Patellar Tendonitis at Tibial Tuberosity (Tubercle) (Read 106 times)

I am an off and on sufferer of patellar tendonitis with pain at the tibial tuberosity (the bump at the end of the patellar tendon). (Note: the tibial tuberosity is also called the tibial tubercle). This bump (tibial tuberosity/tubercle) is the only location where I get the pain, and from my research I have found that patellar tendonitis at this location more commonly affects distance runners.

Do any of you have experience with this type of patellar tendonitis and how have you managed to overcome this condition? Any thoughts, strategies, or experiences you have would be greatly appreciated.

A little more background: from my research I have found that most athletes, particularly those in jumping sports (basketball, volleyball), tend do get patellar tendonitis more commonly at the insertion of the patellar tendon into the patella (knee cap). Individuals who get it at the insertion into their tibial tuberosity are less common and it tends to affect runners more than athletes in jumping sports, although both types of athletes can get patellar tendonitis at either location.

I have been suffering from this current episode of tendonitis for about 7 months. I stopped running, was doing single leg squats but they were also aggravating my condition so I am now doing more static holds (on a leg extension machine) and stretching but with minimal, very slow progress. I have not found a lot of information regarding any specific treatments or strategies for people who have been affected by patellar tendonitis at this location.

I will hijack the thread. I have the same symptoms on the right side. Started after 10 of 14 weeks of half marathon prep and I wasn't going to not race. Now I am concerned. 4 days after the race and I still feel the pain when extending my knee.

Age and sex? 37 m

Swelling? Nope

Pain while walking? Just when climbing stairs.

Pain at rest? Only when I stretch the leg fully

Pain while bending knee? No

Does discomfort go away in middle of a run? Mostly post run.

Running history over the years? I have run 10mpw for the past 3 years and ran 20-35mpw during the 14 weeks before the half.

Did this occur out of the blue, gradually or after ramping up your training? After ramping up to 35miles...

Treatments or modalities you have done? Icing and complete rest during week 13 but that only made it go away temporarily. A short run on day 8 brought the pain right back.

Have you seen a sport medicine professional? Not yet

Have you had your running gait analyzed? No - they did a stance analysis at the shop. I overpronate and have flat feet but strong enough muscles to counter this. So I run in asics nimbus or hoka cliftons or brooks ghost. The drop in the brooks and asics might be too much. I will restart in the hokas.

Are you a heel striker and excessive pronator or supinator? Well I try to hit the 180 strides per minute and am pretty consistent.

My plan is to completely rest for 2 weeks and to start with dynamic stretches plus the tilted one leg squats (board on sidewalk and 3 sets 15 reps of one leg squats but just the down movement) plus clamshells. I was wondering when I could start to pool run or cycle on the stationary bike in order to maintain some of the fitness.

Thanks in advance everyone!

Take the time you need to heal. 2 weeks likely not enough......as mentioned above, strength and core work are crucial for muscle/tendon strength along with other posterior chain work and core work. Google running core exercises. Also, one leg squats are advanced. If you feel they are too much start with 2 leg bodyweight squats or grab a kettle ball while squating. Mix it up and be gradual when you come back. More than anything.....take the time you need. I have no issue with biking or other cross training and likely the biking will help your condition.

Thank you OFR, Chuck.

 

I have been doing loads of core strenghtening 3-4 times a week. That's not the issue. It's more so the tightness of quads and hamstrings and the sudden increase of mileage. It also got worse as I increased squat exercises and lunges in parallel.

 

I had googled exercises for PT recovery before and I think the one that I will definetly incorporate is the single leg squat down to 60° on a slentered surface (& just the downward movement) plus the other core exercises & some mild stretching - as soon as my knee stops hurting.

 

When would you advise me to start with aqua jogging / cycling in order to maintain some fitness? As soon as pain subsides?

According to the first article (read), let pain be your guide- once you get the initial inflammation knocked down- Icing after the activity helps keep inflammation down. Slight pain is to be expected in any rehab. If the pain gets worse, you are probably working too hard, or it is still inflamed. Slow-mo and progressive is the key here. Any aerobic exercise you can do without it causing pain is good and will help your sanity. The problem is when you start back into running, you do too much too soon because your cardio is still in good shape. So just be mindful of this and set low limits of jogging and walking, then cut down the walk breaks until you are running for 30 min. straight. Then consider adding mileage with no speed. Once you get mileage to where you want and are there for 4-6 weeks, then start some light tempo or Fartlek, being very incremental.

Really, looking back,  not rehabbing and then upping my mileage too quickly and starting speed was my mistake. A good base for 6 months will help strengthen everything for any speed coming after.

IMO, running too little can be just as bad as too much-for someone who wants to race. You have to carry enough easy mileage base to support the faster speed work, or something will break. IMO, this is mileage in the 30s per week for most people.

So here is what I have found out in the last couple of days about my injury:

• It has become chronic which means resting won't help;
• My regiment now is twice a day eccentric slant board squats plus stretching, foam rolling and icing;
• Besides the squats I do the other exercises as well e.g. clamshell, planks etc.

The pain is starting to get less and the knee is feeling more stable.

After being pain free I will have to continue with the above for another 1-2 months before returning to running. This sucks particularly because I really dislike acqua jogging and indoor cycling so I think I will have to rebuild the fitness. I will update on any development that could be of help to others here.

Sorry to hijack this thread. I am 52 a old male and I have a six year history (and six different doctors) with the same symptoms. I had cortisone injections, a Tenex surgery (where the bad tissue is removed arthroscopically), and three PRP injections (the last one a year ago), many sessions of PT, acupuncture, stretching, foam rolling and so on, all with moderate success. My last doctor told me to aggressively strengthen quads and core, which I am doing the last 1.5 years. My exercise routine includes bootcamp classes with weighted squats and lunges. I have gotten much stronger, but I am not able to run more than 30 minutes twice per week before the tendon (and the knee) starts hurting. There is not much progress with this since I started strengthening, which is extremely frustrating, as I really want to run longer distances.

My doctor told me to consider giving up running as he is running out of ideas, but I don't want to give up now. Is there anything left over I could try? I have also tried single leg squatting on a slanted board, which makes it actually worse if I stick with the standard protocol (15x3 twice a day). Interestingly, my pain gets worse a day after the exercise. I would love to hear feedback as I am quite hopeless now and close to quit running.