A Surprisingly Powerful Tool to Combat Chronic Patellar Tendonitis
by Brian Patterson
on May 11, 2012
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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.
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:
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- 8 Weeks of Physical Therapy – unfortunately this didn’t help, and it wasn’t fully covered by my insurance, so it was pricey for something that brought about no change
- Iontophoresis – These are little patches that use electricity to put cortisone deep into the tendon. These did relieve pain temporarily (4-24 hours), but there was no long-lasting improvement
- Cortisone Injections – the relief from these injections were instant, but lasted only 8-12 hours. I know these are a miracle drug for some, but it was only a superficial healing for me and it faded away rather quickly.
- Prolotherapy – This is similar to PRP (below)… basically they inject a glucose solution into the problem area. The theory behind this is that the solution irritates that area so much, that the body sends new (and lots) of blood to the injury, thus restarting the healing process. Sounds good in theory, and there are a lot of people who claim to have had amazing success with this, but no such luck for this guy.
- Platelet-Rich Plasma (PRP) – I only did this once, so I can’t give a fair review here. This treatment is really popular right now, and you’ll hear a lot of professional athletes (Tiger Woods, Troy Polamalu, LaRon Landry) talking about the success they had with it . What they did is draw my blood, then that blood went through several spin processes to separate the plasma from everything else. Finally just the plasma was injected back into me, but this time directly into the problem area of the knee. This was really, really painful for the first 24 hours. The plasma seriously irritates the knee, and it hurt. I decided a few months later that I was going to put this treatment option on hold and explore a few other things first. I haven’t completely abandoned it, I’m just not so sure it’s the right solution here.
- Egoscue – I mentioned that I was trying this out, but ultimately I couldn’t keep up with the demand of following my ‘e-cises’ 4-5 a week, at an hour each day. I do think that Egoscue is great for improving posture and overall health, but I’m not so sure that it is a specific tool for healing this precise injury.
- Cissus – I read about this in the 4 Hour Body book by Tim Ferris (which is great, by the way). It didn’t work for me, but I didn’t have high hopes for it anyway.
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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!
Tyler Hurst
May 11th, 2012 at 4:06 pm
Yes, in my right knee. Current treatments include not using it, ice, and a McDavid strap.
Love this idea, though. I’d like to be rid of it.
Does your knee hurt during runs? Mine usually don’t, because I don’t push off much.
But tennis? Ouch!
Brian Patterson
May 11th, 2012 at 4:10 pm
Hey Tyler, I forgot to mention that I tried the strap as well, but that really had no impact at all. Does it help you?
When I try to run for speed I definitely feel it and it hurts, bad. If I’m using good form and just running to enjoy it, I can make it a mile or so before I’m done.
The odd thing is that I can play basketball for 30-45 minutes or so before I have to call it quits. My brain is able to block out the pain a descent amount when I’m chasing a bouncing ball around. Eventually the pain catches up to me though, and it takes a solid 2 days to get the swelling down.
conor
March 14th, 2015 at 8:05 pm
i have a question for ya brian… but I see this is back in 2012
are you still on here?
Julie
July 30th, 2015 at 8:13 am
I can t view the video. One question , I have been diagnosed with tendinitis in both knees. How ever, the pain I have seems to be more when I’m sitting or laying down that my knees just want to keep moving and the only way to relieve the pain would be to get up. Sometimes I try to pop them but it doesn’t work often. Would the slant exercise help this as well?
H singh
September 11th, 2015 at 3:55 pm
Hi, try linnex muscle rub, provides long lasting heat to injured knee….
sai
April 05th, 2020 at 9:34 pm
Hey man, My tendon hurt near the insertion of the tendon, the little bump under the knee. Its been year and I did everything I could, where does your hurt exactly?
Judie
December 28th, 2018 at 11:07 am
Thank you for the info have been using this method off and on for years after seeing this post. I am an RN age 65. If you feel your situation is hopeless give it a try. You should see a difference in a couple of days to a week. You will be surprised.
Kim
September 18th, 2019 at 10:08 am
These exercise strength then tendon or muscles? Wouldn’t this strain the tendon further?
Will Kimbrough
June 13th, 2012 at 8:10 am
I have been running, walking, hiking barefoot for over three years. It has changed my life for the better. I am curious if you think this stretching board is better than the good old heel drop on the stairs calf stretch. My knees, hips and back have been pain-free since I adjusted to barefoot and minimalist life (I rarely wear footwear to run, walk or hike, but do own some flat skateboard shoes and a pair of Sockiplast socks), but I have nagging Achilles Tendon pain. I just got The Stick and hope that will help. I soak in epsom salts, use ice and heat, but that ACL is sore almost every morning—-I stretch upon waking up, gently, on the stairs, dropping my heels for 30 to 60 seconds, on my way to turn on the coffee maker. Anyway, hoping The Stick will help. Love your site.
Brian Patterson
June 13th, 2012 at 9:24 am
Hi Will, I’m not sure how it would compare to stretching on the stairs. In theory, they should be pretty similar, but in practice there could be small motions that make a big difference.
My issue was with the Patellar tendon, so I’m not sure of the effectiveness of the stretch on the ACL, but it has basically been a miracle for me.
