Knee Tendonitis from mountain biking and plyometrics

by Alvaro Hasbun
(Chile, Viña del Mar)



Hi Joshua, before anything, thanks for this site.

I'm a 26 years old man (height 6,15 foot, weight 211 pounds) I start doing sports four times a week since about five years ago.

Mountain bike was my first sport, and since it, I ride bicycle almost everyday. Two years ago I had to have surgury because of a meniscus rupture.

After surgury everything was ok, in like three month I was back to my sport routine with no problems.

Like a year ago I start doing a lot of bodyweight excercises (lounges, squats, and stuffs like that) plus I start doing plyometrics excersies.

So my last year routine was: mountainbike, bodyweight excersies and plyometrics exercises -like an hour jumping practically with no stop-.

Like 6 weeks ago I was really into it, doing sport every day. One night I start feeling a burning pain in the two knees, but it was worst in the one that I had surgery.

I thought that I was in need to stretch so I went to to a yoga class...ufff (big mistake I think).

After that I was really bad, really weak knees and burning pain most of the time, specially when I'm sitting.

I went to the doctor and he told me to rest, give me some anti-inflammatory pills and physical therapy.

It helps, but just a little, it didn't really keep the pain away, and my knees were still weak.

So the doctor gave me a corticosteroids shot in both knees, this was four days ago, I start feeling better, but still with weak knees.

And I know that even if the pain will go, it is because the corticosteroids shot, and is not that I'm really healing. I just want to go back to do some sports, this is really getting me
down, I can't even walk without noting that my knees are bad.

And I just don't know what to do.

Any comments will help.

Thanks!!



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Joshua Answers:

Hello Alvaro.

I'd love to help.

Let me ask some questions so I can know better what is going on...


1. Is the pain different/in a different spot than from the meniscus previous injury/pain?

2. Where exactly were the corticosteroid injection(s) injected into?

3. What have the doctors said was going on? Knee Tendonitis? If so, what tendon(s)?

4. Did this pain come on slow, or come on fast?

5. Describe the weakness in more detail. What exactly feels weak? The muscles, the joint, stability...etc?

6. Are you doing anything else to help your knees? Is that helping or hurting?

7. Do you think you did something specific in yoga that made it worse?

8. Where exactly does it hurt?

9. Does it still burn?

10. Why do you think that it is knee tendonitis, as opposed to anything else.



Answer those questions, and we'll go from there.

And, I think that's very wise of you about the Corticosteroid Injections, that they just get rid of the pain temporarily but don't do anything as far as reversing the Tendonitis dynamic.



Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com
















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Oct 08, 2009
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starstarstarstarstar 		PART 2 - A reply... - Knee Tendonitis from mountain biking and plyometrics
by: Alvaro Hasbún

Hello again Joshua, and thanks for your quickly answer. Well, Im going to answer your questions in order, hoping to be the clear as possible. And forgive me if my english is not really good, but its just not my language.

1.-Yes, in fact, I think that is my whole knee (both of them)in pain, or weak, its not just a spot.

2.-The corticosteroid injections were shot in the goose foot tendons. I think that is the translation.

3.-The doctor told me it was a goose foot tendonitis.

4.- I belive, that the real pain came fast. I just wake up in the night with this pain. But I was feeling some overexercised legs for like two month before this, I just didn't pay enough attention

5.-The muscles are OK, still strong. But I believe, that the joint is really harmed. And I don't have a good stability, sometimes I feel like my knees just spill around. And I hear a strange sound, its not a "click", but I don't know how to describe it

6.-YES! I think that was an specific asana that kill my knee, here is a picture of it Ashtangayoga.info pose picture

7.-I believe its my whole knee, but there are some specific spots, like the patellar tendon and the goose foot tendons.

8.-No, there is no more burning pain, it may be because of the corticosteroids shots, but I'm feeling the opposite (cold knees)

9.-I don't think is a knee tendinitis, I believe is something worst, I hope not. The goose foot tendonitis is the medical diagnosis.

Well thats it. And again, thanks a lot for your help, I see like your more intersted in my problem than my doctor.

GREAT SITE!


