My FiveFingers – Vibram, FiveFingers, Toe Shoes, Minimalist Shoes

A fan site all about Vibram FiveFingers, Minimalist & Barefoot running, and Healthy Living!

Join the Community

Search

A Surprisingly Powerful Tool to Combat Chronic Patellar Tendonitis

by Brian Patterson » on May 11, 2012 499

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.

knee pain patellar tendonitis

Sporting a knee brace to keep my knee warm and 'restricted' during sports. I really wanted a treatment to make the injury go away, not just treat the symptoms.

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:

      1. 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
      2. 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
      3. 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.
      4. 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.
      5. 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.
      6. 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.
      7. 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 Flex-N-Go Baord, side view

Front view of the slant board

And the back view

 

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.

The Results

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!

 


499 Comments

  1. Tyler Hurst

    May 11th, 2012 at 4:06 pm

    Yes, in my right knee. Current treatments include not using it, ice, and a McDavid strap.

    Love this idea, though. I’d like to be rid of it.

    Does your knee hurt during runs? Mine usually don’t, because I don’t push off much.

    But tennis? Ouch!

    Reply

    • Brian Patterson

      May 11th, 2012 at 4:10 pm

      Hey Tyler, I forgot to mention that I tried the strap as well, but that really had no impact at all. Does it help you?

      When I try to run for speed I definitely feel it and it hurts, bad. If I’m using good form and just running to enjoy it, I can make it a mile or so before I’m done.

      The odd thing is that I can play basketball for 30-45 minutes or so before I have to call it quits. My brain is able to block out the pain a descent amount when I’m chasing a bouncing ball around. Eventually the pain catches up to me though, and it takes a solid 2 days to get the swelling down.

      Reply

      • conor

        March 14th, 2015 at 8:05 pm

        i have a question for ya brian… but I see this is back in 2012

        are you still on here?

        Reply

      • Julie

        July 30th, 2015 at 8:13 am

        I can t view the video. One question , I have been diagnosed with tendinitis in both knees. How ever, the pain I have seems to be more when I’m sitting or laying down that my knees just want to keep moving and the only way to relieve the pain would be to get up. Sometimes I try to pop them but it doesn’t work often. Would the slant exercise help this as well?

        Reply

        • H singh

          September 11th, 2015 at 3:55 pm

          Hi, try linnex muscle rub, provides long lasting heat to injured knee….

          Reply

  2. Will Kimbrough

    June 13th, 2012 at 8:10 am

    I have been running, walking, hiking barefoot for over three years. It has changed my life for the better. I am curious if you think this stretching board is better than the good old heel drop on the stairs calf stretch. My knees, hips and back have been pain-free since I adjusted to barefoot and minimalist life (I rarely wear footwear to run, walk or hike, but do own some flat skateboard shoes and a pair of Sockiplast socks), but I have nagging Achilles Tendon pain. I just got The Stick and hope that will help. I soak in epsom salts, use ice and heat, but that ACL is sore almost every morning—-I stretch upon waking up, gently, on the stairs, dropping my heels for 30 to 60 seconds, on my way to turn on the coffee maker. Anyway, hoping The Stick will help. Love your site.

    Reply

    • Brian Patterson

      June 13th, 2012 at 9:24 am

      Hi Will, I’m not sure how it would compare to stretching on the stairs. In theory, they should be pretty similar, but in practice there could be small motions that make a big difference.

      My issue was with the Patellar tendon, so I’m not sure of the effectiveness of the stretch on the ACL, but it has basically been a miracle for me.

      I would say to try the stick for a month and see where it gets you. If nowhere, stop using it, and try something else. The more you test things in isolation, the more you will learn about your body and what is working for you. Good luck!

      Reply

      • Edmund

        February 03rd, 2014 at 12:24 am

        Something I used that worked out was a product called Voltaren Emulgel by a company called Novartis. I am not sure if it is available in the USA though. In Canada you can buy it at most pharmacies. Using that plus heels on an old catalog and squatting but now I will buy Kelly’s board to use instead of the catalog.

        Reply

    • Kelly

      August 01st, 2012 at 10:10 pm

      Hey Will, let me share my experience. I suffered with terrible Foot pain. The heel drop exercise is great. The board enhances it and perfects it. You will be amazed.

      Reply

  3. Brent

    August 08th, 2012 at 12:22 pm

    Interesting article. I had patellar tendonitis about three years ago and it slowly went away after about four months… Unfortunately, it has returned this year (in full force). I cannot seem to shake it. I know for a fact that mine is drawn from impact on a hard surface – as it developed both times from playing on the exact same indoor field. No other indoor field has led to the issue.

    Anyway, I play competitive Ultimate Frisbee, and it requires a lot of starting/stopping for change of direction as well as plenty of hard sprints and jumping. This year, I have tried taking a few weeks off. Currently, I’m trying to floss my quad and the area regulary. I am also doing eccentric squats, but I haven’t had much results year.

    What is the best treatment?!

    Reply

    • Jeremiah

      December 26th, 2013 at 7:33 pm

      For what it’s worth, my patellar tendinopathy can be traced to Ultimate frisbee as well.

      Reply

  4. Lauren

    September 14th, 2012 at 12:26 pm

    Hi,

    I’ve had achilles tendonitis in both my legs and eccentric loading has completely banished the pain. I no longer feel it as much, but if I do it’s very minimal, like it’s never there.

    Eccentric loading works!

    Reply

  5. Steve

    September 28th, 2012 at 7:38 am

    I had patellar tendonitis for years at varying degrees. I learned this technique from an Active Release practitioner, and it works to clear it up every time. I always work up progressively and methodically, and within a week it’s mostly gone. Now, since switching to VFFs exclusively, I haven’t had any issues with it in almost a year.

    Reply

  6. Samantha Saccomanno

    October 17th, 2012 at 12:38 am

    Hey Brian!
    My name is Sam Saccomanno and I think I have the same knee problem that you had. I am a senior in high school and during my sophomore year in track (spring season) I developed my knee pain. I’m pretty sure I developed it from sprinting and lunges (i would do 1/4 – 1/2 miles lunges a week). At first I didnt do anything and I kept sprinting and jumping on it. After a month I had to stop because it hurt so bad. It has almost been two years now and I still can’t run. Ive gotten an MRI, X-Rays, PT, Chiropractor…and I might do Prolotherapy. I have been told that I don’t qualify for surgery because it isn’t internal. One doctor said I have chronic tendonitis. Now, I swim and power walk and ice. It is SO frustrating because I love sports and being active. I just ordered 5 fingers and the Flex-N-Go board from your video. Any other options?

    Reply

    • Brian Patterson

      October 17th, 2012 at 9:42 am

      Hi Samantha, I think FiveFingers and the Flex-N-Go board is the way to go… at least that is what worked for me after several years of dealing with this.

      I can’t give medical advice, but I would say that if I was in your shoes, I might hold off on prolo for a few weeks and give the slant board a try, scaling up using it over a couple of weeks.

      Best of luck, and please post back and let us know your results, good or bad!

      Reply

    • meghan

      April 14th, 2018 at 10:13 pm

      Literally. Me exactly. I cant do anything i love (hiking, biking, running). I work out every day but now i just do upper body, every other day light elliptical, and my physical therapy exercises to activates my glutes. I am 22 years old. I am so restricted. I recently got into yoga and now its even more irritated. I have tried all conservative methods and 3 months ago I have PRP. It honestly hasnt seemed to help. Idk what else to do. Someone help :(

      Reply

  7. Omar Elsahn

    October 27th, 2012 at 8:22 pm

    Hey Brian thanks for the video, i’ve been dealing with Patellar tendonitis for 6 months and i’m now doing a similar exercise to the one you’re showing except im doing it on a chair.. My question for you is doesn’t this exercise make your knees worse thought? I don’t know about you but my knee starts hurting after i’m done a little bit but sometimes i feel my knees are strong after doing them thought.. But did your knees hurt after doing it?

    Reply

  8. Omar Elsahn

    October 27th, 2012 at 8:23 pm

    Hey Brian thanks for the video, i’ve been dealing with Patellar tendonitis for 6 months and i’m now doing a similar exercise to the one you’re showing except im doing it on a chair.. My question for you is doesn’t this exercise make your knees worse thought? I don’t know about you but my knee starts hurting after i’m done a little bit but sometimes i feel my knees are strong after doing them thought.. But did your knees hurt after doing it?

    Reply

    • Brian Patterson

      October 30th, 2012 at 2:46 pm

      I inadvertently responded to Omar’s post above via email rather than a comment. Here is what I shared with him:

      Hi Omar, thanks for your note! I can’t give medical advice, but I can tell you what I would/did do. But you should consult a medical professional before copying anything I say.

      My knee definitely does hurt during and after the eccentric exercise. At first I thought it wasn’t working or that I was doing it wrong or something… but after researching more it seemed that it is supposed to cause some discomfort, and that things should really start slow and don’t push too hard. But for me, yeah, it does hurt. But that goes away after a few hours and I’m better the next day.

      Thanks,
      Brian

      Reply

  9. Omar Elsahn

    October 30th, 2012 at 2:41 pm

    Thanks for your reply Brian.. I just had a few more questions:
    1. So did you get rid of patellar tendonitis? If you did, how long did it take you to get rid of it with this exercise?
    2. When you had Patellar tendonitis did your knee make a crackling/cracking noise when u bended it?
    3. How come this exercise is good for Patellar tendonitis if it makes it hurt?
    Thanks again in advance Brian

    Reply

    • Brian Patterson

      October 30th, 2012 at 2:44 pm

      Hi Omar,

      Here are the answers to your questions:

      1. It took a few months of religiously doing this to get almost completely better… but I did get some good results pretty early on.

      2. No, I didn’t have any crackling sounds in my knees. My wife has that, but doesn’t have any knee issues, so I’d check with a physician to see if the sound is related to the injury (my uneducated guess is that they are not related, but I don’t know)

      3. Good question – I don’t know why the exercise is effective overall, so I’m not sure why there is some pain/discomfort involved. The eccentric piece is still a mystery to me, but it worked in my case. I’ve come to appreciate the pain in the exercise. But again, I’m not a doctor or expect, so consult one first before trying this all out.

      Thanks!
      Brian

      Reply

      • Omar Elsahn

        October 30th, 2012 at 9:29 pm

        Thank you!
        I just want to know, when i bend my knee back and forth and straight it out i crack something in my knee. Is this a good idea?

        Reply

        • Brian Patterson

          October 30th, 2012 at 9:31 pm

          I don’t know the answer to that. I think the best thing to do is just check with a doctor and get their opinion on everything. If your body is telling you ‘no’, don’t do it.

          Reply

          • Omar Elsahn

            October 31st, 2012 at 1:29 pm

            Wait?
            How many reps/sets/sessions you do a day of this workout?

          • Zimbalist

            May 11th, 2013 at 8:29 am

            I also had the clicking. Apparently, so the specialist tells me, it’s a problem with the knee cap tracking; because of the patella injury you (often unwittingly) use the various leg muscles in different ways to compensate for the patella injury. Consequently, one of those muscles exerts greater force on once side of your patella, causing it to become slightly misaliged from the “grooves” on which it usually tracks. The clicking is when the patella clicks back into the grooves.

            At least that’s what the physio and specialist told me.

  10. Omar Elsahn

    October 31st, 2012 at 10:10 pm

    Oh and do you still have pain or did you get rid of it and you’re back to your activities pain free?

    Reply

  11. Omar Elsahn

    November 23rd, 2012 at 5:50 pm

    Hey Brian forget about the other questions. I just want to know did you do any physical activity along with using this slant board or did you take time off from all physical activities and only use this? And how did you build your leg muscles?

    Reply

    • Brian Patterson

      November 25th, 2012 at 10:06 pm

      I took time off of anything I didn’t have to do. I didn’t run or play pickup basketball or soccer for several weeks while I focused on getting my knee better.

      Granted, I did this for every different treatment option I tried.

      If I were you, I’d take it really easy.

      Reply

      • Omar Elsahn

        November 25th, 2012 at 10:34 pm

        I have muscle imbalance on my tendonitis leg and it is smaller than my other leg. When i work it out at the gym on the leg press, it feels strong but later it feels weak.

        Reply

        • Robb

          November 27th, 2012 at 11:54 am

          I think the muscle imbalance and instability is a big issue with PT. I have noticed with intense stretching that my bad PT leg has a lot less flexibility than my other leg. I think constant stretching of these large muscles is critical, along with daily icing, independent strength training of the less flexible leg to fix the imbalance you describe, and then the Eccentric Exercises which I am going to start when my slant board arrives.The worst thing I have done is to do nothing with PT. It will not heal without you prompting it but you also cannot keep reinjuring. I had to totally quit playing basketball. However, no activity was as bad as the activitiy inself. As a result, strengthen the legs and improve your flexibility to stimulate the healing process. I am also trying an anti-inflammatory diet.

          Reply

          • Kate

            November 08th, 2015 at 4:59 pm

            I see this was a few years ago now, but can you point me to any good resources around anti inflammatory diet? Did it help? I am a personal trainer struggling with patellar tendonitis and I’m considering going down this route but it’s hard finding a reliable source.

  12. Shane

    November 26th, 2012 at 4:42 pm

    Hi Brian. I play Australian rules football semi professionally and over the last year or so, I have battled tendinitis quite badly. It has affected my speed and balance. Sometimes it is so bad I even cannot run on grass. I am very interested in giving this a go. How long till you first noticed a result

    Reply

    • Brian Patterson

      November 26th, 2012 at 4:45 pm

      I think it took a couple of weeks before I had a noticeable improvement (its been a while so I don’t remember exactly).

      Let me know if you do end up trying it and what your results are.

      Reply

  13. Robb

    November 27th, 2012 at 11:46 am

    I have been battling Chronic PT for over 2 years. Did not know what it was or how to treat it until I had reallly damaged it and made it chronic. Now Im trying to overcome it. Mine was originally an overuse injury from basketball. Now I cannot hardly play at all because I have injured it so much repeatedly. Doctors are of no use. Im stretching constantly and that is helping. Im also doing lots of strenth training on quads, hams, calves, etc. I just ordered the slant board and I hope the eccentric exercises work. I will say the stretching is a very key component. I believe that these large tight muscles really overstress the tendon. I even get immediate relief from stretching. However, I hope to get it healed and maybe the slant board will help accomplish this. Also going to a diet of anti-inflammatory foods. This condition is very frustrating to people who enjoy sports and working out.

    Reply

    • Omar Elsahn

      November 27th, 2012 at 1:53 pm

      It’s a pain in the ass Robb.. I feel bad for you man that must be annoying as shit. For me i have pt in my right leg and i noticed that the quads on my right leg are smaller than my left. And when i workout my legs on the leg press i noticed that i get sudden relief and it feels strong and doesn’t hurt.. But at night i feel discomfort in my knee.. I think strength training is very important but i don’t know if its bad for the knees itself. I’m working out my legs along with this board.

      Reply

  14. Ian J. Gibbons

    December 03rd, 2012 at 5:20 pm

    It’s great to see all of the comments on this site. I’ve been dealing with patellar tendonitis in both knees for over two years. I first tried physical therapy but I was working a job that required me to run so it wasnt effective. I then had once knee scoped which although it was successful, didn’t cure the tendonitis. I’m now in physical therapy again working strength/flexibility. I’m not having the results I’d like and its crazy expensive. I’ve seen this used before and your story has motivated me. I’m going to get this board and hopefully reclaim my active life.

    Reply

    • Brian Patterson

      January 09th, 2013 at 9:33 pm

      Good luck, Ian. Circle back and let us know how it worked out!

      Reply

      • Ian J. Gibbons

        March 14th, 2013 at 10:30 pm

        Well I’ve finished with my physical therapist and while it has helped some…I’m not quite where I’d like to be. I will say that in PT they have really strengthened by glutes and thighs which provides support, but not quite enough. I have just ordered the slant board and will give it a shot. I can’t knock my PT but I’m hoping this will carry me the rest of the way in addition to their program.

        Reply

        • StuartR

          December 28th, 2014 at 4:17 pm

          Hi Ian,
          Just reading this for the first time. I am in the same place as you were: months of work strengthening glutes but PT is no better. I just ordered the slant board. Now you are 2 years or so on, did the slant board kick start tendon repair in your knees?
          Please let me know if you get this, I’m desperate to hear of any success stories!
          Stuart

          Reply

          • Ian

            December 28th, 2014 at 8:33 pm

            Hi Stuart,

            I’m sorry to hear you are also dealing with knee tendon issues. Before I share my progress I want to recommend that you be absolutely sure of your diagnosis. Do you have tendonitis or tendonosis? Treatments are very different. Is it in your patellar tendon, quad tendon or both? Now where am I at.

            The slant board unfortunately did not help as I had hoped because I also have quad tendonosis so while it helped my patellar tendon, it made my quads worse. It still helped my on my journey and pointed me in my latest direction, Graston technique. Since doing graston which is like deep tendon massage, I have gotten MUCH better. I scaled back my leg exercises and by pairing Graston with a slow approach I’ve seen more gains in 1 month than I did in 6 months of PT. I HIGHLY recommend and am hopeful.

          • Rhys Luxford

            May 05th, 2017 at 5:41 pm

            Hi, I want to hear some more success stories, how is your knee holding up?

  15. Josh

    December 09th, 2012 at 6:18 pm

    Hey Brian, i’m 14 years old and i’m not sure if I have Patellar Tendonitis but the symptoms are very similar! I have been skateboarding for 2 years. Very recently I smacked my kneed against my metal bedstead and i’m afraid this has affected my knee strength. I used to skateboard every day, and only after 3-4 hours my right knee (my knee for popping) started to hurt. I assumed this was from skateboarding for too long. But now after the bang from the bedstead, I can barely walk, I cannot jump or take part in P.E. Bearing in mind my injury happened about 2 weeks ago. Would the Flex-N-Go benefit me? Or do I just need to rest my leg for longer. Please reply soon! Regards, Josh.

    Reply

    • Brian Patterson

      December 09th, 2012 at 9:07 pm

      Hi Josh, I’m really not the right person to diagnose this for you, I’d recommend talking with your parents about going to see a doctor. A family practitioner (family doctor) was able to diagnose my problem, and the orthopedic doctor simply confirmed it. So I’d go see your family doctor and have them diagnose it.

      Best of luck, and update us on how it went.

      Thanks!
      Brian

      Reply

  16. Robinson

    December 14th, 2012 at 10:33 am

    I’m curious as to how big it is – how tall is it? How deep front to back?

    Reply

    • Kelly

      December 15th, 2012 at 11:01 am

      The Box dimensions vary as each box-board is built by hand. However they do run close to 8″ high 17.5″ long & 12″ wide. Thank you.

      Reply

  17. Claire

    January 08th, 2013 at 11:35 pm

    Just bought the Flex-N-Go and I’m trying your exercises. I’ve been down all the avenues you have with my patellar tendonitis; physical therapy, hot and cold packs, massage, and PRP (which cost me a ton!). The success rate of surgery is low so I opted out of that. Thanks for posting this information. I have high hopes for these exercises and will let you know how it goes. Also, check out the Rumble Roller. I discovered it on this website http://www.fix-knee-pain.com/injuries/patellar-tendonitis-knee-tendonitis/ along with some great exercises for strengthening your legs.

    On another site, which I can’t find right now, another person started “loading” on the slant board, after they had progressed a ways on the slant board with just eccentric exercises. Basically, they wore a backpack while doing the exercises, slowly adding 5 lbs at a time, with fantastic results. Could change YOUR healing from 70% to 100% maybe….

    Reply

    • Brian Patterson

      January 09th, 2013 at 9:33 pm

      Hi Claire, thanks for stopping by. I love the Flex-N-Go, it is so sturdy. It sounds like you tried all those other treatments as well, so hopefully you’ve found something that will finally work for you!

      Thanks for posting about the roller. I also have IT bands that cause issue from time to time, and I use a foam roller to work those loose. It hurts so good!

      Agreed on the loading, I should be doing that! Thanks for pushing me. Gotta find a backpack.

      Brian

      Reply

  18. Chris

    January 09th, 2013 at 6:16 pm

    Hey Brian, when you did the lowering/eccentric part on the board, you said you’d lower to the bottom on a count to four. How far down is “the bottom”? Did you work up to going all the way down or did you go half way for a while? Also, how much pain should be felt going down? I get 1/2 way and I have to take some weight off because of pain.

    Thanks,

    Chris

    Reply

    • Brian Patterson

      January 09th, 2013 at 9:30 pm

      Hi Chris, I just lower as far as I can comfortably go… pretty much to the point when it transitions from discomfort to pain. I don’t want pain, but some discomfort is ok.

      How low I went increased over time. It went from a not-very-deep squat to maybe a 90 degree angle.

      Again… not medical advise, I’m not qualified to offer that… just what I did.

      Reply

  19. Kat

    January 13th, 2013 at 9:35 pm

    Hi Brian!

    I completely understand your frustration with you knee. I have been struggling with chronic patellar tendonitis for the past year and a half. Treating tendonitis is slow going and requires a lot of hard work and patience. Traveling from PT to the doctors is not fun. The doctors originally gave me a knee strap and that helped to take the pressure off the kneecap and made running pain free. However, I soon learned that the strap was only aggravating the problem and further weakening the knee. Every time I took the strap off after practice the inflammation, stiffness and pain would be worse. The knee strap also caused me to put more stress on my uninjured knee and now I have tendonitis in both knees. I have learned that the knee strap is not a permanent solution to tendonitis, but rather an aid to recovery. I have been in and out of physical therapy this year and I have been doing exercises to help strengthen my legs. In physical therapy I have also been working on “fixing” my stride. Pronation of the foot can lead to knee and hip problems. PT has helped some but I believe in addition to PT your exercises might be the key to treating my tendonitis! Already I am having some success and my knees are feeling better. I was wondering if you knew any more eccentric exercises to help my recovery.

    Thanks,
    Kat

    Reply

    • Omar Elsahn

      January 13th, 2013 at 10:32 pm

      Kat, i had a question for you:
      You said that already you’re having some success and my knees are feeling better. Are you having success and your knees are feeling better because of physical therapy OR because you tried the slant board exercise?

      Reply

    • StuartR

      December 28th, 2014 at 4:20 pm

      Hi Kat,
      Now you are 2 years or so on from this post you may not get the email but, did the slant board kick start tendon repair in your knees?
      Please let me know if you get this, I’m desperate to hear of any success stories!
      Stuart

      Reply

  20. Graham Sutherland

    January 14th, 2013 at 7:51 am

    Hi Brian

    Thanks for all the info. I’ve been plagued with knee trouble my whole adult life but PT has been the most frustrating for me. My other injuries got surgery and I recovered fully but this injury has pretty much ended me sports wise. Football (soccer) is my sport. I’ve taken a 3 month rest and haven’t healed a bit. I went to the cinema the other night and was in agony! That kind of pain after 3 months of complete inactivity? Not looking good.

    So I’m going to try a slant board, I’ll return and post my findings in a few months. I’ve nothing to lose. Granted I’m not young anymore, just turned 41 but before the PT I was the fittest I’d ever been in my life.

    So to anyone else resting and not healing, you’re not alone! This injury is a real pest.

    If the board fails to help I’m afraid it’s game over for me. Fingers crossed. Good luck to you all facing this injury, I wish you well.

    Thanks again for the tips Brian.

    Kindest regards

    Graham

    Reply

    • Omar Elsahn

      January 14th, 2013 at 8:25 pm

      Graham, just a thought that might help you. I have had patellar tendonitis in the past 9 months and i started physical therapy on december 27 up until now.. That’s about 18 days in and i’m already feeling better. I asked my physical therapist about the slant board eccentric and he too said that he think it would be a great addition to my physical therapy exercises and that i should try it. But he also said that the slant board might work and also might not work because it depends on the person because everyone’s body is different and it can be different things triggering the tendonitis for different people. My point to you is that you should definately consider physical therapy because it can do wonders for you along with this eccentric slant board exercise.

      Reply

      • Graham Sutherland

        January 15th, 2013 at 2:09 pm

        Hi Omar

        Thanks for your advice. I have put off going to see my physio, I figured all I needed was some rest and recuperation. The pain I endured the other night though has me changing my game plan. I will indeed make an appointment and physical therapy is definitely on my agenda.

        Hopefully therapy along with the board will speed my recovery. I’m of the thinking I’ll never truly be rid of PT but if I can be comfortable enough to play then I’ll be content with that.

        Good to hear you’re doing well with your own recovery. I’ll return and update my progress in the spring. If we benefit from these techniques it’s good for others who are unsure. I’m hoping to be one of the benefactors!

        Kind regards

        Graham

        Reply

  21. MILLIE

    January 27th, 2013 at 10:49 pm

    I shattered my Patella in a fall. I have surgery & now the four pieces are trying to knot. The J pins are trying to pop out & now I have trouble even bending the knee to 40 degrees. any suggestion in how to walk normally again.
    BTW, I am 8 weeks since surgery & doing PT.
    I am 65 years you g as well!
    Thanks for any advise.

    Reply

    • Brian Patterson

      January 28th, 2013 at 10:32 am

      Hi Millie, wow, that sounds like a tough injury! That is beyond my experience, and I’m afraid I can’t offer much advice as I really only know a bit about Patellar Tendonitis. I do wish you the best of luck, though, and let us know how your healing goes.

      Reply

  22. stephanie

    February 01st, 2013 at 5:22 pm

    hi i have been having pronlems with both of patellar tendons and i am a avid basketball player. I was just wondering if it is bad to have it in both legs.

    Reply

    • Brian Patterson

      February 01st, 2013 at 5:27 pm

      Hi Stephanie, thanks for the comment. I’m not sure if it is worse in terms of the healing process, but I’d imagine it will take longer. One is bad enough, I can’t imagine having it in both knees.

      I played basketball this morning for an hour, and Wednesday night (2 days ago) for 2 hours, so relief is possible.

      Again, I’m no doctor, but if I were you I’d probably give the slant board a try. Since you have it in both knees, I would think you don’t even have to balance on one knee on the way up, you could still use both.

      Best of luck,
      Brian

      Reply

  23. Omar Elsahn

    February 01st, 2013 at 6:55 pm

    Hi, could this help chondromalacia? I have pain right under my knee cap but it’s minimal.. Where exactly was your pain?

    Reply

    • Brian Patterson

      February 01st, 2013 at 9:15 pm

      Hi Omar, sorry, that isn’t something I’m familiar with.

      Reply

  24. Omar Elsahn

    February 01st, 2013 at 10:11 pm

    Mmm ok, but can you tell me where exactly your pain was?

    Reply

    • Brian Patterson

      February 02nd, 2013 at 2:58 pm

      I feel the pain right underneath the kneecap, fairly close to the surface. I can press on it from the outside and it hurts… and God forbid I bump it on something because that hurts like crazy.

      But, all that said, I am so much better now than I was a year or so ago.

      Reply

  25. Omar Elsahn

    February 02nd, 2013 at 9:43 pm

    Just to let you know that is exactly what chondromalacia is.. It’s softening of the cartillage under the knee. I think they mis-diagnosed you just like they did with me..

    Reply

    • Brian Patterson

      February 03rd, 2013 at 10:20 pm

      That is certainly possible, although I don’t think it is the case based on the MRI, X-Rays, and doctors who looked at it. I could see the inflammation and what looked to be damage on the tendon in the MRI.

      Reply

  26. Tyler

    February 03rd, 2013 at 9:20 pm

    Hey, great article. I’ve been dealing with patellar tendonitis for the past year and a half and it has been a real burden. I play baseball and I feel it every time I throw and land on my left knee. It has subsided a bit but every once and a while it will flare up and I need to shut down. I’ll try this out though, hopefully it can work.

    Reply

    • Brian Patterson

      February 03rd, 2013 at 10:20 pm

      Hi Tyler, best of luck to you! Please circle back and let me know if it works for you.

      Reply

      • Ricardo Espinosa

        February 13th, 2013 at 12:30 pm

        Awesome article

        Reply

  27. Jeff

    February 06th, 2013 at 8:25 am

    thanks.will give these exercises a try. i am long time marathoner battling pt for over a year..tried most of what people have mentioned here,short of surgery..gotten some relief from pain but my knee is so weak i cannot run more than 2 miles at a time. my running career,such as it was, may be shot but i am not giving up yet!

    Reply

  28. Taylor

    February 07th, 2013 at 11:15 pm

    Hey all!

    I am having the same issue as you all! Except I have now, after being busy with school and not being able to work out a lot, developed some atrophy! =(, its not terrible, but enough to notice that when i walk, one glute and thigh muscle feels weaker than the other…

    I have been on a workout regimen (for my legs) of bike or elippltical for 15 mins, then lunges (boy wieght and occansionally 10-15 lbs weights), leg press (just started and doesn’t hurt at all!), and resistance training with a band.

    While the muscle in the leg appears to be bigger, it is not STRONGER persé…any ideas on how to REALLY strengthen that leg more?

    i have added ankle weights and sqauts (with the ball against the wall) to about 45 to me regimen as well!

    I really want to be back to normal by Mid March (I am joining a flag football league!) =)

    Reply

  29. Andy Dorrat

    February 11th, 2013 at 5:20 pm

    Hi Brian, thanks for

    Reply

  30. Andy Dorrat

    February 11th, 2013 at 5:23 pm

    Hi Brian
    Thanks for this website. Really good info.
    When I’m doing these squats, I find the first 10 really sore and then my knee totally loosens up and the last 10/15 to the point where there is ver little pain. Did you experience this when u started these exercises? I’m basically looking for encouragement that this exercise is working for me and I’m on the right track.
    Cheers
    Andy

    Reply

  31. Ricardo Espinosa

    February 12th, 2013 at 8:03 pm

    Brain, Your story is very similar to mine beside the fact you finally found something that worked. I’ve tried physical therapy two different times for 12 weeks at a time and the symptoms never seems to go away. It has been almost 2 years now and I am getting to the point where I am willing to try ANYTHING to get rid of this issue. Just like you said I am constantly moving my Left leg around trying to find a comfortable position but it seems like there isn’t one. I am going to order this slant board and try what you did but I have a few questions. After you did your exercises on the board did you use ice or heat or just stick with pain medication? Is this the only exercise you did while using the slant board or did you also do any other quad strenthening exercises? Where did you order your slant board from? I want to make sure I do this exactly like you did.. any information you can provide will be much appreciated. Thank you -Ricardo

    Reply

  32. Jean-Marc Aliphon

    February 13th, 2013 at 8:59 pm

    Hey dude, thanks for posting your experience on your jumpers knee, i too have the same problem for about 2 years and have tried most of the things you have aswell, prp, cortisone etc .. just wondering if you were able to do this rehab while still playing basketball (obviously limiting minutes) i just cant bring myself to sit out and not play. your thoughts on this would be greatly appreciated.

    Reply

  33. Mia

    February 18th, 2013 at 4:15 am

    Where was this six months ago? I’ve been doing this exercise for a week now & the pain went down from 10 to 6. About my history I’m a 10k runner. Six months ago I’ve increased my running distance to 21 km & did it way too fast which resulted into Patella pain. I had an MRI done, xtray done both showed nothing. I’ve tried chiropractor~~~ waste of money the pain did not go away. Physio ~~< didn't help either.

    Reply

    • Taylor

      April 02nd, 2013 at 4:11 pm

      Hi Mia,

      I am also a runner/athlete…i was a college gymnast.

      How long did it take you to feel healed? Did you completely heal yourself of it? And how many reps did you do? weights at all?

      Sorry to barge you with this but in May of ’13, it will have been a year i have been dealing with this issue…

      Thanks!

      Reply

  34. Mia

    February 18th, 2013 at 4:40 am

    To add to that I’ve also tried hot yoga the pain went away for a day.Cortisone~~ inject to your knee made the pain worse. Dr. recommended surgery which I refuse.

    Reply

  35. michael

    February 19th, 2013 at 11:54 pm

    hey Byran.. im a fighter of mma .. well when i first hurt my knee it was about 3 months ago,,an i’ve been trying every thing i cant to heal properly because i also use to train hard when it came to endurance for later rounds..but my main question is when can i begin tho simple sqwats you did to heal.. cuz i read on one of your coments to someone that when you play 40 or more min of b ball you wont go more well for me.. i like to train an train well for hours i really miss my gym an was hoping to hear back thanks dude..

    Reply

  36. Dimitris

    February 21st, 2013 at 9:54 am

    Hi Brian .I have PT for about 10 months now Im a tennis player an beach tennis player .
    I had diagnosed before 3 months on Pattelar tendonitis on both Knees wich became tendinosis.
    I had ACL and two miniscus sergery on my right Knee before 3 years after an accident.with my DH bike.
    Im a very high level active person and that seems to be my payment on all that thinks that I love to do..
    I made physio Therapy about 2 weeks sessions .But nothing worked Im again on Physio for some friction /massage therapy It seems not working again after 2 weeks and a half on Ph.Th.
    So a had read about eccentric squats and im doing them about 2 weeks now but with out ths slant board .I will make on and I give it a try on it. Im foam ROlling an streching every night before my bed time,It seems to relax me . Heat /cold pack its a day habbit for me now …

    Reply

  37. Cocotal

    March 03rd, 2013 at 1:33 am

    I used to have tendinitis in my “strong” leg from playing tons of basketball, and it didn’t help that I switched to Muay Thai when I graduated college (knees don’t really like heavy bag kicks).

    The way I got rid of mine is to strengthen the whole leg. How does one strengthen the whole leg, with tendon pain? Door-assisted single-leg squats. Full range of motion really beefs up the leg. Eventually you want to progress to unassisted single-leg squats (also called pistols). Check this out: http://www.beastskills.com/one-legged-squat-the-pistol/

    Note, you do NOT under any circumstances want to do the limited-range progressions on that website. For example, you don’t want to do the ones where you put a box under you — the sort of tension on the knee holding it above a box really aggravates the tendinitis, and I know from experience.

    Use a counterweight or a door or a band or a bar to pull yourself back up, but absolutely do use full range of motion. It will take a month, but you’ll be a freaking beast afterwards and won’t get anymore leg problems.

    Reply

  38. Mary

    March 03rd, 2013 at 4:37 pm

    Thank you for writing this, Brian. As a longtime explorer of the body-mind connection, an avid yoga practiioner, power walker, and recent martial arts student – I am just now coming into the home stretch of an 8 month knee tendonosis recovery journey, it was great to finally find your post.

    Knee tendon overuse injury & its accompanying stiffness reduced mobility is not only physically painful but also emotionally hard – it’s scary to have stiff joints that aren’t changing fast. It’s scary to feel like you hobble down the stairs and are prone to falling over easy if you’re in pain. And, taking a break from one’s usual physical workouts in order to rest the tendons, can really alter your brain chemistry with a depressing psychological effect and fear of premature decay of the joints, etc. This is not helped by reading conventional M.D./orthopedist perspective on knee pain (cut open the leg to move stuff around, or inject it with steroids) – it makes it even more depressing.

    My personal healing of knee tendonosis has been a revelation of longstanding biomechanical issues that I didn’t know I had. I discovered them after utilizing my best, highly-informed self-care (including eccentric slant board work – but it made things worse for me pain-wise, and I stopped in order to wait for pro feedback) with not much progress. By chance, I happened to get a new job with generous health insurance, and was able to start working with a unique physiotherapist lady (a triathlete with a PhD focused on A.R.T., not just the typical P.T. or chiro who completed one weekend workshop and proclaims they know & practice A.R.T.). She sourced my tendonosis as coming from scar tissue adhesion of my rectus femoris quadricep – and my TFL. Adhesions go back to childhood/adolescent injuries that happened during growth spurts followed by sedentary post-injury habits that made the tramatized tissue stick to the femur. I had many injuries as a kid (falling down stairs, a huge bicycle crash, skiing falls, to name a few) – and, living in a mountain town that was winter about 6 months of the year – I did do the sedentary post-injury thing, being a bookworm type. So, interestingly, my case history is one that correlates well with adhesion-based tendonosis – while other folks may have other root causes of their own knee pain.

    Some people don’t know that A.R.T. is not passive bodywork – you have to slowly move the area while the practitioner is doing bone-scrapingly painful deep release on it, so the CNS gets retrained. It’s very hard work, yet also wonderful for brain chemistry – lots of endorphins get released. It would be fascinating to study the similarities between eccentric squats and A.R.T. – as they both involve willingly going into pain and opening up properly aligned full range of motion!

    Anywoo, that and a nightly routine of prone, deep quad stretching, thrice a week supported squats/wall sits (like Cocotal said), and doing a temporary 6 week routine of wearing compression socks (the kind that go over the knee are fab) during my deskjob days, are giving me new legs! The compression socks are awesome for reducing edema and assisting with removing wastes from injured tissues – you can find them in black. I had tried T.K. knee sleeves as well as Zensah calf sleeves, but the P.T. explained that the compression action needs to include both the entire ankle and knee. They feel great on, too.

    ROM is completely restored, and I am just working on being able to load, build, and nourish this fledgling mobile RF quad muscle. The RF often has deepest adhesions where it attaches near the hip, and this affects the entire track where attaches below the knee, many people don’t understand how huge a role this plays when it is deformed or malfunctioning.

    So, different body structures and personal histories create different knee tendonosis… Some people may have beautifully functioning upper quads and have knee pain due to foot/ankle/gaits probs or one leg being longer than the other, for example. Other people who are over 40 & super healthy like myself, still have the hormone fluctuations that come with normal aging and can make for a slower recovery journey and a longer time of it.

    Recovery and full healing is indeed possible. You don’t have to go down the rabbithole of steroids and surgeries, it is indeed possible to heal and strengthen the leg so that you become an even better athlete in the end.

    Reply

    • James

      March 20th, 2014 at 5:59 am

      Hi Mary,
      Thank you for posting this information. Thank you also to Brian for posting the original article. Mary – I would love to hear how you are going now. It sounds like your A.R.T practitioner is the kind of person most of us on this site would like to have helping us.
      I should share my story. I have had tendonitis for 5 months. On advice, I iced my knee every night for 3 weeks and rested for a total of 6 weeks followed by 3 weeks of intense mobility exercises to loosen everything from my butt (piriformis) to my ankle including one of the weirdest Ilio-Tibial band stretches I have ever encountered. I also did foam rolling including something called active tack and stretch which involves the using the foam roller on the quad muscle until you find a really tight spot and then flossing back and forth by bending and straightening your lower leg while keeping your thigh on that tight spot – painful but effective.
      After the stretching phase, I did weighted squats with my heels elevated (as Brian did but with weights). My physical therapist suggested 2 seconds down, 2 seconds up and as heavy as I can bear – 25 reps, 3 sets with 30 seconds rest in between – I also concentrated more on keeping my shins vertical since one of the causes of ‘jumper’s knee’ is taking off or landing with the knee past the end of the toes.
      My pain became less but then came back any time I did any explosive movement like jumping or running. Apart from the fact that I did these ‘open kinetic chain’ exercises too early in my treatment, I know now that part of the problem was that I abandoned the stretches for a while. After Mary’s explanations above, I’ll be taking these up again. Especially since I visited an orthopedic surgeon who just shrugged and said “you’ll just have to manage with the pain”
      Well “booo” to you Mr Orthopedic Surgeon. I’m not giving up being active, including my favorite sport – snowboarding – if there is a solution.
      So I’m going to persist. I figure that if I keep trying things in an educated way, eventually something has to work. My plan now is to go back to stretching and rolling upstream and downstream of my injury to feed some slack to the patellar tendon, continue with weighted slow squats and building in some one-legged door frame squats (as suggested above) and wait another 6 weeks before I try anything involving faster movement.
      If that doesn’t work, I’ll try something else.
      Best of luck to you all.

