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A Surprisingly Powerful Tool to Combat Chronic Patellar Tendonitis

by Brian Patterson » on May 11, 2012 530

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!

Submitted Comments

  1. Tyler Hurst says:

    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!

  2. Brian Patterson says:

    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.

  3. 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.

  4. Brian Patterson says:

    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!

  5. Kelly says:

    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.

  6. Brent says:

    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?!

  7. Lauren says:

    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!

  8. Steve says:

    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.

  9. Samantha Saccomanno says:

    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?

  10. Brian Patterson says:

    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!

  11. Omar Elsahn says:

    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?

  12. Omar Elsahn says:

    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?

  13. Omar Elsahn says:

    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

  14. Brian Patterson says:

    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

  15. Brian Patterson says:

    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

  16. Omar Elsahn says:

    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?

  17. Brian Patterson says:

    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.

  18. Omar Elsahn says:

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

  19. Omar Elsahn says:

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

  20. Omar Elsahn says:

    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?

  21. Brian Patterson says:

    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.

  22. Omar Elsahn says:

    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.

  23. Shane says:

    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

  24. Brian Patterson says:

    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.

  25. Robb says:

    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.

  26. Robb says:

    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.

  27. Omar Elsahn says:

    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.

  28. Ian J. Gibbons says:

    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.

  29. Josh says:

    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.

  30. Brian Patterson says:

    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

  31. Robinson says:

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

  32. Kelly says:

    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.

  33. Claire says:

    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….

  34. Chris says:

    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

  35. Brian Patterson says:

    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.

  36. Brian Patterson says:

    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

  37. Brian Patterson says:

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

  38. Kat says:

    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

  39. Omar Elsahn says:

    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?

  40. Graham Sutherland says:

    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

  41. Omar Elsahn says:

    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.

  42. Graham Sutherland says:

    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

  43. MILLIE says:

    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.

  44. Brian Patterson says:

    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.

  45. stephanie says:

    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.

  46. Brian Patterson says:

    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

  47. Omar Elsahn says:

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

  48. Brian Patterson says:

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

  49. Omar Elsahn says:

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

  50. Brian Patterson says:

    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.

  51. Omar Elsahn says:

    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..

  52. Tyler says:

    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.

  53. Brian Patterson says:

    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.

  54. Brian Patterson says:

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

  55. Jeff says:

    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!

  56. Taylor says:

    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!) =)

  57. Andy Dorrat says:

    Hi Brian, thanks for

  58. Andy Dorrat says:

    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

  59. Ricardo Espinosa says:

    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

  60. Ricardo Espinosa says:

    Awesome article

  61. Jean-Marc Aliphon says:

    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.

  62. Mia says:

    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.

  63. Mia says:

    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.

  64. michael says:

    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..

  65. Dimitris says:

    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 …

  66. Cocotal says:

    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.

  67. Mary says:

    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.

  68. Mat says:

    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.

  69. Ricardo Espinosa says:

    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!

  70. Ian J. Gibbons says:

    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.

  71. Ian J. Gibbons says:

    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.

  72. Samantha Saccomanno says:

    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!

  73. Dana A says:

    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?

  74. Francis Sy says:

    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!

  75. Joe Miller says:

    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

  76. David Blanchard says:

    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

  77. Ted says:

    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?

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

  79. Michael Manego says:

    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?

  80. Taylor says:

    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!

  81. Owen says:

    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…

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  83. Bill Uetricht says:

    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.

  84. Bill Uetricht says:

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

  85. TendonMan says:

    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.

  86. TendonMan says:

    “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.

  87. Kelly says:

    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

  88. TendonMan says:

    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.

  89. liz says:

    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?

  90. steve turner says:

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

  91. Joe Miller says:

    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

  92. Kelly says:

    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

  93. Kelly says:

    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

  94. Emily says:

    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.

  95. Samantha Saccomanno says:

    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

  96. TendonMan says:

    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.

