Slowtwitch Forums: Triathlon Forum: B2B and patellar tendonitis

Calendar Coaches Fitters Retailers Triathlon Clubs Stack & Reach Custom Geometry Calculator Training Log
		MAIN INDEX	RULES & LEGEND	LOG IN

Search for (options)

Newsletter Signup

Slowtwitch Forums: Triathlon Forum:
B2B and patellar tendonitis

cayenne

Nov 5, 09 4:21

Post #1 of 11 (288 views)

B2B and patellar tendonitis	Can't Post

I have 2 days to go before my first iron distance tri-B2B this Saturday. Doing well over all however developed a bad case of patellar tendonitis this past weekend after a 30 min run. I had changed out to new shoes several weeks ago, same brand/size. I have lots of pain going up and down stairs etc. I have had this before but never before a huge race.
I have iced/ massaged/Aleved/rode/ swam but no running yet. I have a 30 min jog today then we leave for the race tomorrow. I also have kinesiotaped my knee all of which has been helpful but certainly not a cure.
Any suggestions this close to the race? I plan to bring my cho-pat brace for the run as well as tape first thing in the AM. No running today or at least try a few min? I will switch back to my old shoes for the race.
FYI-I am 50 +yo, and will NOT be finishing in under 11 hours.

Schwingding

Nov 5, 09 4:58

Post #2 of 11 (275 views)

Re: B2B and patellar tendonitis [cayenne] [In reply to]	Can't Post

In Reply To:

At 50 years of age there is no use telling you that if it hurts you should not be doing it. You already know that and choose to ignore it. Patellar tendonitis is a difficult one because the pain often subsides during exercise, making it that much easier for you to abuse yourself and really wind up in trouble. I seriously doubt your shoes as the culprit, rather overuse. The shoes may have been the tipping point, but you were on your way to having the problem regardless. You're going to have to stop running, and soon you'll have trouble walking as well if not already experiencing that in addition to stairs issues. Trust me, this is one where you can't work through the pain. You can try, but I've got a hunch that you know better.
--------------
Don't hate me for not waving.

cayenne

Nov 5, 09 5:39

Post #3 of 11 (261 views)

Re: B2B and patellar tendonitis [Schwingding] [In reply to]	Can't Post

I appreciate the feedback. So you are saying no running during the race? Did I understand your answer? I have planned this for close to 2 years so I don't plan on not doing it. Just need ideas to get through the race. I would hate to walk the whole thing but that is better than not finishing!

csb

Nov 5, 09 5:40

Post #4 of 11 (260 views)

Re: B2B and patellar tendonitis [Schwingding] [In reply to]	Can't Post

Ditto. When I finally gave in to my patellar tendonitis, I had to stop running completely for about 4 months, and was on a drastically reduced plan for another 3 months. It never hurt after the first mile or so of a run, but walking got to be painful and sitting on an airplane was pure agony. I still can't sit cross-legged without a bit of pain.

Ice, etc., did me little good. The only thing that fixed it was rest, physical therapy, and an extended leg-strengthening routine. Looking back, I never should have ignored those first few twinges. I did a few running races (nothing long) injured, and I'm sure it didn't help!

Oh, and I'm pretty sure mine was an overuse injury coupled with a few weeks of running almost exclusively on concrete sidewalks. (I had been used to a mix of sidewalk, asphalt, and dirt path.) I don't think the sidewalk running alone would have done it, but I believe that's what pushed me over the edge from twinges to injury.

FWIW.

csb

Nov 5, 09 5:49

Post #5 of 11 (254 views)

Re: B2B and patellar tendonitis [cayenne] [In reply to]	Can't Post

If it were me, I'd give some serious thought to making it an aquabike. (Well, no, I'd probably run it and make the injury even worse!) But for long-term knee health, if you can ride without pain, that's what I'd suggest. I know that's hard to contemplate after prepping for so long.

I'm not sure walking is that much better. During my rehab, my PT wanted me to restrict my walking as much as I could. Granted, I very rarely drive and walk almost everywhere. But it never occurred to me that walking could also do damage.

Schwingding

Nov 5, 09 6:14

Post #6 of 11 (246 views)

Re: B2B and patellar tendonitis [cayenne] [In reply to]	Can't Post

In Reply To:

Like I said - you already know the answer and you won't be willing to do it. I hope you don't severely injure yourself due to what I would call shortsightedness. The time you have spent training for the race is what is referred to as a sunk cost, you spent it, and can't get it back regardless of future decisions. In business, you don't make future decisions based on sunk costs. I would suggest you do the same here, but I know you won't. I too have had to back out of ironman due to injury. It is difficult to take, but it won't kill you.

So yes, you did understand my answer - it is my bet (and past experience) that you will not recover from this problem while still running. You may make it severely worse by insisting on doing something that you probably shouldn't, which would belie your 50 years of earth experience.
--------------
Don't hate me for not waving.

charlesn

Nov 5, 09 17:45

Post #7 of 11 (202 views)

Re: B2B and patellar tendonitis [cayenne] [In reply to]	Can't Post

I did an ironman marathon with patella teninopathy. I could not run in the leadup so just rode and swam. Ran with a cho-pat strap on the knee, which delayed the onset of the pain. I was able to run the whole way, mostly due to the fact it was my A race and the hype and excitement numbed the pain.