      Reply

  39. Mat

    March 03rd, 2013 at 5:40 pm

    Hi Brian
    I got my tendonitis from dead lifting. One day I did deadlift then next day woke with pain in left knee. Below and bottom right side of knee cap. So rested lot of inflamation then after 3-4 days the other knee started to hurt.slowly progressed and I went through MRI ,PT and stuff. But no progress the weakness and inflamation was gone after 2 months.but lot of pain while walkin below knee cap little bit above knee cap. Have been resting a lot doctor told its tendonitis. I can’t walk or stand without pain. My question is should I start doing this. Did it hurt your knees while walking?what do you recommend? I am walking through pain. At least small walks.

    Reply

    • Ian J. Gibbons

      March 15th, 2013 at 11:27 am

      Your experience sounds very similar to mine, which I have been dealing with for nearly 3 years. I also injured myself lifting too heavy in the gym and not listening to my body. Similarly, I can’t stand or walk without pain and really sympathize. I went through 5 months of PT which has helped some but not quite enough. I’m going to give this board and exercise a try because I have seen and read numerous success stories. I say give it a go man. If you’re knees hurt like mine do then leave no stone unturned and pay any price for potential relief. You can email me at gibbons.ian@gmail.com if you want an update.

      Reply

  40. Ricardo Espinosa

    March 08th, 2013 at 6:21 pm

    Alright so I received my slant board exactly two weeks ago (thanks again Kelly) and I began using it immediately. but I do two legged squats not one legged. I started off doing one set of 10 once per day for the first week and immediately noticed a significant decrease in pain. The second week I started doing two sets of 10 once a day plus various exercises including leg lifts and calf raises along with stretching twice per day (Morning and night). I have not had to ice my knee or take pain meds since I begin doing the eccentric squats with the flex-and-go board. I estimate my decrease in pain to be about 15-20 % less in just two weeks. I honestly feel like this is the best thing that I could be doing to relieve my Patellar Tendonosis and I have tried MANY different options. I am so glad I stumbled upon this article. Thank Brian!

    Reply

  41. Samantha Saccomanno

    March 16th, 2013 at 6:48 pm

    Hey guys,
    I have had this problem for two years. I have done prolotherapy, pt, chiropractors, xrays, MRIs….everything. I HIGHLY recommend acupuncture and staying away from wheat/gluten/dairy. I have noticed a huge difference since I’ve done these things!

    Reply

  42. Dana A

    March 17th, 2013 at 7:56 pm

    25 years old and been diagnosed with patellar tendonosis. Been dealing with injury for over 1.5 years. It came on gradually 2 years ago, but the last 1.5 years it hurts just to walk especially any distances. The only thing I think could’ve caused it was driving a car with a clutch. I sold my car 9 months ago and still dealing with significant pain at times. I’m considering this, I’ve done pt for several months with no great success. Is it possible i got my tendonosis from the clutch in my car? If I got this board, what’s the goal of how many should be done a day?

    Reply

  43. Francis Sy

    March 20th, 2013 at 7:35 am

    hi brian,

    i’m 16 yrs old and i’m also suffering chronic patella tendonitis(both). its almost 11months when i fall while playing basketball. in the 1st to 2nd month after the fall i can endure the pain and in the 3rd to 5th month the pain is being worsen , but i dont want to go to a orthopedist. because i’m afraid that there is probability that i will be sidelined and miss the season. so i decided that after the season i will go to a orthpedist. in the 7th month i been diagnosed and i attend 13 sessions in almost 2months and the pain was subsided for about 70-80% and my rehab doctor said i just need to rest for about 2months. after 2months there still little pain. so i decided to go back to my orthopedist and he request for an MRI. after my MRI its still patella tendonitis so my doctor said i need to have a physical therapy again for 8sessions. after 8sessions there still the little pain.

    now that there is just little pain is that good to try the essentric excercises or got a shots of prp? or other options?

    all advice can be helpful
    Thanks!

    Reply

  44. Joe Miller

    March 22nd, 2013 at 9:26 pm

    Brian, you convinced me to buy the slant board. I had been doing one leg at a time with automotive wheel chocks — a little scary.

    I was wondering if I could use my patellar strap to help support my tendon while doing the exercises?

    –Joe

    Reply

  45. David Blanchard

    March 23rd, 2013 at 11:33 am

    Hello,

    I am writing from the UK. My son has been diagnosed with PT and has had now for 18months in both knees. He is now 16 and I think it started due to over training for cross country running. He finds he has a dull pain when walking upstairs and cannot train on roads anymore.

    He stopped running for a year and has made a come back in the last three months. There has been some improvement in terms of pain but still struggles running up hill.

    He has had plenty of attention from specialists but no exercise has really helped. He has rested and we hoped that it was partly down to growing pains- but he really hasn’t grown in the last two years.

    My question is, is it common to have this problem in both knees?

    He had some blood tests recently which recorded a below average platlet count, will this mean that the healing process in his knees will be retarded?

    The whole problem is really frustrating as he was in the top ten in the country for his running, but last week he came 170 in the National Cross Country.

    David

    Reply

  46. Ted

    March 29th, 2013 at 6:16 pm

    Hi Brian,
    My story is very similar to yours including treatments and lack of results. Just got the Flex-N-Go today and started with the exercise. My questions are:
    1) have you also used the foam roller as on this website that also advocates eccentric exercises on the slant board:
    http://foamrollers.com.au/how-to-use-the-foam-roller-for-patellar-tendonitis/
    AND 2) do you ice your knee?

    Reply

  47. Click Reference

    March 30th, 2013 at 1:38 am

    Hi there, I enjoy reading through your post.
    I like to write a little comment to support you.

    Reply

  48. Michael Manego

    March 31st, 2013 at 3:47 am

    Hi there, im 17 years old and I play competitive basketball almost everyday of the week. I also have osgood schaltters.

    About 6-7 months ago I was playing a game of basketball and went for a layup and my knee started to hurt a bit more than usual. I thought it was just the pain of the osgood so i kept on playing. This pain continued for months to come but as i thought it was just pain from the osgood it didn’t phase me because i was so used to the pain. This last month the pain worsened and it got to the point were i couldn’t even run anymore. I went to the physio and i have been diagnosed with PT. I have done all the exercises, all the stretches, Iced it, Heat packs and strapped my knee yet the pain continued!

    Is there anything i can do to stop the pain without having weeks-months off?

    Reply

  49. Owen

    April 05th, 2013 at 2:22 am

    Hey Guys,

    It’s great to see all of them comments on this site. I’m 20 years old and I’ve had Patellar tendonitis in both knees for exactly 1 year now. I was a college volleyball player and the tendonitis developed over a period of 2-4 months until it hurt so bad that I couldn’t play anymore. One year later, I have been through 4 months of physical therapy, 2 of which included ART, I had PRP in each tendon which was super painful, I’m not sure how much it helped.

    My problem stemmed from extremely, extremely tight quads, glutes, hamstrings and calves. I feel immediate pain relief from stretching after foam rolling (I have a normal black roller and a black RumbleRoller), however keeping up with the amount of rolling and stretching that makes me feel better is absolutely exhausting and it takes so much time.

    Since my injury I have not played any sports and it really, really sucks because I am a hugely active person, and to see this part of my life put on hold indefinitely is really bad for my soul. Confronting aging and stiff joints at 20 years old is not where I saw myself in my life. I fear I have done irreversible damage to my knees…

    Anyway, I’m going to try that board technique, it seems like a good one.

    I’m sending healing vibes to all of you…

    Reply

  50. nummemmoice

    April 09th, 2013 at 11:51 pm

    Tresses stylist Ji Palao: “I am contemplative of Lolita.”[url=http://japanhandbags.webstarts.com/][b]プラダ 財布 メンズ[/b][/url]
    Afflatus from the[url=http://japan-prada.webstarts.com/][b]プラダ 長財布[/b][/url]
    Prada Unexpectedly avail[url=http://jphandbagsoutlet2013.webstarts.com/][b]プラダ トートバッグ[/b][/url]
    for the benefit of [url=http://japanhandbags.webstarts.com/][b]プラダ バッグ[/b][/url]
    2010 program.He said: braids trend,[url=http://japan-prada.webstarts.com/][b]プラダ トートバッグ[/b][/url]
    combined with Lolita doll retailer,[url=http://jphandbagsoutlet2013.webstarts.com/][b]プラダ 財布 メンズ[/b][/url]
    take shape[url=http://japanhandbags.webstarts.com/][b]プラダ 財布 新作[/b][/url]
    the result does not [url=http://japan-prada.webstarts.com/][b]プラダ 財布 メンズ[/b][/url]
    look like the off guard expression.[url=http://jphandbagsoutlet2013.webstarts.com/][b]プラダ 長財布[/b][/url]
    Although the mane is emollient, the maiden’s tucker, but the orate is shimmery and sexy. Ache respecting to beget the temptationlips, the makeup artist 帕特麦格拉 to a consolidate of red lip burnish and discriminatory in favour of orange lipstick, overhangs and not too brilliant.

    Reply

  51. Bill Uetricht

    April 15th, 2013 at 8:12 am

    I have had some kind of patellar tendonitis for 17 years. It has been better at points and worse at times. It has stopped me from running. I recently went through PRP, and things have been much worse since then. My pain is not terrible. It’s mostly a matter of weakness and now since the PRP tenderness if I were to kneel. The doctor has suggested surgery as the next treatment. I want to give your exercise a try. I have tried just about everything, too. It’s depressing.

    Reply

  52. Bill Uetricht

    April 15th, 2013 at 10:06 pm

    Tried some of the exercises. Wow, my knee really hurts now. Did you find there was more hurt before the healing came?

    Reply

  53. TendonMan

    April 17th, 2013 at 12:43 pm

    Good blog. I have had right knee patellar tendinosis for approaching a decade now (from running). First doctors I saw all misdiagnosed it. I finally figured out on my own what it was and eventually a great sports doc confirmed it, including on an MRI.

    In my case daily slant-board eccentric work makes a large difference. I will never run again and I don’t expect to ever be able to walk/ride a bike without some degree of pain (I’m in my mid 30’s).

    Regular slant-board work, however, does bring me to the point where pain is fleeting or non-existent for regular activities, like just moving around and doing stairs. Unfortunately, last year I developed an IT band issue doing these and thus the only way to avoid its pain is to not do them, which introduces the patellar pain again!

    My MRI shows an otherwise healthy joint, and the MRI shows “mild tendinosis”, so nothing crazy, but it’s a chronic very bothersome problem.

    I may go for a round or two of PRP, but the stuff isn’t cheap. However, other than eccentric training or surgery there is very little else showing, in actual real medical studies, much efficacy.

    Considering how common tendinosis is it’s really just a damn shame so many doctors know nothing about it. I had achilles tendinosis not long ago and the specialist I saw about it put me on anti-inflams, a demonstrably incorrect approach. So many docs waste people’s time on ice and stretching and just rubbish. Rest is very useful obviously, but once the recovery stalls something else needs to happen.

    Reply

    • Kelly

      April 17th, 2013 at 2:25 pm

      Hello Tendon Man, Just a quick note. If you go to the FLEX-N-GO website and click on the instruction tab in the column, there is a free downloadable PDF for Achilles tendinosis as well as many other lower leg & foot problems. I am assuming you own a slant board already. Best of luck, Kelly

      Reply

      • TendonMan

        April 17th, 2013 at 3:03 pm

        Thanks. I actually built a slant board a few years back. Just a piece of wood with some gritty sandpaper on it and another piece that keys into a slot in the back to create the desired angle :)

        I should probably get to this achilles with more attention. Unlike my patellar tendinosis it has actually almost recovered entirely by itself. Occasionally it will flare up and just one set of calf raises helps it a great deal immediately afterward. Eccentric exercise does seem to have an anesthetic impact.

        Reply

  54. TendonMan

    April 17th, 2013 at 12:48 pm

    “Tried some of the exercises. Wow, my knee really hurts now. Did you find there was more hurt before the healing came?”

    Personally, yes, a little. Eccentric work should hurt a little bit, and chances are it will if your tendons are even more than a little hurt anyway. Push through the pain a bit. Normally it will only be peaking right after or for a few hours, at least in my case. Within a couple of weeks you may find a decrease in pain, so then you keep at it and see where it gets you.

    Reply

    • Jimmy

      May 04th, 2013 at 6:59 am

      Hi Tendon man …may I ask you something ?
      how old are you and whats your sport backround around your tendinosis problem that you have

      Reply

  55. liz

    April 17th, 2013 at 10:19 pm

    hey brian,
    i was wondering…i have an inclined hill in front of my house. it’s not a slant board–it’s kind of bumpy and lumpy, but will that work? or should i purchase a board?

    Reply

  56. steve turner

    April 18th, 2013 at 1:49 pm

    This board looks really well made. Unfortunately no shipping to UK? Help??!! Really need it for exactly the same problem!

    Reply

    • Kelly

      April 19th, 2013 at 7:29 am

      Hello Steve, There is a company that will ship to the UK, it is called MyUS.com
      We have had a number of people from around the world order through these folks. Feel free to contact us through Kelly@FLEX-N-GO.com for more info
      Hope this helps, Kelly

      Reply

  57. Joe Miller

    April 18th, 2013 at 3:41 pm

    I have had the board for about 2 weeks now and YES it VERY high quality. Worth every penny.

    I saw one other protocol which at one point calls for switching to an entirely one legged squat (as contrasted with Brian’s video demo which indicates simply a shifting of weight). I’m going to stick with Brian’s method for the time being as I feel that my bad leg just isn’t quite strong enough yet to handle the squat on it’s own.

    –Joe

    Reply

  58. Kelly

    April 19th, 2013 at 7:34 am

    Joe, Thank you for the kind words. We are thrilled that you found your board to your liking. Keep us in the loop as to your progress! Kelly

    Reply

  59. Emily

    April 20th, 2013 at 7:56 pm

    Hey Brian, thanks for this article. Ever since studying abroad a year and a half ago, and walking/biking more than I ever had in a semester, I’ve been struggling with Patellar Tendonitis.

    I’ll be trying out your method, but I’m curious if you stopped doing other exercises that stress your knee while you were doing your eccentric squat therapy? I’d like to keep up my jogging schedule, but am not sure if that would just undo any good from the eccentric squats.

    Reply

    • TendonMan

      April 22nd, 2013 at 8:46 am

      Continuing to jog while having this is an absolutely AWFUL idea. Trust me. You need to respect this. I didn’t and I’m coming up on a decade of knee pain and my running days are long since behind me now. This is a very serious issue and you need to commit to a minimum of several months to get over it. Even then you’ll likely be predisposed and it’s absolutely crucial that you avoid antagonistic activities, which I presume for you running is.

      Reply

  60. Samantha Saccomanno

    April 21st, 2013 at 11:17 pm

    Hello everyone,

    I bought the slant board to help my patellar tendonitis however it turns out that I have Chrondomalacia Patellae, SO I want to sell my slant board. If anyone is interested in buying my slant board please email me
    sam.saccomanno@yahoo.com

    Reply

  61. Colby

    April 24th, 2013 at 5:06 pm

    Hi there it’s me, I am also visiting this site on a regular basis, this website is actually fastidious and the visitors are truly sharing nice thoughts.

    Reply

  62. Mia

    April 24th, 2013 at 6:05 pm

    Update : 2 months of doing this excercise I’m pain free. I highly recommend stopping all activities that cause pain. I stop running for 6 weeks as an avid runner it was so hard to do instead I switch to swimming. Patella pain comes with inflammation –(mine was inflame) & my Dr. told me to take aleve (No way)seriously I google all antiflamatory food and came up with blueberry ,celery, apple & sorbet ( I put that in my diet). Worth it

    Reply

    • Brian Jones

      October 11th, 2014 at 8:03 pm

      Dear Writer,

      Hello. I am a sufferer of Patella Tendinitis/jumper’s knee and I am extremely grateful that I came across your comment on this website. I too, was an avid runner before coming down with Patellar Tendinitis/jumper’s knee, and I am attempting to switch over to swimming now to deal with the knee pain. Do you have any advice for me, like when it would be a good idea to switch back to running. Perhaps I could get into some Swimming Races first?

      Thank you so much for your input.
      Brian J

      Reply

    • Brian Jones

      October 11th, 2014 at 8:03 pm

      Dear Writer,

      Hello. I am a sufferer of Patella Tendinitis/jumper’s knee and I am extremely grateful that I came across your comment on this website. I too, was an avid runner before coming down with Patellar Tendinitis/jumper’s knee, and I am attempting to switch over to swimming now to deal with the knee pain. Do you have any advice for me, like when it would be a good idea to switch back to running. Perhaps I could get into some Swimming Races first?

      Thank you so much for your input.
      Brian J

      Reply

  63. Dan

    May 02nd, 2013 at 8:06 am

    Thanks for sharing your experience with this affliction (dramatic)! But seriously, I have been dealing with patellar tendonitis off and on for about 2 years. It was dormant for the last 6 months, but it’s back again. You interested me in the eccentric squat, and, luckily, my gym has a slanted board that is almost identical to the one you use. I did a few low rep sets (fought through some pain), and it felt awesome afterward! I also used a roller to loosen up my hamstrings and quads as part of a new stretch routine which may have helped also. Anyway, thanks for everyone posting on here!

    Reply

  64. Karen

    May 03rd, 2013 at 9:32 pm

    This is a great thread! It is nice to see others dealing with this, not that I want anyone to have to deal with this, but it’s nice to feel not alone. It seems odd that one little tiny spot under my kneecap can cause so many problems! I have moderate arthritis in my other knee, and I have now come to see one as “the good knee”! It’s the one I can kneel on. It doesn’t hurt when I sleep or go up or down stairs.

    I plan to try these exercises and I’ve known about them for some time, but like Brian in the beginning, I thought I couldn’t do them if it hurt so much. I will just start with less of a squat. I guess I will stretch, too, esp quads.

    One thing that DID not help, and actually made things much worse, was prolotherapy. The doc then recommended PRP, but I don’t want to try anything like that again. So much new scar tissue!!

    That was in the fall. In Jan I started with an ART certified Chiropracter. He has helped a lot to break up the scar tissue. He also told me about icing frequently, which I still do. My orthopedist thinks the prolo (done by a sports doc) and the ART are just a bunch of bunk… I spoke to another knee specialist who said he only knew of one other person who got worse after prolo. So I’m not surprised I didn’t get better, but I think it’s rare to get worse, which is why I decided to give it a try. I’m not keen on giving surgery a try, though! But part of me thinks, “If they could only take out the bad piece of tendon and heal back the rest, I’d be OK” Not sure if that can really happen… will have an MRI to determine how bad it really is.

    So I second the ART, the ice, and I think the slantboard (will update after using it for a while). Oh, and a prosthetic and brace guy suggested a type of sleeve brace with a donut area to support the patella (its a really tight sleeve, not like the little lame patellar opening that other knee braces have). This is only palliative, though.

    Reply

    • TendonMan

      May 04th, 2013 at 3:14 pm

      I think you’re right–if they could take out the bad, you’d be good. I have seen the guy widely believed to be the best in my city at this kind of thing and he has a pretty good success rate with surgery for tendinosis, but nothing is guaranteed, so I’ve really tried to put it off. He also practices PRP, which unlike prolotherapy actually puts back your own platelets instead of sugar solution (I think that’s what prolo is). He cautiously recommended, it mainly cautious because he knows the science is still not really out, although there have been a number of studies showing a stistically significant benefit to PRP.

      I would still probably try PRP before surgery. It is almost a grand a pop unfortunately, as insurance rarely covers it.

      I still like to think and hope it’s not too optimstic that a new therapy will emerge that has a much better track record than existing ones.

      In my case my knee is a roller coaster. Today it barely hurts at all and I Just mowed the lawn with a 1/10 pain scale and now it’s 0/10. However, on Monday I may be at work and it will be 2-3/10. Nothing crazy, but just sitting there bothering me.

      I think it’s very important to find the correct level of activity for joint health and it’s a personal thing. I absolutely think total rest is a bad thing for tendinosis, from my own experience and from reading others’.

      Reply

      • Fraser73

        May 07th, 2013 at 6:28 am

        I agree. I gave my knee 1.5 months off during the off season, and I came back to school with my knees in worse shape then when I left. That said I wasn’t completely inactive, but my knees would have been a lot better if I had continued my PT

        Reply

  65. Karen

    May 03rd, 2013 at 9:33 pm

    Oh, and I forgot to thank Brian for the great article and your great answers!

    Reply

  66. Fraser73

    May 07th, 2013 at 6:26 am

    Well Hello everybody!

    I play Australian Rules Football in the Ruck, and I developed Severe Tendinitis last season. Anyway, I am managing it right now with physical therapy and while I had to take off two months of sport, it was certainly worth it because now, while I can still feel it, it is MUCH better then it was.

    However I was wondering whether there was more feedback from people who have had success with this board before I consider getting it myself.

    Thanks in advance,
    Fraser73

    Reply

  67. bio mechanically challenged cyclist

    May 11th, 2013 at 6:43 pm

    My 2 year anniversary with PT will be at the end of this month and just wanted to provide a little input. I stumbled upon this form of concentric exercise in a youtube video early on in my injury but when I tried it I experienced a little discomfort so I quit doing it. Long story short… about 1 1/2 years, visits with the family Dr., visits with a knee specialist, an MRI, and weeks of physical therapy later and still totally floored and frustrated with this injury I found this thread and decided to give it a go again and I think I may have had a break through. What I have learned from this site is to keep doing the exercises despite a little irritation or discomfort. It is very important to know the difference between pain and discomfort. Only you can decide what the difference is for you. When I was at rock bottom after ignoring the injury because it didn’t really hurt that bad at first, I had pain radiating down my shin bones when I pushed on the pedals of my bike. I have been sticking with this routine for about a month now and at first had a little irritation but kept on with it and it didn’t get any worse (if your discomfort gets worse or manifests into pain by all means STOP) and now seems to be getting slightly better. The most important thing I learned is that if you don’t get on top of this early and run it into the ground like I did, rest and anti-inflammatories alone WILL NOT get you better. I think my cause and for many others for this injury is muscle imbalances causing patella maltracking. Hope this adds a little to this valuable thread.

    Reply

  68. Brooke

    May 14th, 2013 at 4:06 pm

    Hi Brain! I’ve had patellar tendonosis for 2 years now and nothing has worked. Beginning eccentric exercises with your recommended slant board.

    Also, I’m getting PRP done this Friday.
    Would you not recommend it overall? Did you find any improvement for the PRP treatment?

    Thank you!

    Reply

  69. Emily

    May 14th, 2013 at 4:38 pm

    Hi everyone, I’m glad I found this website and thread. I’ve been dealing with chronic knee pain since 2004 and had to stop running and most other intense exercise all together since that time. I still remain active and work out as much as I can, but even walking every day is painful in both of my knees. I’ve tried physical therapy (twice), icing, stretching/yoga, NSAIDS, the works. I’m getting another MRI next week…hopefully the doctor will finally have a diagnosis, though my symptoms sound just like patellar tendonitis. It’s been so many years, it’s hard to believe anything will work at this point–and I’m not even 30! If he tells me it’s tendonitis, I’m definitely going to try these exercises. Good luck to everyone. All feedback welcome.

    Reply

    • Audrey Wiedemeier

      May 16th, 2013 at 11:35 am

      Hola!

      Emily, I have the same story as you. The not even 30 part really gets to me so I totally feel your pain. I am going to build myself on of these slat boards right away (I am living in Venezuela and cannot order one) and get going on the exercises. I’ve been battling this is both knees for a year and it was brought on by cycling. Ill be sure to post my results. Buenos suertes!

      Reply

  70. Bobby

    May 16th, 2013 at 10:06 am

    What is a good degree slant for a slant board?

    Reply

  71. Kelly Reeme

    May 16th, 2013 at 11:40 am

    Hello, Bobby: Our boards are 25 degrees. My email address is above; drop me a note, and I would be happy to give you a little advice regarding your board. :-)

    Reply

  72. TendonMan

    May 17th, 2013 at 2:33 pm

    Emily, my tendon pain was from running in late 20’s. I struggled for years and finally gave up running, now 35, but the tendinosis never went away. The first several docs I saw–including having two MRIs–all misdiagnosed. It is really frustrating having a sports doc look at an MRI and conclude that your knee is basically fine, despite you know the fact that even walking can hurt. I had to diagnose myself, as pompous as it may sound, but a third MRI and consult with a better doc finally confirmed what I thought I had, just from voracious internet reading.

    If your doc tells you to do NSAIDS or rest or whatever, at this point they don’t work, so ignore his advice. It’s mind boggling how many physicians just seem completely inept over this common problem.

    “bio mechanically challenged cyclist”

    It is quite difficult psychologically and extremely unintuitive to work _into_ discomfort/pain, as you’ve found and so many of us have, and yet what you suspect is true in a lot of cases: working through that discomfort is the only resolution. Although my personal response to eccentric has been positive but not mind-blowing (didn’t resolve it, is more of a helpful pain management thing), I think back to a shoulder injury I had a few years back. Rest had plateaued and it was not getting better. I went to a PT, we worked through exercises with very mild discomfort and it wasn’t long before that joint finally healed up, now it’s good. I am completely positive without exercise it wouldn’t have healed as quickly.

    Reply

  73. Kayla

    May 27th, 2013 at 4:38 pm

    Hello Ive been dealing with chronic knee pain for the past 2 months. I’ve been to many different doctors and no one can seem to tell me whats wrong. I’ve gotten xrays and an MRI from an orthopedics surgent and they said that my ligaments were fine. He didn’t said say anything about my tendons. I later went home and did research on my own and pinpointed the pain and basically am configuring its patellar ten….
    I’ve been scared to walk on my leg for the past 5 weeks because of the pain and the swelling when I was walking on it. I also had hott and cold feelings radiating out from my patellar tendon. My doctor thought it could be a blood clot so he told me to go to the ER.
    I know have had no results from any professional and havn’t been walking on my leg. Thee hardest part of my injury is trying to find a professional to help diagnos me, so I can know what to do to heal it. Like is it better to try and walk or would it make it worse to walk. I’m curious your thoughts on my situation and have truly appreciated reading your information, thank you for sharing.

    If you have any advice for me, that woud be greatly appreciated.

    Thank you.
    Kayla

    Reply

    • Brian Patterson

      June 05th, 2013 at 12:08 pm

      Hi Kayla, sorry to hear about all your troubles, I know how frustrating it can be! Your case seems to be much worse than mine.

      I like really close to the Redskins training facilities, and so a lot of the doctors in this area treat these professional athletes for various injuries. Some are known as “the back guy” or “the ankle guy”.

      I’d recommend that you keep getting professional opinions, and see if you can find “the knee guy”.

      Brian

      Reply

  74. Scott

    June 03rd, 2013 at 10:56 pm

    I’ve been dealing with chronic patellar tendonitis (or tendonosis depending on which ortho you ask) for about 2.5 years. It started out only bothering me running and skiing. Then it started to flare up hiking later on, and now flares up under low and no impact activities like swimming and biking which I can’t do anymore either. And now its to the point where often walking around the house or office is pretty bothersome…

    So far I’ve been to 3 different orthos, failed physical therapy twice, tried PRP, tried Ionpheresis, no luck. I’ve read several place including here that eccentric squats are the way to go and have been trying it, but at least at the moment it causes me too much irritation. I can let my knees rest for several weeks, do several sets of the eccentric squats and the pain/irritation ramps up to where I limp around for a week straight. I tried, maybe mistakenly to stick with it daily for a week straight, and that was a total failure and set me back at least a few weeks.

    I guess my question is, while you said the eccentric squats are uncomfortable, how long does it typically take for the pain/irritation to go away after you’ve done the eccentric squats?

    Reply

    • Brian Patterson

      June 05th, 2013 at 12:06 pm

      Hi Scott, that sounds like a tough issue! I don’t remember mine being close to that bad. I think I maybe had to skip a day or two at most if my knee was really irritated from the board. So… maybe it isn’t the right solution for you? Or maybe you have something else going on in your knee as well?

      I saw recently that Danny Granger, an NBA player on the Pacers, and surgery because of his Patellar Tendonitis. He makes his living jumping, and I’m sure he chose the best route for him. Maybe you could explore what he did, who he saw, and if it would be a treatment path for you? http://www.huffingtonpost.com/abby-sims/patellar-tendinosis-knock_b_2090055.html

      Disclaimer: Again, I’m most certainly not a doctor so I can’t give medical advice. Ask a doctor before you do anything!

      Reply

  75. Eric

    June 10th, 2013 at 4:02 am

    Hey Brian,
    I have had chronic patella tendonitis for around 6 years. I played many high level sports including football and basketball during my late teens/early 20s, so I had no time to slow down and eliminate the problem. I am now 23 and it has become a real issue, I cannot sit for long periods of time or if its cold my knees hurt like hell.
    I have recently received PRP and can confirm it does help after around 2 weeks. The point of PRP isn’t to fix the tendonitis, its too heal the tendon so you can start strengthening. I really like your advice on here and will buy this board. I also recommend cycling as another form of strengthening. I will let you know how I go with the board!

    Reply

  76. Ron Manaloto

    June 18th, 2013 at 9:16 am

    Hi sir, my name is Ron, I just wanted to say that I have PT for about 4 and a half months now it’s been bothering me the whole 4 months so pissed. I think that Patellar Tendonitis occured to my right knee when me and my friends played whole court basketball then walked for about 4 miles (back and forth) then the day after my right knee feels discomfort. After searching the net i found out about patellar tendonitis and do some squats and straight leg raise from a site I just saw. But it has no result. So now i just wanted to try this eccentric exercise and to see if it will work. I just wanted to add becuase im from philippines(which is other country than yours which is USA) can I find this slant board in some sports outlet?. And also there’s a try out for varsity in our school and I would like to participate but the coach said that we will have to run for 10 mins, Jog for 10 mins, and walk for 10 mins. Should I participate or just continue exercising my knee? any advice will help. BTW great article and I HATE PATELLAR TENDONITIS

    Reply

  77. Mia

    June 18th, 2013 at 9:09 pm

    As a former runner, healthy young woman I was diagnosed with Pt. Also been going to Physio for 2 months. Had acupuncture , ultrasounds, shock wave therapythose were Temporary results.. So far the only exercise that help is GYM.I hired a personal trainer I told him about this knee pain. The reason for this could be weak quad, weak glute(very common for women),weak leg, tight quad.The gym that I go to has one of this board he showed me how to used them. Also been doing weight lifting on my knee. So far a month into the exercise this helps a lot .The only time I feel pain is when the weather changes. I don’t even look at the weather channel anymore my knee will tell me.Maybe it’s something else so I’m going to see the DR.

    Reply

  78. Courtney

    June 20th, 2013 at 3:13 pm

    This is great! I’ve been dealing with tendonitis in my knees for a little over 13 years now due to running track in high school! I’ve tried stretches and all I can say is, they’re not working at all:-(. My doctor informed if those stretches! But I’m definitely going to try the exercises with the slant board! You and I have the same problem and the results for you as I can see have worked well! Thank you so much!!!

    Reply

    • Brian Patterson

      July 02nd, 2013 at 10:10 am

      Great, I hope they work! I got some generic stretches from my doctor as well. They were just a printout from some website, so I didn’t get the feeling he was providing a lot of value by giving me those.

      Reply

  79. Denise

    June 24th, 2013 at 8:53 am

    Hi Brian,
    Great information thanks! I’m 61 and had surgery on both knees (Physio tells me they no longer do this surgery it is now fixed with exercise to strengthen muscles)over 40 years ago as both knees dislocated constantly. My knees no longer dislocate but I have always had reduced mobility in my knees and an almost paranoid fear of them dislocating again(was terribly painful). One year ago I started Physio as I had been diagnosed with osteo arthritis in my knees. I started stretching exercises to strengthen my glutes, squats etc. All these helped but not long after, my son who was terminally ill, was hospitalised and for the next 3 weeks I spent every day at the hospital. This involved climbing numerous stairs daily and the exercises went out the window. Sadly, my son passed away and I found my left knee was now so painful that I had to go to Accident & Emergency myself. I had a huge lump at the back of my knee and after xray and ultrasound I was told I have a huge Baker’s cyst and Chronic Patellar Tendonopathy.
    I have been referred to an Orthapaedic Surgeon but that TERRIFIES me as the surgery I had 40 years ago was extremely painful and it’s the last option for me.
    I feel that your slant board and eccentric squats are exactly what I need now that the stiffness and swelling has reduced right down. Only problem is the Baker’s Cyst is still there and it feels like a golf ball in the back of my knee. I guess I’ll wait to see the surgeon first and see what he says but your option is looking good to me rather than surgery. Thanks for all the information that will help me make a more informed choice. Really appreciate everyone’s comments. Thanks heaps Brian and everyone!

    Reply

  80. Sandy

    July 02nd, 2013 at 10:03 am

    Is it best to do this exercise with bare feet on the slant board?

    Reply

    • Brian Patterson

      July 02nd, 2013 at 10:09 am

      Hi Sandy, I go barefoot whenever I can. I don’t see any good reason (for me) to wear shoes or VFFs on the slant board, so I don’t. However, others may feel the need to wear them. You can give both ways a try and see what works best for you.

      Reply

      • Sandy

        July 03rd, 2013 at 9:15 am

        Thanks for you quick response Brian! One more question, I looked at the slant board and it says it’s at a 25 degree angle. Is that correct? It looks more like 45 to me.

        Reply

        • Kelly Reeme

          July 03rd, 2013 at 9:55 am

          Hello Sandy, It is 25° no worries

          Reply

      • Tony

        September 09th, 2013 at 2:08 pm

        I play basketball and just got to where i can dunk it this year, but about december i started to feel the tendonitis in my left knee and it slowly got worse, i let it rest for about a month and it didnt hurt for about another month then it came back but this time there was pain in my right knee too, my left is still alot worse though. ive used ice, medicine, and a brace, but it still has not much effect on the pain. any ideas? it hurts when i jump, try to cut hard, stop suddenly, and do defensive slides.

        Reply

  81. appbrain app market 5.2 apk

    July 03rd, 2013 at 1:45 am

    I’ve been exploring for a bit for any high quality articles or blog posts in this kind of house . Exploring in Yahoo I finally stumbled upon this web site. Reading this info So i’m glad to show that I’ve an incredibly just right uncanny feeling I found out exactly what I needed. I so much without a doubt will make sure to do not forget this web site and give it a look on a continuing basis.

    Reply

  82. Matt

    July 10th, 2013 at 8:57 am

    Hey Brian. Great article!! I too have been suffering from bilateral patellar tendonosis for about two years now after running through some injuries in the past. I also think that this might have been compounded by very tight IT bands (I had the left one surgically released earlier this year). My question is did you ice after doing the eccentric exercises and how much discomfort did you feel while doing the exercises? Also, were you able to continue doing non-impact cardio such as the Arc Trainer while doing the eccentric exercises. Thank you so much!!!

    Reply

  83. jimmy

    July 12th, 2013 at 10:26 am

    I heard that EMS shock wave therapy) is a new treatment for pattelar tendinopathy …I will give it a try and I let you know.

    Reply

  84. Georgi Stoychev

    July 13th, 2013 at 10:23 pm

    Hi there

    I like your article. I am also dealing with tendonitis on my left knee ( right side of left knee) It happen while cycling. I have been doing long distance cycling since 1998 so i find it doubtful is the sport. I started with bike fit. Went thru medicines, physical theraphy, Iontophoresis . No help. It seems like alot of the excersices from this article with a foam roller helped me. http://www.fix-knee-pain.com/injuries/patellar-tendonitis-knee-tendonitis/. But just for few months. Now i am back at cycling and every time after mile 50 the pain comes back. MInd you i have cycle 400 miles and no pain. Any suggestions are welcome

    Reply

  85. Deb Flawn

    July 14th, 2013 at 3:09 am

    I just had surgery to decompress my patella tendon. The results and relief was immediate. I walked across recovery an hour after surgery without pain or a limp.
    I have read the information on your website and will be your exercises hoping that it will prevent it coming back

    Reply

  86. Jonathan

    July 22nd, 2013 at 1:59 am

    Thank you for this… I will definitely try this.. and after reading your article, I search further about eccentric exercises… Evidence supported study…
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2971642/

    Reply

  87. Moto

    July 23rd, 2013 at 10:37 pm

    So it’s been over a year since you wrote this. Can you say you are 100% pain free? If not, what percentage (assuming its improved from 70% which you reported already).

    Reply

  88. Nick

    July 24th, 2013 at 6:17 am

    Thanks for the advice!
    How is your Knee now, is it 100% yet?
    Basically I’m 17 Y/O and been suffering from PT for two years now. I took countless weeks off which was very risky of me to do because i play basketball at a high level to erase PT in my left knee, basically this reduced the pain a lot, and i was basically able to start playing at a high level again. 6 weeks later i injured my right knee developing serve tenonditis within that knee, along with my left knee starting to inflame again and i had basically no time to take off to heal this all over again. To my luck in some case i recently suffered a horrific ankle injury thats keeping me out for four months, which is doing wonders for my knees as i cant play any sport at all, im praying that this long rest will completely heal both my tendons and i can be 100% again for the first time in years.. What do you think?

    Reply

    • Afreen Quraishi

      July 16th, 2018 at 8:11 am

      hi Nick – Did the long rest help? Are you finally cured from tendonitis?

      Reply

  89. Isabella Stewart

    July 30th, 2013 at 11:54 pm

    This blog offers all the information you needed about knee exercise to avoid knee pain. I really appreciated this blog,,,it is been really helpful. Keep this up!

    Reply

  90. Friðrik

    July 31st, 2013 at 1:28 pm

    I’ve been doing this exercise and the first 5-6 times i bend the knee in the first set it hurts but then i i can do the rest pain-free. Then i feel no pain maybe for 1 hour after the exercise put then the pain emerges again. I have been doing this for 3 days and i see no improvements. And one thing , should your knee go longerthen your toes while bending ?