I would say to try the stick for a month and see where it gets you. If nowhere, stop using it, and try something else. The more you test things in isolation, the more you will learn about your body and what is working for you. Good luck!
Edmund
February 03rd, 2014 at 12:24 am
Something I used that worked out was a product called Voltaren Emulgel by a company called Novartis. I am not sure if it is available in the USA though. In Canada you can buy it at most pharmacies. Using that plus heels on an old catalog and squatting but now I will buy Kelly’s board to use instead of the catalog.
Kelly
August 01st, 2012 at 10:10 pm
Hey Will, let me share my experience. I suffered with terrible Foot pain. The heel drop exercise is great. The board enhances it and perfects it. You will be amazed.
Brent
August 08th, 2012 at 12:22 pm
Interesting article. I had patellar tendonitis about three years ago and it slowly went away after about four months… Unfortunately, it has returned this year (in full force). I cannot seem to shake it. I know for a fact that mine is drawn from impact on a hard surface – as it developed both times from playing on the exact same indoor field. No other indoor field has led to the issue.
Anyway, I play competitive Ultimate Frisbee, and it requires a lot of starting/stopping for change of direction as well as plenty of hard sprints and jumping. This year, I have tried taking a few weeks off. Currently, I’m trying to floss my quad and the area regulary. I am also doing eccentric squats, but I haven’t had much results year.
What is the best treatment?!
Jeremiah
December 26th, 2013 at 7:33 pm
For what it’s worth, my patellar tendinopathy can be traced to Ultimate frisbee as well.
Lauren
September 14th, 2012 at 12:26 pm
Hi,
I’ve had achilles tendonitis in both my legs and eccentric loading has completely banished the pain. I no longer feel it as much, but if I do it’s very minimal, like it’s never there.
Eccentric loading works!
Steve
September 28th, 2012 at 7:38 am
I had patellar tendonitis for years at varying degrees. I learned this technique from an Active Release practitioner, and it works to clear it up every time. I always work up progressively and methodically, and within a week it’s mostly gone. Now, since switching to VFFs exclusively, I haven’t had any issues with it in almost a year.
Samantha Saccomanno
October 17th, 2012 at 12:38 am
Hey Brian!
My name is Sam Saccomanno and I think I have the same knee problem that you had. I am a senior in high school and during my sophomore year in track (spring season) I developed my knee pain. I’m pretty sure I developed it from sprinting and lunges (i would do 1/4 – 1/2 miles lunges a week). At first I didnt do anything and I kept sprinting and jumping on it. After a month I had to stop because it hurt so bad. It has almost been two years now and I still can’t run. Ive gotten an MRI, X-Rays, PT, Chiropractor…and I might do Prolotherapy. I have been told that I don’t qualify for surgery because it isn’t internal. One doctor said I have chronic tendonitis. Now, I swim and power walk and ice. It is SO frustrating because I love sports and being active. I just ordered 5 fingers and the Flex-N-Go board from your video. Any other options?
Brian Patterson
October 17th, 2012 at 9:42 am
Hi Samantha, I think FiveFingers and the Flex-N-Go board is the way to go… at least that is what worked for me after several years of dealing with this.
I can’t give medical advice, but I would say that if I was in your shoes, I might hold off on prolo for a few weeks and give the slant board a try, scaling up using it over a couple of weeks.
Best of luck, and please post back and let us know your results, good or bad!
meghan
April 14th, 2018 at 10:13 pm
Literally. Me exactly. I cant do anything i love (hiking, biking, running). I work out every day but now i just do upper body, every other day light elliptical, and my physical therapy exercises to activates my glutes. I am 22 years old. I am so restricted. I recently got into yoga and now its even more irritated. I have tried all conservative methods and 3 months ago I have PRP. It honestly hasnt seemed to help. Idk what else to do. Someone help :(
Omar Elsahn
October 27th, 2012 at 8:22 pm
Hey Brian thanks for the video, i’ve been dealing with Patellar tendonitis for 6 months and i’m now doing a similar exercise to the one you’re showing except im doing it on a chair.. My question for you is doesn’t this exercise make your knees worse thought? I don’t know about you but my knee starts hurting after i’m done a little bit but sometimes i feel my knees are strong after doing them thought.. But did your knees hurt after doing it?
Omar Elsahn
October 27th, 2012 at 8:23 pm
Hey Brian thanks for the video, i’ve been dealing with Patellar tendonitis for 6 months and i’m now doing a similar exercise to the one you’re showing except im doing it on a chair.. My question for you is doesn’t this exercise make your knees worse thought? I don’t know about you but my knee starts hurting after i’m done a little bit but sometimes i feel my knees are strong after doing them thought.. But did your knees hurt after doing it?
Brian Patterson
October 30th, 2012 at 2:46 pm
I inadvertently responded to Omar’s post above via email rather than a comment. Here is what I shared with him:
Hi Omar, thanks for your note! I can’t give medical advice, but I can tell you what I would/did do. But you should consult a medical professional before copying anything I say.
