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Ouch! Acute patellar tendonitis. What should I do?

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Road Cycling “It is by riding a bicycle that you learn the contours of a country best, since you have to sweat up the hills and coast down them. Thus you remember them as they actually are, while in a motor car only a high hill impresses you, and you have no such accurate remembrance of country you have driven through as you gain by riding a bicycle.” -- Ernest Hemingway

Ouch! Acute patellar tendonitis. What should I do?

Old 06-22-12, 04:24 PM
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enroper
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Ouch! Acute patellar tendonitis. What should I do?

So, long story short is I'm a newbie. I do fine on long flat rides, but last friday night, I tried a new path and tried to power through some hills on my ****ty bike which doesn't like to shift. I knew that night I hurt my knee. The next day, it was a sure thing I hurt it. It chilled out a little bit and so I tried to ride again wednesday night, but all I did was anger it more. So I went to the doc finally today, a week to the day of hurting it. Diagnosed with tendonitis. Prescribed a weeks rest, plus wearing a brace, taking NSAIDS ( naproxen ), and ice.

I also think my fit is off, so that will be addressed as soon as I feel 'healed'.

But I'm wondering if anybody has had an acute case like this, and how you returned to training. I don't want a repeat of wednesday night and keep fighting this thing. Should I wait more than a week? Any advice of how to ease back into riding? I'm scared to death of this being a precursor of bad things to come and possibly ruin a great love affair I've developed with cycling.
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Old 06-22-12, 04:27 PM
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In before the HTFU posts.
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Old 06-22-12, 04:58 PM
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raise your saddle, don't mash.
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Old 06-22-12, 05:13 PM
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These are some good rehab exercises. https://www.floota.com/vastus_mediali...e_popping.html Did the doc not prescribe physical therapy?
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Old 06-22-12, 06:38 PM
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Aspirin, ice, and lots of spinning. Mine took months to heal. It was unbelievably frustrating not being able to sprint, climb standing, and climb more than 5 miles.
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Old 06-22-12, 07:02 PM
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I prefer Advil/Motrin over Aspirin, & I like to rub Voltaren on my knees when my arthritis acts up.
I ride through pain, but take it easy. Keep it in the small(middle if you ride triple), & just keep spinning.
Don't put any strain on your knee using the bigger chainring. I find when I stay active my knees bother me less.
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Old 06-22-12, 10:58 PM
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interetsing, my doc prescribed cycling to help with the patellar tendinitis in my left knee. he said it would strengthen the surrounding muscles and take pressure off of the knee.

as far as I can tell, he was right on. I have hardly any pain there anymore
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Old 06-22-12, 11:28 PM
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Originally Posted by HMF View Post
raise your saddle, don't mash.
This. Seat height primarily, but also fore and aft adjustments to some extent, really changes the recruitment balance of the Quads vs. the posterior chain. Getting these forces to balance across the knee front to back is incredibly important for long term knee health. Equally important is side to side loading of the knees which is usually accomplished with cleat rotation, shims and wedges, and or insoles. Seeing an experienced fitter that really understands body function and doesn't try to fit you via a system into some pre-determined range of angles is the best money you will ever spend in terms of long term cycling health. And SPIN. Put the load on your heart and lungs, not your joints. Hope you heal quick and get whatever caused the issue sorted out in short order.
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Old 06-23-12, 12:37 AM
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Originally Posted by mtalinm View Post
interetsing, my doc prescribed cycling to help with the patellar tendinitis in my left knee. he said it would strengthen the surrounding muscles and take pressure off of the knee.

as far as I can tell, he was right on. I have hardly any pain there anymore
Exactly what my doc said too.
Strengthen the muscle around the muscle in question.
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Old 06-23-12, 04:55 AM
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Originally Posted by LeeRoySD View Post
This. Seat height primarily, but also fore and aft adjustments to some extent, really changes the recruitment balance of the Quads vs. the posterior chain. Getting these forces to balance across the knee front to back is incredibly important for long term knee health. Equally important is side to side loading of the knees which is usually accomplished with cleat rotation, shims and wedges, and or insoles. Seeing an experienced fitter that really understands body function and doesn't try to fit you via a system into some pre-determined range of angles is the best money you will ever spend in terms of long term cycling health. And SPIN. Put the load on your heart and lungs, not your joints. Hope you heal quick and get whatever caused the issue sorted out in short order.
Excellent post.
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Old 06-25-12, 08:24 AM
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Had same problem for years playing tennis. Stopped playing, tendonitis (or pain) went away. Pain started up again when I began cycling a few years ago. Sought a few different opinions but diagnosis and treatment was pretty much the same.