    Reply

  91. Jessi

    July 31st, 2013 at 7:10 pm

    How long did you stop running for?? I am training for my first full marathon. I have been diagnosed with patellar Tendonitis by the chiropractor that I went to see. He did electro current and ultrasound but its not working. I have no problem running. Infact I feel amazing. It’s after I get home that I can hardly walk and going down the stairs is a killer. I have decided to take the week off from running to try and heal this injury. Please tell me it will go away or that there is no harm in me continuing to run besides pain after and for a few days!!!!!

    Reply

  92. Jeff

    August 01st, 2013 at 11:41 am

    Brian, one doctor tells me my muscles are too weak to support my body, so he gave me some exercises to do, helped with clicking and imporved a little, problem is that the pain and problem moves from one knee to the other now. Second doctor, finally is giving me an MRT to check if I have a tear. But in the meantime he tells me that I have Patellar Tendonitis in both knees. Not sure which one is right if any of them. Pain without touching is the inner side of the leg in the knee and below the knee area. Pressure applied to the bottom of the knee is painful especially on the right. I am not sure which doc is right. But want I want to ask you is if both knees have Patellar Tendonitis can one still use this slant board to improve the situation? I saw your video and I am not sure how to do it because both knees have problem. Should I alternate per day or per time or 10 on left and then 10 on right and vice versa? Am very interested in your thoughts. Great post and information by the way, thank you for that.

    Reply

  93. jaevon weston

    August 08th, 2013 at 7:19 pm

    I was wondering if there is an alternative for the slant board if it can’t be afforded or a different type of way it can be done? I go to 24 fitness and I’m sure they have the stay type of equipment that this can be done on .

    Reply

  94. Brian

    August 11th, 2013 at 4:02 pm

    Hi Brian,
    I feel hopeful after reading your story. I have PT for a year now from volleyball playing. my PT has little improvement after seeing 3 physio therapists underling going many types of treatment. Once i feel better and went back to my volleyball games, symptoms come back again. I am going to try the eccentric strengthening exercise you benefited before while continuing my rehab program in stretching and strengthening my targeted muscles.
    I’d like to share this clinical publication which I find very insightful. The slant board exercise is recommended in this clinical article.
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2971642/#!po=11.9048

    Thanks
    Brian

    Reply

  95. Gaby

    August 12th, 2013 at 10:08 pm

    Hi Brian, I’m really interested in this but have some concerns. I hope you’re able to answer this if not I would love to talk to you through email.

    I have tendonitis in both my knees. Would this still be okay to do? I can barely go a mile without it flaring up. Even sitting in one position for too long can irritate it. Thanks!

    Reply

    • Tendonman

      August 13th, 2013 at 8:54 am

      Gabby, PLEASE stop running until you resolve this. No matter what, no matter if you think you need to run to lose weight, are training for a 5k, a marathon, whatever. Ceasing to run while dealing with this problem is a crucial first step.

      Reply

  96. Ian J. Gibbons

    August 15th, 2013 at 11:29 pm

    UPDATE: Hi all, I last posted about 3-4 months ago when i initially got my slant board. I’ve been battling patellar tendonitis for 3 yrs and would like to share some of my insight:

    1. If you have patellar tendonitis then you have to be prepared to CHANGE YOUR LIFESTLYE, potentially for 1-2 years depending on your severity. An inflammed tendon can’t heal if it is continuously being irritated.

    2. Once again, depending on severity. REST ALONE DOES NOT WORK. Strengthening muscles around the tendon is incredibly helpful and proper form is CRUCIAL.

    3. Persistence and hard work will pay off if done properly.

    Now I wish could say that I’m cured….but I’m not. Nor am I a quarter of the athlete that I was 3 years ago but this is real. I CAN say that 6 months ago I was in constant pain during all activities, standing, walking, anything. I lived on knee braces. I am now able to walk around and stand all day without real pain or braces so realistically that’s a HUGE success.

    Actually the last month was awesome and I was nearly pain free. I biked, ran, played volleyball and danced…………..which led me back to patellar tendon pain central. However the blame is mine and it reminds me to respect the condition and not RUSH back into things. If I got pain free I can do it again.

    I currently do the following exercises:

    2x a week in the gym
    Lunges
    Squats
    Hip abductor both in and out
    Calf raises
    Hamstring curls
    elliptical stair climber

    1-2x per week home
    3 sets of 15 on the slant board.

    These exercises helped immensely along with stretching

    I hear the rule of thumb is never let your knee go past your toes.

    My fight continues but battles have been won. Remember to take it slow and listen to your bodies.

    Reply

    • Erika

      October 21st, 2014 at 10:24 pm

      Thx for the post. It’s been a year and I am getting tired of doctor visits. I’ll try this regimen at home.

      Reply

  97. Mark Handberg

    August 17th, 2013 at 10:56 am

    I am an example of a very unlucky person who may never function normally again due to patellar tendinopathy. I will write it down in a timeline so that it will be easier to view.

    Late july 2012:
    Fell into a hole in the woods. I felt only minor pain during the fall and a physical therapist told me that it probably was a meniscal injury. Pain dissapeared completely after about a month and I assumed with light activities as I was rehabing my other knee (patellar maltraking problem).

    April 2013: Felt a sudden pain in the knee while doing leg extension exercise. Since I studied to become a physical therapist myself at that time and wanted to write about patellar tendinopathy in my bachelor project, I learned a lot about the injury and found out that my knee pain actually WAS due to injury to the patellar tendon. I had a possitive palpation test.

    Late april 2013: After a few weeks without pain, I tried just simple squats without weights and even that made it a lot worse.

    Early may 2013: Reinjured it while cycling.

    Mid may: Made it worse doing simple quad setting.. It swelled up a ton and I was forced to walk with crutches for about 4 weeks before I was able to walk again.

    June 25th: At the moment I graduated and recieved an A+ for my project on this damn injury I took literally 3 quick steps towards my mom to hug her and then.. BAM! I reinjured it again. Just I quick sharp pain and swelling a pain returned.

    July 10th. Tried light quad setting.. Boom! a lot of swelling this time.

    July 26th. Dropped an Ice bag right on the tendon and got the worst swelling I have ever experienced. Constand pain for several weeks and forced to lay down all the time and use 2 crutches.

    Today (august 17th). These last few weeks I experienced some decreased swelling and was able to walk a bit with 2 crutches. The entire leg has atrophied a great deal and the patelalr tendon in other knee has started to get painfull and well as the right achilles tendon. I fell asleep with knee slightly internally rotated and got light pain again.

    I’ve never read this before, but the commuon sence is that the more you reinjure a tissue, the harder it will be to strenthen it again.

    Yes, I have been extremely unfortunate and unsmart at times with the injury. I also strongly believe that I am one of those who genetically have weak tendons since I through my life have had more than 10 severe tendon injuries. None as serious as this one though and my bad treatment of it has bitten me in the bud.

    In my bachelor project about the injury that included my own tests of 12 basketball players with and without PT, I found some pretty storng evidence that decreased dorsi flexion and increase pronation of the feet can leed to this injury. Several other studies also showed this tendency. And yes, tight quads and hamstrings can also lead to it.

    I also want to say, that if you have severe PT, especially if you have pain during everyday activity and if you injured it a short while ago, eccentric squats may be very bad for your tendon! Pain is only okay if the tendon already had got some strength. My tendon didn’t and I paid the price, you don’t have to! So start light and build your way up slowly. A serious tendon injury usually requires 6 weeks on rest before the tendon has built up enough strong collagen fibers so that you can just do light exercises and walk on it. That’s why have (myself encluded) have failed to put the right amount of stress to the tendon that can build it up instead of breaking it down.

    Reply

    • Tendonman

      August 22nd, 2013 at 10:32 am

      Mark Handburg, I feel sympathetic to your issue and I hope you resolve it.

      What little condolence it may be I also feel I’m VERY suceptible to tendon injuries. Any time I injure a tendon, be it elbow or whatever I know I have minimum of many months of pain. However, you may get better. I hurt my achilles two years ago and it still is healing–it’s better than it was a year ago (which was better than the year prior), but still not perfect. I believe it’s somewhat common for some tendons to take years to get better.

      As you’ve no doubt figured out, stop squating if it hurts :) I think step one on a tendon injury is to rest it and, as long as it’s continuing to heal, continue to rest it. If a plateau is reached at which point it stops recovering, then introduce activity.

      You may want to see a good doctor. There is one on my area who claims to have a pretty good success rate (80-85%) with tendinopathy surgery.

      There’s good info at tendinosis.org and, as its author points out, in just the last decade this issue is gaining a great deal more traction. I’m still very hopeful that a non-surgical treatment will emerge that is highly effective. It seems right now that PRP, other than eccentric exercise, is probably the best one. Not perfect, but most of the therapies have absolutely no proven benefit, once properly analyzed in a meta study.

      Reply

  98. Jim hannon

    August 22nd, 2013 at 9:37 am

    Hello
    I have PT in both knees equally. How do you suggest I do th exercises on the board?

    Reply

    • Tendonman

      August 22nd, 2013 at 10:25 am

      Jim, you may find benefit by using the slant board between two kitchen chairs, as I have often done. This lets you use the strength of your upper body to assist in the concentric (body going up) portion of the activity.

      Reply

  99. Vishal Sharma

    August 22nd, 2013 at 11:10 am

    I hope this will work for patellofemoral pain as well. By the way what was the angle of slant board you used. I will try to build it myself…

    Reply

    • Kelly Reeme

      August 25th, 2013 at 1:32 pm

      Vishal I can only answer the angle question. Our board are 25º. Also we have recently resized the slant board for the purpose of better shipping options. The boards are 16″ length. Best of luck! All these people have the experience to get you where you need to go! Kelly

      Reply

  100. Vishal Sharma

    August 24th, 2013 at 5:54 am

    Angle of board you used. Also will that work for patellofemoral pain?

    Reply

  101. Nick F

    September 05th, 2013 at 11:55 am

    How steep is the slant board. How deep did you squat also? When you said there was more pain while doing the eccentric squat how long before this soreness decreased?

    Reply

  102. Kelly Reeme

    September 05th, 2013 at 2:20 pm

    Hello Nick, I can answer the Angle question for you. Our boards are 25º. Also we have recently resized the slant board for the purpose of better shipping options. The boards are 16″ length. Best of luck! Kelly

    Reply

  103. Silvia Harris-Payne

    September 06th, 2013 at 10:12 pm

    I’ve had pain in both knees for about 10 year. I was diagnosed as Arthritis around that time. A couple of times I had cortisone injections, but I decided that the injections only took care of the symptom and not the cause of the pain.
    A month ago the pain started again in both knees, but the pain on the left knee was much stronger. A new doctor diagnosed my problem as knee tendonitis (no arthritis!).
    I refused the cortisone injection, I’ve iced the knee almost every day, to no avail.
    I’m going to try the last board you recommend. One question though: will my right knee be OK as a work on my left knee, since a have a milder case of tendonitis on the right knee as well?

    Reply

  104. Tony

    September 09th, 2013 at 2:06 pm

    I play basketball and just got to where i can dunk it this year, but about december i started to feel the tendonitis in my left knee and it slowly got worse, i let it rest for about a month and it didnt hurt for about another month then it came back but this time there was pain in my right knee too, my left is still alot worse though. ive used ice, medicine, and a brace, but it still has not much effect on the pain. any ideas? it hurts when i jump, try to cut hard, stop suddenly, and do defensive slides.

    Reply

  105. Karen

    September 09th, 2013 at 2:50 pm

    Tony,

    Have you been to a doc yet? I have what I thought was tendonitis, but turned out to be a partial patellar tendon tear. It seems to be why my pain is concentrated to a tiny little spot, but it hurts when I do all the types of things you mentioned. So I would try to get an accurate diagnosis from an orthopedic doc. Good luck with it!

    Reply

  106. Eric B

    September 12th, 2013 at 3:42 pm

    Brian,

    Thanks for a great article. Would you mind adding an update on how you are and any new treatments you’ve added?

    Reply

  107. Soccerplayer

    September 23rd, 2013 at 10:18 am

    Hi Brian
    Thanks for this. I also have been struggling with tendinitis for quite some time now (5-6 years). I play NCAA soccer (playing 6 days a week). I go through phases of bad times and others when there’s little to no pain. I’ve just started doing these slant board exercises, and so far I’ve already felt the benefits. Had a question for you, what do you think about using muscle rub or biofreeze on the tendon prior to playing? Have you tried that out?

    Reply

  108. Ian J. Gibbons

    September 24th, 2013 at 8:51 am

    Hi all,

    I just wanted to give another update and provide some hope to those suffering from Patellar Tendonitis.

    This is now my 4th consecutive week using the slant board and I DEFINITELY see an improvement.

    My knees hurt less, make less popping noises and I am able to do more with less discomfort.

    Last week I went out dancing for the first time in ages and played lazer tag which required a lot of running and kneeling. I planned on taking it easy but having fun I pushed it pretty hard. I spent each day after expecting my knees to explode with pain as they have before and shockingly, they feel better than they did!?!?

    It does feel as though the more I do these exercises, the more stable my knee becomes. I AM finding some success and hopefully you are/will as well.

    Reply

  109. Kelly Reeme

    September 24th, 2013 at 11:32 am

    Ian!! Thank you for the update. So happy for you. Dude you have the rest of your life, you don’t have to make up for lost time all in one night! LOL Did I sent you the video on VMO strengthening as well as the link for
    fix-knee-pain.com The owner just published a second book. This one specifically for patellar tendonitis. He has a free news letter that is outstanding! His name is Martin Koban. Like Brian, he is very accessible, and concerned about the wellbeing of people. Major congrats Ian! Kelly

    Reply

  110. Damon Craven

    September 29th, 2013 at 8:19 am

    Hi, after 2 years of suffering from light to extreme pain in my right knee, 5 physio’s, an x-Ray, an MRI, 2 GP’s, an Orthopedic Surgeon and an Arthroscopy 8 weeks ago, I’ve finally found a site with people identifying a real fix.

    Thankyou for taking the time and making the effort to come up with real options that real people can attempt.

    For the first time in a very long time I have something to look forward to and a glimmer of hope. My right knee is now in constant pain and even my surgeon told me that I should just get used to it.

    It’s nice to read of people conquering what has been the most debilitating injury I have ever had.

    I’ll keep you posted.

    Let the training begin!

    Reply

  111. Rod

    October 01st, 2013 at 4:26 pm

    Hello everyone, I just discovered this website and I am very excited to start the slant board exercises. I’ve been really considering surgery due to having extreme pain in my left knee for well over two years… Anyway, you guys are all giving me hope so we will see how it goes. Good to talk to you guys.

    Reply

  112. will

    October 02nd, 2013 at 11:54 am

    great site.

    Reply

  113. will

    October 02nd, 2013 at 12:02 pm

    Are you familiar with Sigfus V.’s eccentric exercise protocol for patellar tendinopathy ?

    Reply

  114. Sigfus Vikthorson

    October 05th, 2013 at 2:11 pm

    Hi everyone,
    I must say that this is a great website with a lot of helpful advice. Kelly of Flex-n-Go slant boards emailed me to say hello and that she saw my name mentioned here recently.
    Best of luck to all,
    Sigfus
    The Eccentric Protocol

    Reply

  115. Kyle Reece

    October 09th, 2013 at 7:32 pm

    I had patelar tendinitis in my left knee for about 2 weeks now and it hurts really bad every time when I play basketball and jump, turn and run. I really want the pain to go away. Do you have any advice for it to heal up? What kind of knee brace or knee sleeve should I wear for basketball?

    Reply

  116. Ian

    October 10th, 2013 at 11:28 am

    Hey Kyle, I see you are a terminator fan huh. Since this injury is within two weeks I am hopeful that you can come out of this one on top. As you have read, many of us have been dealing with what this becomes after years of pain. I do have some advice that I believe will be helpful..but you may not like number 1:

    1. I recommend taking a break from all sports for a period of at least 4 – 6 weeks. Just to be sure.

    2. Go see a sports doctor if you haven’t already done so. They will hopefully put you in touch with a good physical therapist.

    3. There are many exercises for patellar tendonitis that you can find online which incorporate many thigh, glute and hip abductor exercises……remember when doing squats/lunges to never let your knee pass your toes.

    4. Take it easy man and be patient.

    Had I done those things I might not be dealing with what I am now.

    Short term sacrifice for long term health.

    Reply

  117. Jeremy

    October 13th, 2013 at 1:58 pm

    I know this page is iold but the info is very relevant still.
    I am curious if anyone has had Tendinitis flare up from sleep wrong AKA leg bent at the knee all night.

    Reply

    • John

      October 19th, 2013 at 7:28 am

      Im pretty positive this is the reason I’ve been suffering from patella tendonosis. I sleep in the half fetal position for the last 5 years (partner is too warm) and I have suffered from this and hip pain on that same side.

      I can’t correct my sleeping pattern as I always wake up back in the same half fetal which I am obviously doing sub consciously. I have been thinking about wrapping my knee to prevent it bending but still loose enough to keep the blood flow.

      I think your definitely onto something.

      Reply

      • Jeremy

        October 23rd, 2013 at 9:10 am

        I have had to splint and brace my knee and foot to try and train my body to stop curling up at night. All it seems to take is one night with my knee bent (In a natural position) and it will set off the pain that takes months to heal.
        I almost wonder if there is some sort of medical problem causing this on it own, as I also have it happen in my shoulder if I sleep wrong.

        Reply

  118. Biomechanically challenged cyclist

    October 13th, 2013 at 2:18 pm

    @jeremy yes, i always try to keep my legs straight when i sleep. I can feel some irritation if i don’t.

    I have been dealing with PT for 2 1/2 years now and while i’m not better yet, it’s because if this exercise that i am able to manage it, and have slowly returned to cycling after the first 1 1/2 years of not being able to ride at all.

    Reply

  119. Jordan

    October 14th, 2013 at 9:19 pm

    Hi,
    This has seemed very useful to me, I also have PT. I am thinking about getting that board, I have tried everything. I have had constant swelling just below the kneecap for over 2 years now. At first I didn’t rest from sports but now I’ve had 8 months of rest (no running, only biking and upper body weight lifting) and the swelling has not gone down at all and pain is still persistent. It also worth saying I was diagnosed with PT, it’s not auschgood slaughter (or however you spell it lol). Would it be worth getting this board if my knees haven’t got at all better these past 8 months? Or is it worth the risk?

    Reply

    • Ian J. Gibbons

      October 15th, 2013 at 10:45 am

      Jordan,

      Your experience sounds very similar to mine, which HAS gotten better. I recommend getting board so you can do eccentric squats in addition to weight training focusing on quads, glutes and hip abductors. Those things paired with modifying your activities and TONS of patience will hopefully help you as it did me. I’m far from cured but I’m considerably better than before I took action. Now here’s a question for the group: Anyone try PRP injections? I’m looking into it hoping it gets me back to 100%

      Reply

      • Martin Koban

        October 15th, 2013 at 11:06 am

        Hey Ian,

        Brian wrote about PRP in his original post. It didn’t work for him. Based on the research I’ve gone through for my book on patellar tendonitis it seems like a hit and miss treatment approach.

        Researchers actually don’t know whether it works and when it does work, they don’t know why.

        The most effective treatment approaches are eccentric exercises on a slanted board and heavy-slow resistance training. Eccentrics have the most research in support of their efficacy, although they’re being criticized for a number of reasons.

        Reply

    • Don

      January 10th, 2014 at 3:25 pm

      If I can chime in on this………I think the eccentric exercises need to be started after the tendons have healed to a certain point. Where that point is is different for every person. I say this because after developing PT in Feb. of 13′ I continue to play bball through it (like an idiot) for months and months. I would rest for a week here or there or two weeks here or there. It got so bad to the point where I knew I had to rest period. I started eccentric exercises (with the flex-n-go board) but it wasn’t helping…..only continued to irritate my tendons. Now I’ve rested for 100 days and my tendons feel 85 percent better. I’m going to wait until they are between 90 to 100 percent healed and then start the exercises again. Btw, the way I define how they are healed is the level of irritation there is when I massage the tendon area. Initially that irritation was really high but has gone down considerably in the last 100 days. All I can say is this……the healing process is very slow when it comes to the tendons and resting is unavoidable. Any other insights are appreciated:)

      Reply

  120. KB

    October 14th, 2013 at 11:21 pm

    Im a Division 1 college basketball player and I have bad tendonitis. Its really affecting my basketball career and im afraid if I don’t fix it then my career will be cut short. We practice 3 hours a day and it just gets worse. I ice it almost 5 times a day and that gets me through the season but I really need to get rid of it. Im in jeapordy of loosing my starting position. These college trainers are good for nothing. all they do is stem and ice. I NEED HELP! please…

    Reply

  121. Kelly

    October 15th, 2013 at 10:31 am

    KB, there is so much good info here. You can really count on what these folks are sharing here. Please contact me at
    Kelly@Flex-n-go.com And I can sent you some follow up info. Best of luck. Kelly

    Reply

  122. Aldo cianco

    October 19th, 2013 at 9:04 pm

    Martin said eccentrics “are being crticized for a number of reasons”. What are those reasons? I have done a ton of research on eccentrics, and have found only some minor complaints, but nothing significant in my opinion.

    Reply

    • Kelly

      October 20th, 2013 at 1:25 pm

      Hello Aldo, I am not familiar with the criticism, however I am very familiar with Martin Koban. He is extremely approachable, and I am sure he will be more than happy to pass on to you any information you are seeking. Best of luck, Kelly Reeme

      Reply

    • Martin Koban

      October 21st, 2013 at 3:15 am

      Hey Aldo,

      I talk about these things in detail in the book “Beating Patellar Tendonitis”.

      Two reason why eccentric exercises are being crticized are because they hide problems with ankle mobility and because they encourage a knee-forward squatting style, which puts high compressive forces on the patello-femoral joint and the patellar tendon.

      Left unchecked, both of these factors will increase the chance of suffering a reinjury once you return to your sport.

      Reply

  123. Anthony

    October 20th, 2013 at 8:38 am

    Has anyone looked into, or has had Tenex’s F.A.S.T. procedure? It is an outpatient procedure using ultrasound technology to break up scar tissue. I am in the process of consulting doctor’s on the procedure. Recovery is approx 4-6 weeks, and requires wearing a t-scope knee brace to keep the knee straight. However, therapy begins right away so the brace is only used in non-therapy hours.

    Anyway, it would be great to hear someone’s experience with the F.A.S.T. procedure. I found out about it because Pau Gasol (NBA player) had the procedure done last year. Unfortunately I cannot get a hold of him :)

    Patella pain is awful, and being 29 years old I don’t want to live with it for the next 50 years!

    Reply

    • Paul

      December 18th, 2013 at 2:45 pm

      Anthony,
      After trying everything to heal my Patellar Tendonitis for over a year I found a Doctor who has done the F.A.S.T procedure over 40 times. I had this procedure done about 5 weeks ago and as far as I can tell it has given me no relief :( I had really hoped that this would finally be the solution but for me at least it was a waste of time.

      Reply

  124. Dax

    October 22nd, 2013 at 6:11 pm

    my cure was ginger root everyday and omega 3 ,no sugar and no flour…i think thats the 30% you missed!

    Reply

  125. Ian

    November 04th, 2013 at 10:23 am

    Here is another update which I found interesting. First off my knees have been improving slowly since using the slant board for eccentric quats and some other supportive exercises at the gym. I decided to see another sports doctor to get a second opinion and gauge of where I’m at. He takes x-rays and MRI’s of both of my knees.

    I was shocked when his response was that “there is nothing wrong with my knees and I can take part in any activity”. He said there was only a little inflammation behind my knee caps that I could take aleve for.

    Clearly there must be somethin wrong with my knees when standing for prolonged times hurts, any activity hurts and my knees have tons of clicking, popping for the last 3 years. The doctor is convinced it’s not a knee issue and that I see a neurologist.

    I’m no doctor but has anyone had a doctor say nothing is wrong with all their knee pain?

    Reply

    • Tendonman

      November 04th, 2013 at 11:52 am

      Hi Ian, Glad things are getting better. Sorry to hear about your idiot physician. Sounds to me like since he cannot find, in imaging, indication of your pain that it doesn’t exist. This is incredibly stupid and naive of him. As worthless an opinion as going to a psychiatrist and he telling you your depression isn’t real because it doesn’t come up in a scan.

      If I sound annoyed it’s because I am. I saw several physicians about my patellar tendinosis and all were extremely dismissive about it because my knee checked out fine during clinical examination, x-ray was good, even a couple of MRIs came back clear.

      However, in my head, the pain I had was real, it wasn’t neurological, and due to their lack of interest/competency despite textbook presentation of symptoms not a single one diagnosed me as having tendinosis. Instead, I, a lay person, was forced to research this and diagnose it myself.

      Last year I had the best doctor in the city see me, confirm my diagnosis, and finally it actually came up on an MRI (mild patellar tendinosis).

      The moral is: Doctors are smart, but they are not omniscient. I was also told I could more or less get back to activity, despite that activity being the cause of my discomfort. A silly recommendation.

      Reply

  126. Matt

    November 07th, 2013 at 12:33 am

    Hey, i came across your post while researching knee braces…i’m an avid and competitive basketball player who had patella surgery 18 months ago for a completely torn patella. I do wall sits, which have worked great, eccentric also, but i’m intrigued by your experience.

    However i’m curious about the exercise because your knee is noticeably in front of your toes, which according to every PT I’ve spoke to and read, that positioning exacerbates the strain on the patella tendon. Knee should always be behind the toes. Have you discussed this aspect of the exercise? Thanks!

    Reply

    • Troy

      November 26th, 2013 at 2:05 pm

      Hi Matt,
      I’m thinking, because you’re on a 25 degree angle, some amount of you is going to have to be in front of your toes, so you don’t fall back.
      The technically correct normal squat, on flat ground, the knees are supposed to stay behind the toes. It’s a balance exercise, as much as it is a strength exercise. Right? So, I would think to attempt the same type of balance, as far back, and technically correct as possible. But since you’re on an angle pushing you forward, you will have to comensate. That’s just my guess.

      I’m not a medical, physical, legal, or much other of an expert. Just like the helpful young man who started this is.

      Interesting that people keep asking him for medical advice, when he has clearly stated, at least severl, if not many times, he is not a medical expert.

      I would like to thank him for this blog tho. Seems an awful lot like an advertisement, but also seems like a lot of good discussion and information has come of it.

      Ciao!

      Troy

      Reply

  127. jom7@hotmail.com

    November 12th, 2013 at 2:49 pm

    I was suffering for a year with the same problem! Even touching it was excruciating. I got the plasma injection into the knee. It was very painful for the few seconds but a week later it was perfect and haven’t had trouble since! That was 5 years ago! My right knee has developed the same problem now and I’m getting the same injection next month! Unreal results!

    Reply

  128. Ian

    November 12th, 2013 at 2:57 pm

    Jom7

    I’m very curious about your experience with PRP. I’ve tried several different methods in my quest for painless knees and PRP injections are next on my list. I plan on leaving no stone unturned and hopefully my results will be as positive as yours. Please tell me more.

    Reply

  129. Tendonman

    November 12th, 2013 at 4:48 pm

    I have a consult with an exceptional sports doc in my city for next month to talk about PRP. Unfortunately insurance doesn’t cover it–and unfortunately that tells you something, specifically that it’s not a uniformly scientifically proven approach. However, it is covered in some medical techniques, even if not direct tendon injection.

    Moreover, there are enough anecdotal indications about it that I think it is probably worth the $600-800 to try, at least if the doctor agrees. Risks are low, but I have seen some occasional references by people of scar tissue build up. However, my sense is that if you’re considering surgery it is probably worth PRP.

    I am considering it partially because I’m considering surgery but partially because I’m not; sometimes I can go a couple of days straight with no tendon pain. Even though I’ve had it for many years now, I feel it’s probably not severe enough that surgery is truly indicated, so maybe PRP would be worth it.

    Reply

    • Ian

      November 12th, 2013 at 5:06 pm

      I’ve read enough success stories regarding PRP to roll the dice and see if I can become one of them. Fortunately I have the funds, I’ll just have to get oreo cookies for my wedding rather than a wedding cake. Risk seems minimal and when it comes to my health I’ll try ANYTHING! I had arthroscopic surgery on my right knee that definitely wasn’t necessary, I recommend putting of surgery at all costs.

      Reply

  130. Bo Ramsey

    November 25th, 2013 at 9:51 pm

    I stained my acl very badly wh job they honk has cause my patellar tendonitis! I can’t hardly run a short lap without pain! I use the strap but doesn’t really do much for me! If I sit still for to long it stiffens up a lot! Crossfit squat holds help it a lot however the pain always returns! Think this slant board could help! I am a very very active person and rarely slow down!

    Reply

  131. Joseph Latham

    November 27th, 2013 at 12:22 pm

    Great article. Anyone have a success story to share, I could really use some motivation. How are you doing Brian?

    I have quadricep tendonosis in both knees that started with a hiking injury four months go. I have no history of knee problems and am 30 years old. After being misdiagnosed with “runners knee” I spent 2 months in physical therapy, daily icing, NSAIDs. None of this helped. Even resting for a month. It wasn’t until I demanded an MRI that I found out it was chronic tendonitis.

    I immediately started the eccentric squats. Unfortunately, I jumped into it way too fast, adding weight and one legged squats from day one. Big mistake. Now I’m resting for a week or so and will get back to the eccentric work very SLOWLY.

    Anyway, the moral of this story is FIRST get a proper diagnosis and SECOND start eccentric work SLOWLY.

    I would appreciate any encouraging success stories with healing this annoying problem. I’m very depressed and having trouble coping. Please email me at joelatham2001@yahoo.com

    Thanks :)

    Reply

  132. dwayne

    November 29th, 2013 at 12:34 pm

    Hey guyz, I have been dealing with patella tendonitis for almost a year now and I got it through basketball. My doctor said no matter how hard you try to make it get better, your tendon will never be 100 percent again , I cant go hard as I used to . Is this true people

    Reply

    • Brian Patterson

      December 26th, 2013 at 10:11 am

      I got mine through basketball as well. For me, I’m not 100%, but the pain/injury is managed and I can play basketball if I want.

      Reply

  133. Joseph Latham

    December 03rd, 2013 at 6:26 pm

    Also, has anyone here experienced “buckling” of the knee or feeling like its “giving out” with their tendonitis?

    It seems to happen if I overstrech my hamstring once and a while…..any comment is much appreciated :)

    Joelatham2001@yahoo.com

    Reply

    • Brian Patterson

      December 26th, 2013 at 10:10 am

      Mine felt like that, and when the weather is really cold, I put on a brace because I know that it feels weaker when it is cold and tight.

      When it is cold, my knee is also more likely to hyperextend (or feel that way) by going inwards, so a simple neoprene brace keeps it nice and warm without restricting mobility.

      Reply

  134. Longshot22

    December 07th, 2013 at 8:20 pm

    I have had patellar tendinitis for about 7 months now. Almost all my swelling gone. I have a lump on my patellar tendon. My PT told me it was scar tissue. Does anyone else have scar tissue or know if it can be broken up? Also is it permanent? Thanks for all your advice

    Reply

  135. Amanda

    December 22nd, 2013 at 12:17 pm

    Hi,

    My mom has chronic arthritis in her knee and after an arthroscopic surgery, the pain has worsen. Both her knee and ankle have weaken tremendously. She also experiences petallar tendonitis and tends to limp, because she can’t exert any weight or pressure on that leg. Would you still recommend the board for her? Thanks for any feedback!

    Reply

    • Brian Patterson

      December 22nd, 2013 at 6:10 pm

      Hi Amanda, I’d check and see if the doctor will prescribe physical therapy. And, if so, consult with the PT on if the board and or eccentric exercises would help. If they feel it is safe, it could definitely be worth a try.

      I’ve found that doctor’s don’t know much about physical therapy and the route to recovery, so talking with a PT who does it day in, and day out would be best. They know the different modalities, when to push and when to hold off, etc.

      Best of luck, I hope it works out for your mother!

      Reply

  136. Longshot22

    December 25th, 2013 at 1:56 pm

    Do you have any info on healing from patellar tendinosis? It is a graduated form of tendonitis that causes tendon degeneration.

    Reply

    • Brian Patterson

      December 26th, 2013 at 10:08 am

      Hey Longshot22, when I talked to my Orthopedist about Tendinosis vs Tendonitis, he said it is just parsing words and there isn’t a difference.

      I don’t know much more than that, although I do remember thinking, after researching, that I had tendinosis based on what I read.

      The end result was I just pressed ahead, reading as much as I could on both, as it seems there are far more similarities than differences.

      Reply

  137. Jeremiah

    December 26th, 2013 at 7:39 pm

    Brian,

    Hi Brian,

    Great post.

    I’m assuming that this is one of the studies you read:
    http://www.umphysicians.org/prod/groups/ump/@pub/@ump/documents/content/ump_content_421644.pdf

    But can you share the references you found for this comment:
    “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.”

    Thanks!

    Reply

  138. Longshot22

    December 27th, 2013 at 12:37 am

    Hi Brian
    I am happy that you got overload of your pain. Tendinitis means swelling. Tendinosis means tendon degeneration. This means there is a lot of scar tissue built up on you tendon. You have to break it down and remodel it. It’s painful.
    Brian, how long did it take u to recover to where your at now with this injury? Thank you very much

    Reply

  139. Taylor

    December 29th, 2013 at 3:33 pm

    I have been reading this thread periodically over the last year when I had patellar tendonosis on the lower part of my left knee. I decided to get the PRP injection which ACTUALLY WORKED. The best advice I can give to anyone who gets this injection is to be sure you give it time to work. Despite my ortho telling me it would take 6-8 weeks, it ended up taking about 3-4 months before the tendon was healed. This is injection is not meant to be an instant fix, it basically kick starts the healing process (which is why this injury is such a bitch, your body doesn’t do anything to heal it). Unfortunately right when I got back into exercising normally, I seemed to have gotten the injury again at the top of my other knee. I’m currently having insurance issues so I can’t get it diagnosed by MRI, but I may just go for the PRP again considering my previous success.

    Reply

    • Brian Patterson

      December 30th, 2013 at 12:56 pm

      Hi Taylor, thanks for sharing about your experience – that is awesome that PRP worked for you.

      I also think hamstring and quad strength has a lot to do with this injury, as I’ve noticed that as I’ve been doing more weighted front and back squats, my knee has become more spry.

      Since you’ve had it in both knees, it could indeed be a form or strength issue. Maybe not… but just a thought.

      Reply

    • Don

      January 10th, 2014 at 3:40 pm

      Hey man I’ve also been reading this page for the last year on and off to get feedback from different people. Don’t want to sound pessimistic but there is a chance that the PRP still didn’t work……the tendons (depending on how badly they are irritated and injured) can take 3-4 months (or longer) to heal. I’m thinking it will take about 6 months for me to be close to 100%. My ortho also said wait 5-8 weeks which is bogus because A LOT of what I read says you have to rest for 100 plus days. The tendons heal wicked slow which is why its so frustrating to deal with. Best of luck to you.

      Reply

  140. Longshot22

    December 30th, 2013 at 5:56 am

    Taylor
    I’m so happy that you got over this injury. I’m looking into prp injections at the moment. I hear that not many insurance companys cover it. I hope mine does.
    Currently I am stretching my hip flexors, quads, hamstrings and doing ankle dorsiflexion for ankle mobilization. I also do buttocks , hip flexors exercises and eccentric squats on a slant board. Furthermore I am doing cross friction massage on my tendon. I do cross friction massage and the stretching daily. I do the exercises every other day. I have had patellar tendinosis for 7 months now and I am finally seeing some progress. Taylor. How many shots did you receive of prp injections? Please respond as soon as you can :)

    Reply

    • Brian Patterson

      December 30th, 2013 at 12:57 pm

      Hey Longshot, I’d suggest adding in front and back squats, eventually weighted (if you haven’t already).

      Reply

    • Taylor

      December 30th, 2013 at 5:10 pm

      Longshot
      I only received one injection in my knee. It is true that insurance companies won’t cover this yet, however my ortho only charged $300 for the shot (well worth it). From what I’ve heard, the average price for this may be around $1000 which is a bit ridiculous considering they are just injecting your own platelets back into you. I would suggest calling a few orthos in your area and see who is offering the best price. Again I want to stress that this injection starts the healing process of the tendon. If you have been suffering with this injury for 7 months, realize it may take 5 months before it is fully healed. As for what Brian said about quad and hamstring strength, I agree 100 percent that this can help prevent the injury. However, in my case I squat and deadlift often and heavy (have been doing so for a while). My issue likely is due to overuse, as I am also into Crossfit. I, like most others, have a terrible habit of jumping back into my usual routine too quickly after recovering from an injury. Needless to say, from now on I’ll be adamant about easing back in to my workouts, under-doing it is always better than over-doing it.

      Reply

  141. Ian

    December 30th, 2013 at 4:43 pm

    Hi all,

    It’s been about a month and a half since my PRR injection and the verdict is still out. One thing I can say is that both of m knees have been feeling better with significant rest. I was definitely OVERDOING it in the gym and on the slant board. Right now I’m only doing leg lifts, hip abductors and light squats and everyday walking around feels great. Still, that’s a far cry from the athlete that I am hoping to return to. When I return to the slant board I am going to make a point to take it veeeeeeeeery slowly. I’ll share PRP updates as I feel them.

    Reply

  142. Longshot22

    December 31st, 2013 at 4:49 am

    Brian. I will eventually ad back squats once I get over some of the discomfort/pain. I also noticed that when do the exercises; the next day my knees feel great, but later during the day they start to get stiff again. I have to constantly keep stretching to release the tightness.

    Taylor

    I hope I can find an ortho that can charge me that low of a price. I will pay him immediately. I also have read that once you have this for more than 6 months it takes 3 – 6 to heal and up to a year for you to be 100% completely over it. Seems like I got a long recovery ahead of me since I have only been at this fir 2 months.

    Reply

    • Brian Patterson

      December 31st, 2013 at 10:16 am

      Hey Longshot, do a search for Prolotherapy in your area – this is essentially the same treatment as PRP, but they inject saline into the injury area. I’ve found that many of these practitioners are now performing PRP, so you might find someone offering PRP at the price you are looking for.

      Reply

  143. Longshot22

    December 31st, 2013 at 7:42 pm

    Brian
    Yes. U am currently doing that but I must wait till after New Years since every office that I have called recently is closed. :)

    Reply

  144. Helena Spicer

    January 03rd, 2014 at 7:46 am

    Love this blog, thanks. I have learnt so much.
    I bought a slant board from Physiofoam.co.uk because it seemed much cheaper and lighter than the wooden ones, and so far it’s been great. I think that 90% of my knee pain is gone.

    Is this as good as it’s going to get for me? I’m mulling over the injection but I can run again now and don’t want to risk that. My injection would be through the NHS and therefore free.

    Reply

  145. Helena Spicer

    January 03rd, 2014 at 7:48 am

    Love this blog, thanks. I have learnt so much.
    I bought a slant board from Physiofoam.co.uk because it seemed much cheaper and lighter than the wooden ones, and so far it’s been great. I think that 90% of my knee pain is gone.