My knee definitely does hurt during and after the eccentric exercise. At first I thought it wasn’t working or that I was doing it wrong or something… but after researching more it seemed that it is supposed to cause some discomfort, and that things should really start slow and don’t push too hard. But for me, yeah, it does hurt. But that goes away after a few hours and I’m better the next day.
Thanks,
Brian
Omar Elsahn
October 30th, 2012 at 2:41 pm
Thanks for your reply Brian.. I just had a few more questions:
1. So did you get rid of patellar tendonitis? If you did, how long did it take you to get rid of it with this exercise?
2. When you had Patellar tendonitis did your knee make a crackling/cracking noise when u bended it?
3. How come this exercise is good for Patellar tendonitis if it makes it hurt?
Thanks again in advance Brian
Brian Patterson
October 30th, 2012 at 2:44 pm
Hi Omar,
Here are the answers to your questions:
1. It took a few months of religiously doing this to get almost completely better… but I did get some good results pretty early on.
2. No, I didn’t have any crackling sounds in my knees. My wife has that, but doesn’t have any knee issues, so I’d check with a physician to see if the sound is related to the injury (my uneducated guess is that they are not related, but I don’t know)
3. Good question – I don’t know why the exercise is effective overall, so I’m not sure why there is some pain/discomfort involved. The eccentric piece is still a mystery to me, but it worked in my case. I’ve come to appreciate the pain in the exercise. But again, I’m not a doctor or expect, so consult one first before trying this all out.
Thanks!
Brian
Omar Elsahn
October 30th, 2012 at 9:29 pm
Thank you!
I just want to know, when i bend my knee back and forth and straight it out i crack something in my knee. Is this a good idea?
Brian Patterson
October 30th, 2012 at 9:31 pm
I don’t know the answer to that. I think the best thing to do is just check with a doctor and get their opinion on everything. If your body is telling you ‘no’, don’t do it.
Omar Elsahn
October 31st, 2012 at 1:29 pm
Wait?
How many reps/sets/sessions you do a day of this workout?
Zimbalist
May 11th, 2013 at 8:29 am
I also had the clicking. Apparently, so the specialist tells me, it’s a problem with the knee cap tracking; because of the patella injury you (often unwittingly) use the various leg muscles in different ways to compensate for the patella injury. Consequently, one of those muscles exerts greater force on once side of your patella, causing it to become slightly misaliged from the “grooves” on which it usually tracks. The clicking is when the patella clicks back into the grooves.
At least that’s what the physio and specialist told me.
Omar Elsahn
October 31st, 2012 at 10:10 pm
Oh and do you still have pain or did you get rid of it and you’re back to your activities pain free?
Omar Elsahn
November 23rd, 2012 at 5:50 pm
Hey Brian forget about the other questions. I just want to know did you do any physical activity along with using this slant board or did you take time off from all physical activities and only use this? And how did you build your leg muscles?
Brian Patterson
November 25th, 2012 at 10:06 pm
I took time off of anything I didn’t have to do. I didn’t run or play pickup basketball or soccer for several weeks while I focused on getting my knee better.
Granted, I did this for every different treatment option I tried.
If I were you, I’d take it really easy.
Omar Elsahn
November 25th, 2012 at 10:34 pm
I have muscle imbalance on my tendonitis leg and it is smaller than my other leg. When i work it out at the gym on the leg press, it feels strong but later it feels weak.
Robb
November 27th, 2012 at 11:54 am
I think the muscle imbalance and instability is a big issue with PT. I have noticed with intense stretching that my bad PT leg has a lot less flexibility than my other leg. I think constant stretching of these large muscles is critical, along with daily icing, independent strength training of the less flexible leg to fix the imbalance you describe, and then the Eccentric Exercises which I am going to start when my slant board arrives.The worst thing I have done is to do nothing with PT. It will not heal without you prompting it but you also cannot keep reinjuring. I had to totally quit playing basketball. However, no activity was as bad as the activitiy inself. As a result, strengthen the legs and improve your flexibility to stimulate the healing process. I am also trying an anti-inflammatory diet.
Kate
November 08th, 2015 at 4:59 pm
I see this was a few years ago now, but can you point me to any good resources around anti inflammatory diet? Did it help? I am a personal trainer struggling with patellar tendonitis and I’m considering going down this route but it’s hard finding a reliable source.
Shane
November 26th, 2012 at 4:42 pm
Hi Brian. I play Australian rules football semi professionally and over the last year or so, I have battled tendinitis quite badly. It has affected my speed and balance. Sometimes it is so bad I even cannot run on grass. I am very interested in giving this a go. How long till you first noticed a result
Brian Patterson
November 26th, 2012 at 4:45 pm
I think it took a couple of weeks before I had a noticeable improvement (its been a while so I don’t remember exactly).
Let me know if you do end up trying it and what your results are.
Robb
November 27th, 2012 at 11:46 am
I have been battling Chronic PT for over 2 years. Did not know what it was or how to treat it until I had reallly damaged it and made it chronic. Now Im trying to overcome it. Mine was originally an overuse injury from basketball. Now I cannot hardly play at all because I have injured it so much repeatedly. Doctors are of no use. Im stretching constantly and that is helping. Im also doing lots of strenth training on quads, hams, calves, etc. I just ordered the slant board and I hope the eccentric exercises work. I will say the stretching is a very key component. I believe that these large tight muscles really overstress the tendon. I even get immediate relief from stretching. However, I hope to get it healed and maybe the slant board will help accomplish this. Also going to a diet of anti-inflammatory foods. This condition is very frustrating to people who enjoy sports and working out.
