I’ve been battling chronic Patellar Tendonitis (aka ‘Jumpers knee’ and some forms of ‘Runners knee’) for over two years now. I’ve written before about my problem in a post about Egoscue therapy, as I was exploring that as a treatment option for my ailment. Ultimately that wasn’t the right treatment for me, but I do now think I’ve stumbled upon a surprisingly simple ‘hack’ that has a profound impact on Patellar Tendonitis.
Being Diagnosed with Patellar Tendonitis
Before I get into my little discovery, first some backstory on my problem: About 2 years ago my knee felt really stiff after a playoff softball game. There was no pop or pain during the game, I just noticed some tenderness and pain when I pushed off. I figured it was no big deal and that it’d go away in a few days like most other small injuries, but it didn’t.
After giving it a few weeks, I decided to make an appointment at the family doctor to see what was up. He did some remedial tests and diagnosed me with Patellar Tendonitis. He sent me home with a printout of some stretches and exercises I could do to make it go away, but those unfortunately didn’t help at all. To make a long story short, I doubted the family doctor and went to see an orthopedist who specializes in knees. An x-ray and MRI later, the family doctor’s diagnosis was confirmed (sorry for doubting, Dr. Cohn!).
Trying Different Treatment Options
Ok, so I’m gonna wrap up this backstory. I don’t want to get surgery; Patellar Tendonitis does not have a good track record of getting cured via surgery. So I’ve been exploring and testing all my options… literally all of my options. These are my tests thus far:
- 8 Weeks of Physical Therapy – unfortunately this didn’t help, and it wasn’t fully covered by my insurance, so it was pricey for something that brought about no change
- Iontophoresis – These are little patches that use electricity to put cortisone deep into the tendon. These did relieve pain temporarily (4-24 hours), but there was no long-lasting improvement
- Cortisone Injections – the relief from these injections were instant, but lasted only 8-12 hours. I know these are a miracle drug for some, but it was only a superficial healing for me and it faded away rather quickly.
- Prolotherapy - This is similar to PRP (below)… basically they inject a glucose solution into the problem area. The theory behind this is that the solution irritates that area so much, that the body sends new (and lots) of blood to the injury, thus restarting the healing process. Sounds good in theory, and there are a lot of people who claim to have had amazing success with this, but no such luck for this guy.
- Platelet-Rich Plasma (PRP) – I only did this once, so I can’t give a fair review here. This treatment is really popular right now, and you’ll hear a lot of professional athletes (Tiger Woods, Troy Polamalu, LaRon Landry) talking about the success they had with it . What they did is draw my blood, then that blood went through several spin processes to separate the plasma from everything else. Finally just the plasma was injected back into me, but this time directly into the problem area of the knee. This was really, really painful for the first 24 hours. The plasma seriously irritates the knee, and it hurt. I decided a few months later that I was going to put this treatment option on hold and explore a few other things first. I haven’t completely abandoned it, I’m just not so sure it’s the right solution here.
- Egoscue - I mentioned that I was trying this out, but ultimately I couldn’t keep up with the demand of following my ‘e-cises’ 4-5 a week, at an hour each day. I do think that Egoscue is great for improving posture and overall health, but I’m not so sure that it is a specific tool for healing this precise injury.
- Cissus – I read about this in the 4 Hour Body book by Tim Ferris (which is great, by the way). It didn’t work for me, but I didn’t have high hopes for it anyway.
So all of those treatments, no solution, still painful Patellar Tendonitis. No running, often fitful sleep, discomfort when sitting down (think driving, plane rides, and even just relaxing on the couch), just general restlessness as I’m always searching for the next comfortable position to put my leg in.
Finding the Secret?
While doing another scan online, I stumbled across a study that compared the healing results of eccentric exercises vs surgery in treating and defeating Patellar Tendonitis. Their conclusion?
No advantage was demonstrated for surgical treatment compared with eccentric strength training. Eccentric training should be tried for twelve weeks before open tenotomy is considered for the treatment of patellar tendinopathy.
The eccentric part of an exercise is the part when you are elongating the muscle, not contracting. For instance, in a push-up, the eccentric part is when you are lowing yourself down. This study and some other literature seem to point to a healing power that eccentric exercises can have for this injury.
Connecting with the Flex-N-Go Founder
I figured this was absolutely worth a shot. The eccentric exercise for the knee requires just a slant board, which run about $60. A few days after purchasing this ‘Fitter First’ one on Amazon, I got to Tweeting with Kelly at Flex-N-Go. As luck would have it, she specializes in making high quality slant boards and said she’d send one over to help me out. Perfect – I’d be able to test out two slant boards while also putting the exercise to the test.
Well, first off, which board was better? Kelly’s Flex-No-Go board, no doubt. Its super sturdy, light weight, and I have no fear while on it. The other board featured the ability to change the angle of the slant, and while this may be useful for some, I didn’t need that feature and the angle-adjustment capability added instability to the board, which is exactly what you don’t need when you are working on a bum knee. I won’t spend too much time on a comparison because there isn’t one – Kelly’s is great and it is the one I’d choose(that is my honest opinion, I would tell you if it wasn’t). However, if you need multiple slant angles, go with the ‘Fitter First’.
Here are a couple of shots of the Flex-N-Go board:
The Secret Exercise
At first I thought I was doing things wrong. Doing the eccentric squat, basically squatting down, was really painful right in the spot where I can pinpoint the pain of the Tendonitis. I didn’t realize that I should be feeling pain there, so I thought I was doing something wrong. Well, after even more digging, I found that I was definitely supposed to be feeling it because it is literally isolating my knee/tendon on the board so that it has to do all of the work – the slant board basically takes away the hamstring and quad’s ability to help lower me down.
So what I did is I stood on the board with both feet, placed 90% of my weight on my left leg (the one with the tendonitis) and lowered myself down on a slow 4 count. Then, once at the bottom, I switched my weight over to my (good) right leg and straighted myself back up. The result of this is that my injured knee does most of the work in the eccentric (down) phase of the squat, and my unaffected knee does most of the work in the concentric (up) portion of the squat. Here is a simple video detailing what I did:
I slowly scaled myself up over the course of 3 weeks from just 1 set of 10, to 2 sets of 10, and now 3 sets of 30 per session. I shoot to do this in the morning when I wake up, and at night before I go to sleep, but sometimes I only get one session in. The beauty of this is that it is so fast, just a 5 minute session and you are done. And, the equipment is really small, so I just keep it in my bedroom where its really convenient to do after waking up and before laying down.
I can say that about 70% of my pain pain from the Patellar Tendonitis is gone. It honestly feels like the more that I do the exercise, the more stable my knee becomes and the less pain and irritation it has. I highly recommend looking into eccentric exercises if you are dealing with any sort of foot or leg injuries, from Plantar Fasciitis and Achillies Tendinitis to chronic leg cramps.
I’m thankful for this experience because I learned a lot about testing and researching treatments, which is valuable experience to have, particularly when you are dealing with something much more serious than an inflamed tendon.
Are you dealing with Patellar Tendonitis? Or have you used a slant board before? Let us know about your experience in the comments!