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Thursday, June 26, 2008

Q&A: Patellar Tendonitis

Hi Mike,

I've been reading your articles on T-Nation, purchased Magnificent Mobility/Inside-Out and am beginning to incorporate both into training and non-training periods.

I have recently been diagnosed with patellar tendonitis in the right knee and was wondering if you could give any recommendations as to how to treat this. Should I be looking into your "Bulletproof Knees" book, or should something like Magnificent Mobility be sufficient (over time)?

Thanks for your time.

Thanks for contacting me James. I'm glad you're finding the products useful, and hopefully this post will help you get that knee 100% again.

First of all, you should know that true tendonitis is pretty rare - and if it is what you have, then high-dose NSAID's for a couple of days should clear it right up. What you probably have it patellar tendinosis.

While I think Bulletproof Knees would help, it's more of a post-rehab protocol. If you do in fact have patellar tendinosis, current research seems to indicate that eccentric decline squats seem to help clear it up pretty well. I would meet with a qualified PT, or at the very least do a thorough search on Pubmed to help you figure out the best protocol.

As I recall (and it's been a while since I read through the research, so don't hold me to this!), two to three sets of 15 repetitions on at least a 15 degree decline worked quite well over the course of several weeks. You have to perform these twice a day, and it's probably going to be pretty uncomfortable in the beginning.

The bigger question is - why did this happen in the first place? In my humble opinion, people who develop patellar tendinosis tend to be in a greater degree of anterior pelvic tilt on that side when compared to the unaffected side. What does this mean from a training perspective?

- You need more rectus/external oblique work on that side.

- You probably lack glute activation/strength on that side.

- One or more of your hip flexors on that side are either short/stiff.

So once you've cleaned up the tendinosis, work to iron out the side-to-side imbalances that most likely created it initially. This is where Bulletproof Knees would be the most beneficial - to help you get back to 100% after you've dealt with the pathology.

Good luck!


1 comment:

Brian said...

Dear Mike,
Back in 03 I started working out performed squats incorrectly. I read a book saying keep your toes straight or up to 45 degrees out,but for some reason I got to the gym and thought I was suppose to put them 45 degrees in. I did heavy squats and even jump squats. I went from running a 4.4 40 and a 34 inch vertical to running a 4.9 (slow for a reciever) and barley touching the rim. I have seen a physical therapist and multiple doctors but no progress. I am willing to try anything.If you have any advice or know of a program that needs a guenie pig please let me know. Thanks, Brian