Omar Elsahn
November 27th, 2012 at 1:53 pm
It’s a pain in the ass Robb.. I feel bad for you man that must be annoying as shit. For me i have pt in my right leg and i noticed that the quads on my right leg are smaller than my left. And when i workout my legs on the leg press i noticed that i get sudden relief and it feels strong and doesn’t hurt.. But at night i feel discomfort in my knee.. I think strength training is very important but i don’t know if its bad for the knees itself. I’m working out my legs along with this board.
Ian J. Gibbons
December 03rd, 2012 at 5:20 pm
It’s great to see all of the comments on this site. I’ve been dealing with patellar tendonitis in both knees for over two years. I first tried physical therapy but I was working a job that required me to run so it wasnt effective. I then had once knee scoped which although it was successful, didn’t cure the tendonitis. I’m now in physical therapy again working strength/flexibility. I’m not having the results I’d like and its crazy expensive. I’ve seen this used before and your story has motivated me. I’m going to get this board and hopefully reclaim my active life.
Brian Patterson
January 09th, 2013 at 9:33 pm
Good luck, Ian. Circle back and let us know how it worked out!
Ian J. Gibbons
March 14th, 2013 at 10:30 pm
Well I’ve finished with my physical therapist and while it has helped some…I’m not quite where I’d like to be. I will say that in PT they have really strengthened by glutes and thighs which provides support, but not quite enough. I have just ordered the slant board and will give it a shot. I can’t knock my PT but I’m hoping this will carry me the rest of the way in addition to their program.
StuartR
December 28th, 2014 at 4:17 pm
Hi Ian,
Just reading this for the first time. I am in the same place as you were: months of work strengthening glutes but PT is no better. I just ordered the slant board. Now you are 2 years or so on, did the slant board kick start tendon repair in your knees?
Please let me know if you get this, I’m desperate to hear of any success stories!
Stuart
Ian
December 28th, 2014 at 8:33 pm
Hi Stuart,
I’m sorry to hear you are also dealing with knee tendon issues. Before I share my progress I want to recommend that you be absolutely sure of your diagnosis. Do you have tendonitis or tendonosis? Treatments are very different. Is it in your patellar tendon, quad tendon or both? Now where am I at.
The slant board unfortunately did not help as I had hoped because I also have quad tendonosis so while it helped my patellar tendon, it made my quads worse. It still helped my on my journey and pointed me in my latest direction, Graston technique. Since doing graston which is like deep tendon massage, I have gotten MUCH better. I scaled back my leg exercises and by pairing Graston with a slow approach I’ve seen more gains in 1 month than I did in 6 months of PT. I HIGHLY recommend and am hopeful.
Rhys Luxford
May 05th, 2017 at 5:41 pm
Hi, I want to hear some more success stories, how is your knee holding up?
Josh
December 09th, 2012 at 6:18 pm
Hey Brian, i’m 14 years old and i’m not sure if I have Patellar Tendonitis but the symptoms are very similar! I have been skateboarding for 2 years. Very recently I smacked my kneed against my metal bedstead and i’m afraid this has affected my knee strength. I used to skateboard every day, and only after 3-4 hours my right knee (my knee for popping) started to hurt. I assumed this was from skateboarding for too long. But now after the bang from the bedstead, I can barely walk, I cannot jump or take part in P.E. Bearing in mind my injury happened about 2 weeks ago. Would the Flex-N-Go benefit me? Or do I just need to rest my leg for longer. Please reply soon! Regards, Josh.
Brian Patterson
December 09th, 2012 at 9:07 pm
Hi Josh, I’m really not the right person to diagnose this for you, I’d recommend talking with your parents about going to see a doctor. A family practitioner (family doctor) was able to diagnose my problem, and the orthopedic doctor simply confirmed it. So I’d go see your family doctor and have them diagnose it.
Best of luck, and update us on how it went.
Thanks!
Brian
Robinson
December 14th, 2012 at 10:33 am
I’m curious as to how big it is – how tall is it? How deep front to back?
Kelly
December 15th, 2012 at 11:01 am
The Box dimensions vary as each box-board is built by hand. However they do run close to 8″ high 17.5″ long & 12″ wide. Thank you.
Claire
January 08th, 2013 at 11:35 pm
Just bought the Flex-N-Go and I’m trying your exercises. I’ve been down all the avenues you have with my patellar tendonitis; physical therapy, hot and cold packs, massage, and PRP (which cost me a ton!). The success rate of surgery is low so I opted out of that. Thanks for posting this information. I have high hopes for these exercises and will let you know how it goes. Also, check out the Rumble Roller. I discovered it on this website http://www.fix-knee-pain.com/injuries/patellar-tendonitis-knee-tendonitis/ along with some great exercises for strengthening your legs.
