I tried roller-blading today though and that actually bothers my knees even less than walking! I am planning on continuing that as a form of cross-training as I build back into running. I got a few strange looks, but there are worse things.
Edit: I talked to a few people about my knee pain while biking and I think I was biking on too high of a gear (I rarely switched my bike from the highest gears) and my seat was too low. I raised my seat and have been working on increasing my cadence and biking in lower gears. This has helped significantly.
As long as the leg extensions/strength training cause no pain, definitely stick with it for a month or so. It might not be the cure, but then again it might !
R.E. the biking, having your seat up high (leg almost completely straight at bottom) is way,way easier on the knees as are lower gears : spin, don't grind.
And, BTW, if you're in someplace hot and rainy : go for a swim !
10 weeks with a, "proximal patellar tendinopathy" after running a marathon that is annoying the heck out of me. Saw a physio just over a week ago and he reckons I can start a rehab program in now 3 weeks time but I know it's not that simple. He said I need to deload the tendon until then by strapping (among other things like trigger point with elbows and stretching my quads). The strapping he gave me was fat pad deloading technique but he reckons it does the patella tendon too. I don't know if I even trust physios because I know more than he seemed to know from my obsessive researching. I don't know what to do but when can you start? Like, what was the, "go" button he told you?