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Charlie Stone
08-29-2011, 03:21 PM
Hello,

last month i hit some new pr's (95/110) after following some of the advice given on this forum.

http://www.facebook.com/video/video.php?v=10150374502743082&oid=153677904652950&comments

(I've got the long hair tied back)

I kept the training frequency up and it seems I've developed patella tendonitis. I tried dropping squats and just doing the power lifts/ pulls but that still seems to aggravate it. I visited the physio and she believed it is caused by a weak vmo in comparison to the vastus lateralis. She was adamant that I must rest, explaining patella strapping could work but it would not deal with the root cause of the tendonitis. She prescribed single leg partial squats (only if there is very little pain) and single leg lifts while sitting/lying turning the foot out and lifting the leg while contracting the vmo. Also clams with resistance band around my legs as my right glute is slightly weaker than my left.

I visited a sports massage therapist and she was convinced a lack of stretching would have caused this.

What are you're experience with this? I'm interested in you're opinions with stretching as-well. Any useful training I could do that doesn't aggravate the symptoms?

Also once the tendon is fully healed again what can i do to make sure it doesn't come back?

Any opinions, advice would be gratefully appreciated!

Front squats: http://www.youtube.com/watch?v=L7mwk2YrdhQ

Thanks

Greg Everett
08-29-2011, 04:10 PM
Ice Ice Ice. Stretch and foam roll your quads and hip flexors like your life depends on it. Quit bouncing in your squats for a while and reduce squat volume for a bit.

The glute and VMO strengthening certainly won't hurt and may help considerably.

But bottom line is that if you have tendonitis, you do need to back off a bit temporarily until you can get the inflammation under control, then come back with the cause fixed.

Charlie Stone
08-30-2011, 01:07 PM
Thanks for the reply. Its been about a week since I have trained and the pain has reduced considerably but I can still feel that it is not 100%.

How much rest has it taken others to fully recover?

Does my technique look like it could be causing any problems?

Greg Everett
08-30-2011, 01:19 PM
It can take a long time (weeks, couple months), but that long is usually when people are not being serious about correcting it and just continuing the same training with a bit more icing.

Nothing about how you're squatting in that video stands out to me as being problematic.

Charlie Stone
08-30-2011, 01:43 PM
Ok. Do you think stiff leg deadlifts and good-mornings would aggravate the condition? Are there any other accessory lifts I can do to hold onto some strength while resting from the main lifts/squats?

Greg Everett
08-30-2011, 03:07 PM
posterior chain work shouldn't aggravate it and will probably help. you may be able to keep squatting 1-2x/wk, just keep it light and at a controlled speed. Muscle snatch/clean from the hang, all kinds of pressing variations, hang pulls/high-pulls, etc should all be fine. I would stay off power snatch/clean for a while unless it's really light and causes zero pain, but stopping short like that can put a lot of stress on the patellar tendon.

Steven Low
08-30-2011, 03:43 PM
Generally speaking treatment varies depending on if it's chronic or acute so keep that in midn too.

Charlie Stone
08-31-2011, 01:16 PM
I did some good-mornings and shoulder press tonight after lots of foam rolling and stretching, they both seemed fine. I did try some back squats with just the bar but there was pain around the parallel point as usual. I'll give it another week and try again.

Does anyone have any experience of coming back from patella tendonitis?

Tyson Wright
09-07-2011, 07:36 PM
I would love to hear a follow up on this. Patella tendonitis is eating my lunch right now.

Charlie Stone
09-12-2011, 03:18 PM
Tyson, I started a similar thread at the California strength forum. You might find it interesting

http://californiastrength.com/forum/1-california-strength-forum/3-olympic-weightlifting/131-patellar-tendonitis

I feel like I have the tendonitis under control. I'm currently doing the following:

taking High potency fish oil around 5580mg dha/epa a day
icing every morning, every evening and after training
stretching lower body every morning and after every session
foam rolling before every session and after (a hard plastic tube, very painful to start with)
doing posterior chain training 3x per week (stiff leg deadlifts, goodmornings and single leg romanian deadlifts dumbell, sometimes back raises)
doing the reverse sled drag with 65kg for about 40 yards for 5 sets.

I feel like its under control and i've started training the full lifts/squats 3 times a week. Not 100% but getting there. I believe the tight muscles above the knee led to this as i was not stretching after training.

Hope this helps

Tyson Wright
09-13-2011, 03:55 PM
Thanks Charlie. This is good stuff. I need to buckle down and stick to these recommendations.

Tyson Wright
09-14-2011, 09:39 AM
For the record, I went to the chiro today and I mentioned my knee. Apparently my IT band is exceptionally tight causing me to miss quite a bit of internal rotation which may be causing my knee pain. I guess foam rolling it isn't enough :)

Charlie Stone
09-15-2011, 02:46 PM
Did he recommend any good stretches?

Tyson Wright
09-15-2011, 05:34 PM
Not really. It was simply ice and stretch....I was in a time crunch so I didn't have much time to discuss it.

Steven Low
09-15-2011, 06:25 PM
Strengthen your glute medius

Also, very light RDLs would probably be useful for rehab if its chronic.

Ben Moskowitz
10-01-2011, 11:59 PM
Kelly Starrett has a bunch of great videos for you to check out.

Dealing with "knee-itis":
http://www.mobilitywod.com/2010/12/episode-107365-friend-calls-with.html

Here's one on the IT Band:
http://www.mobilitywod.com/2010/10/episode-61-it-band-hell-and-help.html

The first stretch in this one feels like it really opens up my IT band-related muscles:
http://www.mobilitywod.com/2011/04/episode-238365-hip-opening.html

...I like to really to do the "informed freestyling" he talks about in this video with that stretch (see below). It feels like I am cranking on that ITB area really well.
http://www.mobilitywod.com/2011/04/episode-221365-flexion-external-rotation-hip-opener.html

If you have a weak glute medius, then step-ups onto a low box with a 2-1-1-1 tempo or even a 3-1-1-1 tempo will light it up. I like about 12 reps, load as necessary. I like to dorsiflex the non-working leg to try and ensure I don't assist the concentric portion at all. Like this video, but with a longer eccentric:
http://www.youtube.com/watch?v=oUi3SP_6eaM

Charlie Stone
10-02-2011, 10:49 AM
Thanks for those Ben, I have been looking at alot of Kelly S's videos lately. Something that helped immediately was stretching the quad between squat sets. I was shocked at how little pain there was the first time i tried it.

I found the stretch around 30secs in was the most effective: http://www.youtube.com/watch?v=CjGn-83ZQUk