On another site, which I can’t find right now, another person started “loading” on the slant board, after they had progressed a ways on the slant board with just eccentric exercises. Basically, they wore a backpack while doing the exercises, slowly adding 5 lbs at a time, with fantastic results. Could change YOUR healing from 70% to 100% maybe….
Brian Patterson
January 09th, 2013 at 9:33 pm
Hi Claire, thanks for stopping by. I love the Flex-N-Go, it is so sturdy. It sounds like you tried all those other treatments as well, so hopefully you’ve found something that will finally work for you!
Thanks for posting about the roller. I also have IT bands that cause issue from time to time, and I use a foam roller to work those loose. It hurts so good!
Agreed on the loading, I should be doing that! Thanks for pushing me. Gotta find a backpack.
Brian
Chris
January 09th, 2013 at 6:16 pm
Hey Brian, when you did the lowering/eccentric part on the board, you said you’d lower to the bottom on a count to four. How far down is “the bottom”? Did you work up to going all the way down or did you go half way for a while? Also, how much pain should be felt going down? I get 1/2 way and I have to take some weight off because of pain.
Thanks,
Chris
Brian Patterson
January 09th, 2013 at 9:30 pm
Hi Chris, I just lower as far as I can comfortably go… pretty much to the point when it transitions from discomfort to pain. I don’t want pain, but some discomfort is ok.
How low I went increased over time. It went from a not-very-deep squat to maybe a 90 degree angle.
Again… not medical advise, I’m not qualified to offer that… just what I did.
Kat
January 13th, 2013 at 9:35 pm
Hi Brian!
I completely understand your frustration with you knee. I have been struggling with chronic patellar tendonitis for the past year and a half. Treating tendonitis is slow going and requires a lot of hard work and patience. Traveling from PT to the doctors is not fun. The doctors originally gave me a knee strap and that helped to take the pressure off the kneecap and made running pain free. However, I soon learned that the strap was only aggravating the problem and further weakening the knee. Every time I took the strap off after practice the inflammation, stiffness and pain would be worse. The knee strap also caused me to put more stress on my uninjured knee and now I have tendonitis in both knees. I have learned that the knee strap is not a permanent solution to tendonitis, but rather an aid to recovery. I have been in and out of physical therapy this year and I have been doing exercises to help strengthen my legs. In physical therapy I have also been working on “fixing” my stride. Pronation of the foot can lead to knee and hip problems. PT has helped some but I believe in addition to PT your exercises might be the key to treating my tendonitis! Already I am having some success and my knees are feeling better. I was wondering if you knew any more eccentric exercises to help my recovery.
Thanks,
Kat
Omar Elsahn
January 13th, 2013 at 10:32 pm
Kat, i had a question for you:
You said that already you’re having some success and my knees are feeling better. Are you having success and your knees are feeling better because of physical therapy OR because you tried the slant board exercise?
StuartR
December 28th, 2014 at 4:20 pm
Hi Kat,
Now you are 2 years or so on from this post you may not get the email but, did the slant board kick start tendon repair in your knees?
Please let me know if you get this, I’m desperate to hear of any success stories!
Stuart
Graham Sutherland
January 14th, 2013 at 7:51 am
Hi Brian
Thanks for all the info. I’ve been plagued with knee trouble my whole adult life but PT has been the most frustrating for me. My other injuries got surgery and I recovered fully but this injury has pretty much ended me sports wise. Football (soccer) is my sport. I’ve taken a 3 month rest and haven’t healed a bit. I went to the cinema the other night and was in agony! That kind of pain after 3 months of complete inactivity? Not looking good.
So I’m going to try a slant board, I’ll return and post my findings in a few months. I’ve nothing to lose. Granted I’m not young anymore, just turned 41 but before the PT I was the fittest I’d ever been in my life.
So to anyone else resting and not healing, you’re not alone! This injury is a real pest.
If the board fails to help I’m afraid it’s game over for me. Fingers crossed. Good luck to you all facing this injury, I wish you well.
Thanks again for the tips Brian.
Kindest regards
Graham
Omar Elsahn
January 14th, 2013 at 8:25 pm
Graham, just a thought that might help you. I have had patellar tendonitis in the past 9 months and i started physical therapy on december 27 up until now.. That’s about 18 days in and i’m already feeling better. I asked my physical therapist about the slant board eccentric and he too said that he think it would be a great addition to my physical therapy exercises and that i should try it. But he also said that the slant board might work and also might not work because it depends on the person because everyone’s body is different and it can be different things triggering the tendonitis for different people. My point to you is that you should definately consider physical therapy because it can do wonders for you along with this eccentric slant board exercise.
Graham Sutherland
January 15th, 2013 at 2:09 pm
Hi Omar
Thanks for your advice. I have put off going to see my physio, I figured all I needed was some rest and recuperation. The pain I endured the other night though has me changing my game plan. I will indeed make an appointment and physical therapy is definitely on my agenda.
Hopefully therapy along with the board will speed my recovery. I’m of the thinking I’ll never truly be rid of PT but if I can be comfortable enough to play then I’ll be content with that.
Good to hear you’re doing well with your own recovery. I’ll return and update my progress in the spring. If we benefit from these techniques it’s good for others who are unsure. I’m hoping to be one of the benefactors!
