Patellar Tendonitis: My Own Experience from Debilitating Pain to Full Recovery
Patellar tendonitis is not only an extremely common injury, but it is also a frustrating and painful condition, leaving many sufferers unable to lead the lifestyle they want. Patellar tendonitis, also known as jumper’s knee, is a condition characterized by inflammation of the tendon that connects the patella (kneecap) to the tibia (shin bone). This injury can present itself to a variety of people. For example, this injury is common in athletes, particularly those involved in jumping sports (i.e. basketball and volleyball) or running activities (sprinters and endurance runners). This injury can also present itself in post-operative knee surgery patients (i.e. ACL reconstructive surgery). What’s more, this injury can present as an overuse injury, afflicting those who are putting too much stress on their knee during training or conditioning, and it can also arise from poor biomechanics (how you move your body when you walk, run, etc.). Whichever of these categories you may fall in, patellar tendonitis progresses relatively the same. The stressors on the tendon result in tiny microtears to the tendon, which your body attempts to fix. However, these tears often cause inflammation, tightness, and pain. When this tendonitis is chronic (lasting more than a few weeks), the condition can develop into a tendinopathy, which is classified as a diseased tendon. Tendinopathy, something I struggled with for almost 3 years, can be extremely tough and stubborn to treat and find relief from. However, after trying virtually everything to placate my pain and inflammation in my knee, I finally found a cure and have been pain-free and back to normal. Below I’ll discuss my personal experiences with patellar tendinopathy, including how it developed and the treatments I used.
My experience with patellar tendonitis (and later on, patellar tendinopathy) started after I had an ACL reconstruction to my left knee in September of 2017. For me, my orthopedic surgeon used a section of my own patellar tendon for the graft during my surgery. Although my surgery went well and my knee regained stability and range of motion, I developed rather severe pain in the front of my knee. I let this go for a couple of months, assuming it was just my body healing. However, the pain got worse when I would do my exercises at physical therapy (such as squats, jumps, and leg raises). Eventually, it got to the point that I could not do my therapy without tears in my eyes because the pain was so severe. I eventually went back to my surgeon to discuss this pain, and I was prescribed a steroid pack to reduce the inflammation in my tendon. I went through two steroid treatment packs, with no relief whatsoever. My physical therapist and I decided that I should take a break from activity for a month and see how my knee feels. The rest felt great for my knee at the time, but when I eventually went back to doing physical therapy exercises a month later, the pain came back, and with a vengeance. At this point, I knew I had to continue doing my therapy to strengthen my knee, given that I was a collegiate soccer player who wanted to return to play in the upcoming fall season. My physical therapist changed my exercises so that I was doing mostly eccentric strength training. Eccentric strength training is basically strengthening the muscle when it is in its lengthened state. The best way to picture this is to think of the act of sitting down in a chair starting from a standing position. The quadriceps (muscles of the front upper leg) contract eccentrically (lengthen) as you go to sit down. Conversely, they contract concentrically (shorten) when you go from sitting in a chair to standing. Research has shown that eccentric strength training has been useful in patients suffering from severe patellar tendonitis or tendinopathy, so my therapist and I gave it a shot. The eccentric strength training provided some relief and was a great way to build up the muscle I lost from my surgery. However, my knee would begin to hurt again when I tried to do concentric (muscle shortening) strength training, or when I ran on the treadmill.
Given that I was still having pain when running, squatting, and cutting (during soccer movements), my physical therapist told me about a treatment option known as Dynamic Tape. This tape is unlike the kinesiology tape (k-tape) typically seen on athletes and other active individuals. This tape, according to the official website, acts mechanically to strongly decelerate or assist motion to aid movement patterns. It also helps to reduce the load on an injured or overworked joint (such as the knee). After my therapist told me about the success they had in treating other tendonitis patients with this tape, I decided to invest in it and see if it would provide any relief. For me, this tape did not provide total relief, but it did significantly reduce my knee pain during soccer, and I think it significantly contributed to me being able to return to collegiate soccer in the fall of 2018. I wore this tape at practice and games, and it definitely took some load and stress off of my knee, enough for me to be able to play and deal with some of the dull, achy pain still leftover. Although I am thankful for this treatment option, since it allowed me to return to sport with less pain, it was not a cure for me. Rather, it was a temporary fix masking a greater issue, which was my patellar tendinopathy.
My quest for a cure led me to visit another orthopedic doctor who had a certification in shock wave treatment. My physical therapist, knowing that I was still experiencing pain, told me that this was a last-ditch effort for my tendinopathy. My therapist said that it has worked extremely well for past patients, especially for those suffering from long-term tendinopathy. This was a last-ditch effort because not only was this the one of the last treatment options I could pursue, but also because this treatment was pricey (and not covered by insurance). After talking to my physical therapist, I decided that I wanted to try this treatment out. I was tired of the constant, nagging pain I was experiencing in my knee, and I longed to be able to play soccer and be able to run pain free. Shockwave therapy is a new, innovative, and non-invasive treatment used primarily for stubborn tendinopathies and other connective tissue injuries. Shockwave therapy, also known as extracorporeal shock wave therapy (ESWT), involves creating a series of low energy sound wave pulsations that are directly applied to the injured area. The purpose of this treatment is to actually trigger your body’s natural healing process in the afflicted area. For me, I underwent 4 sessions of shock wave treatment. The treatment is mildly uncomfortable (but not really painful), and as you get used to the treatment the intensity will increase. By my second treatment, I was noticing significant improvement in my pain, and by my last treatment (the fourth treatment), my knee literally felt like it did before my ACL reconstruction and before I started developing patellar tendinitis. I personally credit this treatment in curing my chronic, stubborn patellar tendinopathy. I am grateful to have been able to undergo this treatment, and I am now able to enjoy playing soccer and long-distance running pain-free.
My own journey with patellar tendonitis/tendinopathy was long, tiring, and frustrating. Fortunately, I was able to find some relief with treatments like rest, eccentric strengthening exercises, and dynamic tape. And better yet, I was finally able to find a cure for my patellar tendinopathy, which was shockwave therapy (ESWT). The main point I want to make is that there is hope for anyone who suffers from chronic patellar tendonitis or tendinopathy. There are many treatment options available, and you may have to do some trial and error before you find relief. For all of you patellar tendonitis sufferers out there: hang in there, have hope, and do your research on treatment options! It is possible to find both relief from the pain and a long-term cure!