Ask the Doc: How Do I Treat Tendinosis?

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What is the best way for an athlete to approach tendinosis (a chronic condition, as opposed to tendinitis, the acute condition) — specifically, longstanding pain in the patella tendon?
-Randy Hill

Missy says…

Missy Albrecht, (DPT, CSCS, FMS| Physical Therapist/Coach)

Hey, Randy –

Thanks for your question. Treatment of this particular injury can be tricky, especially if it is in the chronic stage. The hardest part is finding out what is causing the tendon to be put under stress in the first place. Common faults that cause patellar tendinosis include weak glutes, tight IT bands and poor exercise form. A lot of times these injuries are treated initially with ice, rest, and then some hip strengthening. Treatment from a PT may include decreasing inflammation in the injured area (ultrasound, laser, ice massage, etc.); restoring proper movement of the joint; and then strengthening of the muscles supporting the joint. If it is chronic, part of the treatment may be to restart the inflammation process intentionally (through massage or some other technique) in order to get things healing properly. So here are some things you can do:

  1. REST from whatever is aggravating your knee. Not forever, but if you don’t take some rest and stop irritating the tendon it won’t heal.
  2. Make sure you are foam rolling your entire upper thigh, front and side. If you find a tight spot, stop and relax on it. Maybe rock side to side. Really try to breathe through it because if you don’t relax you won’t get the benefits of the foam roll.
  3. Make sure your glutes are strong! Here’s a video of some good glute exercises.
  4. Depending on what exercise is causing your knee to hurt, make sure you focus on perfect form. This will also help the tendon heal faster and prevent further injury.
  5. Depending on the stage of your injury you can also do ice massage to the patellar tendon.
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