Kind regards
Graham
MILLIE
January 27th, 2013 at 10:49 pm
I shattered my Patella in a fall. I have surgery & now the four pieces are trying to knot. The J pins are trying to pop out & now I have trouble even bending the knee to 40 degrees. any suggestion in how to walk normally again.
BTW, I am 8 weeks since surgery & doing PT.
I am 65 years you g as well!
Thanks for any advise.
Brian Patterson
January 28th, 2013 at 10:32 am
Hi Millie, wow, that sounds like a tough injury! That is beyond my experience, and I’m afraid I can’t offer much advice as I really only know a bit about Patellar Tendonitis. I do wish you the best of luck, though, and let us know how your healing goes.
stephanie
February 01st, 2013 at 5:22 pm
hi i have been having pronlems with both of patellar tendons and i am a avid basketball player. I was just wondering if it is bad to have it in both legs.
Brian Patterson
February 01st, 2013 at 5:27 pm
Hi Stephanie, thanks for the comment. I’m not sure if it is worse in terms of the healing process, but I’d imagine it will take longer. One is bad enough, I can’t imagine having it in both knees.
I played basketball this morning for an hour, and Wednesday night (2 days ago) for 2 hours, so relief is possible.
Again, I’m no doctor, but if I were you I’d probably give the slant board a try. Since you have it in both knees, I would think you don’t even have to balance on one knee on the way up, you could still use both.
Best of luck,
Brian
Omar Elsahn
February 01st, 2013 at 6:55 pm
Hi, could this help chondromalacia? I have pain right under my knee cap but it’s minimal.. Where exactly was your pain?
Brian Patterson
February 01st, 2013 at 9:15 pm
Hi Omar, sorry, that isn’t something I’m familiar with.
Omar Elsahn
February 01st, 2013 at 10:11 pm
Mmm ok, but can you tell me where exactly your pain was?
Brian Patterson
February 02nd, 2013 at 2:58 pm
I feel the pain right underneath the kneecap, fairly close to the surface. I can press on it from the outside and it hurts… and God forbid I bump it on something because that hurts like crazy.
But, all that said, I am so much better now than I was a year or so ago.
Omar Elsahn
February 02nd, 2013 at 9:43 pm
Just to let you know that is exactly what chondromalacia is.. It’s softening of the cartillage under the knee. I think they mis-diagnosed you just like they did with me..
Brian Patterson
February 03rd, 2013 at 10:20 pm
That is certainly possible, although I don’t think it is the case based on the MRI, X-Rays, and doctors who looked at it. I could see the inflammation and what looked to be damage on the tendon in the MRI.
Tyler
February 03rd, 2013 at 9:20 pm
Hey, great article. I’ve been dealing with patellar tendonitis for the past year and a half and it has been a real burden. I play baseball and I feel it every time I throw and land on my left knee. It has subsided a bit but every once and a while it will flare up and I need to shut down. I’ll try this out though, hopefully it can work.
Brian Patterson
February 03rd, 2013 at 10:20 pm
Hi Tyler, best of luck to you! Please circle back and let me know if it works for you.
Ricardo Espinosa
February 13th, 2013 at 12:30 pm
Awesome article
Jeff
February 06th, 2013 at 8:25 am
thanks.will give these exercises a try. i am long time marathoner battling pt for over a year..tried most of what people have mentioned here,short of surgery..gotten some relief from pain but my knee is so weak i cannot run more than 2 miles at a time. my running career,such as it was, may be shot but i am not giving up yet!
Taylor
February 07th, 2013 at 11:15 pm
Hey all!
I am having the same issue as you all! Except I have now, after being busy with school and not being able to work out a lot, developed some atrophy! =(, its not terrible, but enough to notice that when i walk, one glute and thigh muscle feels weaker than the other…
I have been on a workout regimen (for my legs) of bike or elippltical for 15 mins, then lunges (boy wieght and occansionally 10-15 lbs weights), leg press (just started and doesn’t hurt at all!), and resistance training with a band.
While the muscle in the leg appears to be bigger, it is not STRONGER persé…any ideas on how to REALLY strengthen that leg more?
i have added ankle weights and sqauts (with the ball against the wall) to about 45 to me regimen as well!
I really want to be back to normal by Mid March (I am joining a flag football league!) =)
Andy Dorrat
February 11th, 2013 at 5:20 pm
Hi Brian, thanks for
Andy Dorrat
February 11th, 2013 at 5:23 pm
Hi Brian
Thanks for this website. Really good info.
When I’m doing these squats, I find the first 10 really sore and then my knee totally loosens up and the last 10/15 to the point where there is ver little pain. Did you experience this when u started these exercises? I’m basically looking for encouragement that this exercise is working for me and I’m on the right track.
