How to Treat Tendonitis in the Knee
The most common place to experience tendonitis in the knee is in the patellar tendon, the large sheath that encases the kneecap (patella). There are two ways the kneecap can suffer from tendonitis. One is by inflammation on the back of the kneecap, where the encasing tendon contacts cartilage that cushions the kneecap. Deterioration of this cartilage irritates the tendon behind the kneecap. Another is by inflammation anywhere along its length---but often on the front. Fortunately, both ailments (patellar tendonitis and patellofemoral syndrome respectively) have the same solution: correcting the mistracking of the patella.
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Things You'll Need
- Ankle weights
- Leg extension machine
- Anti-inflammatories
- Ice packs
- Orthotic inserts
Instructions
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Build up hip muscles to promote tracking of the knee. To do so, perform stiff-leg leg lifts using ankle weights. Ankle pouches are available with which you can increment the weights gradually. (Three rolls of pennies equal a pound.) Do not return to the sport that caused you the trouble until you can lift 8 pounds for three sets of 10 repetitions without discomfort. Continue to build up to 15 pounds.
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Build up the vastus medialis--the quadriceps muscle just above your knee on the inside. Do this by performing leg lifts, taking special care to move slowly at the top and bottom of each rep. Avoid 180- and 90-degree angles, since these are the least stable. The vastus medialis atrophies quickly, since it is barely used in daily activity; therefore, it should always be exercised during a layoff. Don't be afraid to cut back on the weight by a third or more in order to find a level that you can sustain without pain.
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Stretch your hamstrings and calves. They can cause mistracking of the patella, despite being unconnected. Stretching the hamstring is even more important than stretching the quads in order to get the knee to track correctly.
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See a podiatrist for custom orthotic inserts. A weak foot arch leads to twisting of the tibia (shinbone). This irritates the patella, which sits in a groove at the top of the tibia.
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Reduce inflammation with ibuprofen and ice packs. Do not use ice packs before exertion. Cover your knees in cold weather for the same reason: Cold makes tendons brittle and more prone to damage.
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Warm up alone, slowly, before joining the team for warm-up. You'll need more warm-up than they do as you recover. One reason is your need to warm up more gradually, more slowly. Another reason is to activate the vastus medialis, which is slow to activate and necessary for proper tracking. Its slowness to activate is why the patellar tendon can hurt at the start of a warm-up and feel fine at the end of it.
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