  97. Colby says:

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  98. Mia says:

    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

  99. Dan says:

    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!

  100. Karen says:

    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.

  101. Karen says:

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

  102. Jimmy says:

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

  103. TendonMan says:

    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’.

  104. Fraser73 says:

    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

  105. Fraser73 says:

    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

  106. Zimbalist says:

    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.

  107. bio mechanically challenged cyclist says:

    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.

  108. Brooke says:

    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!

  109. Emily says:

    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.

  110. Bobby says:

    What is a good degree slant for a slant board?

  111. Audrey Wiedemeier says:

    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!

  112. Kelly Reeme says:

    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. :-)

  113. TendonMan says:

    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.

  114. Kayla says:

    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

  115. Scott says:

    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?

  116. Brian Patterson says:

    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!

  117. Brian Patterson says:

    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

  118. Eric says:

    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!

  119. Ron Manaloto says:

    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

  120. Mia says:

    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.

  121. Courtney says:

    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!!!

  122. Denise says:

    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!

  123. Sandy says:

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

  124. Brian Patterson says:

    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.

  125. Brian Patterson says:

    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.

  126. 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.

  127. Sandy says:

    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.

  128. Kelly Reeme says:

    Hello Sandy, It is 25° no worries

  129. Matt says:

    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!!!

  130. jimmy says:

    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.

  131. Georgi Stoychev says:

    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

  132. Deb Flawn says:

    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

  133. Jonathan says:

    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/

  134. Moto says:

    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).

  135. Nick says:

    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?

  136. 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!

  137. Friðrik says:

    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 ?

  138. Jessi says:

    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!!!!!

  139. Jeff says:

    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.

  140. jaevon weston says:

    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 .

  141. Brian says:

    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

  142. Gaby says:

    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!

  143. Tendonman says:

    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.

  144. Ian J. Gibbons says:

    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.

  145. Mark Handberg says:

    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.

  146. Jim hannon says:

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

  147. Tendonman says:

    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.

  148. Tendonman says:

    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.

  149. Vishal Sharma says:

    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…

  150. Vishal Sharma says:

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

  151. Kelly Reeme says:

    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

  152. Nick F says:

    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?

  153. Kelly Reeme says:

    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

  154. Silvia Harris-Payne says:

    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?

  155. Tony says:

    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.

  156. Tony says:

    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.

  157. Karen says:

    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!

  158. Eric B says:

    Brian,

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

  159. Soccerplayer says:

    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?

  160. Ian J. Gibbons says:

    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.

  161. Kelly Reeme says:

    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

  162. Ian J. Gibbons says:

    Hi Kelly,

    Yes things are looking up. You did not send me the link but I would love to check it out. Please shoot it to gibbons.ian@gmail.com

  163. Damon Craven says:

    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!

  164. Rod says:

    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.

  165. will says:

    great site.

  166. will says:

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

  167. Martin Koban says:

    Hey Ian,

    You can check out the book that Kelly mentioned on Amazon:

    http://www.amazon.com/Beating-Patellar-Tendonitis-Treatment-Pain-free/dp/1491049731/ref=sr_1_170?ie=UTF8&qid=1380859898&sr=8-170&keywords=knee+pain

    Unfortunately, you just missed the free download period that ended on the first of October :-( … Amazon limits the number of days that I can offer the book for free, so I’ll have to wait a couple of months before I can do that again.

    The good news is that you can easily refund Kindle titles within 7 days of purchase :-)

    Hope you get well soon.

  168. Sigfus Vikthorson says:

    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

  169. Kyle Reece says:

    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?

  170. Ian says:

    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.

  171. Jeremy says:

    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.

  172. Biomechanically challenged cyclist says:

    @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.

  173. Jordan says:

    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?

  174. KB says:

    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…

  175. Kelly says:

    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

  176. Ian J. Gibbons says:

    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%

  177. Martin Koban says:

    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.

  178. John says:

    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.