Cheers
Andy
Ricardo Espinosa
February 12th, 2013 at 8:03 pm
Brain, Your story is very similar to mine beside the fact you finally found something that worked. I’ve tried physical therapy two different times for 12 weeks at a time and the symptoms never seems to go away. It has been almost 2 years now and I am getting to the point where I am willing to try ANYTHING to get rid of this issue. Just like you said I am constantly moving my Left leg around trying to find a comfortable position but it seems like there isn’t one. I am going to order this slant board and try what you did but I have a few questions. After you did your exercises on the board did you use ice or heat or just stick with pain medication? Is this the only exercise you did while using the slant board or did you also do any other quad strenthening exercises? Where did you order your slant board from? I want to make sure I do this exactly like you did.. any information you can provide will be much appreciated. Thank you -Ricardo
Jean-Marc Aliphon
February 13th, 2013 at 8:59 pm
Hey dude, thanks for posting your experience on your jumpers knee, i too have the same problem for about 2 years and have tried most of the things you have aswell, prp, cortisone etc .. just wondering if you were able to do this rehab while still playing basketball (obviously limiting minutes) i just cant bring myself to sit out and not play. your thoughts on this would be greatly appreciated.
Mia
February 18th, 2013 at 4:15 am
Where was this six months ago? I’ve been doing this exercise for a week now & the pain went down from 10 to 6. About my history I’m a 10k runner. Six months ago I’ve increased my running distance to 21 km & did it way too fast which resulted into Patella pain. I had an MRI done, xtray done both showed nothing. I’ve tried chiropractor~~~ waste of money the pain did not go away. Physio ~~< didn't help either.
Taylor
April 02nd, 2013 at 4:11 pm
Hi Mia,
I am also a runner/athlete…i was a college gymnast.
How long did it take you to feel healed? Did you completely heal yourself of it? And how many reps did you do? weights at all?
Sorry to barge you with this but in May of ’13, it will have been a year i have been dealing with this issue…
Thanks!
Mia
February 18th, 2013 at 4:40 am
To add to that I’ve also tried hot yoga the pain went away for a day.Cortisone~~ inject to your knee made the pain worse. Dr. recommended surgery which I refuse.
michael
February 19th, 2013 at 11:54 pm
hey Byran.. im a fighter of mma .. well when i first hurt my knee it was about 3 months ago,,an i’ve been trying every thing i cant to heal properly because i also use to train hard when it came to endurance for later rounds..but my main question is when can i begin tho simple sqwats you did to heal.. cuz i read on one of your coments to someone that when you play 40 or more min of b ball you wont go more well for me.. i like to train an train well for hours i really miss my gym an was hoping to hear back thanks dude..
Dimitris
February 21st, 2013 at 9:54 am
Hi Brian .I have PT for about 10 months now Im a tennis player an beach tennis player .
I had diagnosed before 3 months on Pattelar tendonitis on both Knees wich became tendinosis.
I had ACL and two miniscus sergery on my right Knee before 3 years after an accident.with my DH bike.
Im a very high level active person and that seems to be my payment on all that thinks that I love to do..
I made physio Therapy about 2 weeks sessions .But nothing worked Im again on Physio for some friction /massage therapy It seems not working again after 2 weeks and a half on Ph.Th.
So a had read about eccentric squats and im doing them about 2 weeks now but with out ths slant board .I will make on and I give it a try on it. Im foam ROlling an streching every night before my bed time,It seems to relax me . Heat /cold pack its a day habbit for me now …
Cocotal
March 03rd, 2013 at 1:33 am
I used to have tendinitis in my “strong” leg from playing tons of basketball, and it didn’t help that I switched to Muay Thai when I graduated college (knees don’t really like heavy bag kicks).
The way I got rid of mine is to strengthen the whole leg. How does one strengthen the whole leg, with tendon pain? Door-assisted single-leg squats. Full range of motion really beefs up the leg. Eventually you want to progress to unassisted single-leg squats (also called pistols). Check this out: http://www.beastskills.com/one-legged-squat-the-pistol/
Note, you do NOT under any circumstances want to do the limited-range progressions on that website. For example, you don’t want to do the ones where you put a box under you — the sort of tension on the knee holding it above a box really aggravates the tendinitis, and I know from experience.
Use a counterweight or a door or a band or a bar to pull yourself back up, but absolutely do use full range of motion. It will take a month, but you’ll be a freaking beast afterwards and won’t get anymore leg problems.
Mary
March 03rd, 2013 at 4:37 pm
Thank you for writing this, Brian. As a longtime explorer of the body-mind connection, an avid yoga practiioner, power walker, and recent martial arts student – I am just now coming into the home stretch of an 8 month knee tendonosis recovery journey, it was great to finally find your post.
Knee tendon overuse injury & its accompanying stiffness reduced mobility is not only physically painful but also emotionally hard – it’s scary to have stiff joints that aren’t changing fast. It’s scary to feel like you hobble down the stairs and are prone to falling over easy if you’re in pain. And, taking a break from one’s usual physical workouts in order to rest the tendons, can really alter your brain chemistry with a depressing psychological effect and fear of premature decay of the joints, etc. This is not helped by reading conventional M.D./orthopedist perspective on knee pain (cut open the leg to move stuff around, or inject it with steroids) – it makes it even more depressing.