- Don't mash big gears if you can avoid it
- Ice after every hard ride
- Massage to affected areas
- Rest
- NSAIDS
- Stretching
- Most importantly, physical therapy exercises to build up your VMO!

To me, last one is the key and the only one which really worked. Surprisingly, cycling builds up much of your quad, but not the VMO, which helps with the tracking of the patella tendon. Stick to it and you will see results.
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Old 06-25-12, 08:26 AM
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Since I seem to be in an acute flareup, anybody have an experience of how long you had to rest before you felt like you could start doing some rehab ? A week sitting idle really bugs me..
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Old 06-25-12, 09:54 AM
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I've had patellar tendonitis since last November. I attribute this to trying to do too much through pain. I aggravated my condition to the point where even climbing some stairs can cause discomfort.
My advice is to stay way from cycling while you're in pain. I've tried most patellar tendon strenthening exercises and they just aggravated my condition. Do something else. Swimming works for me. It gets the weight off the tendon and gives it exercise with little resistance.
Take your time to heal before you return to cycling. Good luck.
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Old 06-25-12, 10:27 AM
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Originally Posted by enroper View Post
Since I seem to be in an acute flareup, anybody have an experience of how long you had to rest before you felt like you could start doing some rehab ? A week sitting idle really bugs me..
i had acute tendonitis (according to the doc) in my right knee following a strenuous climb in and around Yellowstone Park while backpacking. and although i had been backpacking without issues for hundreds of miles and a number of months immediately proceeding that without issue, i had recently increased the weight i was carrying. i had to hitch a ride from a passerby to West Yellowstone, contact a doc, (he recommended the brace thing, and rest too) and i waited it out in a motel for about a week. i then resumed my journey to Denver and had little problems thereafter. i will say the the most strenuous part of the trip WAS the section through Yellowstone, so that was probably the straw that broke the camel;s back.
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Old 06-25-12, 12:29 PM
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Originally Posted by Ghost Ryder View Post
I ride through pain, but take it easy.
In my experience, don't do anything that irritates the tendinitis. Sometimes I would do a little test just to see if it's getting better, but no exercise that involves any joint pain at all.

My Dr. backed that up too -- if it hurts (tendons), don't do it even once.

I had patellar tendinitis, treated nicely, and it went away completely. Now I can do sprint workouts with no problem.
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Old 06-25-12, 12:59 PM
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Originally Posted by enroper View Post
Since I seem to be in an acute flareup, anybody have an experience of how long you had to rest before you felt like you could start doing some rehab ? A week sitting idle really bugs me..
I have an accelerated solution that may be available to you. Are you actually in phoenixville pa?
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Old 06-25-12, 12:59 PM
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Originally Posted by HokuLoa View Post
I have an accelerated solution that may be available to you. Are you actually in phoenixville pa?
Yep...
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Old 06-25-12, 01:20 PM
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Totally random, but I'm in Phoenixville and think we ran into each other last summer back when I first started riding.

I've been having a similar issue and found that wearing a Cho-Pat strap while riding helped a lot (rode the century route of the French Creek Iron Tour and I could still walk afterwards). The other thing I think helped some as well was taking a good look at my seat height. I ended up raising it about a cm, maybe a little less and that seems to have helped some as well.
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Old 06-25-12, 01:54 PM
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Originally Posted by enroper View Post
So, long story short is I'm a newbie. I do fine on long flat rides, but last friday night, I tried a new path and tried to power through some hills on my ****ty bike which doesn't like to shift. I knew that night I hurt my knee. The next day, it was a sure thing I hurt it. It chilled out a little bit and so I tried to ride again wednesday night, but all I did was anger it more. So I went to the doc finally today, a week to the day of hurting it. Diagnosed with tendonitis. Prescribed a weeks rest, plus wearing a brace, taking NSAIDS ( naproxen ), and ice.