    Is this as good as it’s going to get for me? I’m mulling over the injection but I can run again now and don’t want to risk that. My injection would be through the NHS and therefore free. Any thoughts?

    Reply

  146. Ian J. Gibbons

    January 03rd, 2014 at 1:12 pm

    Hi all,

    A couple of things to respond to:

    Longshot:
    You had mentioned scar tissue and I wonder if I am experiencing something similar POST PRP. There is a lump where the doctor did the final injection. There is still pain in the area which is apparently unusual. I’m still hoping PRP worked for me but wonder if I now have scar tissue in that area due to it.

    Helena:
    That’s great that you are now able to run. I wouldn’t consider PRP. Being able to run is a HUGE accomplishment. I’m curious:
    1. How long have you dealt with Tendonosis?
    2. How long have you been using the slant board?

    Thanks

    Reply

  147. Longshot22

    January 04th, 2014 at 7:22 am

    Ian J gibbons.
    The scar tissue form because I kept re-injuring the tendon. I have almost gotten rid of most if it but it is still there none the less. I noticed once all the swelling had subsided there was a bump only tendon. I can see it slowly go away as I continue to do cross friction massage daily but the progress is gradual.

    Reply

  148. Peter

    January 05th, 2014 at 6:14 pm

    Hey Brian,

    I started with tendonitis from eliptical over use above my kneecap ( quad tendonitis) and about 6 months later it spread to my patella below. I had MRis PT doctors etc and theres no tearing just swelling. Above my knee and below ( below the the kneecap the patella tendon itself is swollen and above the VMO muscle http://www.physioadvisor.com.au/8290850/quadriceps-strengthening-exercises-vmo-strengthe.htm is swollen along with soreness in both tendons north and south of the kneecap.) I noticed after I do your excercises the swelling is worse…have you ever heard of this, or this type of injury? I know your not a doctor but thought it cant hurt to ask.

    Thanks

    Reply

  149. Ian

    January 05th, 2014 at 7:53 pm

    Hi Peter,

    I am very familiar with what you are describing as I have experienced it as well. I have taken a break from the slant board and the soreness north the kneecap was gone in 2 weeks. I had realized a couple of things:

    1. I was doing too much too soon, in addition to gym exercises

    2. I was doing the exercise in the morning and then walking all day. It began getting better when I did the slant board at night and had 6 hours of sleep for the muscles to rest.

    3. Be very mindful of not letting your knee pass your toes.

    Those things helped but rest really knocked it out.

    Good luck.

    Reply

  150. Damon Craven

    January 12th, 2014 at 10:38 am

    Hi again, just touching base to give an update on progress and some additional advice. Things definitely moving in the right direction since first post 3 months 2 weeks ago. Poison significantly less and even a few pain free days here and there. Not quite back to running but within a month I reckon.

    I have also found that in addition to the eccentric exercises, if you jump on an orbital trainer and cycle backward, yes backwards, it is doing wonders for strengthening my vmo. It is also another option for cardio much less painful than running or other impact exercises.

    Again thanks for making this site. Keep the results coming in.

    Reply

  151. longshot22

    January 12th, 2014 at 9:33 pm

    Has anyone bought this e-book?

    http://anthonymychal.com/kneepain/?hop=jamtack

    Reply

  152. BENSON

    January 14th, 2014 at 5:00 pm

    Fucking Fucking patella tendonitis! Am I right?

    I also tried everything:

    Rest for 2 months – worst decision
    Gym exercises – bad decision
    Knee socks – useless
    Osteopathy – who knows
    Cycling backwards – a little helpful
    PRP injection – 2 months later 30% pain is reduced
    Pilates – helps track the knee. This combined with eccentric cycling and PRP seems to be helping a little although I am still a long way from running.

    I am 21 and have had severe PT for a full year now. Hopefully one of these techniques will clear me completely although I’m not too confident :/

    Quick question:
    Who knows about/has had the Grastin technique? Is it advisable to try and what sort of doctors do it? it looks damn painful

    Reply

  153. Longshot22

    January 15th, 2014 at 12:49 am

    Hey benson. U need to wait for most of the inflammation to subside before u start doing any kind of exercise. What u can do in the mean time is stretch. I have had this for 8 months and I m finally looking at some great progress. I can see my tendon begin to take shape. I will say my tendon is almost back to normal and my pain level dropped over 60%.
    What my remedy is stretch my quads hamstring hip-flexors and calves. Then I follow these exercises
    http://www.fix-knee-pain.com/jumpers-knee-treatment-triangle/
    I have been faithful for two whole months and it has really helped me. I also due cross friction massage after I complete this process. U should also try to avoid pain when doing daily activities. Like when climbing stairs and getting into a car or even getting up from using the toilet. I have modified every aspect of my life and I happy to that it has helped a lot.
    About the graston technique. I did it on myself and it did help. The night after my leg felt loose and I had no pain, but eventually the pain came back as it always does with patellar tendinitis. I don’t think I will be trying the graston technique at all anymore. It is very painful and your leg gets bruised very badly. It basically speeds up the recovery time by breaking down scar tissue. None the less it yields results.

    Reply

  154. Mark Handberg

    January 20th, 2014 at 8:27 pm

    Hi Again.
    I want to update you all about my patella tendinopathy situation. Obviously my knee got so bad this summer that I had to walk with crutches. After trying to protect the knee by compensating a lot, my other patellar tendon got tender as did one of my achilles tendons. That meant that I couldn’t walk anymore and got in a wheelchair for 2 month patially due to that and since I got severe tendinopathy in both shoulders (supraspinatus tendons) since I had to use my shoulders to to a lot of the work the legs usually did. I was also hospitalized for 2 weeks because a couple of doctors and myself started to believe that the main cause could be rheumatoid arthritis, which often starts out with tendon pain in ankles, knees and shoulders.

    After having rules any arthritic condition out, the doctors best guess was that I have natually weak tendons judges on my history of tendon injuries the past 5 years (about 15 different tendon injuries) and the fact that several on my moms side of the family have had severe tendon issues.

    After that I was at a rehab center for a month before I was able to move into my own apartment again and walk properly.
    Then after new year, I started up at a new rehab facility where the intensity of the rehab exercises went up. It wasn’t very hard to do, but after the first, 2nd and 3dr time especially, the knee felt wrong. The physical therapist didn’t understand why cause a previous ultrasound scan back in late october revieled nothing abnormal in the tendon. I tried to warn her since an ultrasound scan doesn’t tell everything about a tendon condition. I had really severe swelling and tenderness prior to it and had not done much rehab since then, only rest. Rest alone is a must to start of with and may last for weeks depending on the severety of the injury.

    As I mentioned in my previous post, as I studied to become a physical therapist myself and did my bachelor project last spring on patellar tendinopathy, I found a great deal of evidence, that decreased ankle dorsi flexion and increased ankle pronation (related to knee valgus) does increase the force on the tendon during sports activities. That being said, those factors are msotly important to be aware of is you are and athlete where you jump and LAND a lot.

    But back to my situation. Through my journey through the Danish health care system I’ve met a lot of people from doctors, to physical therapists and occupational therapists and very very few of them have had any real insight of how serious my injury(s) was/still is and how to deal with them. I had a ton of arguements with them because they wanted to take over my rehab and make me to things, they thought would help me. They failed to realize that my long immobilization period wasn’t a choise of mine, but a nessasary thing for me since I had to stop compensating during my daily activities.
    On top of that, the occupational therapists and a nurse wanted me to do as many daily activities as possible by myself and stop thinking about protecting myself since they thought that the cause of my problems was in between my ears. I decided to do some of the activities they wanted me to do and still regret it here 3 months after cause it made my shoulder problems increase so much since my shoulders were aldready fatigued at that time. First after their tactic failed they started to listen to me a bit and let me decide the rehab approach.
    I based to rehab on a combination of knowledge on tendon healing and knowledge of my own body’s response mechanism. Both thise things are absolutely crucial. The therapiststs didn’t know nothing about that and had 0 experience with tendon rehab. Yet they were wouldn’t believe that they were wrong about a lot of things.
    The biggest mistake they made were:
    . Not listening to the patient
    . Not paying attention to me injury history
    . Not learning about the healing time and mechanics of tendons
    . Attacked my rehab like they normally did with their patients (mostly older people) with the ,ain focus on activities of daily living.

    Finally I want to bring up a few key things I’ve learned through studying and experiencing the injury myself:

    . Respect the tendon’s healing time!! Go through the different stages and phases one by one and MONITOR the injury.

    . Don’t push through the way. Avoid it completely eventhough some therapists and even programs say that pain is okay. Yes, if you have a chronic injury, the tendon will be wery sensitive to stimuli and will send pain signals to the brain even when to damage has happend to the tendon – related to allodynia. Despite that, it’s a risk to go into the pain and as I’ve learned the hard way, the more your tendon is injured (weakened), the less pain your must feel when you rehab! I’ve made my injury much worse without feeling anything before the next day.

    It’s all about beeing in control of your injury, which I will define as experiencing progressive improvement through your rehab and notice increased force tolerance. That may take 3-4 weeks to notice that.

    This is very important! If you suffer at setback, be careful: Don’t try to keep doing your rehab at the same intensity. Your tendon has weakend and it needs A: rest B: less intensive rehab.
    The restperiod is not described in detail anywhere it seems, but I believe that the more serious your injury is, the longer your rest period needs to be. Remember, this is not a muscle injury. It won’t heal up in just a few weeks.

    If it’s a very severe tendinopathy, you may have to treat the injury like a post surgery rehab. That will include RICE for 2-6 days, (mostly) rest for 3 weeks followed by stretching (very light). Stretching is important to avoid that scar tissue to become unorganized and stiff cause that will make you prone to reinjure it. A lot of scar tissue may require shock wave therapy and/or Graston Technique to break up adhesions. I will also give PRP a try as well as laser.

    Strength training may have to wait till after 6 weeks where the primary healing has taken place, but the tendon can remain vulnable till 100 + days.

    Hope some of this was usable to some of you.

    Reply

  155. jp

    January 21st, 2014 at 4:47 am

    hi brian,
    I want to thank you for sharing the slant board miracle! The more I perform eccentric exercises, the more my knees become stronger and the pain was gone. It helped me a lot. This stuff really works!!!!

    Reply

  156. Mark Handberg

    January 21st, 2014 at 5:55 am

    Just to add to what I wrote just above:
    Some of you have described pain despite having been “cleared” by doctors who say that your tendon is fine. Like I wrote above, if their statement only is judged on palpation test and/or ultrasound, there can EASILY still be tendon weakness. There was in my case. MRI may give you more information than just an ultrasound and it could revial other problems than just the patellar tendon. Now, why should there be other issues than just tendon injury? Because if you’ve had long lasting tendinopathy/tendinosus, the tracking of your patella (knecap) is likely not proper because intraarticular knee pain and swelling will severely decrease the activation of the VMO (vastus medialis obliquus) on the medial side of your knee. The vastus medialis is vital for the patella tracking so that the kneecap can run smoothely in the femoral groove. If it’s not working properly, the kneecap will track laterally and possible tilt as well and compres the structures on the lateral side of the knee including the lateral plica and wear down the retropatellar cartilage. I had
    On top of that, your lateral retinaculum will get tight and make your kneecap even less mobile.
    If your patellar tendon have gotten injured and reunjured several times, chances are that a lot of scar has build up shortening the tendon which can lead to patella baja (where the kneecap is aligned too low and often inferiorly tilted too. That will likely put excessive pressure on the fat pad (located just underneath it) which is a very sensitive area.

    I personally experienced all the secondary problems above with my other knee (yes I also had patellar tendinopathy there several years back), and even after the tendon had healed, the pain and discomfort comtinued. Several doctors told me my knee was fine due to non positive tests and even and MRI scan. After 3 years of pain I got rid of the pain within one month of treatment once I realized what the root cause of my pain was – maltracking of my kneecap. So I specifically worked on the VMO, strecthed out the lateral structures (vastus lateralis, lateral retinatulum and IT band), did cross friction massage on the lateral plica (to break up scar tissue) and recieved 6 PRP injections. After that absolutely no pain, so it worked out great for me. That being said, I can not say it will for you guys too, but I want you to pay attention to those other areas inside your knee as well. You can ask your PT, orthopedic surgion or doctor about it, but if your problem is really an issue for you, it would be smart to ask more than just one “expert” about it.

    With my other knee I got the wrong diagnosis by a PT who claimed that I had a partial tear of my ACL and told me to never play sports ever again. 3 experts and an MRI scan later I leaned that nothing was wrong with the ACL.

    As far as those other trouble causing areas inside the knee is concerned, it can be difficult to feel if your pain is located to the tendon or those other structures I just mentioned, but in general, if you feel discomfort from just sitting with your kneejoint in the same position (also not flexed), it can be due to chondromalacia patella. Pain when hyperextending the knee can come from the fat pad.

    The PRP may work for some but not for other for the simple fact that not allc clinics uses a machine that spins the blood properly to extract the platelets from the rest of the blood. The PRP should have up to 8 times the amount of platelets compared to the normal blood, which they say often is not the case.

    Reply

  157. Dan

    January 22nd, 2014 at 4:27 am

    So is patellar tendinitis something that would show up on an MRI? I’ve been having sore knees after squatting for a few years now and it can just get sore while sitting down. Finally I got an MRI and all it showed was a thickening of the fat pad? Doctor says its just a strain injury but it seems to hurt even if I haven’t squatted in a few weeks. Anyone had any similar experiences? Is the eccentric movement likely to help me?

    Reply

  158. Mark Handberg

    January 22nd, 2014 at 7:18 am

    Slight tendinitis may not show up (but will on an ultrasound with doppler effect showing the inflammation as red colours), but chronic tendinopahty of the tendon will (thickening of the tendon) will be visuable. You can get more information from an MRI than you can get from an ultrasound and see other problems like the fat pad in your case.
    Here is a bit from a study about MRI’s on patellar tendinopathy: “The radiological and MRI appearances of 24 knees with
    patellar tendonitis resistant to conservative therapy
    were analysed to identify the characteristic MRI
    appearance and to determine if the patellar morphology
    was abnormal. A significant thickening of the tendon
    was found in all cases; this was a more reliable
    diagnostic feature than a high signal within the superior
    posterior and central aspect of the tendon at its proximal
    attachment
    The site of the lesion shown by MRI is more
    compatible with impingement of the inferior pole of the
    patella against the patellar tendon than a stress overload
    of the tendon. There were no significant differences in
    the length of the patella, inferior pole or length of the
    articular surface when the patellar morphology was
    compared with that of a matched control group.”

    Reply

  159. Mark Handberg

    January 22nd, 2014 at 12:22 pm

    I’d also like to comment on a few things that are rarely toughed on related to the healing process of an injured tendon.

    First of all, an injured tendon, like I mentioned and as you might have found out, has a very long healing time due to poor blood supply.
    From point of injury, the healing process will take place and consist of several overlapping phases:
    . Bleeding followed by and inflammation stage (normally within the first 72 hours)
    . Proliferation stage with (from day 2 till about 6 weeks)
    . Remodelling stage (from about week 6 till 6 + months)

    Recently it has been accepted in the medical world that chronic tendon problems is NOT an inflammatory condition as most of the inflammation has cleared the tissue with the first 3 days on injury. That being said, you can still have injury recurrence which will be inflammatory.
    Inflammation is said to be bad for the healing process, but it’s actually vital in the first part of the healing in order to clean up the area.
    Now, in the chronic tendinopathy, there is often adhesions with scar tissue laid down in a very unorganized way, unlike healthy tissue. That weakens the tendons significantly by reducing it’s stress tolerance and can be a major problem for good rehab results. That is why aggressive methods like shockwave is often introduced for the chronic problem in order to break up the adhesions and restart the healing process. In that instance, inflammation is wanted and needed. That being said, you still don’t too much inflammation after every rehab session you’ve done because that delays the healing process, which is why you don’t start rehabbing just after you’ve had shockwave treatment.

    So for the most part, I encurage you to eat healthy and get enough calories in so that you DON’T LOOSE any weight during the healing phases of the tendon. Reason being is that tendons only grow stronger like muscles when you take in more calories that you burn! Huge but yet overlooked factor!

    I will recomment eating a healthy diet with a lot of vegetables and less meat, SUGAR and grain. If you can. stay away form alcohol, tobacco and even caffeine which will higher your stress level by switching on your symphathetic nervous system.

    Stress can delay tissue healing by a great deal by increasing inflammatory activity, decreasing blood blow to the injured target tissue.
    If you look at the elite olympic athletes, the best of those recover the fastest and they have a great ability to calm their selves down and relax when needed. Many of then practice relaxation in some form for example by breathing exercises, yoga, meditation, and more. If those athletes became stressed, overuse injuries like tendinopathy would possibly occur because of a lack of postworkout recovery.
    If you have a chronic injury, your are very likely to have a higher daily stress level and if your CNS is in that mode, your body’s own ability to heal itself will be affected. You tolerance to external stress will be low, meaning both the tissue itself and your nervous system.

    That’s why a good rehab for the chronic patient should focus on the mental part of the rehab as well and why you should too.
    Like the great Tony Robbins have said. The most important thing for us humans to feel better when sad is personal growth. So while being injured, take the time to grow. Don’t waste the time but use it wisely to get stronger both physically and mentally every day. Think: Today I am going to get stronger than I was yesterday. Be patient with it and slowly but surely the result will show and that will get you emotionally high. It doesn’t matter that much that your not 100% yet. But just improving day by day feels great and if you place smaller goals along the way, improvements are easier to spot when you reach those goals.

    Look at this as a test and an opportunity to grow. You have the opportunity to learn something about yourself and become a better and more humble human beeing from this experience.
    As they say, tough times don’t last but tough people do! Stay strong!

    Reply

  160. Dr. Farzana Doctor

    January 25th, 2014 at 5:20 am

    hey.. thanks for this article on ur site.. I am suffering from tendonitis since past more than 2 year.. I have tried everything EVERTHINHG.. my ortho gave me a steroid injection as well..
    I am sick and tired of thing injury now.. pls pls help me.. I was a regular runner (doing high intensity interval training) i had to stop it cause of this injury and my weight have increased in past 2 years..

    please please help me.. i want to do high intensity interval training as soon as possible..

    thanks very much.. really appreciate your article but will this slant board thing help me ??

    kindly reply and guide me..

    Reply

    • jp

      January 29th, 2014 at 11:32 pm

      The slant board really helped me and the pain in my knee is almost gone. The more you perform eccentric exercises using the board, the lesser the pain in the affected area. You will suddenly feel that your affected knee is getting stronger.
      I am also using the LP open patella knee support 788 when playing basketball and I can say that I am slowly but surely recovering from Patellar tendonitis. The slant board is indeed a miracle!

      Reply

  161. Stefan Thomsen

    January 29th, 2014 at 11:20 pm

    I’ve suffered tendonitis in my right knee for about 2years now.

    I have had cortisone injections and countless physio appointments. Costly process but only temporarily stopped the pain, i play soccer all year around so no time to rest.

    The season before last I took 2 months off but it never got better on its own, so a few pain killers ( inflammations ) before the game and I’m good to go. After once i’ve cooled down the my knee is very painfull to touch very imflammed. I find it hard to sit down sometimes my knee needs to be straight and moved around a bit to stop the discomfort. Only being 24 fit and healthy this is a problem I am willing to fix once and for all.

    I am willing to try anything and I hope I can try this treatment method within my normal soccer scheduled and hopefully see results. I don’t want to sit around with this problem anymore, no one can seem to help me its not normal. Long car rides and plane rides are a nightmare, aching knee just from being bent is a nightmare.

    will stay posted

    Reply

  162. bryan

    February 04th, 2014 at 1:38 am

    hey.. thanks for this article on ur site.. I am suffering from tendonitis since past more than 2 year.. I have tried everything EVERTHINHG.. my ortho gave me a steroid injection as well..
    I am sick and tired of thing injury now.. pls pls help me.. I was a regular runner (doing high intensity interval training) i had to stop it cause of this injury and my weight have increased in past 2 years..

    please please help me.. i want to do high intensity interval training as soon as possible..

    thanks very much.. really appreciate your article but will this slant board thing help me ??

    kindly reply and guide me..
    http://healthtipsspace.blogspot.com/2014/01/how-to-get-rid-of-knee-pain-fast.html

    Reply

    • Brian Patterson

      March 24th, 2014 at 12:09 pm

      The slant board definitely helps me. I do HIIT training now (CrossFit) without issue, although I do wear a sleeve on my knee, just to keep it warm.

      Reply

  163. jp

    February 06th, 2014 at 4:11 am

    hi bryan,
    I’ve been using the slant board for 3 weeks and the results are amazing. Now I can play basketball and the pain in my knee is slowly vanishing. I think it will be more effective if you try to focus on the eccentric exercises using the slant board and isolate yourself from other harsh activities that causes knee pain. I perform these exercises 3x a day. Again, the slant board is a miracle to me. I hope you will also experience the same thing. Good luck!

    Reply

  164. Jernej

    March 06th, 2014 at 3:37 pm

    Hei Brian

    I have the same problem as you had. I have pattela tendonitis on right knee. I have just one question.
    My healty left knee is some degres more flexibility than injury knee. I feel kind of limited when trying to stretch both legs equally. Have you the same problem?

    I am from Slovenia so sorry on my english.
    Bye

    Reply

    • Brian Patterson

      March 24th, 2014 at 12:08 pm

      Hi Jernej, no, I didn’t have that problem. If I did, I would probably work on mobility and flexibility in my soar knee/inflexible leg.

      Come to think of it, the lack of flexibility might have an impact on your patellar tendon, as perhaps the tendon is having to compensate when you are doing complex movements.

      I’m no expert, but just a thought.

      Reply

  165. Mark Handberg

    March 06th, 2014 at 6:10 pm

    I want to make one thing clear to those of you who are suffering a lot from the chronic problems with the patellar tendon problem is no longer inflammation (unless you’ve reinjured it just recently). Your problem is degeneration of the tendon tissue with thickening of the tendon and scar tissue formation. The scar tissue forms primarily in the first 6 weeks of the healing after injury or reinjury. If you’ve had decreased range of motion in the knee for a while it is most likely because the scar tissue has formed but in a very unorganized manner. Therefore you will also be far more likely to reinjury your tendon, so therefore you have to regain full range of motion in your knee as one of the first things.
    Your knee may not tolerate the standing eccentric exercises because it’s too weak, so you must focus on the elasticity of the tendon first and maybe just do Terminal Knee Extensions early on.

    In a very extreme case like my own, the rehab should be treated like a postsurgery rehab with very limited activities for those first 6 weeks until the remodelling phase is reached.
    After 3 weeks of relative rest, you can begin to stretch the tendon. The most safe way is dynamic stretching where you bend the knee for about one second and extend it again. Do only bend the knee very slightly past the first stop of resistance and do it 10-15 times every 2-3 hours every other day. Make sure that the knee has been warmed up a lot before you do it. This may cause slight discomfort after you’ve done it, but if it goes away after less than 10 minutes, you should be okay. If you experience a set back (increased pain and/or swelling), you may not know it before the day after as inflammation has entered the area then. That’s the tricky part of the rehab knowing how much/little the tendon can tolerate. In terms of a setback, you might have to take a brake for anywhere from 4 days to 3 weeks depending on the severity. Waiting more than 3 weeks won’t do you any good and only allow the tendon to stiffen up more. There are the somewhat official recommendations from manual therapists in my country of Denmark.

    Reply

  166. Abbey B

    March 06th, 2014 at 10:01 pm

    Hi! I’ve been in pain in my right knee for almost a year now. I’ve done the lot, just like everyone else. PT has not helped at all, and my doctor is out of ideas. I’m very willing to try this, but I can’t get hold of one of the boards any time soon. Is there a way to do eccentric exercises for my knee without the board?
    Thanks!

    Reply

    • Abbey B

      March 06th, 2014 at 10:15 pm

      Also, did anyone have success with immobilizing the knee for a period of time?

      Reply

  167. Bio mechanically challenged cyclist

    March 06th, 2014 at 10:26 pm

    Knee immobilization is a bad idea. Some movement is necessary. As far as the board I just use a concrete stepping stone propped up with a few bricks. If you can’t get an official slant board just get creative.

    Reply

    • Brian Patterson

      March 24th, 2014 at 12:06 pm

      Great idea!

      Reply

  168. jp

    March 13th, 2014 at 11:42 pm

    patellar tendonitis-cured 100%
    thank you very much slant board!
    thank you for this wonderful article brian..

    Reply

    • Brian Patterson

      March 24th, 2014 at 12:06 pm

      Amazing!! So glad my article/video helped you.

      Reply

  169. Amanda

    March 14th, 2014 at 3:32 am

    The answer is neurosoma! Neurosoma! Neurosoma!
    Hopefully you guys remember my post regarding my moms patellar tendonitis and pain she experienced with similar symptoms to jumpers knee. She had tried surgery, physical therapy (3 different places), even the slant board (which eased the pain at the moment only to return the following day), acupuncture, and Bikram yoga (which also eased the pain but short term )
    We were about to resort to PRP but….
    Longest story short
    Neurosoma therapy!
    She found a chiropractor who does neurosoma therapy, he eases the muscle spasms with a pulstating machine and manually.. my mom who was limping yesterday is walking straight today! She had her chronic arthritis and tendinitis pain for 2 years so it’s taking her 5-6 treatments, but she felt the difference the first day.
    If you reside in California I can refer her doctor, he lives in the Central Valley.. Worth the drive. From neck pain to weak ankles they work on everything
    This guy had a back injury where he lost sensation in his foot, neurosurgeons recommended surgery, but 3 treatments and he was able to walk so and he is now studying to do therapy on others.
    It’s amazing & wish you all quick recoveries

    Reply

  170. GB

    March 14th, 2014 at 8:25 pm

    Had patellar tendinosis for over 3 years now. I’m 25 and love sports and being active, so I’ve been very limited and its so annoying. I’ve done all the basic stuff, but nothing seems to have worked so far. I did prp last summer, that didn’t work, I’ve tried physical therapy twice, other techniques, etc. I just did the Tenex FAST procedure three weeks ago. I haven’t noticed any changes yet, but hopefully it at least does something. Whether it helps or not I’m for sure gonna go back to the slant board eccentric strengthening. I did them for a little bit but didn’t notice a difference so I stopped. Maybe I just didn’t give it enough time or didn’t do them right or something. One of these days I’m gonna get rid of this thing. I don’t wish this upon anybody!

    Reply

    • Brian Patterson

      March 24th, 2014 at 12:06 pm

      Good luck. It didn’t work for me the first time around, but I think it is just because I didn’t give it long enough.

      Circle back and let us know either way if it works out for you.

      Reply

  171. Mike B

    March 15th, 2014 at 12:40 am

    Hey Brian, I’m right around your age and I’ve had patellar tendinitis now since December 2012. Just wondering how long you had the injury before it started getting better? Is it still doing well? I have consistently been seeing physical therapy over the past year with really no real improvement. Any suggestions other than the slant board? I guess my main question is: with having patellar tendinitis for over 15 months now, is there still a way to get improvement where the pain in the tendon area could be reduced 75-85%? Thanks!

    Reply

  172. valentina

    March 18th, 2014 at 2:29 am

    what if you have patellar tendonitis in both knees? i’ve been dealing with this for about 3 months now.

    Reply

  173. Longshot22

    March 19th, 2014 at 1:34 am

    GB

    Please post your an update and let us know if tennex fast helped u. I am considering having it done. Thank u.

    Mark Hanberg

    I have patellar tendonisis for about 1 year. 4 of those Months I have been doing some stretching, eccentric strengthening and cross friction massage. I have seen a lot of improvement. I can feel the pain get lesser and lesser every day as I do my routine. Unfortunately I have reached a platoe on my recovery. I have about 40% of scar remaining on my tendon. This scar tissue is a lot thicker than the previous one I worked on. It goes away very very slowly.I am considering having the tennex fast procedure if it won’t go away in 2 to 4 months. Any suggestion? Thank u

    Valentina,

    U need to do eccentric squats on a slant board. I suggest u wait until done of the inflammation goes down. Wait about 4 to 6 weeks if I haven’t done so already. Do the squat using both legs and use a stick or a or a balcony to pick yourself self up with out putting stress on your knees. This will help u a lot. Also try to avoid anything that causes pain to your knees and keep them flexible. I do the routine on http://www.fix-knee-pain.com/jumpers-knee-treatment-triangle/. I wish u luck on your recovery.

    Reply

  174. Paul Miller

    March 19th, 2014 at 6:29 pm

    Hi Brian,
    I also have been fighting patella tendonitis for about a year and a half. Unfortunately I have also developed it in both knees. I have gone to Therapy for a year, I also had the F.A.S.T procedure done 4 months ago(no relief at all). I had a PRP injection a month ago also no deference. I also tried nitro glycerin patches. I went to my follow up today and the Dr recommended surgery but I am not going to deal with that for both knees. I purchased a slant board a while back and used it for a few weeks consistently. How long did you use it before noticing some relief? This is so frustrating, I just want to put this behind me :(. Thanks

    Reply

    • Ian Gibbons

      March 19th, 2014 at 7:41 pm

      Paul,

      Sorry to hear about your knees. I also have this problem in both knees so maybe I can help. I’ve had to completely modify my activities and it’s now tolerable on a day to day basis but mind you I can’t do anything close to aggressive.

      I do the slant board at night so they get rest while I sleep and alternate legs. In the gym I don’t go anywhere near lunges but I do smith machine squats, abductors and hamstrings.

      Pain is present but if I want to live it up for a day of hiking I find that they don’t hurt AS much afterwards.

      I’ve tried PRP as well and somehow my knee is worse. Still looking for answers but day to day is relatively ok.

      Reply

    • Brian Patterson

      March 24th, 2014 at 12:04 pm

      Hi Paul, it sounds like you are on a similar journey to me in terms of treatment. I would give the slant board a few months, really closely counting your reps and measuring pain level, to see if it gives you any measurable improvement.

      I haven’t heard great things about surgery on the patellar tendon, particularly because there is no surefire guarantee of success. I’d hate to go that route before exhausting every other possible option.

      Reply

  175. kim bent

    March 21st, 2014 at 4:02 pm

    Please can you advise what training you did to keep your strength and fitness whilst doing these exercises as my training programme is mostly concentric but don’t want to affect my progress if doing these exercises!
    Thanks

    Reply

    • Brian Patterson

      March 24th, 2014 at 12:03 pm

      I kept things pretty light. Lots of slow movement (walking), stretching, occasional sports game.

      Now that I’m all good, I go pretty hard at Crossfit and am looking to play soccer and basketball more when the weather turns.

      Reply

  176. Brandon Jaramillo

    March 24th, 2014 at 10:51 am

    Hi Brian, would you recommend still using the one-leg technique if you have it in both knees? I have patellar tendonitis in my right knee but my left knee gets a little sore at times. I was wondering if I would just do 10 reps on each side?

    Reply

    • Brian Patterson

      March 24th, 2014 at 12:02 pm

      Hi Brandon, hmmm…. tough question. The reason I use one leg is to isolate the bad knee on the eccentric (down) motion, and then I bring in the other leg so that my bad knee doesn’t have to do all the work on the way up.

      I think that, depending on severity, I would do both or one at a time if I were in your position. If I could do singles, I’d probably do that. But if I couldn’t yet, I’d do both legs at the same time until I could work up to singles.

      Again, I’d talk to a Doctor or PT first, as I’m not an expert.

      Reply

  177. Eric Aratta

    March 25th, 2014 at 7:37 am

    Glad I found your website.
    I’ve had knee issues for 3 years now, including an 8 month stint with PT, which was mismanaged by my first physical therapist, had the FAST procedure done–maybe did more harm than good–and then had open surgery (debridement) when I couldn’t walk the dog around the block when it became so painful. That surgery is a big deal. I’m almost 6 months out of surgery and after working my tail off in pt and at gym, PT is back. I also have OA, I’m told by present surgeon, and patellofemoral pain syndrome–lots going on, but the PT is the star of the show. I can tell that my current surgeon feels he’s done what he can do and is giving up. He’s my fourth knee doc! I’ve had neighbors get and recover from knee replacements and I’m not closer to solving this PT situation. I’m going to check with current physical therapist about the eccentric ramp to see if it would be OK for me–I’ve been told no squats by surgeon and therapist, but maybe what you illustrate is a different mechanical thing than ordinary squats.
    *Thank you for this website and this topic thread*

    Reply

  178. Lewis

    March 27th, 2014 at 2:23 am

    Hi all I just want to start of by saying what an amazing forum you have set up Brian.
    my story is I have had pain in both of my knees for 2 years now. I am addicted to sports and have played many high impact sports for years, football, basketball, cricket, squash, tennis and golf. I have been using a physiotherapist for at least 6 months. He diagnosed me with pattela tendonigtous in both legs and I have been having brutal treatment during this time. I get to a stage where he is happy for me to go for a light cycle or run and without fail the burning pain returns. It’s so frustrating ahhhhhhh… I have tried magnetic pattela straps. Continuous stretches, ultrasonic treatment and ice.
    I decided to go to doctors which resulted in an X-ray followed by a MRI all my doctor told me from results is that inflamed around bottom of knee and offered me an expensive chiropractor. Cheers then hahaha. I am going to try this board as due to my job and lifestyle I rarely time to have major resting periods. I asked my physio why I have it and he believes it’s due to my youthful stretching techniques which I bloody regret now? He also explained that the tendon is like a piece of leather which makes it difficult to free up the scar tissue to allow blood to flow through easily.
    I will update people when I have gave the board a try. Cheers

    Reply

  179. Chrisitan

    April 04th, 2014 at 4:13 pm

    Hello Brian
    Thank you for sharing your experience with Patellar Tendonitis. I have been dealing with the same injury for two years. Would say that your pain is completely gone? Have you been able to return to normal physical activity? specifically basketball
    Thank you

    Reply

  180. Ian Gibbons

    April 08th, 2014 at 8:58 pm

    Hi folks,

    It’s been awhile so I figured I’d share some thoughts.

    First off, either PRP sucks or the doctor that administered it sucks. I have considerably MORE pain in the knee that had the PRP injections and it’s been 5 months. MRI confirmed that the tendon is worse. His last injection hurt so much and it’s still swollen and painful in that very spot. Another hurdle but life is full of them.

    Now….I’ve been 2 months steady with the slant board and while I feel FAR from good, my knees seem to have more longevity before they feel awful. A week and a half ago I completed a steep 7 mile hike through an unexpected 2ft of snow, probably the most grueling I’ve done in years. My knees hurt a lot but don’t stop me in my tracks as they did 6 months ago from less strenuous activities. I do see signs of progress.

    I would like to share a band aid for if you just need some relief or need to use your knees. My doctor gave me Voltaten Gel, which is an anti-inflammatory. Aside from sounding like it’s from another planet…..it provides some solid relief. Since I’m looking for a SOLUTION and not a band aid I don’t rely on it…but it’s nice for the occasional gift to myself. I recommend.

    Keep on keepin on people.

    Reply

  181. Mark Handberg

    April 09th, 2014 at 5:25 am

    I’d like to make a few things clear here.

    A lot of you are mentioning that you have used the slant board. What the slant board does it that it increases the load on the patellar tendon itself since the quad muscle have to work harder. As I may have mentioned earlier in a previous post, if you haven’t had any succes with that type of rehab, you might want to stop doing it. The could be several reasons why your rehab hasen’t payed off:

    . Overloading of the tendon either from not being warm enough before exercising or making the exercise too hard either loading wise or too many sets or reps.

    . Doing it too often – In contrast to what some say, this is really not something you should do every single day. Like muscles tendon need time to regenerate and that rest period must be at least two days, maybe several more depending on how hard it was and how fast you recover.

    . Slow healing – you may be a slow healer if you are up in age, are stressed, smoke, drink alcohol, eat inflammatory foods with sugar, gluten and even a lot of meat. Genetic factors can also play a role here.

    . You tendon fiber may consist of a lot of adhesions, which restrics the normal elasticity of the tendon and makes it stiff.

    . Calcification – some parts of the scar tissue may be dead and could make you a candidate for surgery in case calcification is very visible on an MRI.

    . Taking too many anti inflammatory drugs. Yes if you’ve had tendon problems for a long time you don’t have any inflammation left in the tendon anymore. At this stage, you tendon is thickened and degenerated and likely very stiff which is the main problem. The inflammation btw. is vital for the tendons healing and is the first of 3 phases in the process. In the case of a chronic tendon problem, inflammation might be a necessary thing because it can help break down some of those adhesions and restart the healing process concisting of several healing factors floating into the injured tendon. That is why shockwave therapy is used for chronic tendon problems. After a shockwave treatment you are not allowed to use antiinflammatory medication for this exact reason just as with PRP.

    Reply

  182. Nick F

    April 13th, 2014 at 11:01 pm

    I have been at the slant board for about 5 months. I have had slight improvement but can’t get over the hump. My tendon has always been extremly sensitive (painful) to the touch since I got tendonosis. Did this pain go away for you?

    Reply

  183. Jeremy S

    April 27th, 2014 at 11:03 am

    This caused pain to flare up for me. Is it normal? The one thing I am not getting here is should it hurt? Shoudl it flare up the next day? Should I wait a day for this to suside?

    Reply

  184. Mark Handberg

    April 27th, 2014 at 11:15 am

    No Jeremy S, if you’ve experienced pain the next next, you have pushed the tendon too hard! As I’ve mentioned earlier, in some cases the tendon will not reinjure despite of some leight pain when exercising, but if it feel any worse the next day (and even the hours after exercise) you’ve done too much. You should wait until the pain isn’t constant anymore and the warm sensation (inflammatory stage) is gone. That can take up to 6 days, but even after that, the tendon will be even weaker than it was before and you’ll need to do less than before and be really really patient with intensifying the exercise. Remember to WARM UP a lot before you do any exercise at all.

    Reply

    • Jeremy S

      April 27th, 2014 at 12:05 pm

      I have had this for 2 years and only now decided doctors cant help. Trigger point seemed to help a lot so I though I could start to strengthen by doing this. What if I cannot seem to get to a point where it doesn’t hurt to do this?

      Reply

      • Mark Handberg

        May 07th, 2014 at 11:20 am

        I am not quite sure what kind of tripper point treatment you are referring to. Usually we refer to trigger points in the muscles, where there is excessive tighness very locally, but tendons can get very tight too in the areas of adhesions where the scar tissue from the injury has become regid. This can be treated in several ways, like cross friction massage or dynamic stretching with knee flexion. This should not be done until at least 3 weeks after a flareup since the tendon needs some time to heal.

        In the case chronic injury though, you might have to brake some of the adhesions down by literally creating a new injury in order to get better elasticity to it. This can also be done with SHOCKWAVE treatments. For me it is hard to determine, which way is more helpful for you. I still remain possitive, that every patient should try the PRP treatment due to it’s good evidence. I will be recieving that in a few months myself.