My personal healing of knee tendonosis has been a revelation of longstanding biomechanical issues that I didn’t know I had. I discovered them after utilizing my best, highly-informed self-care (including eccentric slant board work – but it made things worse for me pain-wise, and I stopped in order to wait for pro feedback) with not much progress. By chance, I happened to get a new job with generous health insurance, and was able to start working with a unique physiotherapist lady (a triathlete with a PhD focused on A.R.T., not just the typical P.T. or chiro who completed one weekend workshop and proclaims they know & practice A.R.T.). She sourced my tendonosis as coming from scar tissue adhesion of my rectus femoris quadricep – and my TFL. Adhesions go back to childhood/adolescent injuries that happened during growth spurts followed by sedentary post-injury habits that made the tramatized tissue stick to the femur. I had many injuries as a kid (falling down stairs, a huge bicycle crash, skiing falls, to name a few) – and, living in a mountain town that was winter about 6 months of the year – I did do the sedentary post-injury thing, being a bookworm type. So, interestingly, my case history is one that correlates well with adhesion-based tendonosis – while other folks may have other root causes of their own knee pain.
Some people don’t know that A.R.T. is not passive bodywork – you have to slowly move the area while the practitioner is doing bone-scrapingly painful deep release on it, so the CNS gets retrained. It’s very hard work, yet also wonderful for brain chemistry – lots of endorphins get released. It would be fascinating to study the similarities between eccentric squats and A.R.T. – as they both involve willingly going into pain and opening up properly aligned full range of motion!
Anywoo, that and a nightly routine of prone, deep quad stretching, thrice a week supported squats/wall sits (like Cocotal said), and doing a temporary 6 week routine of wearing compression socks (the kind that go over the knee are fab) during my deskjob days, are giving me new legs! The compression socks are awesome for reducing edema and assisting with removing wastes from injured tissues – you can find them in black. I had tried T.K. knee sleeves as well as Zensah calf sleeves, but the P.T. explained that the compression action needs to include both the entire ankle and knee. They feel great on, too.
ROM is completely restored, and I am just working on being able to load, build, and nourish this fledgling mobile RF quad muscle. The RF often has deepest adhesions where it attaches near the hip, and this affects the entire track where attaches below the knee, many people don’t understand how huge a role this plays when it is deformed or malfunctioning.
So, different body structures and personal histories create different knee tendonosis… Some people may have beautifully functioning upper quads and have knee pain due to foot/ankle/gaits probs or one leg being longer than the other, for example. Other people who are over 40 & super healthy like myself, still have the hormone fluctuations that come with normal aging and can make for a slower recovery journey and a longer time of it.
Recovery and full healing is indeed possible. You don’t have to go down the rabbithole of steroids and surgeries, it is indeed possible to heal and strengthen the leg so that you become an even better athlete in the end.
James
March 20th, 2014 at 5:59 am
Hi Mary,
Thank you for posting this information. Thank you also to Brian for posting the original article. Mary – I would love to hear how you are going now. It sounds like your A.R.T practitioner is the kind of person most of us on this site would like to have helping us.
I should share my story. I have had tendonitis for 5 months. On advice, I iced my knee every night for 3 weeks and rested for a total of 6 weeks followed by 3 weeks of intense mobility exercises to loosen everything from my butt (piriformis) to my ankle including one of the weirdest Ilio-Tibial band stretches I have ever encountered. I also did foam rolling including something called active tack and stretch which involves the using the foam roller on the quad muscle until you find a really tight spot and then flossing back and forth by bending and straightening your lower leg while keeping your thigh on that tight spot – painful but effective.
After the stretching phase, I did weighted squats with my heels elevated (as Brian did but with weights). My physical therapist suggested 2 seconds down, 2 seconds up and as heavy as I can bear – 25 reps, 3 sets with 30 seconds rest in between – I also concentrated more on keeping my shins vertical since one of the causes of ‘jumper’s knee’ is taking off or landing with the knee past the end of the toes.
My pain became less but then came back any time I did any explosive movement like jumping or running. Apart from the fact that I did these ‘open kinetic chain’ exercises too early in my treatment, I know now that part of the problem was that I abandoned the stretches for a while. After Mary’s explanations above, I’ll be taking these up again. Especially since I visited an orthopedic surgeon who just shrugged and said “you’ll just have to manage with the pain”
Well “booo” to you Mr Orthopedic Surgeon. I’m not giving up being active, including my favorite sport – snowboarding – if there is a solution.
So I’m going to persist. I figure that if I keep trying things in an educated way, eventually something has to work. My plan now is to go back to stretching and rolling upstream and downstream of my injury to feed some slack to the patellar tendon, continue with weighted slow squats and building in some one-legged door frame squats (as suggested above) and wait another 6 weeks before I try anything involving faster movement.
If that doesn’t work, I’ll try something else.
Best of luck to you all.
Mat
March 03rd, 2013 at 5:40 pm
Hi Brian
I got my tendonitis from dead lifting. One day I did deadlift then next day woke with pain in left knee. Below and bottom right side of knee cap. So rested lot of inflamation then after 3-4 days the other knee started to hurt.slowly progressed and I went through MRI ,PT and stuff. But no progress the weakness and inflamation was gone after 2 months.but lot of pain while walkin below knee cap little bit above knee cap. Have been resting a lot doctor told its tendonitis. I can’t walk or stand without pain. My question is should I start doing this. Did it hurt your knees while walking?what do you recommend? I am walking through pain. At least small walks.