Running w/ a bum kneecap

December 14, 2008 12:21 PM

I have patella tendonitis in my right knee and I am a runner. Please give me some tips!

I'm wondering if folks out there can share their experiences with running with tendonitis in one patella. I have an orthopaedic sports medicine doctor and a physical therapist so I will be getting some strengthening and stretching exercises and I have a band that wraps around my knee and essentially supports my kneecap. I'm wondering if folks have specific advice for either better/more substantial braces or things I can do before, during and after runs to minimize discomfort. My doctor has told me that I can definitely run but must make sure I stop before it becomes painful, which at this point is about 20-25 minutes. I prefer longer runs and had been trying to build my distances until this happened. I want running to still be fun and challenging and make me feel like I am really getting a workout even though I have to stop after less than a half hour.

Any advice on making the most of my training despite this setback would be very welcome.

posted by Rudy Gerner to health & fitness (9 comments total)

I used to have the same problem when I ran cross country in highschool... To counter it, I would take some ibuprofen before I went out, icing when I got back, and I would make an effort to run only on softer ground -- like on trails or fields around the school. In a pinch, though, asphault is easier on your knees than concrete sidewalks -- I found that running in the bikelane could make a world of difference when I started to hurt. Running like this with a band for your knee ought to help... I was never held back by patellar tendinitis for more than a week or two doing this, though ymmv.

Good luck!
posted by ThomThomThomThom at 1:16 PM on December 14, 2008

I had what might be a similar problem a while back. I'd be able to run just fine and then within a few steps the knee would be un-runnable, usually . My problem was a tight quad. Tendonitis in the knee is caused by tight or weak supporting muscles. Usually tight. Is your quad unusually tight? Just stretching that might have a big impact, but I'm sure you've tried this already.

My solution with training was to do treadmill runs at the gym doing another activity as a warmup (one less stressful on the knee) and then running a hard 'tempo' (near-race pace effort) for as long as the knee would hold. The mileage suffered but the fitness was maintained to some degree. The treadmill was very helpful as it didn't require walking home whenever the knee decided to go. This, combined with quad stretching, allowed me to gradually extend the time on the knee until I was back to normal again.
posted by jimmythefish at 1:16 PM on December 14, 2008

It would probably be worthwhile to find another orthopedist or sports medicine specialist who actually is a runner. Such a doctor may be both more motivated and more knowledgeable to help you create a plan to strengthen your legs in ways that mitigate the patellar tendonitis. Finding a doctor who was an athlete was great for me.

Other than that, all I can offer is good wishes. I've had some ongoing low-grade patellar tendonitis myself, but it's always other stuff (plantar inflammation, ITB syndrome, weak medial quadriceps... the list goes on) that keeps me from running or riding.
posted by The Michael The at 1:52 PM on December 14, 2008

IANAD and especially IANYD...

I've had 3 surgeries on my knee and know what you're experiencing - it's actually chondromalacia, and I get it when I run for extended periods. As a result, I don't; rather, I bike and swim for cardio, neither of which are high-impact. However, assuming you do want to keep running, I highly recommend a Cho-Pat strap to alleviate the symptoms while you strengthen your legs.

I talk about strengthening your legs because strong legs = stable knees, and in the end you want to take as much stress off the underside of your patella as you can. Full extensions of your knee, be they on a machine or doing squats, are actually counterproductive, as they place the most pressure on your patella when it's already hurting. Instead, go with terminal extensions. Use machines that allow you to set the range of motion on them and go with it accordingly.

In any event, take it slow. The pain you're feeling in your knee is your body telling you to slow down, as something isn't quite right. Talk to your orthopedist and see if he/she has any additional information or tests for you.
posted by squorch at 1:56 PM on December 14, 2008

I had a similar problem with my knee, had an MRI done (negative), and was sent out to physical therapy. At one point, I was running 4-5 miles a day for 4-5 days a week and I was building up my distance quite a bit. However, I wasn't cross training at all. At least for my body type (5'10, 195 lbs), I only focused on running each day as part of my exercise.

Of course, there are plenty of threads that deal with knee/running problems and the jest of all them include reducing mileage, physical therapy, and buying new shoes. I agree with squorch above, I started lifting weights for my knees, substituting swimming laps in lieu of running, and completely stopped running for the past 6 months. Now, my pain in my knee when I walk down stairs is greatly reduced.

I too wear a knee strap similar to the Cho-Pat strap and it held my knee together fairly well. Best of luck and keep us updated!
posted by huy_le at 2:03 PM on December 14, 2008

When I run and get pain in the knee I just keep running. Run through the pain and it will disappear. It works for me. Thank you, Doctor John Sarno.
posted by Zambrano at 3:43 PM on December 14, 2008

Oh man, I love hearing the range of approaches that runners take to pain (this is typed with lots of love). I've had problems with chondromalacia/patella tendonitis for years. I took a different approach to dealing with it the last time it really flared up. I stopped doing all of my regular athletic activities except the stretches and exercises that my doctor recommended to deal with the PT. I did those fervently and faithfully, and worked on increasing reps and intensities as my knee started to feel better. I think I only took about a month or so off, but by that time, everything felt great, I got back into my happily active world, I worked on paying attention to really stretching my quads out on a regular basis, and I haven't heard a peep out of my knee since (she said, frantically looking around for something wooden to knock on).

Just keep that in mind if you find this problem becomes chronic for you, which I hope never happens! Every time I've had a tendonitis problem in some part of my body, the lasting solution seems to have been to give that part a (sometimes quite lengthy) break from whatever I'd been doing to annoy it, while also doing stretches and exercises designed to help it out. I've learned (the slow and hard way) that in the repetitive-strain battle between my will and my body, my sneaky, tricksy, passive-aggressive body always wins.
posted by Hellgirl at 4:54 PM on December 14, 2008

Aargh, sorry - it's me again. I've just realized that patellar tendonitis and patellar-femoral syndrome (the new name for chondromalacia) are not the same thing. My apologies for not double-checking that before I posted. I'll still make the point that rest can be a really important part of training, as frustrating as it might feel at the time. All the best with the knee!
posted by Hellgirl at 5:06 PM on December 14, 2008

Here's an update for you all!

I have been treadmill running for short stints (~30 minutes at a time) with a Cho-Pat strap. I have gotten through my runs with no pain so far (woo hoo!) and have been only moderately sore after. I've been icing a bunch postrun. I am going to my PT tomorrow, who actually is a runner (good call, The Michael The!) and will be getting some very specific stretches and strengthening exercises as well as more tips. I hope to build my distance up, but way more slowly than last time. If that just doesn't work, speedwork will be the name of the game. I think I'll need to get more into trailrunning because it will be more forgiving on my body. The treadmill is just too boring, especially once the weather turns nice.

I will be taking more or less all of your advice and crosstraining (when I can bear the bike; I cannot abide swimming unfortunately) and rest when I need to. I think paying attention to my body is the most important thing.

Finally, Zambrano, I am a big believer in Dr. Sarno already and I'm very glad you mentioned this because I needed to get back to my Sarno roots and start thinking about this beyond just the physiological problem. Totally by coincidence on the same day you posted this response, I picked up an old copy of Runners World magazine that discussed running "injuries" that are very common and Sarno feels are very psychological in nature. Patella tendonitis was one of 'em. So, yeah, I think that taking a step back and looking at this from a psychological perspective, especially with how crazymaking it is not to be able to run and the kind of crappy feelings/injury cycle that sets off, was very important.

Thanks, everyone!
posted by Rudy Gerner at 3:53 PM on December 16, 2008