        Reply

  185. James michael

    May 07th, 2014 at 3:04 am

    When is the right time to start the eccentric exercise? I got a chronic patellar tendinosis… I learn that after a month before you start eccentric because it is in the remodeling phase.

    Reply

    • Mark Handberg

      May 07th, 2014 at 11:38 am

      James, I really think it depends on the induvidual case in terms when the time is right for eccentric exercises. The severety of the injury will dictate when the time is, but it is also important to remember how slow tendons heal. According to physiology, injured tendons normally need 3 weeks (post injury) to gain enough tensile strength to sustain just dynamic stretching. At 6 weeks the real remodelling phase begins and can last up to over a year. That’s when I normally would be doing eccentrics for the chronic tendinosis. In very extreme cases like my own, the eccentric exercises will have to be with only your own bodyweight to start of with and maybe only starting with 15 degrees of knee flexion and working it down to around 90. A period of just concentric exercises and/or eccentrics with ultra light resistance may begin after about 3 weeks of relative rest, but since tendons take extremely long to adjust to new loads, you are going to have to take really small steps in terms of exercise progression, definately less than 10 % intensity increase per week. Personally it took me over 4 months to get my knee ready to just doing 3 sets of 20 reps of TKE’s after being in a wheelchair for 3 months due to jumper’s knee and many other tendon injuries at the same time. So be really really careful and monitor your knee looking for any signs of overuse (increased discomfort and/or swelling).

      Reply

  186. Jernej Stojnsek

    May 11th, 2014 at 2:39 am

    Jumping knee can not stretch like a healthy knee. There is a considerable difference. When I try to fully compensate the injured knee pain and appears as a kind of blockage in the knee. Is this a result of this injury which has lasted for more than a year, but before I did not know what the problem is.

    Reply

  187. Mark Handberg

    May 11th, 2014 at 6:35 am

    Well Jernej, that depends on what you mean by blockage, but in general, the diseased tendon has lost some of it’s elasticity. Therefore it may limit knee range of motion and can’t store potential energy like and tendon normally would during running of jumping. That makes it more vulnable. In my opinion dynamic stretching and cross friction massage should be a regular part of the rehab for the knee to realign those tendon fibers and regain some of the lost elasticity within the tendon.

    Reply

  188. Longshot22

    May 14th, 2014 at 3:17 am

    Mark please help me sir :(
    I have had tendinosis for about 11 months and 5 months I have been in rehabilitating on my own. I got to a point where I would hardly feel any knee pain for about a week. I got excited and I did some gymnastic training and nowy legs hurt again. I notice I feel pain on both legs but there is hardly any scar tissue my right leg and no scar tissue on my left. Why do they still hurt? I don’t have swelling either. I really want to get rid of this. The mental anguish is unbearable. I feel like crying right now… As I do most of the time when I am rehabbing my legs.

    Reply

    • Ian J. Gibbons

      May 14th, 2014 at 7:40 am

      Hey longshot,

      Patellar Tendonosis is no fun and I can relate to you. I’ve been battling this for 4 years now and in the last 2 months I have seen marked improvement. I know in the past, when things improved I got a little too excited and did too much too soon, only to experience pain and let down. Now I take things veeeeeery slowly. I have been pain free for 2 weeks and plan on going slow for at least another 2-3 months. I do the slant board and every month I go up only 2 pounds. I think I’m far from healed but I did do a viscous 7 mile hike 2 months and oand only had 4 days of flare up. 2 weeks ago I danced hard for 5 hours in dress shoes and no flare up at all. Maybe taking it slow will help you to?

      Reply

  189. Andy Schrimshaw

    May 14th, 2014 at 8:01 am

    EVIDENCE–SUPPORTED REHABILITATION OF PATELLAR TENDINOPATHY

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2971642/

    Reply

  190. Mark Handberg

    May 14th, 2014 at 9:34 am

    Well said Ian J. Gibbons.

    Longshot22, I can understand your frustrations with this when experiencing a setback like that. I’ve been though it too many times myself. I can not give you a definitive answer just based on the info that you are giving me though. I’m in a bit of a disadvantage since I can’t test your knee manually. I you want to seek help from any sort of health care provider, it has to be a specialist in knee and/or sports injuries. If you can do that, clearly that should benefit you the most. If not the person most likely wont know how to give you the best advice fro your problems.

    Here are my thoughts: There could potentially be some different tissues around the tendon that causes you issues as well, but if there is pain or even the mildest discomfort when (or just after) you palpate and push directly on the tendon, chances are high that it is a patella tendon problem.

    And I would not be surpriced if your injury has reoccured since the tendon still may be weak even though there isn’t any visible adhesions left on ultrasound or MRI’s. I’ve experienced setbacks myself with my knee just by doing bodyweight squats several months after an MRI revied “nothing wrong”. So this injury takes a very long time to recover from in most cases and a lot longer than most people think, including many therapists and doctors. Personally I had a tendon injury in my elbow once that didn’t hurt for 4 months, so I thought it had healed, but when I started doing curls with very light weight after those 4 months, I reinjured it immitiately. That is the tricky part about tendon injuries, they can fool you and be very serious even though you don’t feel that much pain or swelling.

    The key is to progress so slowly that you never take more than a half a step at a time up that “rehab latter” at a time since the tendon needs so much time to adapt.

    There is not any rules for when to rehab after the injury has reoccured at what intenisty to start from, but I like to recommend a slightly longer rest period than most before starting on rehbabing, just to be sure that things don’t get out of control and the inflammation continues beyond normal time. If it’s just a very small flairup, a week of rest could be enough, just to get the inflammation away and get the tendon to calm down first. In a moderate to severe case though, the tendon tissue needs 3+ weeks before it can handle any real stretching. I would start doing cross friction massage after 3 weeks of relative rest. You can look the technique up on the net, but just start with 1 minute with light pressure and try to pay attention to how it feels. The discomfort should not increase after that. If it does, you may have overdone it and you need to stop and ice it. Then you may want to wait a few days before you try again. If it feels okay tough, you can do the cross friction every day, but remember to warm up the tendon first! Warming up is extremely important when you rehab from this! Here after 3 weeks, most people will get benefit of doing light exercises for the legs like squats. Like I’ve mentioned before in here, eccentric squats with added weight and on a decline board might be too much of a load to put on the tendon at first. Some people think this type of rehab is the definate magic cure to all tendon problems. That being said, big loads like that should be included in the rehab at some point and for at least two months before doing any jumping, but done too early, it can do a lot more harm than good. In contrast to what some people claim, I would absolutely not accept any pain when doing the leg exercises. Only a real mild discomfort at the last few reps is okay and that sensation most not get worse after the rehab is done. I would just start of with one set of 15 reps and

    After 6 weeks, the most important part of the healing has taken place, and a more intence stretching regime can begin, where I would combine the cross friction massage with dynamic knee flexion. That should be done (again after proper warmup) sitting or laying down where you grab your leg and bend your knee slowly until you feel a firm stop. That should be done for 10-15 reps and every other day.

    So after 6 weeks (post injury/reinjury) you should be able to do both crossfriction massage, knee bending and squats with at least your own bodyweight and bending down at least 30 degrees. Only in very rare and extreme cases like my own, that squats would be too much at that point.

    Based on scientific evidence, I still think that PRP (platelet rich plasma) treatment is worth trying. I will be getting that myself within the next couple of months. That should accelerate the healing quite a bit.

    One last thing: This comes from my own experience of not being able to walk at all for 4 months due to this injury – feeling sorry for yourself wont help at all here. It tels me that you need to work on your approach to this and that you need to start finding some positive things to focus on. You can not let this destroy you! There is a way out of this and you will find it! Remember that tough times don’t last but tough people do, so keep your head up and take it one day at a time.

    Reply

  191. Tendonman

    May 14th, 2014 at 10:57 am

    Awesome last post from Mark.

    I posted to this earlier, have skipped most of the replies since, as it’s getting too much activity to stay abreast from.

    Quick status update from me: 2005 started with my patellar pain, saw doctors, PT, etc. had some results with decline board. Saw this city’s best doctor yet again in Dec/2013 and had a 3T (that’s a new, nice one!) MRI that, at the very most picked up “mild tendinosis”. In fact, the MRI didn’t mention it, but 18 months earlier the same machine scanned me, and doc said it looked the same even though radiologist 18 months prior called it mild tendinosis.

    Anyway, for most of 2014 I’ve had basically no pain. It aches at times, but I’ve gone days without pain, including a short vacation last week with a lot of walking. That’s after damn near a decade of dealing with this in a number of ways: rest, working out, negatives, etc.

    I was going to get PRP–and I do think it is worth doing for patellar tendinosis (and the research to date supports that), but the doctor said my tendon didn’t even look diseased enough for that, let alone surgery.

    Although I’m only 36 I am positive ALL impact sports are gone from my life forever, and I’m okay with that. I won’t even jog after the kids. I’m being very careful with working out now, just 10-15 minutes biking or elliptical at a time, and I can generally feel a bit of discomfort over those. As far as strengthening my most recent kick has been ultra light squats, so 50-100 reps in a set on a hack squat machine, for example. I want to bring my muscle to failure without it being a lot of weight on the tendon.

    I also got achilees tendinopathy 2.5 years ago and it’s slowly recovering. I tried some PT stuff (eccentrics), but basically I’ve just been leaving it. For some of us these injuries will take years to heal and we need to be honest about that.

    The bright light at least in my case is that in 2012 I couldn’t even descend stairs in the morning without pain and now I can. Honestly, I haven’t even thought about it that much these past five months. My knee hasn’t been this good since 2005 before I got into running. It is absolutely compromised, and I’ll never run again, nor can I even expect to do weighted squats or anything like that, but just having most of the past several months being pain free is enough for me.

    You never know. 20 years from now they might be injecting all kinds of stem celly magic into our joints and they’ll be like when I was 18 :)

    Reply

  192. Mark Handberg

    May 14th, 2014 at 3:54 pm

    That was interesting to hear Tendonman!
    Eventhough your tendinopathy has been there for several years, you still seem to have found many ways to enjoy life. Great to hear.

    Obviously having dealt with it for 9 years on and off is a very long time and makes your tendon condition sound very permanent. Theoretically speaking, a cronic tendinopathy should be able to heal if A LOT of right things are done and even more wrongs things are avioded. That can be extremely tough to accomplish and it makes the rehab one of the most difficult of all injuries. Complete tears of tendons and ligaments tend to heal 100 percent or very close, but the chronic tendinopathy can be an even more serious injury over time.

    What would be ideal in order to get to 100 percent would be:

    To get rid of excessive scar tissue, remodel/realign the scar fibers and strengthen the tendon.

    As you probably know, there are a number of ways to accomplish those things:

    . Surgery (not the first option though): get remove scar tissue and eventually the apex of the patella (bottom part of the kneecap) since that tends to pinch the tendon

    . You can also use Shockwave treatment to brake up the adhesions and restart the healing process.

    . PRP: Get more blood into the area and accelerate the healing

    . Remodel the fibers my stretching and strengthening

    . Work on global muscle balance with a lot of focus on ankle and hip joint alignment.

    . The “little” things: ake sure to be healthy in other areas: Get enough sleep, east right, avoid stress, to much alcohol and tobacco.

    . And: Avoid flairups and progressing too quickly

    If we can continue to do the good things and avoid the no so good things, the tendon should keep getting more and more healthy as long as there is no arthritic condition pressent.

    Those are the main things your should do – in my opinion at least. However I would like to know much you’ve done of what I just mentioned. What has worked out the best and what hasn’t? Would be interesting to hear from your experience.

    Reply

  193. Tendonman

    May 15th, 2014 at 1:56 pm

    Hi Mark, over the years I’ve spent dozens of hours reading about this, I’ve had four MRIs (!), seen a number of sports docs, three different PTs. I could write an essay on it, but as brief as I possibly can be:

    Male now in 30’s.

    2005 started running too much. Had anterior knee pain. Inside of 6 months noticed a clicking in joint upon extension

    2006 first MRI, joint looked perfect other than a mild meniscus tear. Sports doc & PTpist put me on a strengthening regimen because my hips were (and are to this day) weak/imbalanced. Cut back on running but still did it. Knee got a bit worse.

    2007 another MRI, less indication of meniscus tear (not sure if even used the word possible tear that time), also possible minor tear in patellar tendon. I only asked for this MRI because doc was about to go into joint, thinking my issue was a meniscus (damn glad I asked for that MRI). Did a lot of PT that year, still doing some running and a ton of cycling. Joint was better from the strengthening for sure, but still hurt.

    Last 2007: I first read the term tendinosis (nobody had aforementioned it). And started eccentrics. These helped a good bit, getting heavy on a decline 1-2 times/day.

    2007-2011: Running on and off, including exploring different ways to run. Still some eccentric work. Sometimes I’d take months off and joint would get a bit better, but back to pain when resume activity. Finally gave up running in 2011 after getting tendinosis in left achilles (due almost certainly to aforementioned hip imbalance).

    2012: got 3T MRI. Other than a couple of cysts doc said are no concern, it had “mild tendinosis”. This doctor–a well reputed one who has co-authored a paper on PRP and is widely considered the best in the city–was surprised nobody else prior had mentioned tendinosis. Was nice to finally have somebody who had heard about it in the medical profession!

    Also early 2012 I noticed a prominent scrunching in my knee when extending it. This was prior to MRI–clearly cartilage wear, but nothing enough for MRI to care about. No indication of meniscus tear.

    I got back into eccentric work again and after a few weeks it helped massively. However, then I started getting a clicking in what I think is IT band upon descent, and it began to hurt, so I stopped.

    End of 2012 MRI again. Unlike 2012, no indication of patellar wear, but doc said it looked the same (i.e. very minor). No meniscus tear, but this time some pattern change on a small bit of articular cartilage (surely related to my scrunching). I think it’s totally unrelated to my knee pain, though, and doc played it down as totally irrelevant.

    The biggest frustration over a number of years was being forced to research this myself. When i finally read about tendinosis online I couldn’t believe nobody had mentioned it before, because it was so obvious that I had it–and quite common. I know earlier PTs struggled to take me seriously, too, because here’s a fairly young person complaining of chronic knee pain and yet nothing/virtually nothing on the MRI.

    My pain has never been “omg I can’t walk”. Never, ever. Most it’s ever been was maybe a 5-6/10 after I ran a marathon in 2005 (oops), otherwise it hovers from 0-4/10. This generally mild, nagging pain has been an annoyance and it’s not entirely surprising some health care professionals haven’t taken it seriously, because they are used to people with torn ACLs.

    Also interestingly I can generally do weights, even heavy ones, without pain. But small impact stuff, even like a stair climber I’ll feel it.

    My knee scrunches a good bit now, but the MRI shows my cartilage as pretty good overall, so I continue to believe the pain is all tendon related. Pressing on it rarely hurts, and rarely ever has.

    Shockwave therapy never did much/anything for me.

    It’s possible my hips still are a pretty strong cause of this, as they are weak, and this impacts my functionally short right leg. I am cognizant of that.

    Reply

  194. Mark Handberg

    May 15th, 2014 at 3:30 pm

    Hi agian Tendonman.

    I can tell you’ve also been through a lot with your knee. Struggles like that alone will give a kneepatient a lot of experience that can be vital for the diagnosis and rehab, especially when no health care provider seems to understand the real issue nor it’s seriousness. Most of the doctors and therapists, I’ve been in contact with over this last year of my knee struggles, have had very poor understanding of how serious a patellar tendinopathy can be. If it wasn’t for my physical therapist education and the fact that I wrote my bachelor project about this exact injury, I would have been in even bigger trouble than I am today. I was wrongly “diagnosed” with a meniscal tear after a fall in the woods almost 2 years ago, but first found out that it was the patellar tendon, AFTER I started my project about it in april last year! By then the injury had gotten so bad and out of control, that traditional rehab made it even worse and I had to use crutches for 2 months and a wheelchair for 2 months since I also got an achilles tendon injury and 2 rotatorcuff injuries by simply very bad luck I believe… even though an arthritic condition still isn’t ruled out. Genetic factors have possibly also had an impact. Many in my family have had tendon injuries.

    Under the circumstances we’ve both been through, the injury story can provide very usefull information to the “expert” that is dealing with it – also since scans won’t reveal the injury every time. To a certain extend, the patient is the expert in his/her own injury since the patient is the one who’ve experienced how it feels, what makes it better and what makes it worse. A doctor who’ve never had a patient with a serious tendon injury or having had it him/herself is probably not qualified to rely on. My own doctor never believed that my injury was serious at all and thought that my main problem was placed between my ears. It never occured to her that the experience and background I had made my words worth listening to. That’s why you have to seek a real expert when dealing with this type of injury. Good for you that you did!

    Based on your decriptions, I don’t doubt that you’ve been dealing with your patellar tendon a lot. When some abnormal tissue is visible on MRI’s, then it’s pretty safe to believe it. Obviously you have also battled some other knee injuries and it can be very hard to determine, what your current pain comes from.

    In terms of injury rehab and preventing recurrence, we always like to find the root cause of the patient’s pain. Even though I can’t prove it, my best guess would be that the scrunching you’ve experienced is a result of tracking issue of your kneecap. During any type of intraarticular knee damage, the vastus medialis (especially the oblique part) will atrophy and loose some of it’s tone causing an imbalance between the pull of the musclefibers and other tissue on the lateral side and the pull of the vastus medialis. So the kneecap will run more lateral in the femoral groove and tilt a bit too. That will cause the scrunching and over time that will wear down soem of the cartilage underneath the kneecap, causing discomport after sitting down for longer stretches (“theater sign”). If you are lacking cartilage in that particular place, chances are high that you have/have had a maltracking issue of your kneecap. Maybe a slight displacement of your kneecap is also visible. If the cartilage wear is between the femur and the tibia, it’s more likely a secondary problem to the meniscus injury.

    Personally I’ve had some problems with my cartilage (in my now healed knee) too due to the issues mentioned above. After 6 PRP injections the daily retropatellar pain, that had been there daily for over 2 years completely dissapeared and has never returned since. In that knee I also had impingement of the lateral synovial plica due to the lateral tilt of the kneecap. That also went away after the PRP and some aggressive cross friction massage.

    Another secondary problem occuring from patellar tendinopathy can be irritation to the fat pat (infrapatellar corpus adiposum). If the kneecap is tilted too inferiorly, it can pinge the fat pad. That could happen is the quad muscle or tendon is very tight after a tendinopathy. A relief when pushing the superior border of the kneecap posteriorly (like a see-saw) will be present if the fat pad is irritated. In opposite, wearing a patellar tendon band will relieve pain in the tendon, but irritate the fat pat. Excessive hyperextention of the knee and anterior pelvic tilt will dispose people more to this problem. This can explain why a fat pad issue can literally be hidden behind a tendinopathy.

    It is also a possibility that your meniscal injury disposed you more to injuring your tendon since the knee tends to lack a few degress of extension after meniscal tears. That will put more pressure on the tendon during weight bearing activities, based on some studies.

    If all this information confused you, then you are welcome to ask me questions about it. But since your symptoms haven’t pointed directly at the same issue, it can be a good thing to rule certain things out.

    Reply

    • Ian J. Gibbons

      May 15th, 2014 at 3:51 pm

      You sure are a well of information regarding the knees. Maybe you should go to medical school, specialize in treating Patellar Tendonisis and rescue us all!

      Reply

  195. Longshot22

    May 15th, 2014 at 6:45 pm

    Mr. Mark handberg.
    First of all I want to thank you for encouraging me to stay positive and be optimistic a bout dealing with such a delicate injury. I have made promise to myself to not do anything relating to fitness until 2015. It’s the only way to beat this injury. It has been almost a week since I re-injured my patellar tendons and I can feel my legs getting better as time moves forward. Today I felt some discomfort but I wasn’t bad at all.my tendo still has a bit of scar tissue and it feels thicker thang left one. It doesn’t hurt at all when put pressure on them at all. It actually feels good. I do series of stretching daily which included my hamstrings,quads,calves,adductors and hip flexors. I then do the fix jumpers knee strengthening protocol that is available at http://www.fix-knee-pain.com/jumpers-knee-treatment-triangle/
    It seems to help a lot. I end my entire routine with some cross friction massage. That has gotten rid of a ton of scar tissue that I has accumulated only tendon. Once I get back where I was prior to reinjuring myself; I will do some quad exercises like leg extensions and leg raises which were recommended by my dr. Furthermore. I have had an MRI recently. My dr said that my tendon was fine. He suggested just to stay off it and to strengthen the tendon. He said if were obedient that it would go away. Overall my progress with this injury has been substantial. I made a promise to not do anything relating to fitness until next year. I positive that if I continue to stay off it and strengthen the tendon very slowly; I will get rid of this once and for all.
    Thank you for all your advice mark and Ian. God bless u

    Reply

    • Ian J. Gibbons

      May 22nd, 2014 at 10:22 am

      Hey Longshot,

      We are all helping each other here so I can thank you as well. Like Mark, I also had issues with traditional leg extension so I actually cut them out of my workouts FOR LIFE. If anything I would consider eccentric leg extensions but only if/when this whole patellar thing is behind me.

      Have you ever used ace knee braces for some relief? How I emotionally handle my patellar issues these days is once a month, I treat myself to something that I would normally do like dancing, hiking etc with the knee braces on. Yes my knees often hurt afterwards but in time the pain goes down so long as I behave again. Life is short and it lets me feel like my old strong athletic self for the day. My knees also seem to bounce back quicker so I can now do this.

      Maybe the same would work for you?

      Reply

  196. Mark Handberg

    May 16th, 2014 at 5:36 am

    Good to hear that Longshot22. Remain very patient, listen to your body and don’t take any chances in the process. Be careful with the legs extension exercise though. This exercise gave me my biggest setback a year ago, where lifting just 30 kgs backfired big time. That was after months of being able to do eccentric single legs squats without problems, so save that exercise to the very last stage of your rehab.

    Reply

  197. Mark Handberg

    May 16th, 2014 at 5:39 am

    Btw. Great article about battling jumper’s knee! I totally agree with just about everything in it. But again, the eccentric squats on the slant board may have to wait much longer than a months in very severe cases like mine. Just don’t accept any discomfort while doing the exercise. You body will tell you when you are ready to do it.

    Reply

  198. Biomechanically challenged cyclist

    May 22nd, 2014 at 10:31 am

    I swear by the Donjoy neoprene patellar strap. They gave me one when I was going to therapy a few years ago and it works wonders for me. If i’m on my feet I have it on and feel almost no pain. I usually wear out 2 a year. I don’t know where I’d be without it.

    Reply

  199. nick

    May 30th, 2014 at 12:52 am

    hey guys. I’m a college athlete that found this looking for some answers. Went to an orthopedist about my patellar tenondonitis, which i already knew i had, and all he did was give me some anti- inflammatory pills and schedule physical therapy. what i wanted was an ultrasound to make sure that there were no micro tears in the tendon because i had a feeling that it is whats causing the pain. i have known about my tendonitis for months now but it never really affected my play before until recently. i came home for the summer after not playing soccer for two weeks because of finals, and i played a few games and about an hour in i could even run anymore. when i got home i couldn’t walk up the stairs, and it took me a week of laying off physical activity in general to recover. now i just want the pain to go away because i haven’t been at 100% in almost a year and its killing me. please help.

    Reply

  200. Mark Handberg

    May 30th, 2014 at 8:11 am

    Hi Nick,

    I would like to clarify a few things for you and offer you some advice. Granted that you’ve had issues with your patellar tendon for months, this injury is no longer referred to tendinitis, but tendinosis or tendinopathy. The reason why I am bringing that up is that “tendinITIS” means inflammation of the tendon. However inflammation normally only lasts for less than a week (unless you keep reinjure the tissue all the time). In the chronic stage, this means that inflammation is no longer present in the tendon. The inflammation right after the injury has occured (or recurred) and is part of the body’s natural healing process. It gives you pain, discomfort, a warm sensation and maybe slight redness in the area. In the chronic stage of a patellar tendon injury (after a few months) inflammation is not your concern anymore, in fact taking anti-inflammatory medication is not a good thing because it will calm down the reactive cell response which you actually need at this stage. That’s why I would NOT recommend you taking this right now. Just like when you recieve PRP (platelet rich plasma) or Shockwave treatment for a chronic tendon injury, you are not allowed to take any anti-inflammatory medication afterwards for that excact reason. It doesn’t surprice me that the orthopedist wasn’t aware of this since, this is fairly new stuff.

    I would recommend taking fish oil, b and c-vitamins instead, eating greens (like salat) and stay away from tobacco, alcohol, stress, junk food and sugar (for the most part).

    Make sure to get enough sleep too as your tendons collagen synthesis needs proper rest periods.

    Now the most important thing: Since your injury has progressed so much already, you immediately have to stop all physical activity that gives you pain, discomport and/or swelling afterwards! I can not stress the importance of that enough. This is a VERY serious injury that may recuire surgery (like in my own case) cause when you’ve reinjured it so many times, you’ve not only created micro tears in the tendon, but also changes the fiber alignment making the fibers look unorganized. That severely decreases the tendons elasticity and tensile strength.

    To tell you like it is, you will very likely need to go through many months of pretty intence rehab consisting of a structured stretching and strength training program. Doing this with help from a skilled physical therapist is a must and should be tried for a few months with very very slow progressions. Hopefully that will result in improvements, but if not, surgery might be necessary.

    I am telling you all this based on my personal experience with this injury and my knowleadge as a physical therapist.

    I will also recommend getting the book “Beating patellar tendinitis” by Martin Koban, which can be really helpful to let you know what you are up against.

    Hope this was helpful. Good luck.

    Reply

  201. Alan Wilson

    June 04th, 2014 at 6:17 pm

    I have patellar tendonitis in both of my knees how should I go about using the slant board seeing as u would raise yourself up with the good leg I have pain in both

    Reply

  202. Paul

    June 04th, 2014 at 7:04 pm

    Alan,
    I also have it in both knees. I use a long stick or a railing to help me back up. I started squating down with both legs and using the stick to assist me up. After I progressed, I added weights in a backpack, then I went to single leg squats still using the stick.

    Reply

  203. Ian

    June 05th, 2014 at 10:48 am

    Hi all,

    How many of you do cross friction massage and how has it benefited you? I just started it and initially I have to say that it feels pretty darn good. Has anyone has this help “cure” tendonitis/tendonosis or is it just a relief?

    Thank!

    Reply

    • Brian Patterson

      June 05th, 2014 at 12:14 pm

      Hey Ian, my PT did it. It felt great (hurt so good), but I’m not sure if it did any good (or bad).

      Reply

  204. Ian

    June 05th, 2014 at 12:29 pm

    Thanks Brian,

    How are your knees feeling these days and how do you maintain?

    Reply

  205. Brian Patterson

    June 05th, 2014 at 12:53 pm

    This will be the 300th comment on this page – wow!

    I’m doing great. I’ve done a lot of Crossfit over the last year, and I really feel that the increased quad strength takes a lot of the load of my knee for explosive movements. I think this definitely helps.

    I break out the slant board every few days and still get my reps in. For me, it is still the silver bullet for keeping everything all good in the left knee. It isn’t perfect, but I operate at 100% most days, and it only flares up after extended workouts with a lot of running.

    Reply

  206. Philip Sharpe

    June 06th, 2014 at 6:20 am

    Hi Brian,

    This is a fantastic article and the advise inspired me to buy a declined board and work the same exercises as yourself.

    I have been plagued with patellar tendonitis for 7 months now but since starting to use the board I have really progressed, I hope to be pain free in the next month.

    My question to you is: When I become very comfortable and controlled with the eccentric movement, should I start to use my bad leg in the upward movement as well…provided it doesn’t induce any pain.

    Also my quad has become quite depleted over time. do you have any exercises that work the quad well without aggravating your tendonitis.

    Thanks in advance,
    Phil

    Reply

    • Brian Patterson

      June 06th, 2014 at 9:22 am

      Hi Philip, I still don’t use the bad leg in the upward movement. For the slant board, for me, I just focus on the eccentric movement.

      In regards to strengthening your quad while still working through the tendonitis – good question. I waited until my knee was feeling a lot better, and then started incorporating squats to strengthen the quads. I’m sure there are other things that perhaps a PT could suggest.

      Best of luck, and keep us posted on how it goes!

      Reply

      • Philip Sharpe

        June 06th, 2014 at 11:31 am

        Thats great Brian, I appreciate the reply.

        All the best!

        Reply

  207. Ian Gibbons

    June 19th, 2014 at 8:21 pm

    Hi all,

    A couple of questions:

    1. Has anyone found orthotics insoles helpful at all?

    2. I’m doing one leg eccentric squats with 5lbs and everyday seemed a little taxing on the quads. Anyone having better luck with only a couple of times/week?

    Oh and Philip, I’ve found that squats on a Smith machine with your legs out in front of me has allowed strength without any noticeable issues with the knee. I just NEVER let the knee go anywhere near past the toes.

    Reply

  208. Mark Handberg

    June 20th, 2014 at 9:13 am

    Hi Ian

    To answer your first question: Possibly – if you tend to either pronate or supinate a lot when to play sports, run, walk or lift weight. Eccessive pronation or supination in these situation will definately increase the wear and tear on the patellar tendon. WHen you are doing one legged squats, you must make sure that your weight is balanced correct on your foot. If not, you could move into either pronation or supination, which will affect your knee and hip joint position. So yes orthotics can help, but they are a quick fix and even Podiatrists tend to recommend corretive exercises over orthotics for the best results in the long run. The exercises that should be done, will depend on what your malalignment of your foot is like – overpronation or supination (?)

    Your answer your 2nd question: I will not recommend doing eccentrics ever day because just like in strenth training of muscles, you are trying to stimulate tendon growth. When you try to build up muscles you don’t traing the same muscles every day because they need time to recover. The same thing goes for tendons and the rest period might have to be slightly longer since the collagen synthesis takes longer than the protein synthesis process. The so called experts who recommend eccentrics every day have not taken these above fact into context. If you just lift every day, you might end up braking down the tendon instead of strengthening it!

    So I will only recommend doing it every other day at your level and if/when you start lifting heavy (like under 10 RM) do it only every 3rd day.

    Reply

  209. Jeremy

    June 20th, 2014 at 10:13 am

    Just an update. Before I could begin to attempt this exercise I found that using a foam roller 1-2 times daily (pain!) on my quads allowed my knee to relax. It has begun to heal and I am able to perform at least 10 reps safely now. Slowly getting there! FOAM ROLLER

    Reply

  210. Titus

    June 26th, 2014 at 7:50 pm

    Hey Brian,
    Your article gave me hope for the first time in quite awhile. I have a bad case of pt in my left knee as well and haven’t played any sports or even jogged for 6 months now and yet i haven’t felt much improvement if any after quitting these recreational activities. I’m planning on trying your recipe for success but i have a question. How deep should I go on my ‘squats’? Should I be feeling a significant amount of pain, or do I only lower myself till I begin feeling pain?

    Reply

  211. Titus

    June 26th, 2014 at 7:51 pm

    Hey Brian,
    Your article gave me hope for the first time in quite awhile. I have a bad case of pt in my left knee as well and haven’t played any sports or even jogged for 6 months now and yet i haven’t felt much improvement if any after quitting these recreational activities. I’m planning on trying your recipe for success but i have a question. How deep should I go on my ‘squats’? Should I be feeling a significant amount of pain, or do I only lower myself till I begin feeling pain?

    Any input on the whole pain factor would be appreciated. Thanks

    Reply

  212. Randy.p

    July 06th, 2014 at 12:53 am

    Hey Brian
    I am currently suffering from patella tendonitis. I am considering doing this. Just curious as to knowing if you think it will still work if I am still involved in physical activities such as basketball. I am also currently doing a jumping program.

    Reply

  213. Danny

    July 12th, 2014 at 1:20 pm

    Guys, I’ve been trying decline squats on the Flex-N-Go for about a month and a half now to treat my severe PT and have seen minimal results. In some cases it hurts worse the next day. Can anyone comment on whether its worked for them, and if so, how long you stuck it out….. this is the the worst affliction!

    Reply

    • Ian

      July 13th, 2014 at 8:13 pm

      Hey Danny,

      I would have to agree, this IS the worst affliction. In my experience I have found the slant board to be a lesson in trial and error. For numerous periods of time I’ve had to lighten the amount of weights in my backpack or lessen the amount of times/week I do the slant board, to not over do it. Things have gotten better………..slowly but not without setbacks. For example lately I have only been doing the slant board once a week because my knees and quads hurt from overuse. Take it slow and mind your activities because when I push too hard the Patellar tendonitis/nosis whatever pushes me right back.

      Reply

  214. Don

    July 12th, 2014 at 7:58 pm

    Brian,

    Thanks for the info. Everything you mentioned sounds exactly like what I’ve been going through. I’ve got over 25 years of basketball on my knees and my left knee is feeling the affects. I’ve had the patellar tendinitis pain for nearly two years and it’s progressively gotten worse. I’ve tried just about everything. The best treatment I’ve experienced is an anti-inflammatory my doctor prescribed called Medrol (comes in a 6-day dosepak). Took the pain away almost immediately and lasted several weeks, but the pain eventually returned.

    I would really feel the pain when I would jump pretty hard off my left leg playing basketball. Upon landing, I would immediately feel searing pain like I had been hit with a bat. It severely weakened my knee. It also really hinders my leg workouts, particularly with leg presses, squats, and lunges. I recently aggravated it again playing basketball and it’s worse than it has ever been. I can’t even walk up or down the steps without fully supporting myself. It’s been 3 days and the pain and weakness in my knee has not subsided at all. Went to see an orthopedist and he confirmed it was Patellar tendinitis and suggested a topical AI and physical therapy. I’ve tried a topical (Voltaren) before which did nothing, and PT is expensive and a waste of time. I was seriously considering surgery since it has not improved in almost two years. I will give this method a shot and see how it goes. I just have to be patient, but it will be extremely difficult with as much as I workout and play basketball.

    Reply

  215. matt

    July 13th, 2014 at 8:08 pm

    So, I have tendinitis in both knees. How should I start?

    Reply

  216. Rago

    July 16th, 2014 at 11:41 am

    Guys,

    I have been having this problem on my left knee for 6 months now (due to long time ~10 years involvement with shuttle badminton) and had to stop most physical activity during this time. I am working on physical therapy and recently started with the eccentric exercises using a slant board. It definitely seems to help! One question I have is about swimming. Have anyone tried swimming with this problem? I am looking to take swimming classes (need to do some physical activity) and am wondering if this would worsen or make better the patellar tendon problem. Any suggestion/tip would be greatly appreciated! Thanks.

    Reply

  217. Piers

    July 31st, 2014 at 6:29 pm

    Hi everyone,

    I discovered I had tendonitis in my left knee in August 2012 after a weekend of Ultimate. I didn’t believe it was tendonitis for ages because I hadn’t had gradual increase of pain, it went from 0 to 8/10 in one long car journey. The ache was incredible.

    After seeing a friend who was a physio he suggested I did some squats. I half heartedly did them and then sought out the advice of a doctor on the UK NHS which was a big mistake. It meant that I didn’t actually start seeing a decent Physio until January / February. By now my knee was aching a good 7/10 all of the time it was unbearable.

    I then in April 2013 started seeing a Sports Rehabilitation guy who to be fair was pretty good. He tried to get me fixed quick (which didn’t work obviously) and then put me on a stretch / loading regime / ankle mobilisation. I didn’t do any strength work which was a mistake I believe. Amazingly by August 2013 I felt pretty good, and went to compete at the European Championships with my team. I was dreading the bus ride because I knew my knee would ache the whole way, but with the help of some tape (from my original Physio friend) we managed to get the knee to sit in a position where it didn’t ache. I think that because the location of my tendonitis is so specific (right on the bottom of the knee cap) shifting the patella slightly gave it some relief.

    I went and had a great time, only playing maybe 10 / 15 points over 4 days. I then came back all excited about the idea of playing another season of Ultimate. The next week I played again (without the tape) and I was back to square 1. Nightmare. I was so devastated that I just gave up for another 6 months because I was heartbroken.

    I decided to give it one last shot so in January 2014 I managed to get an MRI just to confirm that I hadn’t damaged the patella itself, because the pain was so concentrated on the bottom (tip) of the patella itself it really feels like the bone is bruised. Alas the results came back and said “Mild thickening of the tendon, inflamation of the hoffa fat pad and a mild marrow oedma at the inferior pole of the patella) which basically confirmed everything. I have a damaged tendon and the patella has a mild oedema (bone bruise) at the bottom of it. Apparently these oedema’s are part and parcel of the tendonitis. I found a new (more qualified) physio to work with who’s main focus now was to sort out the huge difference in size of my quads. My damaged knee has caused me to over compensate on my other leg for so long that I have some serious wastage in my left quad. They are almost 2 inches different in size.

    I didn’t really feel like with the new physio’s regime that I was making much progress. Zero change after 14 weeks of single leg raises (apparently as good as eccentric squats) and knee stabilisation exercises I decided that I wanted another change. I remembered reading this blog ages ago and thought I would try the slant board again (I did try it for a few months in Dec 2013 to Jan 2014 with not change).

    I also decided to add in some extra exercises that I had read / watched online.

    So now my regime comprises of eccentric squats on my slant board, 2 x 20 once a day going down with both legs but 90% of the pressure through the damaged knee. I also do some quad activation exercises which I think really help. I sit with my legs straight out infront and really focus on tightening the quad but making sure the muscle activates at the top of the leg (I try and do this everyday). I also so side leg raises to get the glutes firing, 3 x 10 maybe 3 times a week (although it’s got mega tight recently so going to get it massaged out next week). I have also started doing front squats at the gym (low weights focusing on form) and added in some Bulgarian split squats to try and strengthen up the weak leg.

    I feel like my condition is getting a tiny bit better every day with this new regime. The knee still aches a lot but it’s a low dull pain and I can do the slant board with minimal sharp pain and I am pretty amazed that the front squats don’t aggravate it as much as I would of thought.

    This whole scenario has been one of the hardest things I have ever been through in my life. I know people have awful diseases and I should consider myself lucky, but I wouldn’t wish this upon anyone. It has taken away everything I love in life and I am so determined to beat it now and get my normal life back. I am 28 years old and am really hoping to be back playing Ultimate by Decemeber.

    I wish I had known what I know now back in August 2012 when the issue first started. I have been offered a PRP injection by the hospital to help try and speed up the process but I am very scared to do it because if the pain got any worse I would be completely devastated.