I don't know if running on race day made the problem much worse, as my knees were already ratshit, and I knew a long layoff from running was pending. It is unlikely for the tendon to rupture, so I personnally would do your big race. Recovery is a long slow process, as tendons don't heal quickly, and it will be easier for you to commit to the recovery process comfortable in the knowledge that you finished your target race.

Post-race, find info on an eccentric decline squat program for rebuilding the tendon, and perfom it to a consistent level and to a consistent schedule, which for me, is 3 x 20, twice per day

good luck in the race

daveinmammoth

Nov 5, 09 20:23

Post #8 of 11 (154 views)

Re: B2B and patellar tendonitis [charlesn] [In reply to]	Can't Post

I'm on the decline squat program....haven't started my return to running yet.

Did you build a progression to 1 leg up/down reps?

Are you better (please say yes, please say yes, please say yes.....).

Any other tips?

Thanks,

Dave

daveinmammoth

Nov 5, 09 20:30

Post #9 of 11 (151 views)

Re: B2B and patellar tendonitis [cayenne] [In reply to]	Can't Post

I can tell you what I would do, but it may not be the smartest thing.....

I'd try and suck it up and race. I ran on PT for 6-7 months - it did stop a few of my runs early on - I would develop sharp pain and have to stop running that day. Most of my runs were a dull ache. Was I stupid to continue to train on it? Yes - but I figured it would go away as most nagging pain does.....it never got that much worse but it never got better.

If you develop sharp pain - you're done - walk it in.

If you can run - you can run. Will you do more damage? Sure but its what I'd do :). You can try and rehab after you take a month+ off after the race....

Again - this is what I'd do. The other posters are smarter than I. Is it possible you could rupture your patellar tendon and require surgery? Sure its possible but unlikely if you have typical PT.....

Dave

charlesn

Nov 5, 09 21:42

Post #10 of 11 (144 views)

Re: B2B and patellar tendonitis [daveinmammoth] [In reply to]	Can't Post

I was told to perform eccentric exercises until the point of pain then stop and ice the knee. 2 years into the program, the point of pain for me was still 5 squats, followed by 3 days recovery �hardly great progress for drastic tendon restructuring and recovery. Learn to push through this early pain by treating it as constructive rather than destructive pain

I started off very slow, once per day 1 leg down to a count of 3, 2 legs back up. I now perform a program of regular eccentric squats. I have now done 30 successive weeks of eccentric squats, single leg raise and lower, to a count of 5, 3 x 20, twice per day, on a homemade decline board. I have made the board steeper with recovery, as well as the squat deeper and increased the number of times I do it per day. Consistency is important, to stress the tendon to the same level each day, allowing it to remodel, without further degeneration. Skipping sessions, doing it when it fits in to your day, on different slopes and steps, etc, seems not to crack the back of it. These exercises will also help strengthen your quads, core, hip and gluteus max muscles if done in a slow controlled manner.
I can now sleep, sit, walk up and down stairs, bushwalk, kneel on the floor, crouch, ride everyday, rowing machine, spin class � all without pain. I have changed my running style to a low impact, high cadence, forefoot landing, running style and this combined with tendon recovery has allowed be to run again.

I haven�t had a followup MRI but would love to see the state of my knee. It feels fine most the time, but if I have a big week of consistent eccentric exercises, running and riding hills, my knees are sore by the end of the week ... but only for a few days, at which time I bash them all over again, so it is manageable.

In conclusion, I am not pain free, but can predict and manage the pain. I feel that the pain I am getting is not degenerative, like it used to be, and this is very important. I have been running 30 - 50km week and have pencilled in an IM for 5 months from now ... so have faith and stick with the program

daveinmammoth

Nov 6, 09 13:27

Post #11 of 11 (100 views)

Re: B2B and patellar tendonitis [charlesn] [In reply to]	Can't Post

Its interesting that you added the forefoot landing part as I've been thinking about the link with "jumpers knee". I was wondering if something on landing while running caused the problem. Is my quad not firing properly? This lead me to wonder if I should try and change my landing a bit. I run fairly high cadence (I aim for 90) but I definitely heel strike fairly hard - esp. when cold or tired. I was even thinking of trying Newtons :).

Anyway, thanks for the feedback. I'm trying to do be good about my exercises.

Re: MRI - seems like ultrasound would be better to follow it as MUCH cheaper....I have access to an U/S so I've looked at the area in ? on my tendon. I haven't tried to measure it or follow it but it sure is easy to see (thick, hypoechoic region of tendon). Seems like you could do some measurements and follow it. Also only takes about 2 minutes to do and you don't have to worry about all those strong magnetic forces erasing your credit cards and who knows what else....:).

Dave