I also think my fit is off, so that will be addressed as soon as I feel 'healed'.

But I'm wondering if anybody has had an acute case like this, and how you returned to training. I don't want a repeat of wednesday night and keep fighting this thing. Should I wait more than a week? Any advice of how to ease back into riding? I'm scared to death of this being a precursor of bad things to come and possibly ruin a great love affair I've developed with cycling.
I think you need to address the "doesn't like to shift" issue long before any fit issues. If you are dooming yourself to climbing with a very low cadence with this bike, you are going to continuously injure yourself in the climbs. You need to be able to use proper gears for climbing.
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Old 06-27-12, 10:01 AM
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Probably a better question for my doctor, but for anybody who's been through this before, while you were taking some rest time from the bike, does anybody know if it's ok to do some swimming in the mean time? I bike mostly for weight loss, and its killing me to think of losing momentum on that front while I cant bike/run/walk for a few weeks...
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Old 06-27-12, 10:25 AM
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Originally Posted by enroper View Post
Probably a better question for my doctor, but for anybody who's been through this before, while you were taking some rest time from the bike, does anybody know if it's ok to do some swimming in the mean time? I bike mostly for weight loss, and its killing me to think of losing momentum on that front while I cant bike/run/walk for a few weeks...
I mean, you should ask your doctor, but in general swimming is precisely what they recommend for people with knee injuries. My father has had knee surgery twice now, and each time the doctor recommended swimming once he felt up to it as it would be the lowest impact exercise for his knees.

That said, please do address your bike issues or this will just be the first of many similar injuries.
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Old 06-27-12, 11:29 AM
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Take it very easy for a while after you feel you've been healed. I can't count the number of times I reinjured myself right after I 'felt better' and went too hard (and I thought I was being careful!). Whether or not it feels painful or not, Ice the bejesus out of it after the ride.

And yes, fix the shifting issues. Your knees will feel much better if you can spin up and not mash at a low cadence. Once you get used to it one's just as fast as the other.
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Old 06-28-12, 02:08 PM
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Originally Posted by Ghost Ryder View Post
I prefer Advil/Motrin over Aspirin, & I like to rub Voltaren on my knees when my arthritis acts up.
I ride through pain, but take it easy. Keep it in the small(middle if you ride triple), & just keep spinning.
Don't put any strain on your knee using the bigger chainring. I find when I stay active my knees bother me less.
Just try to avoid taking ibuprofen daily for extended periods - it can wreak havoc on your digestive system and liver. Ice is better short term. Ride through pain to get home (unless it's severe), but after that, you should take at least a couple weeks off to give the inflammation time to settle down a bit. Then gear up from there slowly. Chronic inflammation leads to chronic tendinitis which leads to no more bicycling for you... and that's no good.
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Old 06-28-12, 02:13 PM
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Well, at least help is on the way. My doctor prescribed some PT and I start monday. Thank god. I've been aching all week, as well as not able to ride or do anything. Going crazy...
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Old 06-28-12, 02:13 PM
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Originally Posted by DeadheadSF View Post
Just try to avoid taking ibuprofen daily for extended periods - it can wreak havoc on your digestive system and liver. Ice is better short term. Ride through pain to get home (unless it's severe), but after that, you should take at least a couple weeks off to give the inflammation time to settle down a bit. Then gear up from there slowly. Chronic inflammation leads to chronic tendinitis which leads to no more bicycling for you... and that's no good.
I've been avoiding advil for about 3-4 weeks now, I'm not the type to take pills for pain unless the pain is unbearable.
I always ride through a bit of pain on the way home, if I'm hurting before a ride, I'll just skip it.
I never knew about the effects it could have on my digestive system, or liver.

Thanks.
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