    My advice to anyone who has mild tendonitis do something about it straight away. Find a good physio / pt / friend who can help you through the process of sorting yourself out. There is quite a bit of good advice on here about how to make sure your leg is balance, ankle, knee, quads, hamstring, hips. http://www.fix-knee-pain.com/patellar-tendonitis-knee-tendonitis/ and do not under estimate how bad it can get! I wish I had caught it quick and had been given a total understanding of the problem / healing times at the very beginning. Also keep a note of all the exercises you do (I still don’t do this which is a huge mistake)

    To everyone which chronic tendonitis, be strong and believe that it can get better! I’m just gunna keep at it, making sure I take it easy and listen to my body. I’m gunna work hard to make sure my ankle, knee, muscles and strength are all balanced before going back to Ultimate.

    Reply

    • Piers

      July 31st, 2014 at 6:33 pm

      Forgot to mention in that write up that in the last 18 months I have done very very little cardio, I had trained maybe 5 times (with great pain) from initial injury to heading out to Europeans and then I haven’t trained again since. To be honest I am just very scared that if I train it will get worse. I want to be almost pain free and confident in my mobility / strength now before trying any kind of running.

      Reply

    • bharath

      August 19th, 2014 at 2:57 pm

      Very nice explanation Piers. I’m on the same boat. I’m suffering with PT since Aug 2013. I made the same mistakes that you did. Overuse of the Injured knee. I met a doctor and all he said was to take rest and there is nothing serious. I took rest for a couple of weeks and back to normal gaming activity(I play racquetball a lot or I used to play a lot). I doubted my doctor and met an other, had an MRI, Xrays and he also concluded saying nothing. The second doctor even advised of surgery if the pain doesn’t go away in a couple of months with out explaining the exact problem. I then went to a Chiropractor which is of no use. Finally now i’m into Physio Therapy. Its been 5 sessions and i’m working on building the strength around the knee, quads, calf. Working on balancing activity as well and then my therapist puts me on the stimulation. I’m 26 and some times I get depressed for not able to be as I was an year back. But yeah i’m being strong. Hopefully you, me and others suffering from PT will get better. I have a list of exercises that i’m doing which are making me feel better. I will share them shortly.

      One suggestion is wearing a shoe with good support helps a bit. I bought Asics GT 2000 – 2, added Orthotics. Its doing a little good.

      Reply

    • Kyle A Massey

      March 07th, 2017 at 2:03 pm

      Hello,

      I was just reading through all of these comments & couldn’t help notice that your comments sound very similar to what i’m going through now. Did you ever fully recover? I’ve been trying to get better now for 8-9 months & have tried almost everything (PT, Stretching, eccentric squats, foam rolling, massage, etc). I also just did my first PRP injection 2 weeks ago, so still waiting to see how that helps. Let me know if you found anything that is more helpful with healing…i’m desperate!

      Kyle

      Reply

      • Ian

        March 07th, 2017 at 2:50 pm

        Hi Kyle,

        I guess I have good news and bad news for you.

        Good news: Patellar Tendonitis on my right knee went away on it’s own with significant rest

        Bad news” PRP on my left knee made my knee far worse. I definitely came back WAAAY too soon so I probably did that to myself.

        I’m 7 years in with Patellar and Quad Tendonitis and have found relief only through modifying my activities. Still eager to get back to aggressive activities but haven’t found the magic formula yet. Keep in touch. Try the Graston Technique. I haven’t fully committed to that yet one yet.

        Reply

        • Kyle Massey

          March 07th, 2017 at 3:11 pm

          Thanks Ian,

          Curious how long did you rest after your PRP injection? I wore an immobilizing brace for 10 days, and have been told not to exercise for another 2-3 weeks. Then i suppose i’ll slowly get back into PT. But I am worried because it feels a lot weaker & is more painful now than before (hopefully because I didn’t use the tendon for 10 days). I guess the hope is that it will heal better/quicker with with extra platelets. But still hesitant about the PRP impact.

          Lastly, when you say your right tendonitis went away with rest, what do you mean? I’ve tried long periods of rest…but that doesn’t help at all as i’m pretty sure my issue is a strength issue. Did you do eccentric exercises to get it better?

          Thanks,
          Kyle

          Reply

          • Ian

            March 07th, 2017 at 3:32 pm

            Hi Kyle,

            Regarding my right knee that got better. Miraculously I didn’t have to do anything but do light weight workouts and just do normal people stuff. The tendonitis just went away?!

            My knee was NOT immobilized after PRP which surely didn’t help. I wasn’t instructed properly with my recovery. You will surely have better luck than I because it sounds like your doctor is better.

            My issues are also with Quad tendinosis and I’m still working on that one.

      • Ian G

        April 04th, 2017 at 4:48 pm

        Hey Kyle,

        I just figured I’d check to see if the PRP injections seem to be helping. I hope you are having better luck than I. I have been having the Graston Technique done to my knee which seems to be having some positive results. Anyway, fill me in.

        Reply

        • Kyle Massey

          April 04th, 2017 at 5:16 pm

          Hi Ian,
          As of now it does seem to be helping. I’m still trying to rehab my leg & tendon since i lost a lot of strength post-injection. I was in a knee brace for two weeks & then pretty immobile for another two…so lots to build back up. But it certainly didn’t hurt my rehab…but still have to wait and see once i get strength back to how effective it really was. Hope that helps!
          -Kyle

          Reply

          • Ian G

            April 17th, 2017 at 12:37 pm

            It’s good to hear that you’re having a better PRP experience than I did. I’ve now had Graston done for 4 weeks and I would confidently recommend it. Significant decrease in pain, tightness and swelling in my patellar tendon. MY PT also has me doing some eccentrics. It’s gotten me over a hump and I’m going to stick with it.

  218. Jo Joyce

    August 21st, 2014 at 8:25 am

    I’ve been suffering with PT for around four years now and to make matters worse I have it in both knees, left side far worse. I’ve gone through the motions over the time, physio therapy, steroid injection in both knees, cortisone injection under ultrasound in both knees, I’ve tried knee braces tendon strap and even had surgery in March this year on the left side. I’m a keen footballer and been playing around 20 years, since I was 14. Since having PT I haven’t been able to play and I’d really like to get back, I though after the surgery this may be possible but at the moment I’m not hopeful. They were planning to move onto the right knee with surgery but I fear they won’t do this being the left is still painful. Where do I go from here? What are my next option? Is it PRP? I like the idea of the flex-n-go board but in all honesty it makes me feel quite ill the thought of doing something that I know is so painful. Help!

    Reply

  219. uninstall google plus android

    August 25th, 2014 at 4:41 am

    This piece of writing gives clear idea in support of the
    new viewers of blogging, that in fact how to do blogging.

    Reply

  220. thecapturehisheartreviewed.tumblr.com

    August 26th, 2014 at 1:26 pm

    Hello There. I found your blog the usage of msn. This is a very well written article.

    I will make sure to bookmark it and come back to read extra of your helpful
    info. Thank you for the post. I will definitely return.

    Reply

  221. J R

    August 30th, 2014 at 2:47 am

    I do hope that Brian Patterson gets to read this.
    I have suffered with this condition for many years and take morphine for the pain when it becomes unbearable.
    I have noticed, over the years it took to get my diagnosis that no-one ever listened to me, until one day, by accident, I was told by my insurance company that all relevant consultants were on vacation and they could only free me to a foot specialist.
    Revelation was this. He listened to me. He diagnosed that the problem was not my knee, although this is where the pain was. The problem was that my feet were causing a rotation of the knee when I walked and it was this that irritated the tendon.
    Shoe inserts were made in an attempt to resolve this and realign my feet. Sadly though, this came too late and I ruptured the perineal tendon in one of my feet. There was no option and surgery to repair the tendon and rebuild the foot was required. It took some good few month of surgery, but the transformation has been amazing.
    My surgeon was very reluctant to undertake surgery, until the tendon rupture, because this operation to reconstruct a foot is complex and can easily go wrong.
    Long and short of experience is that just because it hurts, it does mean that that is she the problem is.
    My life is a lot better now and I found this blog really useful.

    Reply

  222. nx698zs.com

    September 02nd, 2014 at 4:25 am

    Brilliant website plenty of great steam shower information here

    Reply

  223. September 03rd, 2014 at 5:52 pm

    With havin so much written content do you ever run into any
    problems of plagorism or copyright violation? My
    blog has a lot of unique content I’ve either
    created myself or outsourced but it looks like
    a lot of it is popping it up all over the internet without my agreement.
    Do you know any solutions to help reduce content from being ripped off?

    I’d truly appreciate it.

    Reply

  224. lingeries f謩nine

    September 04th, 2014 at 3:21 pm

    Hello I am so thrilled I found your weblog,
    I really found you by accident, while I was searching on Bing for something else,
    Anyhow I am here now and would just like to say many thanks for a fantastic post and a all round
    thrilling blog (I also love the theme/design),
    I don’t have time to look over it all at the minute
    but I have book-marked it and also added in your RSS feeds,
    so when I have time I will be back to read more, Please do keep up the excellent jo.

    Reply

  225. creole queen

    September 09th, 2014 at 9:24 am

    I know this website provides quality based posts and
    extra material, is there any other website which offers
    these kinds of information in quality?

    Reply

  226. port royal prestige corner sofa

    September 11th, 2014 at 10:56 pm

    Wonderful web site, really been searching forever for tips on the best rattan furniture pieces for our
    home and in our garden. The website really helpedgreat blog some great info here

    Reply

  227. www.youtube.com

    September 14th, 2014 at 7:21 am

    Come across this great site and ordered a steam shower and never gazed back again, great content here can not
    give thanks enough

    Reply

  228. Aaron Hale

    September 16th, 2014 at 12:08 pm

    Hi! Do you know if they make any plugins to help with Search Engine Optimization? I’m trying
    to get my blog to rank for some targeted keywords but I’m
    not seeing very good gains. If you know of any please share.
    Many thanks!

    Reply

  229. Jeffie Laughary

    September 16th, 2014 at 3:02 pm

    They readily suckle one another’s cubs, enabling one to survive when lactation fails or death occurs.

    Lions can and sometimes do eat Humans, but we
    are not one of their main food sources either. Fact is, if every sales person had that
    one book alone and mastered its principles, they’d be
    the best in their chosen field.

    Reply

  230. port royal rattan sun loungers

    September 16th, 2014 at 10:37 pm

    Wonderful website, previously been browsing forever for ideas on the very best rattan furniture pieces for our
    home and in our back garden. The site seriously helpedgreat blog some great info
    here

    Reply

  231. Stan Casemento

    September 17th, 2014 at 8:05 am

    HEy Brian,

    Great article. I live in the Netherlands and i’m suffering from Patellar tendonitis for almost two months now, my right knee is swollen and it doesnt get any better. I stopped playing soccer and futsal and dont do anything that increases the pain.

    I do the eccentric squats 4 times a week so not everyday. I do them exactly the same way you do them. i make the squats a little deeper and do them a little slower. I dont feel a little uncomfort during and after. After 24 hours usually it is worse. What do you think of that?

    Reply

  232. broken lyrics

    September 18th, 2014 at 2:07 am

    I like the valuable information you provide
    to your articles. I will bookmark your blog and check once more here frequently.
    I’m relatively certain I will learn many new stuff right here!
    Best of luck for the following!

    Reply

  233. poisoncentral.net

    September 21st, 2014 at 4:12 am

    Thank you for the auspicious writeup. It if truth be told was a entertainment accdount it.

    Glance complex to far introduced agreeable from you!
    By the way, how can we communicate?

    Reply

  234. Eric

    September 22nd, 2014 at 12:42 pm

    the board looks like something I could actually make. what are the dimensions if you don’t mind telling me.

    Reply

  235. Kelly

    September 22nd, 2014 at 2:53 pm

    Hi Eric, I am more than happy to share with you the dimensions. The original board was 8″ high 17.5″ long & 12″ wide. In order to save on shipping and do away with so much scrap, we have resized the length to 16″ best of luck Kelly

    Reply

  236. Mike

    September 23rd, 2014 at 10:22 pm

    Brian, thanks for taking the time to post this information. I’ve been dealing with PT for more than 15 years. Most of the time it was bad enough that I favored my right leg so much that it was noticeably larger than the left. Never thought I would be able to do squats. Been doing them on the slant board shifting the weight as instructed. In just days the results were noticeable. In less than two weeks I’m no longer favoring the right leg. If anyone out there is having trouble with this condition please try the squat exercise on the slat board. You have nothing to loose. I’m using a set of foam “boards” sold on Amazon for around $20.

    Reply

  237. Lacy E

    October 06th, 2014 at 7:07 pm

    Hello,
    While this article is very informative I also find it alarming! I thought this was something that would go away in a few weeks!

    I got it from training for a half marathon, and running 8 miles after hardly running all summer. It was really really painful at first, and then it went away, and I tried running again. A four mile run, around 2 1/2 miles it seized up again and now I can’t go more than that, often just a 1.5 before it seizes. Stinks because fall is my running season but anyways, should I completely stay off of it for a period of time? I haven’t been, I’ve still been running quite a bit. I’ve been staying off sugar to help the inflammation but it now has almost constant pain.

    Sorry for the novel!

    Reply

  238. Ian G

    October 06th, 2014 at 9:00 pm

    Hi Lacy,

    Sorry to hear about the knees. Based on my own experience, I really think you should cease all activity for awhile….a long while. If you don’t, your most likely tendonitis could become tendonosis, which is what happened to me and very difficult/time consuming to treat. Get an MRI and find out exactly what’s going on in there asap and rest. Tendonitis and tendonosis have different treatment methods so you want to be sure.

    Reply

  239. knee guard

    October 07th, 2014 at 11:31 am

    Appreciation to my father who informed me concerning this blog, this webpage is actually amazing.

    Reply

  240. thesimonfaulknerband.com

    October 08th, 2014 at 10:20 am

    I was suggested this web site by my cousin. I’m not sure whether
    this post is written by him as no one else know such detailed
    about my trouble. You are amazing! Thanks!

    Reply

  241. Bellewaters condominium

    October 09th, 2014 at 4:20 am

    Attractive component of content. I just stumbled upon your blog and
    in accession capital to assert that I get in fact
    loved account your weblog posts. Any way I’ll be subscribing
    in your augment and even I success you get
    admission to consistently quickly.

    Reply

  242. Mauricio

    October 14th, 2014 at 11:08 pm

    Hello all, here every person is sharing these
    kinds of know-how, so it’s good to read this web site, and I used to
    pay a visit this weblog daily.

    Reply

  243. annonces football

    October 16th, 2014 at 8:49 pm

    Whenever there’s some sort of spillage, use a clean cloth to remove
    it. In the metropolitan culture of France, French furniture connotes
    Parisian furniture; furniture made in provincial centers such as Blois and Orlans in the Loire valley,
    and at Lyon or Lige (never part of France politically but within its cultural orbit), followed at some distance the design innovations that were initiated in the luxury
    trades of Paris, often with a time lag that could amount to decades; its history is told separately: French provincial
    furniture. So to experience the joy of owning an item of furniture that
    is a beautiful design, of sound construction, and created from the best quality
    raw materials, you need look no further than Amish furniture.

    Reply

  244. Matthias

    October 19th, 2014 at 1:59 am

    We stumbled over here by a different page and thought I may as well check things out.
    I like what I see so now i’m following you. Look forward to looking over our web page again.

    Reply

  245. Theda

    October 20th, 2014 at 12:50 am

    Excellent site a large amount of fabulous steam shower knowledge here

    Reply

  246. Erika

    October 21st, 2014 at 10:42 pm

    Very thankful for the article and comments. I’ve been dealing with patellar tendonitis for almost a year now. I’ve done PT & chiropractor work. Right now we are focusing on soft tissue scraping, stretching and foam rolling. I did use the slant board in PT & will incorporate this again along with the stretches.

    Reply

  247. direccion tecnica

    October 22nd, 2014 at 5:20 am

    Thanks a bunch for sharing this with all folks you actually
    realize what you’re speaking about! Bookmarked.
    Please additionally consult with my site =).
    We could have a hyperlink change arrangement between us

    Reply

  248. Esta limpieza zapatos de ante troy

    October 22nd, 2014 at 9:32 pm

    Thankfulness to my father who told me on the topic of this website, this website is in fact amazing.

    Reply

  249. Piers

    November 05th, 2014 at 9:23 am

    Such a shame that this site is now getting so many SPAM comments. Brian can you add a CAPTCHA form or something?

    Reply

  250. Eric

    November 05th, 2014 at 3:00 pm

    Hello Brian
    Great Blog,

    Around 4 years ago after playing basketball I had an extreme amount of pain I thought I for sure have a major issue that would require surgery I couldn’t sleep at night trying to figure out the best position to keep my leg so I wouldn’t have and pain and then could barely walk with my knee being so stiff and tender,

    I went to the doctor he took a few x-rays and told me to get an MRI ,The results were far better than I thought it would be he told me my knee was internally inflamed and I would need to do therapy and it should get better in 1-2 months.

    It did get better a lot better I started playing sports again I was fine I also used the knee strap I still do and I find it helpful for me at least the pain however still came from time to time but very manageable simple ice and day recovery would do the trick until eventually I was not dealing with any pain.

    Last year I attended a spin class for the first time of my life I really enjoyed it and want to keep going but 1 day later my tendinitis came back in a bad way and was un active for a few month trying to strengthen my knee with my therapy stretches that I learnt i eventually got better started playing basketball 2-3 a week with my knee strap I still had the pain after playing but was really nothing it went away within a day.

    I recently went back to spin thinking I was going to manage how much strength I was going to put into it but obviously didn’t work out very well as the tendinitis came back just a few days after.

    Obviously the rite thing to do is not to go to spin class and I would probably be fine but my question for you is isn’t biking less strenuous to your knees then playing basketball or running.

    I also want to ask you if I keep doing my therapy exercises and keep strengthening my knee even when I don’t have the pain do you think this would help if I go spinning next time?
    Also would you thing the Flex-N-Go Board is the best option for exercise
    Thanks hope you can get back to me

    Reply

  251. robin

    November 06th, 2014 at 2:21 pm

    How do you recommend doing this if both knees have tendonitis? Possibly over a stable object to use arms to come up? Just curious …have a friend who has been suffering a long time. Wants to keep running..
    Thnx

    Reply

  252. Andrew

    December 03rd, 2014 at 5:50 am

    Hi all, (i’m cured…somehow)

    I’ve had patellar Tendonitis/tendonosis for over 2 years now. First 6 months it was just in the 1 knee and i didn’t really know what it was, then i went to the doctors, he told me to have 3 months of rest, not as easy as it sounds, but on my second attempt, i managed 3 months off. Even though the day to day pain had gone, as soon as i played football the pain was pack as if it had never gone. So i decided to just play football regardless, ended up getting it in both knees. Then i tore my medial ligament…however, this is where the good news comes in, i had another 3 months off at least, but then i decided to try the squats with addidtional weight, with my feet at an angle like mentioned above, and for the first time in over 2 years i can actually bend down without any pain in my legs. I also played football again and although i’m taking it easy because of my medial ligament, no pain was felt on the tendons during or after. These squats + the rest from any impact activity has somehow cured my knees. I’m making sure i keep doing the squats, not eccentric sqauts by the way, just normal ones, but with the feet at an angle. My physio said the idea is to overload the tendons and the muscle around it, so that they get used to the amount of weight that they need to deal with on an impact from jumping etc.

    So in sort,
    Rest for at least 3 months (the hardest thing to do)
    Do the slanted squats while holding weights, i do 12kg in each hand. 3 x 10 a day (i don’t us a board, just something to but the heels of my feet on to get the angle)
    I also started taking health suppliments because i read that it might help repaire the tendon, just things like cod liver oil tablets etc, but i doubt that would of worked so fast, but it can’t hurt.

    Reply

  253. Athena

    December 03rd, 2014 at 11:29 am

    Hi Brian,

    Good post! I have had a few different running injuries the past couple months rooted from my marathon training. Currently, I am diagnoised with a stress reaction on my left shin and patellar tendonitis on both legs. How long did you do the eccentric squats to heal?

    Reply

  254. Ian

    December 13th, 2014 at 2:10 pm

    Has anyone tried The Graston technique for this? I have tendonosis on both knees and have been slowly improving. I just started Graston and it feels good but not sure if it’s truly helping.

    Reply

  255. steve

    December 14th, 2014 at 3:00 am

    I was in the checkout process for this slant board on their site, but then the $18 shipping charge got added to the already $70 charge, and immediately shut down the browser tab.
    I’ll just get a 2 dollar solid wood board from Lowe’s and lean it against my bottom stair in my den, and keep pilling clothes between the board and stair until it gets to 25%

    Reply

  256. Kelly

    December 14th, 2014 at 11:30 am

    Hello Steve, so sorry to hear you had difficulty using the site. We have been told that a small % of people visiting have had an issue. These folks have been primarily Mac users that are behind on a few software updates. Safari seems to be having a problem with the site. We are working on it. Anyone having these issues can call the # on the site and we will take a phone order so that all goes well. Additionally, UPS just did an increase and unfortunately, we have no control over shipment prices. What we can do however, is offer a $5.00 discount to offset the the recent increase and to help with a happier holiday. Thanks for letting us know about the problem. To get the coupon code feel free to email us or call the number on the site. Best of luck to you, and may I recommend stair treads also sold a lowes, to keep you on the board.

    Reply

    • steve

      December 14th, 2014 at 11:41 am

      Kelly, I misworded it. Meant to say, I closed the browser tab myself immediately. It was just a shock to see the shipment price. Your site is fine lol.
      That’s a shame about their shipment prices. I was using the 5$ discount, but still too expensive.

      Reply

  257. StuartR

    January 01st, 2015 at 8:24 am

    Hi everyone,

    I have bilateral Patellar Tendinosis / tendinopathy and I am determined to beat it. I wanted to share my story so that anyone who reads it can identify the signs and begin their recovery in the proper way. I read the posts on this thread and I don’t know about you, but some of them – many of them in fact – make for very very depressing reading. I am determined to focus on the cases where people have battled and beaten this horrible condition, because I believe I CAN. Brian (who conceived this page), Martin Koban and also Mark Handberg are all examples we can follow and should focus on. As debilitating as this condition is, everything I have read and learnt is saying the tendon fibres CAN be remodelled and you can go back to doing what you were doing before, in certain cases, even more.

    So here’s my story so far: I am in my early 40’s, male, married with kids, live in the UK and have led a very active life until now. All sorts of sport at school, university…field hockey, golf, cricket, long distance running. For the last 20 years, road cycling, mountain biking and over the last 5 or so years, a structured free weights program at the gym. I’ve had a few tissue injuries but nothing major thankfully. My gym program started many years ago, I did the usual stuff without any instruction but decided to get a little more prepared about my approach about 4 or 5 years ago and started 12 months of core functional strength program (essentially bodyweight only stuff) with an instructor before moving onto free weights and lifting a bit more. I’d do functional strength 3 times a week and cardio (spin classes)twice a week, roughly. Since then I have progressed and made some really great gains in my strength and ability.

    For example: Leg days at the gym? I love them. Squats, I used to hate but I grew to love them, as well as deadlifts. I have progressed from hardly being able to proper squat (keeping your shinbone as close to vertical as possible) a few years back to squatting over 50KG this year. I know not much but, a big number for me. In ~March 2014, I noticed some mild pain in both knees (2 out of 10) from inflammation after a squat session, but it cleared up before the next session 5 or 6 days after. Of course, I kept doing the same thing like we all do. I was in “denial” about my condition until it just steadily, got worse, and worse, and worse.

    Then, in late summer this year, I noticed the inflammation flared after sessions on the spin bike. The inflammation was worse than after squats or lunges. It all came to a head on a holiday in Spain in August. After a few long distance cycle rides (30miles) I could barely walk 6 hours afterwards due to the pain. So I decided to stop all the exercise and I went to see a physiotherapist who advised me where I am at.

    My physiotherapist has told me I have “Bilateral Patellar Tendinopathy” (in both knees), due to being very “quad-centric”. Basically my medial glutes (the ones in your ass) switched off many years ago. This biomechanical imbalance has led to repetitive excess strain on the patellar tendon and ultimately, Patellar Tendinopathy. It was diagnosed when my physio asked me to do a 1 leg squat (I cannot do one, nor have I ever) and a normal bodyweight squat, and a lunge so that she could observe me.

    My physio advised me the Recovery period can be as short as 12 weeks but, can last much much longer, depending on the state of the tendon. As I have been suffering for 6 months (at that point) the outlook was (and still is) pretty good. Nett: I can make a full recovery and through a disciplined body movement and re education, can actually return to doing even more than I did before injury. The recovery is spread across 4 phases:
    1) Rest
    2) Re education (4-6 weeks)
    3) Conditioning & strength work (such as the one legged eccentric squat on a slanted board) (1mth to 6 months)
    4) Adding “speed” – essentially getting back on the bike and running again in very slow increments. Starting with 2minutes on the bike, progressing to 3 minutes 2 weeks after that, and so forth.

    Where am I now? Well basically, flip-flopping between Stage 1. It’s frustrating and I could let this get me down but I will now. I have LEARNT so much in the last 3 months. Here’s a precis:

    I started the re education phase in September but, I did not LISTEN to my physio and if I am honest with myself, I overdid the exercises. The exercises were:

    Daily glute re activation: 2×15 reps of Clams, glute bridges, standing on 1 leg (2x30secs each leg), bosu ball squats (1×15) , light hamstring curls (25% of the usual weight), split leg lunges. These were all designed to re educate the motor neurones and movement.
    My physio said to do these so that the pain does not go higher than 3 out of 10 (with 10 being debilitating pain). Whilst I have focused relentlessly on the exercises, it was in ignorance of my knees crying foul. There was low level pain during the exercise, but afterwards, the pain really never dipped below 6 out of 10 and regularly hit 9 out of 10 (where I can’t even walk, or step down the stairs without a flash of pain in the front of the knee) but I carried on in blind faith it would get better.

    After 8 weeks (end of October), I decided that the program was not working and we had to re assess. I started resting the knee completely. Cold gel packed it 3 or 4 times per day to help with the pain, and after another session with the physio just talking about the injury, I went to see a specialist sports medicine doctor here in the UK who specialises in Tendinopathy. She sees elite athletes as well as weekend warriors like me with this condition. My consultation was one week ago.

    An ultrasound scan revealed the tendons are really not in a bad way. The Dr mentioned she has seen people with very bad tendons, where they have become thickened (Mark Handberg can comment maybe on why this happens) and covered with “gloop”. Basically an apple-sauce looking substance which the body produces trying to heal the tendon. I have none of that but do have a little of the “Doppler effect” on one tendon, where the blood vessels are trying to grow into the tendon to repair it. This is perfectly normal for a Tendinopathy I am told.

    So, what next? Well, the Doc prescribed:
    1) 1×15 reps of glute bridges per day, progressing to as many as you can (4 or 5 sets) as long as the pain stays under 3 or 4 out of 10 afterwards and comes back down within 24 hours.
    2) 1×10 reps of single leg eccentric squats on a leg press machine. Bodywieght squats are too much for me at this stage. Per Mark Handberg’s posts, I am naturally keen to start doing the eccentric squats on a decline board asap but, it is clear that the bodyweight is too much for my tendons right now. I explained to the doc that 3 sets of 4 reps of bodyweight decline squats was too much (more of this below) and my pain the next day flared too high. So, the plain is to do 1×10 reps ea on the lowest weight and see how the tendons respond the next day. The key is keeping the pain <3 and ensuring it does not return the next day.

    Hamstrings? They will have to wait til stage #2.

    WHAT I HAVE FAILED AT, AND LEARNT OVER THE LAST 4 WEEKS

    1) Tendons take much longer than muscles to repair and grow. I didn’t know this. It explains why in the gym I/you can add weight to each session quite quickly. When I was rehabbing my shoulder in the summer (I strained my supraspinatus muscle doing deadlifts, at the back of the shoulder) I went from being able to only shoulder press 5kg dumbells to pressing 20KG dumbells in under 6 weeks. That gives you an idea why you feel strong but may develop tendonitis in your elbow, shoulder or knee inadvertently. I read somewhere that muscles take 2 weeks to show strength gains. Tendons take 2 months to adapt.
    2) Buy Martin Koban’s book – “Beating Patellar Tendonitis” http://www.fix-knee-pain.com/patellar-tendonitis-knee-tendonitis/ I have started doing all of his stretches and exercises aside from the eccentric squats. I want to start these soon but need to build up to them. It is clear the eccentric squats achieve the same results, if not better, than surgery. Brian’s page here is the example to that, as is Martin himself.
    3) Buy a notebook. Record your pain levels and EVERY exercise you do, and the corresponding effect this has 3,6,9 hours afterwards and the next day. It wasn’t until I did this I understood that basic stuff, such as stepping out of my car with one leg vs 2, aggravates the tendon.
    4) 8 days of rest takes the pain from 8/10 to 2 out of 10 for me at least.
    5) Finding how long you can REST for before undertaking any exercise is the key. Martin’s book is amazing but the only gap I think is some more information on how to manage your pain and rest so that you know where and when to begin and maintain exercises. I have had 6 weeks of false starts now, basically resting then doing the smallest thing that will flare the pain.
    6) Doing 25 minutes of swimming – front crawl and breaststroke after 8 days of rest is good for cardiovascular fitness, but it inflamed the knees again. The next day, I was up to 6 or 7 out of 10. Took 3 or 4 days to get back down to 2. Now, I can swim 15mins per day with a pullbuoy float between my legs, which provides the flotation you need and isolates the upper body. . It is still good for my CV fitness and I feel GREAT afterwards. This will become my solace for cardio exercise.
    7) Daily foam rolling and weekly deep tissue massage has released a lot of tension in the knee. When your tendons are in the degenerative stage of disrepair (Tendinopathy), they are shortened and tight. The tissue massage has revealed a very tight TFL (Tensor fascia latae) on my right side. Basically a very tight hip flexor. This I think is causing additional tightness on my right patellar. It’s taken 2 sessions so far of deep tissue massage but it is coming out. 2 more should do it before I can start re educating that muscle group how to work
    8) My tendons will get overloaded if I don’t re educate, activate, condition and strengthen my glutes and hamstrings.
    9) 3 sets of 4 reps of bodyweight eccentric squats are too much at this stage. I need to start the process of collagen synthesis by lowering the weight with good form on the leg press machine. Note: I haven’t been able to start this yet. I did 1 set of 10 reps of glute bridges 2 days ago. My pain went from #1 to #3 or 4 about 4-6 hours after doing the exercises, but was back down to #2 or 1 the next day (yesterday). I said I would give myself 48hours between any exercises for the first 2 weeks so I can understand where my level is. Stupidly, I raced my daughter 30 yards on a family walk yesterday. Result: may pain is at level 4 this morning. So I will have to wait at least another 2 days before I can start the first eccentric exercises. I will do a swim today though.
    10) I bought a flex n go board from http://www.flex-n-go.com/default.asp I won’t be able to use it for a while but will let you know when I do.
    11) Brian’s page and Martin’s book are the only resources I have found for this for this condition. So, I am going to start my own blog. Partly to record my progress but also to provide a resource for anyone else who tries to overcome this condition. Note: this is not intended to be a replacement to this page or Martin’s book. Any tiny bit of information you can get (I have learnt a lot from Mark Handberg’s posts on here) I have found is helpful.
    12) I am actually progressing, even though it doesn’t feel like it. 2 months ago, I would have pain when doing squats. Now I don’t. It is only afterwards. The pain is gradually coming down. However, the smallest things seem to make it flare.

    REMODELLING YOUR MIND IS MORE IMPORTANT TO START WITH……

    Re-modelling your tendon is one thing, but I have found unless I am clear with myself what I am prepared to do to beat this thing, and how long it *could* take, the mental, emotional labour of fighting the pain 24/7 and thinking I will never get better will probably be the undoing of me. Not exercising, like everyone on this thread I guess, has left a seemingly irreplaceable hole in my life. Everything has to change. How much I eat, drink, what I do at the weekend. It has been very very difficult to frame properly. I am a father 2 to beautiful daughters and I have a demanding job with lots of travel. If I start showing up as a miserable git then everyone loses out. This would not be good!

    So, I asked myself this question. One year from now, if you were able to do the following stuff, would you be happy?

    3 times per week: 3 sets of 15 eccentric decline squats, calf raises, hamstring curls, essentially a full leg workout.
    My normal upper body and core workouts.
    Be able to complete a round of golf without pain.

    And in 18months from now, would I be happy if…

    I can start road cycling again
    I can start running again.
    |even just a little bit. Eg: 1hr per week without bad pain.

    The answer, is a resounding YES.

    Of course I would like to do more but, I am accepting that this condition took years to develop, and will take year(s?) to remodel the collagen fibres so I have a healthy tendon. What’s more, if I can remodel these tendons, AND address the biomechnical issues with glutes not activating properly, who is to say I cannot get back to doing MORE than what I was doing before?

    I just want to begin the process of rebuilding. The first set of 1 legged decline squats I do on that leg press machine will be a big day. It might be day 1 of 365 days of rebuilding, but 1 day done is another day closer to my goal. I hope to give this a crack when my current pain level (4) goes back down to what it was yesterday morning (2 or 1). I think this will take a few days but, I will post back on here.

    Finally, I’d like to say thanks to everyone who posts on here. I’d like to ask you to keep coming back with any development you have. This thing CAN be beaten.

    Reply

    • Zach

      February 02nd, 2015 at 8:02 pm

      Hi Stuart,

      I’m in the same situation with you. I will beat this damn. I’ve had in the injury since late October 2014 and it is getting better. As a powerlifter and drug free bodybuilder I will be back my sports.

      I do have true plantar fasciitis (flat feet), and when I was younger had bad achilles tendonosis. Orthotics solved that over time, and stopped wearing them after the pain dissapeared. 8 years or so down the line and I’ve developed this. I’m hoping the orthotics help.

      Zach

      Reply

      • StuartR

        February 09th, 2015 at 10:11 am

        Thanks Zach. Good to hear. How long have you been rehabbing on the board?

        I have done ~6 weeks of eccentric loading on a leg press and only just started on the slanted board yesterday.

        Reply

        • Zach

          March 03rd, 2015 at 6:26 pm

          Hey Stuart.

          My physio hasn’t recommend use of the board – yet. How is your knee after the eccentric loading on the leg press now? If your fine, I’d like to communicate over email, it would be easier then first having to come to this website to discuss (seeing as I’m a month late to respond) , you can email me at : with no spaces : 2zacshalack (at) gmail (dot) com . Not trying to give away my address for spam bots out there lol.
          Hope to hear from you soon, I hope we can encourage each other through this ordeal.
          Zach

          Reply

          • StuartR

            March 03rd, 2015 at 6:53 pm

            HI Zach,
            I am making slow, but steady progress:

            Single leg eccentrics on the leg press was successful in progressing me from very weak legs following essentially 10 weeks of no activity and muscle atrophy into….

            Bodyweight half squats and isometric wall sits into….

            Bodyweight squats into…..

            2-leg bodyweight squats on the slanted board.
            As of Sunday I am up to 3×12 reps (36 reps) of bodyweight squats, squatting to the horizontal (deep squat). I do 9 second reps for the eccentric phase.

            Pain levels: Have gone from having prolonged increases in pain after squatting to having hardly any reaction at all. This is a sign I need to get onto the 1-leg squats. I have found I am able to do 2 sets of 4 reps each side, but only really dipping down about a quarter squat….until I see my knees reaching my vertical toe line. After that, I just don’t have the functional strength in my glutes (yet). But my form with both legs is really good.

            This entire process, from leg press to where I am today has taken 9 weeks. I think the next phase for me is progressing from 2-legs to one. Specifically building the glute strength to do 1-legs down to near the horizontal – which is much better already – will take another 10-14 weeks.

            Appreciate this is different for everyone.

        • Zach

          March 11th, 2015 at 8:19 pm

          Just read your update. Glad to hear the eccentric work is helping. Do you do the exercises every day?

          As for me: Along with my mobility and exercises (glute hip thrusts, hamstring curls, etc.) I have made some progress since I last posted in February. Going down stairs is getting easier and same with going up. Today I actually managed to go 3 sets of 10 bodyweight squats (to parallel) and two sets with the olympic bar with 0 pain and no inflammation at all. (no warm knees). Mind you the sets were slow and controlled rather than speed work.
          If I can do this, any ideas of what I should try next?

          I totally understand it’s different for everyone. Everyones got different sized limbs etc that all play part in the healing of the tendon.

          Reply

          • StuartR

            March 16th, 2015 at 4:30 pm

            Hi Zach,
            Yes I do the exercises every day *HOWEVER* it’s really important to provide enough time for your muscles to recover and remodel themselves. You are teaching them a new movement pattern and unless you rest sufficiently, you can literally overload the nervous system and you hit a plateau. I found that after 3 months of very little activity, I had become deconditioned and as a result, it set off all sorts of imbalances; a tight ITB, TFL, resulting in patellar maltracking and all sorts of other crap. I continued with the squats and now I have picked up an even worse condition than patellar tendinosis. I’ve provided an update below.

            Stu

  258. Jake

    January 09th, 2015 at 3:31 pm

    I just wanted to chime in on WHY eccentric loading on the patellar tendon heals it while causing discomfort.

    The idea behind eccentric loading is to cause mild discomfort by putting a CONTROLLED eccentric load on the knee unlike the uncontrolled jar of running or jumping. This mild discomfort causes the body to produce collagen which heals the tendon over time.

    You should have mild pain in your knees after this exercise but the pain should go away within an hour or two. If your crippled from it, slow down and build up gradually.

    Reply

  259. Michael

    January 25th, 2015 at 8:26 pm

    I am in need of a quick-fix as I feel sharp pain in my left knee each time I do the triple jump. Not only does it effect my jumps but my sprinting also becomes more difficult. I have trained hard all winter with no complaints but the minute I do any straining jumps my knee gives underneath me! Willing to try anything to ease the pain

    Reply

    • Taz

      February 01st, 2015 at 8:10 am

      Get one of these bored bud they really do work, any help or advice just ask

      Reply

  260. Taz

    February 01st, 2015 at 8:08 am

    I’ve had patella tendinitis for around 4-5 years, I’ve had the injections and loads of physio. I too surfed the net looking and praying for answers other than the operation and then I came across the bored. So I made myself one as Im a carpenter. Well at first the pain was unbearable but as the weeks went by I found the pain had more or less gone, I started to step up the exercise by wearing a back pack and loaded it with weights and this worked my knee grew stronger and stronger, I was able to play football again and other sports with no pain at all but a very slight acke afterwards but I managed to get rid of that too with stretches. My only criticism is that you have to maintain the exercise at least twice a week to keep it strong or else it will return, so it’s not a cure, more of a pain relief. So now I’ll do it several times a week and I’m fine.

    Reply

  261. Gabriel

    February 05th, 2015 at 5:52 pm

    Hey Brian.
    Thank so much for sharing your experience. I play volleyball and I suffer from chronic patellar tendonitis. I have started doing this exercise for the last two months while still playing volleyball and it still feels like is too painful on my tendon when I am doing the squats. Is it better if I just stop playing volleyball to actually have better results with this exercise?

    I made the biggest mistake of letting this injury become chronic in the first place and it so hard to get rid of it even if I do take some time off from sports. I am just hoping this exercise could give me better results. I also wanted to ask you if you ever enconted pain on the chin bone just below the patellar tendon. Recently this is what I have been dealing with so I can’t perform the eccentric exersise.

    Reply

    • StuartR

      February 09th, 2015 at 10:16 am

      Hi Gabriel,

      You really have to take time off your chosen sport whilst you are recovering. The reason is that when the condition becomes chronic (ie: the pain and discomfort is persistent and prolonged) the collagen fibres in the tendon have become disorganised. They look like brown pulled chicken. When the tendon is healthy, the collagen fibres are long, straight and white, like a nicely cooked chicken breast.

      When the tendon is in this degenerative state, the only way the tendon will repair itself is via consistent, frequent, controlled loading. As you have seen on this thread, people’s recovery time varies from 12 weeks to 9 months. The hardest thing I had to do was convince myself to do no other sport on my legs. I am way off recovering but I am on the right road now. Hope this helps.

      Reply

  262. Jordan Alvaro

    February 06th, 2015 at 8:58 am

    Brian I also have suffered from patella tendonitis and share a story similar to yours. I found that eccentric exercises have really helped ease my pain. Do you still suffer from the pain at times after playing sport or have you been able to kick the injury for good?

    Reply

  263. Dan

    February 16th, 2015 at 6:59 am

    Hi, I have been suffering with PT for around 3 or 4 years, stupidly ignored it for too long. I did have some Osgood slatter problems younger and still sport the knobbly knees. I have had the tendon massaged and strapped whilst using the slant board, which made it worse in the long wrong, it seemed far easier to get sharp pain or become inflamed again. I have had ultra sound and acupuncture, which did help with the pain in the knee it didn’t stop further inflammation when exercising. I am now carrying physio on my back,hip and quads to try and cure the cause of the knee pain, It looks like its a problem with my hip flexor and lower back, causing tightness in my quad and ITB. however, whilst everything feels loose and improved a day after the physio session, a week after my knee pain is as bad as if I had had just played football(soccer) the day before. I haven’t played football for 3 weeks. Everything seems to irritate it, and even an hour long drive yesterday became very uncomfortable.
    not really sure what to do next, i will continue with the physio sessions to loosen up my back, but i am not very hopeful of a proper cure.

    Reply

  264. StuartR

    February 16th, 2015 at 8:35 am

    Dan,

    Similar for me. I have learnt that once you come out of your normal exercise routine, it creates imbalances. For me, initially the lack of leg exercises meant I had significant atrophy in the Quads and VMO. My quads and ITB on the right hand side tightened and pulled the patella over to the right (Patella maltracking) which inflamed the hoffa/fat pad behind the knee and caused bursitis. I have twice weekly sports massage on my TFL (Tensor facia latae), ITB and quads. Since I was able to start on the slant board with a proper technicque, I have noticed some muscle returning in the legs and it is slowly recorrecting my maltracking.

    In between, I foam rolled obsessively, which had a very positive effect as it is frequent (twice daily) but about 4 weeks ago I noticed some inflmmatory pain in both shoulders, at the top and back, where the infraspinatus and supraspinatus tendons attach. It would turn out the foam rolling caused subacromial bursitis (see link below) so I have had to lay off foam rolling for a few weeks now, which has been very frustrating.
    My physio has been amazing. She has told me that although it feels you are the only person in the world suffering like this, it is entirely normal observed course of events they see on a daily basis.

    The only thing I can recommend is to play the long game. It might be worth taking a week of any exercise, squats, slant board included and just focusing on 2x physio sessions on your hips and ITB and daily stretching and foam rolling. It takes 7-10 days for a muscle to break off scar tissue and lay down new fibres. Let it settle the restart your squats. It’s worked for me so far.

    http://physioworks.com.au/injuries-conditions-1/bursitis_shoulder

    Reply

  265. Ian

    February 16th, 2015 at 6:23 pm

    Hi all,

    A positive update:

    I sometimes get disheartened when I can’t be the athlete I’d like to be and often overlook how much WORSE my patellar and quad tendinosis once was and how far I’ve come, despite the many setbacks and mistakes I’ve made. 2 years ago merely walking day to day was difficult. Nowadays I can walk around all day with only mild to no discomfort. My quads used to be so tight and filled with pressure, now I can kneel down and they feel loose, flexible.

    I really turned a corner in last few months by scaling back on my exercises doing leg lifts and body weight squats only. I also introduced soft tissue mobilization 2x/week which I model after having the graston technique done several times. These two modifications have helped my daily life significantly. I’m going to slowly introduce more activity but I’m reminded that this is working…..with a slow and steady approach. I hope you are all finding success in your own journeys.

    Reply

    • StuartR

      February 17th, 2015 at 6:36 am

      Ian,
      Great news. Same for me. I am *verrrrry* cautious to mention it but I am making incremental improvements every day. 1 month ago, I was still trying to condition my tendons to coping with even 4 or 5 half squats on a flat floor per day, and the thought of a slant board was months away. Now, I have just finished one week straight of double leg FULL squats on the slant board. Starting at 3×2 reps and now at 3×8 reps (18 reps total). Each time, the peak post exercise pain is dropping from 5/10 to now 3/10 and dropped from taking 12-24 hours to return to the baseline to taking less than 3 hours to. I’ll post a fuller update I hope in a few weeks time.

      Good luck. Keep it going. Do as much glute and hamstring work as you can. The more you do on your quads the more you are maxing out other areas which may have atrophied. I am taking 3 days off it now as my right ITB got very tight so I had a deep tissue / NMR massage yesterday on it. I’ll be returning to it on Thursday with glute bridges, ham curls and calf raises and get back to the squats later in the week.

      Stuart

      Reply

      • Dave

        June 14th, 2015 at 7:07 pm

        Hi, Stuart

        I’m curious to hear about your current tendonitis status.

        How has your rehab panned out?

        Thanks, Dave

        Reply

  266. Jeremy

    February 17th, 2015 at 1:26 pm

    I’ve been following this thread for 1.5yrs. My journey eventually lead me to weight loss and low carb dieting. After 3 years it took cutting sugar out of my diet! It has all but removed my inflammation and allowed me to heal. There is a reason you see comments like mine sneak in to these threads. It’s because it works. Take some time to research Low Carb and lose some weight!

    Reply

  267. Kaylee

    March 06th, 2015 at 1:08 pm

    I’m a competitive cyclist, & i’ve been suffering from PT for about a year and a half now. It’s been killing my ability to even ride! I started to really believe i was never going to get better.
    But I’ve been doing the eccentric squats (and muscle balancing/joint mobility excercises) for about four months now, and i’m probably 50-70% healed!! I bought Martin Koban’s book “Beating Patellar Tendonitis” & It’s been excellent.
    Also, I’ve noticed that my pain levels during and shortly after my eccentric sessions are directly related to how much water i had been drinking the 12 or so hours before….

    Reply

  268. Megan Plante

    March 06th, 2015 at 7:17 pm

    I started using new balance minimus running shoes about a year and a half ago. Within 6 months, I had to quit running and since March of last year, I haven’t gone out running since. The swelling and pain keeps me from lifting weights or working out at all for about 4-6 weeks at a time, and I have flare-ups at least every 3 months. I have no idea what’s wrong with my knees, but they hurt on all sides and swell on top. The right one always swells more than the left. A lot of times they get swollen just after sitting at my desk at work…

    I’ve been to several doctors and gotten a different diagnosis every time (one diagnosed me with having stepped on a pebble and twisted something in my calf, which may have affected my knee…still paying off that medical bill and not happy about it!)…been diagnosed with anything from tendonitis to arthritis to chondromalacia…

    I want to know what I have and get rid of it! I miss running..and squatting..and deadlifting!!!

    Reply

    • Megan Plante

      March 06th, 2015 at 7:19 pm

      I guess my question is if this is something that can help my case, being something chronic?

      Reply

  269. Soft Picture Collage Maker v2.0.3.1976 key

    March 10th, 2015 at 10:07 pm

    I got this website from my pal who told me
    concerning this site and now this time I am visiting this web site and
    reading very informative content here.

    Reply

  270. Academy Money online

    March 14th, 2015 at 10:32 pm

    I got this site from my pal who informed me on the topic of this site and at the
    moment this time I am visiting this web site and reading very informative content here.

    Reply

  271. Creme Del Mar Skin

    March 15th, 2015 at 9:25 pm

    My family members always say that I am wasting my time here at net, however I know I am getting knowledge all
    the time by reading thes pleasant content.

    Reply

  272. Luka

    April 30th, 2015 at 8:06 am

    Very helpful site and really useful to read some of the comments. I have chronic PT in both knees for about a year and a half now, really wish I knew what I had earlier, but now I am determined to beat this thing. I have made myself a slant board and do 5 repeatitions of 15 eccentric squats 3 times a day. In the start the pain was around 7, now the pain is around 2, lately going low as 1. I was really happy with the progress I made I decided to play soccer again, and this was a mistake, as I forced myself too hard on the last session and now I am back to 5 or 6 lvl pain. I’ve decided to only play the goalie and to do as little running as possible (or none). My biggest problem is sitting at work for 8+ hours, which mostly leads to pain in my knees. I get up every once and a while, but don’t have the luxury to do it as often as I would like. Any ideas what to do to prevent/avoid this? Thanks, Luka

    Reply

  273. Dennis

    May 09th, 2015 at 10:39 am

    I have had Patellar Tendonitis for about 5 years. It only bothered me after playing tennis. Last year I tore my meniscus in the same knee and had it surgically repaired in January of this year. Not sure how or why but the surgery actually made the tendonites worse. It’s been 17 weeks and the pain persists. I went through conventional physical therapy and it helped some. I stumbled onto Martin’s book and bought the flexn-go slant bar and have been doing the exercises for a couple of weeks. So far seems to help. I noticed recently that my pain would flair up after gently rubbing the area where the patellar tendon attaches to the tibia just below the patella. I also felt some fiberous material or scar tissue in the area. Further research led me to a runners blog where contributers were extolling the virtues of a physical therapy procedure called ASTYM (A-STIM). The process is performed by a specially certified physical therapist and consists of using an instrument to massage area where there is scar tissue to break the
    scar tissue down so it can be re-absorbed into the body and facilitate production of healthy tissue. According to information obtained at ASTYM.COM the tendon cannot heal properly without getting rid of existing scar tissue. I plan to start this therapy next week and will post results. ASTYM therapy is also used for IT band problem, planter issues as well a other tendon and muscle issues. Check it out.

    Reply

    • Matt

      June 17th, 2015 at 6:05 pm

      How has the ASTYM therapy been working for you? I have been wondering if I should do that for my quadriceps tendinosis that I have been dealing with for the last 12+ months.

      Reply

  274. Dennis Durost

    June 18th, 2015 at 6:05 pm

    Completed four weeks (8 sessions) of ASTYM last week. The PT said scar tissue removed but it would take another six weeks for the tendon to heal and strengthen. I am to continue the exercises including the eccentric squats. The PT said I should be good to go after six weeks. The process seems to work, was not painful, and insurance covered the cost. To find a practitioner near you go to ASTYM.com and use the locator function. I will post my results as I make (or don’t make) progress.
    As a point of clarification, the slant board will also eventually help remove the scar tissue but ASTYM is faster.

    Reply

    • Martin Koban

      June 19th, 2015 at 3:00 am

      Thanks for keeping us posted Dennis. I’m curious to see how well ASTYM works for you.

      – Martin

      Reply

  275. Academy Online Income

    June 19th, 2015 at 6:32 am

    Hi there colleagues, its fantastic paragraph on the topic of educationand
    completely defined, keep it up all the time.

    Reply

  276. TR Brown

    June 27th, 2015 at 6:30 pm

    I have had patellar tendonitis since I was a teenager and now I am 59 years old. I have a condition called patella alta which means the patellar tendon is too long. It places extra stress on the tendon. I grew up playing basketball. Now I am primarily running and snowboarding. My situation is a cautionary tale. I have ruptured both my patellar tendons and had them surgically repaired. One ruptured at age 33 and the other at age 54. My primary point is that for some people this is a chronic and debilitating condition. I have rehabilitated my knees multiple times but it never completely goes away. My latest problem stemmed from running multiple half marathons and moving up my training to a full marathon. I am currently in shut down mode. I have been looking at multiple websites to try to figure out a way to rehabilitate once again. I am exciting to try the eccentric conditioning. I have not done that before. I have found that when I don’t do my exercises and when I push my athletic progression too fast is when I get a flair up in my symptoms. I encourage everyone with this condition to keep participating athletically. Respect the pain and back off when it hurts. Methodically do your exercises and don’t push too hard, too fast.

    Reply

  277. Geroge

    July 04th, 2015 at 11:46 pm

    Should I do these exercises everyday?

    Reply

  278. Matt

    July 09th, 2015 at 12:15 pm

    I have been following this blog on and off for the last several months and thought I would share my experiences in the hope that it might be useful. I have a long history of tendinosis in multiple joints. First in my Achilles tendons around 13 years ago, then my patella tendons 9 years ago, and now more recently in both quadriceps, right hip, and right shoulder. The Achilles and patella tendons were damaged from years of running, the quadriceps and hip tendinosis from biking, and the shoulder from weight lifting. In all cases the issue came about from doing too much too soon. The quads and hip were exacerbated, or possibly caused by poor bike fit.
    The Achilles and patella tendons pretty much healed over time after I quit running. I am currently doing daily eccentric strengthening, flexibility, and muscle strengthening to rehab my quadriceps, hip, and shoulder. After nearly 10 months of that I estimate that I am about 2/3 of the way there. On a pain scale I started at 6 and now I am between 1 to 3. However, I very stupidly continued to bike 2-3 times a week and did not stop completely until April. Most of the progress has occurred since then. To summarize:
    • You have to rest. Avoid the activity that caused the problem for at least 3 months. Preferably 6.
    • You have to have to have a lot of patience and discipline. Avoid the temptation to start training again when the pain dissipates. You need to continue resting and rehabbing for several more months.
    • Eccentric exercises work. I say this as it has “only” taken 10 months or so to get to where I am with my quads, hip, and shoulder. I did not do any rehab for my Achilles and patella tendons and those took years to heal. In truth the Achilles and left patella never really did as they still twinge from time to time.
    I have also started doing ASTYM on my knees once a week and will post back with a progress report in a couple of months.
    Good luck.
    -Matt

    Reply

  279. Dennis Durost

    July 09th, 2015 at 8:13 pm

    Matt: The knee ASTYM should only take about 4-5 weeks (8-10 sessions). After I completed my knee ASTYM, the PT told me to continue the eccentrics and other exercises/stretches for an additional six weeks. He encouraged me to gradually return to normal activities after six weeks. According to ASTYM.com, returning to the activities that contributed to you problems is part of the strengthening phase of ASTYM. You may want to discuss this further with your ASTYM certified practitioner. Good Luck

    Reply

    • Ian G

      April 09th, 2018 at 1:35 pm

      It’s been quite some time since you posted this. How is the knee feeling these days? I’m thinking of ASTYM to get me over the final hump.

      Reply

  280. Matt

    July 10th, 2015 at 4:43 pm

    Dennis – The ASTYM website says to continue doing the problem activities while receiving treatment. I would not do that if I were in the early stages of rehab but I have been off the bike for 3 months now and doing eccentric exercises since last November so maybe that makes sense for me now. I have recently started working in one or two short rides a week on top of my daily commuting. This was on the advice of my PT, who is also my ASTYM practitioner. Also, I am only doing one session a week. He did not say anything about more frequent sessions but then he only just got his certification so I am his guinea pig…

    Reply

  281. James

    July 12th, 2015 at 12:39 pm

    I’ve suffered it in my left knee for a year now and thought I would give my advice

    1. Rest is not always good. Patella tendons need to be worked and stretched otherwise it just comes back

    2 in my case it was a combination of weight and flat feet that caused me to damage my tendons along with playing football

    Although I haven’t recovered I have found that squats was the best treatment along with foam roller

    Everyday I do 40 mins of different activities to help that are not to painful

    Running on the spot
    Shooting a pretend basketball
    Jumping jacks

    The trick is to do little and often I do four 10 minute sessions a day but you can do what suits you

    I try and use the foam roller twice a week and before any football is kicked I do half hour warm up on my own
    Light jogging stretches focusing on my knees

    Hip flexors etc

    I can now pay 45 mins of football with minimum pain
    Hoping to get to 90 by the start of the season in September

    Ohh and swimming is great takes all the pressure from your knees and gets you legs working

    Reply

    • Eric

      July 12th, 2015 at 6:27 pm

      Hey man, i have flat feet too! I have tendonitis in both my knees and it sucks!! Been trying the eccentric squats for 2 weeks, but I havent noticed much change. Its hard to stand up for a long period of time, I can still walk though. Did you do anything about you’re flat feet??

      Reply

  282. Dennis Durost

    July 30th, 2015 at 10:07 am

    Try orthotics. there is a machine at Walmart that you can use to determine what orthotic device is best for you. The cost is about $40 but if you have a single set they can easily be switched between shoes. Made a big difference with me.

    Reply

  283. Danilo

    July 31st, 2015 at 1:49 am

    myfivefingers.com has potential, you can make
    your page go viral easily using one tricky method.
    Just type in google:
    Kimting’s Method To Go Viral

    Reply

  284. nathan

    August 10th, 2015 at 11:38 am

    I have been diagnosed with patella tendonitis 10 months after it started. Its only got worse. I can’t run for a bus without huge pain during and afterwards. I can cycle on a cycling machine and my leg is much more comfortable straight than bent. I was scheduled for the cortisone injection but some paperwork went wrong and it wasn’t treated. I will try these squats but feel like my symptoms are worse that what you describe

    Reply

    • Dennis

      August 10th, 2015 at 4:53 pm

      Nathan: Skip the cortisone as it represents, at best, a very temporary fix. Find a physical therapist that is certified in ASTYM therapy. The therapy only takes about four weeks and is highly effective for PT. After completing the therapy and continuing to do the squats and other exercises outlined in Martin Coban’s E book “Beating Patellar Tendonitis”, as well as working into some normal activities, I was good to go in an additional six weeks. I now play tennis a couple of times a weeks and and do an hour on the treadmill. To learn more about ASTYM therapy go to ASTYM.com

      Reply

  285. Michelle

    August 15th, 2015 at 4:22 pm

    What if you have patellar tendonitis in both knees? How can this board work in my case?

    When I came down with patellar tendonitis in only my right knee, I was made to constantly use my left leg to drag it up and down stairs so often that in just about a month, I developed tendonitis in my left knee, and now I can barely walk, and it’s been this way for two years. The simple 4-step stairs at my front door did me in and it has ruined my ability to sprint and play tennis.

    Can anyone offer me advice?

    Reply

    • StuartR

      August 17th, 2015 at 1:44 am

      Michelle,
      My PT was as bad as yours. I can tell you that the eccentric exercises do work. Here’s some summary points that will help you:

      1) There is no average period of time for Tendinosis / Tendinopathy (tendonitis is not really used anymore) to recover. It is very much patient specific. However, if you start eccentric exercise, you should see some gains within 6 weeks. It can take years though.

      2) Start at the lowest possible level. For me, my PT had got so bad even bodyweight squats were too much. I started on an assisted leg press then moved to bodyweight squats. 2 reps of 6-7 seconds on the eccentric phase, finishing the rep sitting on a chair. Any reaction? If not, do same reps again the next day. Any reaction, up it by 1 rep the next day and so forth. By the time I got to 2 sets of 10 reps on the flat floor, I moved to using the board.

      3) Only start on the board in a phased approach. Don;t suddenly start doing 3 sets of 15 reps out of the blue every day. 26′ incline is a serious level of loading on your feet and ankles. I would recommend doing only 1 set of 10 twice per week for about 4-6 weeks until your body adapts. Do the rest of the reps on a flat floor.

      4) Keep a journal. I keep a daily journal in google docs and just write it up on my phone or laptop whenever I get the chance. Type up every exercise you do

      5) Be partient. My patellar tendinopathy has caused:
      – Flexor Hallucis tendinopathy – this is tendinosis of the big toe tendon that runs across the arch of your foot – from the incline board. I’ve had this for 6 months now.
      – Supraspinatus tendinosis: (Shoulder) in both houlders – from too much foam rolling and bracing myself with one arm

      So I have had to do my knee rehab on a flat floor only. However I have progressed massively:
      In August 2014: My PT was getting worse but I didn;t know I had it. I was still squatting and deadlifting some serious weights in the gym twice per week.
      In December 2014: The lowest. Basically was not able to walk further than 2 minutes in 1 go without debilitating. I mean debilitating 9/10 burning pain. It never got better than 5/10 all day
      0 January 2015: started rehab. 2 eccentric squats per day. Then built it up 1 or 2 reps per day depending on pain scores recorded in my journal.
      – February 2015: started on the incline board. Made significant progress in 3 weeks. Could walk much longer distances for example. But could not walk down stairs normally.
      – March 2015: Tendonitis started in my feet. Had to drop the incline board.
      – August 2015. Since May 2015 I have been doing 1-leg squats 5 times per week. In between many glute activation exercises: bridges, clams, etc. I have gone from 3×5 single leg eccentrics on a flat floor to 3×15 eccentric 1-leg squats every session. No matter where I am, I do my 1-legs. I travel a lot with work and can tell you I have done my 1-leg squats in a bedroom of almost every hotel chain in the world! All I need is a chair and a table to help support me.
      – I can now walk down stairs properly.
      – In May I took my daughter to watch her hero Rory McIlroy at a golf tournament. I ws worried about the amount of walking but according to Mr Fitbit, I did 24,000 steps (11+miles) and my knee pain was maximum 2/10 in the evening.
      – I just started doing 2 waatbike sessions of 5mins each per week. Currently I can average 140 watts for 5mins and I get roughly a 2/10 pain afterwards. During the day, I have no noticeable knee pain.
      – I can walk >10 miles per day with no real knee pain, although if I walked for 45mins without stopping I would know about it.

      All of this has been done without the incline board. It can be done. Just be patient. And very determined.

      Reply

      • StuartR

        August 17th, 2015 at 1:48 am

        PS: I am only 40% heeled in my knees. The incline board will accelerate my healing as it really isolates the Patellar tendon but until my feet recover, I have to make do with just a flat floor.

        Reply

      • Zach B

        September 15th, 2015 at 5:35 pm

        @Stuart,

        Been a while since I’ve updated my progress on here. Last time we chatted I believe I was squatting and slowly getting back, but still had lots of pain after exercise.

        I’ve been doing loads of mobility and flexibility and rest coupled with exercise specific to me.

        For five months I completely did not do any squats, or go to the gym (if you remember I was powerlifter), instead I focused on outdoor activities like hiking and cycling etc – lower impact activities on the knee. I lived in the mountains for this time so I decided to let go of the gym to give my body the rest it deserved and do the lower impact work. I can now say my knee tendon is much much much better now , I’d say around 85%-90% healed. I can now squat without any pain afterwards(first gym session last week). The odd day I can feel the pain – but it’s minor and goes away the next day. Stairs are easy. I can jump now and be fine. Orthotics have been a big big big help, I always wear them outside of the house (again something specific to me: I’m flat footed.)

        All in all, for anyone who reads this, what helped me the most was giving yourself the rest, and slowly, and I mean to emphasize the slowly, work your way back up. It won’t take one week, or two months, or five months, or a year; it’s specific to you and your body anatomy/physical exertion. Be patient and things will turn around.
        Z

        Reply

        • StuartR

          September 15th, 2015 at 5:48 pm

          Hi Zach,
          Good to hear!
          I have been making progress as well. Compared to March this year I can now:
          – Descend stairs like a normal person
          – Do 10mins on the Wattbike each day at 170 watts average resistance, increasing at 30secs per day.
          – Walk for an hour without pain.

          I’m continuing with 3×15 eccentric squats on each leg once per day. I manage this 5 times per week and as you say the progress is incredibly slow but it is tangible. Week on week I am improving.

          I would say this:
          – I have a great physio who works with Elite athlete in the UK. We have all read a lot (too much) on the web but after a point, your tendon NEEDS concentric exercise as well. We have been doing deadlifts and full weighted squats in the gym as well and this has definitely helped.

          on top of all this, I do glute specific exercises 3 times per week: Clams, glute bridges and various other exercises to fire the glutes and get those neural pathways working so the tendons don;t get overloaded as the weight increases.

          Reply

          • Ian G

            September 15th, 2015 at 9:27 pm

            Correction. I did that hike with 55+ pounds on my back. Severely steep inclines and declines. Finally I won a round and kicked tendinosis in the face!

        • Ian G

          September 15th, 2015 at 9:14 pm

          Hi all,

          I have to echo Zach on this one. I am not only battling patellar tendinosis but quad tendinosis as well so the slant board turned out not to be the best move for me.

          I also took a nice 3-4 month break from the gym, stretched and iced like crazy and began using more “life muscles”. Best decision since my knees got so damn angry.

          I’m not 100% cured but I did recently do a rigorous 50 mile hike carrying 5+ pounds and patellar and quad tendons held up with only minimal discomfort. A year ago when merely standing was a nightmare did I think I’d ever get here.

          Listen to your body and perhaps consider some good ole fashioned rest. I am slowly but surely coming back to life and I wish the same for you.

          Reply

          • Ian G

            September 15th, 2015 at 9:27 pm

            Correction. I did that hike with 55+ pounds on my back. Severely steep inclines and declines. Finally I won a round and kicked tendinosis in the face!

          • Zach

            September 28th, 2015 at 6:46 pm

            @ Ian, glad to hear this worked for you too. Keep us posted on here about your progress. Going to be interesting to see us in another year from now.

            Zach

  286. Nathan

    August 16th, 2015 at 8:09 am

    Michelle. I am in a similar boat. My left knee has started hurting as well. I saw a very good physio on Friday whom I trust implicitly. He said a steroid injection was inevitable and not just a temporary fix. BUT it has to be ultrasound assisted. He said at most you may need a follow up jab later. He gave me some ultrasound treatment ( like a high intensity vibro massage ) that may have helped a little bit and confirmed the exercise shown here will strengthen the tendons

    Reply

  287. aastik sharma

    August 16th, 2015 at 9:01 am

    i am a taekwondo player and i am suffering from a jerk just below my knee joint!it don’t pain me until i kick i feel the pain below he knee joint and thies ! please help me out !

    Reply

  288. Dennis Durost

    August 16th, 2015 at 7:14 pm

    Let me repeat comments I made previously. If you have had PT for a long time you probably have scar tissue. The eccentric squats will help removal of the scar tissue but it takes at least several months. A better option would be to see a physical therapist who is certified in a soft tissue mobilization technique called ASTYM (see astym.com). He or she can get rid of the scar tissue in about 6-8 20 minute sessions. During the therapy, the therapist will supervise certain exercises including eccentric squats. However, I recommend you download Martin Koban’s e-book, Beating Patellar Tendonitis (Amazon.com) and make a copy of his exercise program. Take that with you to the first visit. I did that and the therapist approved the program and I was allowed to do the exercises on my own, saving on the therapy fees. After therapy I was instructed to continue the exercises for approximately six week. So, after a total investment of about 10 weeks I am back playing tennis and only have a minimum of discomfort for a short period of time afterwards. Regarding dealing with both knees having PT, the slant board sold by Flex-n-Go, can be used. Simply place a chair on either side of you and use your arms to assist in getting back up to a standing position. Another point, conventional physical therapy that involves such techniques as ultrasound, cold therapy, electrical stimulation and hydrotherapy is ineffective if you have chronic tendonitis. However, if you have a new, recent case, it may work fine.

    Reply

  289. keith

    August 22nd, 2015 at 7:12 pm

    – i do not earn money from prp therapy in any capacity.

    – have dealt with bilateral jumper’s knee/anterior knee pain on and off for 5-6 years.

    – i have cured the issue in one knee using a generic, 12 week jump training program used by basketball players.

    – reinjured the L knee slipping on ice during the winter months winter 2013 and winter 2014). two successive slips resulted in starting over rehabilitation.

    – didn’t stop playing and knee deteriorated over time.

    – pain was 10/10. couldn’t sit in a car or movie theatre…

    – invested in PRP (which is very expensive in canada) in june 2015. no issues with injections into tendon. great healing response. could do intense and explosive sports (ultimate, basketball, flag football, olympic lifting etc) with minimal irritation afterward. allowed 3 weeks of healing before returning to sports. did a rehab program concurrently. returned to sports at full-speed after 3 weeks.

    – mid-july 2015 reirritated the knee. actually felt the instant of reinjury. a bit of stiffness and soreness afterward. nothing that ice couldn’t control. at this point i could still play for 2-3 hours per day for 3-4 days in a row resulting in some soreness and discomfort 3-4/10. again, ice reversed the soreness.

    – summary: jumpers knee pain 10/10. unable to jump off L leg. PRP injections. less than 2 weeks later pain was 0/10. returned to sports 3 weeks post-treatment. tweaked knee and have similar knee pain 3or4/10. as soon as i have saved up for the procedure, i am going to go again.

    i would recommend the prp procedure.

    Reply

  290. keith

    August 22nd, 2015 at 7:16 pm

    happy to answer any questions you may have about prp therapy for knee tendon problems

    Reply

  291. Dennis Durost

    August 23rd, 2015 at 8:35 pm

    Keith: You might want to enlighten the group by explaining what PRP stands for. What are you being injected with?

    Reply

  292. Jake

    August 28th, 2015 at 12:08 pm

    Hello Brian,

    I’ve been dealing with patellar tendinitis for about 2 years now. At first, the doctors thought I had chondromalacia, but after a plethora of tests they concluded it was just tendinitis in the patellar tendon. I bought the slant board last week and just started using it, but for some reason I’m having pain in the tendon area the next few days after I use the slant board. Is this normal? Or am I doing something wrong. Also, is it okay to use eccentric workouts for people who may not have “chronic” patellar tendinitis.

    Reply

  293. Dennis

    August 28th, 2015 at 5:17 pm

    Discomfort after eccentric squats is normal for a period based on my experience. I would suggest you go at it at a slower pace. You can mount the slant board on a leg press machine and start with a low weight then once you can do three sets of 15 with only minor pain, add a bit more weight. The other benefit of using the leg press machine is that you can really slow don the eccentric portion under full control. Simply use your other foot to return the leg press to the extended position and repeat.

    Reply

    • Jake

      August 28th, 2015 at 8:10 pm

      Are you dealing with or have you had patellar tendinitis in the past? If so, have you found that doing the eccentric workouts on the slant board helped get rid of your pain?

      Reply

  294. Dennis

    August 28th, 2015 at 8:38 pm

    I have had PT for 6 years. Started the eccentric squats about 12 weeks ago as part of Martin Koban’s program that includes many other important exercises. Also started ASTYM therapy to get rid of scar tissue and speed up the recovery (ASTYM.COM). I am back to playing tennis but still have some issues. The patellar tendon doesn’t heal quickly. I suggest you get Martin’s e book and follow his plan (available on Amazon)

    Reply

  295. Gradys Mendoza

    September 07th, 2015 at 10:49 pm

    Hey! This is definitely something new,I just wanted to know the update on how your knee is doing I’m very curious on trying this method

    Reply

  296. Phil Cooper

    September 16th, 2015 at 6:02 pm

    I have been battling PT for 8 months now. I feel like I have been on the brink of making a recovery for a while but I can’t seem to get rid of this slight ache. I went for my first run (10 mins) 2 days ago and have just got myself a slant board. Got through the run fine, but the ache still comes on. I’d love to try these exercises to see if they can aid me in getting rid of the ache.

    My only question is regarding the form of the exercise. It’s not really a squat. I have always been taught to squat by leaning back as if you’re sitting down into a chair. In the video, i see a man pushing his knee forward. Does this really work?

    Also, if i try and start doing this exercise, should i stop trying to build up my running?

    Any help will be really appreciated!

    Reply

  297. Dan Stallone

    September 22nd, 2015 at 1:55 pm

    Brian – great article and very imformative

    I know it has been a few years, but do you still have pain from this?

    Can you describe the pain you did have from Patellar Tendonitius (I’m trying to figure out if this is what I am experiencing post ACL surgery)

    If the pain is gone, how long did you do your eccentric squats for and what was your rep/set progression?

    Reply

  298. Grace Roberts

    October 10th, 2015 at 3:14 pm

    One Prescription Medicine that my Rheumatologist prescribed for me to block the inflammation and swelling: SULFASALAZINE. It has been a miracle. My knees are both affected by Chronic Tendonitis. I have suffered for over 20 years. Weather has always played a role as well. When it’s going to rain or the atmospheric pressure drops, my knees flare up. I was an avid tennis player and long jumper for many years. SULFASALAZINE has given me back mobility and the ability to be active again.

    Reply

  299. Clayton

    October 11th, 2015 at 8:34 pm

    I’d like to share my PT experience in hopes of helping others who are dealing with this injury.

    First of all, I developed PT in both knees 5 & a half months ago. It was so bad, I was unable to walk without feeling debilitating pain. I was waking up in the middle of the night, couldn’t drive because pressing the break hurt too bad. It was a very nasty case to say the least.

    Where do I stand now? I am able to walk around for hours, and for the first time last week was able to go out dancing with my friends for a with only mild discomfort afterword.

    I wish I was told this sooner, but I learned it for myself. If you are experiencing consistent pain, you need to stop doing any physical therapy, and get off your knees as much as possible. The slightest bit of exercise in an early stage will halt new collagen fibers from forming. I’m talking about spending two months in your bed, and the only reason you should leave is to eat & go to the bathroom. Once the pain levels have died down to a 1-2 its time to start slowly getting active again.

    I prolonged my recovery by a couple months because while I should of been resting, I was doing intense physical therapy.

    On top of finally resting, I have had a couple of PRP treatments which I do believe have helped tremendously considering how long some people wind up with PT. There is limited evidence concluding that PRP does help Tendonapathy & leads to a greater chance of coming back to sports. If you have the extra money I highly recommend getting the injections. If you do go this route, keep in mind that the injection is going to make the Tendonitis a LOT worse for an entire 4 weeks. After the 4 weeks, much improvement happens for the following few weeks. I believe the author of this blog benefited from PRP without even knowing it. I could be wrong, but my guess is the doctor didnt tell him it would make it a lot worse for 4-5 weeks (which is a long time) before making it a lot better.

    I’m 6 weeks into my second injection, I am hoping I won’t need a 3rd one but its hard to say at this point. I will not be satisfied until im 100%. Wishing all of you the best on your road to recovery!

    Reply

  300. Christine

    October 14th, 2015 at 6:05 pm

    I’m suffering from this in BOTH my knees right now. Since I can’t raise myself back up with a good knee, I wonder if I could step off the device and then raise myself back up.

    Reply

  301. Michelle

    November 25th, 2015 at 11:04 pm

    Just to update on my progress (I posted my original post at the bottom): I was able to begin my program 3 weeks ago. I would have started sooner.

    Day 1 of using my slant board, I was so scared to stand on it due to the level of pain I was experiencing. My pain score was at least 8-10 out of 10 for weeks before this, and getting worse. I could not walk up any stairs without throwing my weight or using a walking stick (I also have a torn meniscus for 14 years so this only made it harder!), walking down was frightening, I could not walk over curbs or in grass due to uneven terrain, and I could not bend my knees for any reason. My sense of balance was poor when standing still and I could not maneuver around friendly obstacles without falling over as I guarded from the intense pain. So, if you can imagine, doing one squat was a scary experience, as the amount of pain since my last post here had become absolutely severe. Stepping on that board, I was rightly expecting jolting pain.

    Day 1, I started with single leg squats, 1 set of 10 as recommended. Pain score for right knee was 10/10, and for left knee, 4/10. I didn’t feel much was accomplished. That was too much pain, so I decided I’d do double leg-squats next session.

    Day 2-3 (I’m doing my routine every 2 days), I did 2 sets of 10 double-leg eccentric squats, holding for 10 seconds each rep, then holding for 20 seconds on the last rep. Pain on both knees scored on average 1/10. I incorporated calf stretching at the end.

    Day 4-6, I added knee rotations to my routine to focus on increasing my dorsiflexion, which I do not suspect is pertinent to my issue, but beneficial nonetheless. For the eccentric, double leg squats, I moved it to 3 sets of 10, repeating the same processes. Pain scores averaged from zero to 3 or 4 out of 10 each. Then, on days 5 & 6, no pain at all for the remaining two sets. I’ll get to what I noticed about that in a sec.

    Day 7 (today), I increased it to 4 sets of 10. Pain scores were 1 out of 10 each on the first set, then no pain at all for the remaining sets. Pain scores tell me I’m getting somewhere, but that’s not the best part.

    For about a week, I have been able to lunge (as in, taking wide steps when stepping over things, not the actual exercise), and I can walk up stairs and onto curbs without throwing my weight, nor needing a walking stick. Yes, I can walk normal up the stairs! I can bend my knees now with little to no discomfort, and even with it being 27 degrees F (that’s below freezing), there was still no joint pain, something that always worsened in cold weather before this. Normally, my pain is an 8 in cold weather. I feel so strong, but I’m jumping no guns, here, and I will incorporate more advanced exercises that focus on movement in months to come before I so little as think about sports.

    As for why my pain disappeared around the 2nd set on days 5-7, I think it’s a simple matter of warming up the joint from what I was able to deduce.

    I’ll keep updating. I hope this inspires you to consider giving this a shot.

    Here’s my old post from August:

    “What if you have patellar tendonitis in both knees? How can this board work in my case?

    When I came down with patellar tendonitis in only my right knee, I was made to constantly use my left leg to drag it up and down stairs so often that in just about a month, I developed tendonitis in my left knee, and now I can barely walk, and it’s been this way for two years. The simple 4-step stairs at my front door did me in and it has ruined my ability to sprint and play tennis.

    Can anyone offer me advice?”

    By the way, thanks for the detailed reply, StuartR!

    Reply

    • Michelle

      November 25th, 2015 at 11:44 pm

      By the way, I’ve been supporting my full weight on the upwards phase of the eccentric squats using my walking stick and a door knob. Neither of my legs do any lifting / concentric actions.

      Reply

  302. Eric

    November 29th, 2015 at 9:08 am

    any updates?? Had it for 6 months now And its completely frustrating!!

    Reply

  303. Mark

    November 29th, 2015 at 12:12 pm

    I wrote in here a long time ago. I had been dealing with patellar tendinopathy a lot as well as injuries to many other tendons. As a total I’ve had more than 20 tendon injuries in my addulthood, including while I studied physiotherapy. I wrote my bachelor project about biomchanical causes of patelar tendinopathy, where my only focus was the food and ankle. Through my own case-control studies I found some evidense (far from conclusive) that decreased ankle dorsi flexion as well as increased foot pronation (during landing from vertical jumps) is more often seem in basketball players with this injury (also called jumper’s knee) vs basketball players who are injury free.
    The reason why these two biomechanical dysfunktions would be related to jumpers knee, is that during landing from jumps, it increases the stresses on the patellar tendon as you are more likely to land on your toes (because of tight ankle joints) and/or pronate (compensation for lack of ankle joint dorsi flexion.

    If you land mostly on your toes, your knees will shift way forward as you are landing in an attempt to not fall backwards. This stresses your quad muscles a lot more which therefore also stresses your patellar tendons more.

    Pronation will most likely shift your knees inward and put more rotational stresses to your knee joint, which your tendon won’t like either.
    This could mean that if you want to minimize the rick of reinjuring yourself, you should focus should not only be on rehabing the tendon, but strengthening your entire leg as well as mobilize your ankle. This is quite a complex job and should be orghistrated by a physical therapist, who can modify exercises to your level of tolerance and correct your form.

    What the slant board does, is that it shifts your center of gravity forward, increasing the force load on the tendon. This can be both good and bad, depending on how strong/weak the tendon is. Tendons are put through the greatest amount of forces at their most lengthened positions (fowards the end range of the joint they go over) which means that maximum knee bending will put the biggest load into it. If you have a severely damaged tendon, you might want to wait with bending that much to start of with.

    Also note that if your tendon is inflammed (almost constant pain or just with light exercise especially in the acute phase lasting up to 14 days) you can very easily provoke the inflammation tendon sheath (the layer surrounding the actual tendon) with dynamic motion. Therefore I recommend isometric strengthening in the early phase until you experience a significant pain relieve (may take 1-3 weeks). After that you can gradually start doing concentric and then eccentric exercises for the tendon.

    Be also aware of the tendon healing phases. Unless you only did minor damage to your tendon once or a couple of times, your tendon is likely in a degenerative state where long term inflammation and overuse had broken down it’s collagen fibers.
    This makes tendon healing much more difficult and long lasting.

    Even after most of the pain is gone, the tendon will still be very weak. After 6 weeks, the initial part of the healing has ended (proliferation stage) By then the tendon will have regained approximately 50 percent of it’s tensile strength as a new layer of (scar) tissue has formed. This scar consists of type 3 collagen which is not nealy as strong as the regular type 1 collagen, that you see in healthy tendons. After about week 6, you remodelling phase gradually starts, where the scar will be remodelled and strong collagen type 1 will start replacing the type 3 very slowly. This proces might take more than one year, but the tendon will eventually get very close to 100% strength.
    That is why so many people need to realize that they can and will heal up and their long lasting pain might not be related to tissue injury anymore, but the brain being overly sensitive after the trauma it’s been through. A long lasting physical injury is not only tramatic to the body, but indeed also the brain as it remembers pain and becomes far more sensitive. Being affraid of the old injury is also proven to produce pain even though NOTHING is wrong with the tendon anymore. It happend to myself also – I had a lot of pain until a scan showed a fully healthy tendon. One week after I realized that, I was nearly pain free.

    One last thing. Tendon healing is not just about doing some magical exercises. It’s about promoting nutrients to heal the wound as well as preventing damaging factors to the tendon/healing proces. Since long term inflammation slows down the healing of the tendon, stop increasing the inflammation by smoking, drinking alcohol, being stressed, eating meats (besides fish), sugar and oils with high amounts of omega 6’s. Eat fish and plant based foods with high amounts of omega 3’s, vitamin C and D. That type of diet also balances your body’s homeostasis by preventing low Ph’s levels (that makes the dangerous free radicals grow and do damage).

    Hope this served you.

    Reply

    • Erran

      September 12th, 2016 at 4:08 pm

      Very good post. This seems to be what current research says as well.

      Reply

  304. Steve

    February 04th, 2016 at 5:22 pm

    Hi All.

    I came across this site just now, I thought I would throw in my experience, maybe as more therapeutic endeavour more than anything else, as I basically have no advice on the subject.

    I have been suffering from Patella tendonosis for around a year now. I used to be a keen runner, maxing at around 45Mpw. When training for my local half marathon I felt it start to have sharp pains towards the start of runs. This soon dissipated after a few minutes, basically once the knee was warmed up. It was never really that painful so I did not worry about it too much at the time.

    After my half marathon (when it had started to get worse and worse) I decided to take a few weeks off, I have had niggles before so I thought this would do the trick. Indeed no, 3 weeks later – exactly the same.

    Started seeing a physio, he (oddly) advised I do wall squats, and run a 10k every 2 days at a slow pace. Needless to say this did nothing, after about 3 months of this I took 3 months off, no exercise – no better.

    After some googling I found many sites like this going on about slant boards, it honestly seemed like the miracle cure.

    Indeed, after about 3 weeks of having one the pain of doing single legged squats went from agony, to reasonably pain free. This was In November, since then things simply have not got any better. I have tried all sorts of variations, do a day, miss a day/none in morning/none in evening/deeper squats, shallower squats. Indeed, just simply will not get better from here.

    I would not say I am ever in agony, but it is a bit painful when I walk around or my knee is bent for a while like whilst sitting at work. I find if I ever do a single legged squat (just on the flat floor) it hurts a little going down, then I almost get an “afterburn” for a few minutes afterwards where the knee has a dull aching

    This is after the usual “12 week” course that should, apparently pretty much sort this issue out. I think I have joined the ranks of the various poor people above who cannot shift this, I have seen another physio who says I am doing everything right, but indeed it is not getting any better.

    I have never been so depressed, I have gone from doing 10k’s most days, to no exercise, its a real killer. Every time I see someone running along without a care in world it really angers and upsets me, why won’t this thing fix!?

    My only question is I guess, can this ever be a manageable condition? I.E if you do strengthening exercises/squats regularly, can you just “live” with the pain? I really just cannot ever see it getting better, I would love to do just 3 maybe 4 “fun runs” a week it would really cheer me up.

    Has anyone got any experience of this, or is it a plain bad idea?

    Anyway. My heart goes out to all who are all struggling, it really is an awful condition. And to those who recovered – enjoy it, smash in 10 tempo run for me, and everyone else still struggling. When your lungs start to buckle under the pressure, and your legs slowly build up with lactic acid – smile, and realise you are the lucky one. ;)

    Reply

    • Nir

      May 30th, 2016 at 4:41 am

      I feel you, I’m in the same position after 8 years (!) of (possibly) Patellar Tendonitis. Only recently I started two-legs eccentric squats but that did nothing. Only now started one leg squats (on both legs), hopefully I’ll see some results but at this stage I’m highly skeptical.

      Reply

  305. Bio mechanically challenged cyclist

    February 06th, 2016 at 10:02 am

    Hello All,
    I have commented on here a few years ago and thought I would give an update. I developed this condition about 5-6 years ago and like most people on here, I thought it would go away with a little rest like most other injuries. How wrong I was. To make a long story short, back then I was doing equal parts running/cycling, this injury started as a nagging pain and slowly got to the point where I could barely finish a 5 mile bike ride. Went to the Dr., took physical therapy (not much Help). Then around 2011 I took a year or a little more off of running/cycling while I focused on work and helping my sister and her husband build their house. After that I slowly returned to cycling with the help of a patellar tendon knee strap and slant board squats. As of now I am fully back to cycling, and about a year ago stopped wearing the knee strap. Although I have not returned to running I now feel I am fully recovered. In all I would say that the whole ordeal lasted about 5 years and at times I thought I would be living with it for the rest of my life.

    Everybody is different and you may not have it as bad as I did, but this is the most stubborn, frustrating, and annoying injury I’ve ever had to deal with. But for what it’s worth, the 3 things that helped me the most were these slant board squats, a Don Joy patellar tendon knee strap, and REST. If you are like most runners I know, you are tough and determined to push through anything… well be prepared because this injury will keep knocking you to the ground until you submit.

    Reply

  306. Adam

    February 18th, 2016 at 11:31 am

    We all know the drill, I won’t bore anybody with the background details. I was a good cyclist then one day my knee just went. No pop, no crack, no swelling, no blood. Just that dull, monotonous pain every time I’ve put a load through it since that day. And that day was a long time ago.

    I can fully relate to countless posters above. I suddenly went from being a relatively serious and competitive and totally in love with my sport, to being completely unable to do any form of exercise. It’s thoroughly depressing every time you think about it really.

    And then whilst having yet another depressing trawl through sites telling me rest is the only thing that’ll work (I’ve done plenty of that, and it has never got any better) I come across this. I’m totally desperate now. I’m going to give this a go. I’ve got nothing to lose and everything to gain.

    I don’t even really want to race any more, I just want to get out there and enjoy riding my bike again like I used to. I reckon that’s a long way off though… maybe just a small improvement for day-to-day stuff would be a start.

    Will let you know how I get on.

    Reply

    • Steve

      February 19th, 2016 at 2:26 pm

      Aww man, this upsets me to read it. I am in exactly the same boat, used to run ever day and do it for the speed, now my expectations have got so low (after a year of nothing working) I would kill to just start running slowly again, no racing just to plod along in the sun. Well good luck fella, I genuinely hope you are one of the lucky ones. Let us know how you get on

      Reply

  307. JP

    April 26th, 2016 at 10:44 pm

    Hi Brian,
    Just underwent partial meniscectomy of my right knee due to bucket handle meniscal tear. It’s been 10 months now but I can feel pain under my patella which is the same feeling on my left knee when i dad patellar tendonitis before. My left knee is 100% cured because of your post here. Now, my question is can I perform eccentric exercises using slant board on my right knee? thanks!

    Reply

  308. Michelle

    May 10th, 2016 at 7:23 pm

    Keep motivated, guys, I have a fantastic update!

    Recap: in summer 2013, I obtained severe tendonitis in both knees, more severe in the right knee. I was barely able to walk correctly. I had to take one step at a time on stairs, meaning both feet had to be on one step before taking the next step. I had serious balance issues when standing and couldn’t walk on grass. It became its most severe in October 2015 where I ended up needing a walking stick for both legs. I lost my balance routinely and needed a second person to assist me when walking on uneven terrain. I started the exercises in November 2015.

    I’m sobbing so much right now. I am so happy. I haven’t been able to run in nearly 3 years. I haven’t been able to walk in nearly 3 years without wobbling, without being challenged by walking up to curbs. I have not been doing these slant board exercises for very long and I can finally run with a mindful, yet light starting burst on my right knee, the one with the most severe tendonitis — no pain. I can dash up stairs very easily! I can jump off of about 3 steps high without jolting pain sending me to the ground; the pain is less than 1 out of 10 when I land and sometimes not at all. (Not pushing it, I’m being more careful than I sound.) I’m able to walk fast and pivot on a dime, carefully, and not quite full strength, something I was not able to do months ago since my last update. I’m moving with so much agility these days that I’m bragging to everyone how I can walk, something people take for granted. It sounds really silly to say, “I can walk! I can jump off stairs! I can run a little bit! I can step on this curb, watch!” but when you’ve been incapacitated by severe pain for almost 3 years while needing someone else to help you walk, you would brag, too! The joy is indescribable.

    This is what my routine has been: I missed most of April and February (I have no excuses, lol). During that time, at worst, my progress has remained stable, but as for the rest of the time, I’ve gradually moved it up to 3 sets of 25 every two days, counting 5 seconds down slowly to almost a right angle knee bend, fast concentric contractions (2 second count straightening legs). I’m fearless on the slant board now, but there is still a very tiny amount of pain during the first set, as always. On days where I do not use the slant board, I go on walks, during which I do my best to ignore my knees and walk with full strength, making the pain undetectable. I only feel pain when I think about my knees during the walks, the purpose of which is to rebuild strength. And, as of today, I have discovered that I can now do single-leg eccentric squats with either leg. Progress, baby! Imagine having such a severe case of tendonitis that you can’t even do the basic, recommended exercises! Well, I now finally can. Single leg squats are going to be added to my routine and I’m going to try 4 sets of 10 each, also about to move into light, motion-based exercises. I’m just a tiny bit nervous after all that progress, but I’ll test the water. I want to make sure that this is the absolute, most correct next move to make.

    I told myself I’d be jogging by early summer and sprinting by winter. So far, I’m right on the money despite missing almost two months. That’s how effective this slant board is.

    Tonight, I’m going for a light jog and I promise to stop at the first instance of pain, should there be any. I can’t wait to feel that sweet, sweet runner’s high. Thank you so much for this.

    Reply

    • Michelle

      May 10th, 2016 at 11:29 pm

      Same-day update:

      A 30 minute walk. Following, a slow-jog across a soccer-sized, uneven, grassy field, my first attempt being 98% pain-free. Literally two of those steps had tiny, little bits of discomfort, but I wouldn’t qualify them as pain. Attempt 2, I fast-jogged across it, pain-free. Attempt 3, I ran across it as hard as I could and it was still totally pain-free, not even once. It was more of a weak run (slower than a sprint) given how out of shape I am, but that was expected. This is a huge success.

      I could not do this 3 years ago without it jabbing every other step. I got emotional part way through the 2nd jog and almost couldn’t finish it. I wanted to cry in the grass, lol. I’m feeling sky-high right now! Now that I know my limits, I’ll stick to this routine: 20-40 minute walks, mild running every two days, same day as slant board exercises (slant board ensures there is no pain and is a good way to prepare the joints at least in my case).

      Good luck to everyone.

      Reply

      • Ian G

        May 11th, 2016 at 6:11 am

        Hi Michelle,

        This is great to hear and I am so happy for you. Considering that I have been dealing with this for 6 years, i can only imagine the joy you must be feeling. I’ve come a long way but I think your recovery has blown me out of the water. I have tendonitis in both my quads as well as 1 patellar so I go about things a little bit different. I’m curious, do you do the slant board going down with both knees at the same time?

        Reply

        • Michelle

          May 11th, 2016 at 6:25 pm

          Hello Ian,

          It’s unbearably annoying to have it just in the knees, but quads as well? It sounds like you must have to really baby it during each exercise. I can see where it would take you extra time to recover with how much extra care you have to give it. How have you managed exercises, as in what have your methods been so far? After 6 years with such such an annoying, frustrating injury, the fact you’ve made progress, albeit slowly, shows you’ll eventually come to a full recovery. Yes, I used both knees when going downward. Up until now, it was impossible for me to go down with one leg at a time.

          Reply

          • Ian G

            May 11th, 2016 at 9:27 pm

            Yes indeed. I somehow managed to get tendonitis in both patellar and quads. I seriously did a number on myself by not listening to my body. Even after learning of my condition I was still very reluctant to give up my active lifestyle. What’s helped me most is just plain old rest. I’m miles away from the active guy I once was but I can walk around, do light hikes and day to day activities with mild to tolerable discomfort. The patellar tendonitis in one knee went away with the rest. The other patellar is worse due to a PRP treatment that I didn’t handle responsibly. May need surgery there but I own my ignorance. I do a lot of cross friction massage on the quads and it helps a lot. I have my good days and I’m sure you can understand….I have really really bad ones. Trying acupuncture right now so let’s see how it goes. I like hearing that things are coming along for you. I don’t know you but having dealt with this..I am genuinely happy to see you happy.

      • Ian G

        June 01st, 2016 at 9:46 am

        How have the knees been coming along? Hope you are still finding progress

        Reply

        • Michelle

          July 09th, 2016 at 8:13 am

          Oh, yeah, I know all about being impatient and pushing through an injury just so you can have a little fun. You never think it will be as bad as what you end up with, but boy, I’ve been down that road before. If only you could take back those moments in favor of a little patience, right? But, what can you do? You live and learn. I have nothing but sympathy for you. And, yes, bad days are living nightmares, equally as annoying as they are crippling. At least you’re keeping active. (Are you able to swim, have you considered?) How has acupuncture therapy been going for you? and, I’ve also looked into cross-friction massage. Maybe I should give that a shot. Like you, I really hope you see a solid recovery. I really do.

          Progress is pretty stable, so far, and healing is definitely occurring. I have not had any problems since my last post, while pain is also no longer a show-stopper for me. When it happens, it doesn’t even make me wince anymore, whereas I would yelp or hiss a little bit just a few months ago from misstepping. Now, when I misstep, it’s either a faint pinch or nothing. The pain is now more of just a ghost of its former self on most days, a kind of presence that comes up mostly if I think about it. Sometimes I feel actual pain like a 2/10 on rainy weather, an all-day ache that still doesn’t slow me down, doesn’t stop me from running or taking stairs at full strength. If there is any pain before physical activity, it certainly vanishes during and long after.

          Today, unusual circumstances tested my abilities. I walked a few miles in a big hurry, a mix of running with quite a powerful stride and walking with speed as though I’d never had an injury at all. My crowning moment was how I ended up running down a rocky slope with 100% control, agility, and speed, something that actually still scared me somewhat just days prior, not something I’d considered doing. Not one step was carried out with fear or hesitation of getting hurt. Pain was a grand total of zero. It was all strength. The thought of running down a hill probably scares the daylights out of most people here when you think about all the resistance against gravity you must use when slowing down. You would probably decide to let yourself slow down as you reached the bottom, letting gravity do all the work. Well, I didn’t even let myself slowly decelerate. I full-on just stopped against gravity near the bottom as a healthy 15-year-old would. I think if I had been afraid of hurting myself, I most certainly would have. During parts of the walk, my knees gave me trouble only if I focused on them, and only early on.

          Pain now seems to mostly be mental in origin. I would assume it’s because I’ve been used to experiencing it in severe amounts for so long that there’s some memory of it in my tendons. I occasionally notice myself guarding when I walk, then I feel pain, and when I notice it, I force myself to relax, and the pain vanishes as quickly as that. The line between cellular memory and actual injury is a little fuzzy, but I’m sure having awareness means I can train my cells out of it. The actual injury is pretty minor and I’m still making it a goal that December will be when the last cell finishes renewing.

          (I recently recovered from a muscle-memory related injury in my throat, which I’ve had for over a whole year, caused by straining my voice and injuring a muscle. It would tighten up and choke me when I spoke, and after a year, I realized that I only choked because I put awareness on it. I trained it to stop guarding by taking my mind off of it for good! Very sure the same case is with my knees.)

          Reply

          • Ian G

            July 11th, 2016 at 3:13 pm

            Glad to hear things are still coming along. I would say give acupuncture a shot. It was very relaxing and seemed only to help. I had to stop due to financial issues but I’m definitely going to do it again when I can afford it. I really recommend the cross friction massage using graston technique emollient. Feels good.

            Right now I’m strengthening the hips, glutes and putting faith in good ole fashioned rest. I grew up very skinny and hit the weights hard in my 20’s and 30’s. It was a fun ride but I think it caused a lot of muscular imbalances and strain which was killer on the knees. Now at 40 it’s time to let the body be skinny again, it’s natural state. The more my legs look like twigs…the better my knees feel!

            Progress is promise….that’s what I tell myself.

          • Lia A

            May 26th, 2017 at 2:31 am

            Hey everyone

            Michelle just been following your thread and good on you for continuing to find ways to combat through this painful experience. I know how u feel. Both my knees have severe tendonitits and the whole stairs thing lol – I cannot walk up or down without holding onto rails and /or taking one step at a time. I cannot do one after another (left step then right step without stingy pain) …. it was diagnosed 2months ago but i felt like ive had it for nealy 2 years (after seeing many physios and going through endless therapys.)

            Have you tried/ anyone tried dry needling? Im currently seeing a new Physio therapist and its one of the treaments i get. Its almost taken alot of pain off my left knee but it didnt work too well with my right. Its only temporary based on fitness levels and how well you follow your therapy. So its not deemed long term BUT TO BE ABLE TO PUT UP WITH PAIN for so long i was prepared to do anything. What dry needling has done but to be able to run “freely” in years, it nearly brought me to tears (and i hate running!!!) Look into it. Its got no “chemicals” in the needle but what it does the needle goes right through to the muscle or where its tight and to give you an idea how it feels like: it creates a “pop ” sensation that its painful – that means its found the area its targeting. Supposedly it helps offsets the pressure its causing against the knee. I got about 4 of those needles on my leg (mainly in my quads) and about 5 on my right ( quad, near the itband and near the hip flexor region)

      • romsy

        June 29th, 2017 at 3:27 pm

        Hi michelle,
        I had patellar tendonitis in my right knee after my jogging sessions on uneven field. This happened in 2015 Jan. activities like kick starting my bike or putting it on main stand, or lifting bucket would cause me setbacks. Diagnosed of Patellar tendonitis after 1.5 year. Treated it to an extent where I could do straight leg raises with 2Kg comfortably. Went for trekking, came back with setback. Started AGAIN from pillow presses. reached same level of strength. Was told my my physiotherapist that start with wall sits 3*10 slowly twice a day. This caused different kind of discomfort after exercise sessions. After having done this for ~10 days twice, I reversed all my progress and messed up my knee.
        Now, I am trying to get back with pillow presses and my knee is not cooperating. I am seeing no improvement in strength from 1 session to other. And I feel I am now in severe TENDINOPATHY. I don’t feel feedback pains post exercise sessions. Strength just goes away.
        What did you do during your initial phase to be able to reach slant board excercise levels.

        Reply

        • Michelle

          August 18th, 2017 at 4:09 pm

          romsy, I wasn’t able to do *anything* before the slant board exercises. I couldn’t even walk up a 4-step stair or step onto a curb, and couldn’t walk in grass without barking with intense shooting pain. I went straight into the slantboard out of last hope. When I started my slant board exercises, I held onto a walking stick and a door knob on the concentric/up movement and went really slowly downward with both knees sharing the full body weight load, I bent shallowly, as it was severe in both knees, 1 set of 10, if I recall correctly. It was a scary amount of pain at first. Even one set of 5 is better than none if you can’t manage, shallow bending at the knees on the way down, using your arms to pull yourself up. It sounds like you really have to baby yours, so all I can recommend safely is exercise your better judgment. Have you considered looking into bone broth? One of its uses is for collagen rebuilding. It couldn’t hurt to try. I wish I thought of it early on; certainly on my list, as my tendon journey is nearly complete and I’m very curious to see if it’s a good finisher.

          Reply

          • Ian

            August 18th, 2017 at 4:28 pm

            Michelle,

            I really enjoy hearing your progress, it’s motivating. I finally began a consistent and tracked slant board regimen and it really is helpful. Still have a way to go but it’s nice to feel on the improving end rather than the despair end of things.

  309. AJ Page

    June 18th, 2016 at 12:18 pm

    Going to give the slant board a shot! Wish me luck!

    Reply

  310. Luka

    June 18th, 2016 at 1:28 pm

    Hi AJ,

    Just keep the progression slow, and don’t rush anything. Beng patient is the key here, trust me.

    Best of luck!

    Reply

  311. Kimberly

    July 27th, 2016 at 10:28 am

    I unfortunately have it on both knees. How would I do this exercise? Would it still work?

    Reply

    • Ian G

      July 27th, 2016 at 5:25 pm

      Hi Kimberly,

      I’m sorry to hear that you are also dealing with tendonitis. I also had tendonitis in both knees so can relate. You can lower yourself using both legs and raise up on one leg. Take it slow and try 1 set of 5 each leg and see how you feel. I recommend getting the board because it’s great to stretch anyways and may just help you.

      I’m curious to know if you have tried physical therapy or any other treatments. I had to give up the slant board because of other injuries but my patellar tendonitis has gotten SO much better with rest and cross friction massage.

      Reply

  312. Erran

    September 12th, 2016 at 3:42 pm

    If you really want to fix your knee and get rid of pain. I suggest you read what Jill Cook has to say.
    First, if you have a highly irritable tendon, eccentric decline squats will not work. Eccentrics can make tendons worse. You don’t want to stretch a reactive tendon.

    You need to do isometric knee extensions or leg press.
    Second, let pain be your guide; any pain that exceeds 24 hours after the event was harmful and means you need to cut back. With isometrics this would mean you need to lower the weight. If you do isotonics this means you need to go back to isometrics.

    Read this:
    http://www.jospt.org/doi/pdf/10.2519/jospt.2015.5987

    Most doctors and physical therapists in the USA don’t know how to fix this unfortunately. You need to do your own research and find a tendon expert/clinician and read the most recent findings, in the last 3 years. In many cases, especially tendons, medicine is like technology with the speed of change and knowledge.

    Hopefully this helps someone.

    Just an FYI, I partially tore my left patellar tendon (over 2 years ago) doing light weight squats, did PT which made things worse, then tried eccentric squats which started to aggravate the good knee. Isometrics have made a noticeable difference in under week.

    Reply

    • Matt

      September 13th, 2016 at 10:56 pm

      My PT handed me this study a few weeks ago and then told me to forget everything I ever learned about eccentrics. I feel like I have made more progress since then than the last 2 years of messing around with a slant board. I also have rectus femoris tendinopathy and would be great to find similar exercises for that.

      Reply

  313. Lynda J

    September 25th, 2016 at 12:16 pm

    Hey, I was finally diagnosed with patellar tendonopathy as well having a small patellar tendon tear. This was after 2 years.

    Have been using the slant board for 3 days now and it seems to get easier and less painful. Feeling hopeful, as I REALLY miss running.

    Reply

  314. Mel Jones

    November 12th, 2016 at 12:40 pm

    Hi there, I can’t say how frustrated I am with my knee. I have seen many physios, osteopaths etc and everyone gives conflicting information. I did find by chance the slant board eccentrics and started them. I was then told it was too extreme and to rest and not do anything that involves bending the knee for at least 6 weeks. After that time, I was told I could start jogging and gentle squats, well I’m right back to where I started but worse as my quads have atrophied so badly there is no definition and strength. My lastest therapist has told me to do eccentric step downs onto the floor. I asked why not do the slanted version to which she said due to my inflexible ankles it would make it too easy for me. I then find out that she is now going to Australia for the next 6 months. Who should I believe?

    Reply

    • Matt

      November 12th, 2016 at 10:02 pm

      Scroll up a few posts to the discussion on isometric & isotonic vs. eccentric training. Eccentric training can cause more harm unless done exactly right.

      Reply

  315. Ian G

    November 15th, 2016 at 5:06 pm

    I hope everyone has been finding success, by any means. I was curious to know what patellar tendonitis feels like for you? At it’s worst my tendon was actually lumpy, squishy and feels like playdough. I get a burning sensation and sometimes a sharp pain.

    Tons of improvement and it’s far less lumpy, less squishy and is actually taking a leaner shape.

    Does anyone else have a lumpy, doughy kneecap?

    Reply

  316. Ray Kirton

    January 13th, 2017 at 6:00 pm

    Hi Brian…………………..my concrete like tightness is in the lower end of the right adductors…and one I think in a quad muscle…maybe a vastus or rectus femoris…..and I am wondering if wave genetics can help?

    Reply

  317. Ciaran Mc Kenna

    February 17th, 2017 at 6:54 pm

    My son,who is 21,developed knee pain in 2014 after intense training at football.He had several different diagnosis and went through a lot of rehab but nothing worked.Only in April 2016 was he diagnosed with severe patellar tendonitis after an MRI scan.He is now back playing football and training hard with no pain in his knees.Hopefully he wont have this problem again.I have written this to let everyone know that the problem can be resolved with dedication to physical therapy and PEMF therapy. We bought Martin Koban’s book and he followed it to from start to finish and then hired a PEMF machine for home use.The results have been great.

    Reply

  318. Rhys Luxford

    May 05th, 2017 at 5:50 pm

    Hi Brian, I hope you find this email, I really want to hear how you are now? Would you say you’re 100% or are you still recovering?

    Please get back to me when you get this.

    Reply

  319. Anne L

    May 26th, 2017 at 2:59 am

    Hey everyone

    Michelle just been following your thread and good on you for continuing to find ways to combat through this painful experience. I know how u feel. Both my knees have severe tendonitits and the whole stairs thing lol – I cannot walk up or down without holding onto rails and can only take one step at a time. I cannot do one after another (left step then right step without stingy pain) …. it was diagnosed 2months ago but i felt like ive had it for nealy 2 years (this is after seeing many physios and going through endless therapys i nearly gave up my sport.)

    Have you tried/ anyone tried dry needling? Im currently seeing a new Physio therapist and its one of the treaments i get. Its almost taken alot of pain off my left knee but it didnt work too well with my right. Its only temporary based on fitness levels and how well you follow your therapy. So its not deemed long term BUT TO BE ABLE TO PUT UP WITH PAIN for so long i was prepared to do anything. What dry needling has done it has allowed me to run “freely” but its only temporary because the pain returned on the right leg. But just Look into it. Its got no “chemicals” in the needle but what it does the needle goes right through to the muscle or where its tight and to give you an idea how it feels like: it creates a “pop ” sensation that its PAINFUL – that means its found the area its targeting. Supposedly it helps offsets the pressure its causing against the knee. The first time i got it, I got about 4 of those needles on my left leg (mainly in my quads) and about 5 on my right ( quad, near the itband and near the hip flexor region)

    That was done about 5 weeks ago to get me through a competition. Yesterday I got another 3 in my right leg as my new therapy now is NO RUNNING for 3 months ???????? ( off season training for me now) so strictly bike and the strength workouts shes given me ( plus the stretches and rollers) Pretty much i play a sport that involves alot of quick sprints and squats so its hard when your muscle memory wants to do this do that but been on strict orders.

    When they did tests on me i was surprised that I had no power/lost all power in my glutes, hammies, whatever the name(s) of the muscle inside the inner thigh haha and calves. Left leg is okish but the right is shocking. So literally i have to start again in my trainings but to know that I could possibly have it sorted its given me #goals. I WISH that i got this earlier or maybe me being so stubborn that I thought “im going to be ok”attitude i should have stopped and listened to my gut instinct but as a competitive sportswomen i wasnt prepared to give in.

    It was the endless nagging from my mum who reminded me that at my age i shouldnt be stuggling to walk, i shouldnt struggle to get out of bed in the mornings ( where i have to rely on my upper body strength to throw my legs out of the bed, and then use my arms to grip onto something to get me up) and sitting down for short periods without the knees flaring up and hammies cramping. Im only 28. So for everyone else, dont be ashamed to seek 2nd or 3rd opinions and listen to your body lol. The physio or that other person will never know the pain as much as you…. i might try that slant board

    Reply

  320. Chris Edmonds

    August 23rd, 2017 at 6:20 am

    The flex and go slant board is 25 degrees one, do you think a 22 degree or 30 degree one would still work?
    Less degrees or more is better whats your opinion, would either purchases work in your opinion.

    https://www.amazon.com/RiversEdge-Products-15-722-Slant-Board/dp/B008RB99YC/ref=sr_1_6?s=exercise-and-fitness&ie=UTF8&qid=1503483320&sr=1-6&keywords=slant+board

    Reply

    • Michelle

      September 05th, 2017 at 5:36 pm

      Chris, it depends, but I agree that less could be more if you’re to make a choice between the two. I think it would still be enough to concentrate the load on the patellar tendon and could be gentler than 25. Have you made a purchase yet?

      Reply

  321. Michelle

    September 05th, 2017 at 7:10 pm

    An unusual update: I did a water-only fast for 26 days where water was the only thing I put in my body, including potassium and iron supplements. Days before the fast, my knees were not bothersome as my great progress has granted me, just on and off, insignificant discomfort that still allowed me to move with agility and feel great after. But, the first two-three days on the fast, I experienced ridiculous tendon pain along with a fever, but it all went away for the remaining 3 weeks of the fast. There was no “on and off discomfort.” There was just “none.” The day I began eating again, which was just a glass of raw milk, within the hour, all the pain hit me with stabbing force before subsiding back to normal, faint discomfort a couple days later. This tells me there is a clear, body-wide inflammation problem for me that extends beyond the main tendon issue. Diet-related inflammation may be a factor to take into consideration along with the actual injury. I don’t want to give up my milk, lol.

    I have been off the slant board for a year, and no problems in that time except for breaking the fast, a pretty stable condition to levels I’m comfortable with. In my case, not a lot of effort on the slant board was needed to get to “well enough,” where I stopped. The level of inflammation I experienced during re-feeding tells me I should not stay at “well enough.” My patience tendon needs more work than anything.

    I started bone broth this week. 5 lbs of beef neck bone and 2 lbs of marrow bone, jelled up real nice, aiming to consume about a half gallon a week at 1 cup a day, alternating between chicken and beef bones. I will resume exercises, as I will be getting a large dose of collagen per day, hoping the collagen will speed it up more than without. I will keep updating as a human experiment every couple weeks. I’ve been 3 meters away from the finish line this whole time.

    Reply

    • Michelle

      September 05th, 2017 at 9:51 pm

      Ridiculous! I exceeded my last set/reps from around this time last year with no problems! Both legs simultaneously, 2 sets of 25, 1 set of 30 to finish it off; down slowly for 6 seconds, pause for 4, hold for 10 on the last rep of each set, focusing all the work on the quads. One pinch of pain in one knee on one rep, and that was it. I may allow 72 hours recovery this first couple exercise days before doing my usual 48 hour recovery. I know for a fact the effort for this session is going to make my knees even stronger in the 3-4 days to come. The fast did make me lighter, so there’s that!

      OK, I’m done posting for the day, lol. Just very excited.

      Reply

  322. Sabrina Giliberti

    October 03rd, 2017 at 12:25 pm

    So I’m asking this question for my boyfriend. He’s got chronic Patellar Tendonitis and literally tried everything like you have. He decided to try out this board. My question to you is, after the first time doing it, did your knee absolutely kill you afterwards? He did it for one day, and then a week later did it again and he’s in a lot of pain afterwards. This normal? Were you in pain and then it got better after doing it for a while?

    Reply

    • Chris Edmonds

      October 04th, 2017 at 1:24 am

      Im dealing with patella tracking issues too, and the slant board gave me lots of pain by doing too much too soon, the form has to be perfect and slowly build up, maybe get him to do 10 downward motion on bad leg but don’t push up from bad leg use good leg to get back up.

      An anti inflammotory diet is helpful too, keto, only mct oil shots every few hours, detox on bone broth and have a small spinach and fish salad for dinner, 20 grams carbs + sugar together max daily, protein roughly 100 grams a day, 200 grams fat a day,

      Just as this video shows slowly build up.
      https://www.youtube.com/watch?v=a-4tQxO8_QU

      and if ur rich get deep tissue massages as much as possible on injured legs, otherwise buy a quad baller and self release injured leg.

      Ice after all activity.

      God Bless!!!

      Reply

    • Chris Edmonds

      October 04th, 2017 at 1:24 am

      Im dealing with patella tracking issues too, and the slant board gave me lots of pain by doing too much too soon, the form has to be perfect and slowly build up, maybe get him to do 10 downward motion on bad leg but don’t push up from bad leg use good leg to get back up.

      An anti inflammotory diet is helpful too, keto, only mct oil shots every few hours, detox on bone broth and have a small spinach and fish salad for dinner, 20 grams carbs + sugar together max daily, protein roughly 100 grams a day, 200 grams fat a day,

      Just as this video shows slowly build up.
      https://www.youtube.com/watch?v=a-4tQxO8_QU

      and if ur rich get deep tissue massages as much as possible on injured legs, otherwise buy a quad baller and self release injured leg.

      Ice after all activity.

      God Bless!!!

      Reply

  323. Ian G

    April 09th, 2018 at 1:28 pm

    I haven’t been here for awhile so I thought I’d provide an update. Let me first say that I’m not cured, nor am I 100%.

    The slant board technique isn’t great for my other injuries but I have found something that’s REALLY improving the condition of my knee: Acupuncture.

    I’ve been doing acupuncture 2x a month for the last 6 months and it’s helped SIGNIFICANTLY. My patella tendon was very swollen when I first began and now almost all the swelling is gone. I recently started applying heat using moxa sticks daily and my knee LOVES it. I can feel the tendinitis disappear like I’m burning it away as the heat stimulates growth.

    Stairs used to suck but not anymore. I’ve done some light hiking with zero issues. Considering I used to have tendinitis pain with each step, it’s a victory. It may not be what gets me back to crazy athletics but for day to day….acupuncture and heat with moxa sticks have been awesome for me.

    Could be worth looking into and I hope you find the same success.

    Reply

  324. Lois dv

    September 07th, 2018 at 3:37 am

    If you suffer from the pattelar tendinitis. We may be able to help you with our treatment program. We’ve done research about the injury and treatment at school. We need people to try this treatment. It’s for free.

    Please contact us if you are intrested.

    Our mail: 19780@dewillem.nl

    Reply

  325. Chris Edmonds

    September 07th, 2018 at 8:04 am

    After careful reflection of everything ive tried,
    I felt best after using the quad baller and relieving all my tight muscles, felt like a new leg.

    EMS pad to stimulate the vmo and activate is an important step, the vl pull the new and activates while the weak vmo spasms and isn’t utilised.

    Do EMs before your slant boards 1/4 squats with Resistance bands around your legs to stop your knee caving in, use the ems pads on the vmo.

    Ice, rest and progress slowly.

    Reply

  326. Chris Edmonds

    September 07th, 2018 at 8:06 am

    TYPO IN PREVIOUS MESSAGE, READ THIS ONE

    After careful reflection of everything ive tried,
    I felt best after using the quad baller and relieving all my tight muscles, felt like a new leg.

    EMS pad to stimulate the vmo and activate is an important step, the vl pulls the knee and activates while the weak vmo spasms and isn’t utilised.

    Do EMS pad shocks before your slant boards 1/4 squats with Resistance bands around your legs to stop your knee caving in, use the ems pads on the vmo.

    Ice, rest and progress slowly.

    Reply

  327. Chris Edmonds

    September 07th, 2018 at 8:16 am

    I feel however many things aren’t going to eliminate the mechanism causing the issue, it could be inflammation, tendon damage, a muscle imbalance, bulking the vmo without causing further damage is what is ideal for my case, some people can’t build muscle in certain areas due to genetics which is me, huge vl and mini vmo.
    for a laboratory experiment ideally, you’d have a diet high greens fish and bone broth to reduce inflammation, provide joints lubrication and heal muscles after workouts.
    Building muscle takes months and months but if you want to correct a life corrupting issue its worth it.

    Reply

    • Ian G

      September 07th, 2018 at 8:22 am

      Very true. We are all different but in my case, I’m now very aware of the muscular imbalances that have caused my Patellar Tendinitis. The slant board alone would never fix that. I was severely quad dominant which put lots of strain on my patellar. Over the course of several months, I’ve hit the hammies and glutes to balance my body. Everything feels better! Lower back pain…..gone, quad pain…..gone, patellar tendinitis…still needs work but I’m slowly jumping, hiking and dancing again. I can more easily address the PT without the imbalances overworking it.

      Reply

      • Chris Edmonds

        September 07th, 2018 at 7:46 pm

        Yeah true and a good give a away to tell what muscles your lacking is observing what muscles spasms (the weaker ones), which muscles have a good pump after a workout, what your bulky dominant muscles are etc.

        Reply

  328. nắp gang hố ga

    September 17th, 2018 at 3:29 am

    It’s going to be end of mine day, however before end I am reading this enormous article
    to increase my know-how.

    Reply

Leave a Comment