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Joshua Comments:

Good answers Alvaro, thanks.

So, the goose foot is the slang term for Pes Anserinus.

Google search 'pes anserinus anatomy picture' or some such and take a look at the structure.

It's common to have bursitis problems with that too, but your description doesn't really sound like that.


OK....so....this won't be an easy one to figure out. It's not very clear cut. And yes, this is where I get more interested and doctors try to move onto their next patient....

1. How is your diet/nutritional intake?

2. Does your knee squeek at all when you bend/straighten it?

3. I'm not clear. Is it an all over pain, or are there hot spots?

4. The 'wobbliness'. It doesn't feel weak, it just feels unstable? True/false?

5. On that yoga stretch, do you think it's the straight leg part of the stretch that hurt you? (Which would make a lot of sense).

6. Historically, being so active, did you stretch much?

7. Did the yoga start the bad pain? Or was it already there before that.

8. Does it feel like the joint itself is hurt, or stuff on the outside of the joint?


It's coming together, I just need more info.

Oct 10, 2009
Rating
starstarstarstarstar 		PART 3 - 3rd post - Knee Tendonitis from mountain biking and plyometrics
by: Alvaro Hasbún

Hey Joshua!! How´s it going? Hope everthing is ok for you. Well here are my answers to your last post.

1.- My nutritional intake is good. Most of the time I eat healthy food. A good quantity of protein, may be too much carbs, and a lot of vitamins (fruit and vegs). I think my calories intake is around the 2500 per day.

2.-Yes it does. When I bend it and when I straighten it. But I don't know if it is a squeek, its more like the croak of a frog, this sound specially arise if i sit on the floor like in Indian pose, or when I'm sit in a chair and start moving my legs form side to side and the discomfort or pain increase. This sound is located in the patellar tendon.

3.-It feels like the whole knee its in some pain. But there are clearly three hot spots. 1) The Pes Anserinus, the patellar ligament (that the spot where I fell, the instabiblity) and the vastus lateralis muscle.

4.-False. Its weak and unstable. But with the time it feels like its going away. It may be because of the corticosteroids. But after this shot, it was going away too, but really slow.

5.-No, I felt that the bend leg was the one harmed in that stretch.

6.- Yes, I always stretch a lot, but not before or after doing exercise. I do my stretches on a specific day of the week, usually when i feel tired to ride my bike or to workout. And I stretch most of the muscles, it takes me like an our.

7.-The pain was before the yoga class. But after the yoga class began the burning pain, the instability and the strange sounds on my knees.

8.-I think is the joint itself, but i feel pain and weakness in the vastus lateralis muscle too.

Best Regards!!!
Oct 10, 2009
Rating
starstarstarstarstar 		PART 4 - Knee Tendonitis from mountain biking and plyometrics
by: The Tendonitis Expert

Good info. Ok.

1. So, when I was in high school, my knee hurt and creaked/squeeked when I bent/straightened it.

My mom took me to the acupuncturist and he told me to put peanut oil on it a couple few times a day.

I did, and by god, the squeaking/creaking stopped.

Go get some peanut oil. Probably other oil works, but that one I have first hand knowledge of.

When the muscles are tight (yours are) they put constant tension on their tendons. So your patellar tendon is held tightly, and leveraged down against the structures it's on top of.

Like taking a rag, pulling the ends tight, and going over your shoe with it back and forth. Your tendon/connective tissue kind of does of that.

Put a bunch of peanut oil on your knee area a couple few times a day. Catch it from dripping off, but put lots on and let is soak in.

Theoretically it shouldn't soak in that much, but apparently it does.


2. Probably good on the protein. I'm going with TOO TIGHT for too long. This causes your kind of problems, and Tendonitis.


3. Probably the bent knee overstretched your too tight structures, and signaled the nervous system to PROTECT you....with more tightness, and pain.

I'm guessing same thing with the pes anserinus, but when you had straight leg, and it didn't actually hurt till later.

Strain can hurt like that too.




So we need to get those too tight structures opened up!
Oct 14, 2009
Rating
starstarstarstarstar 		PART 5 - Knee Tendonitis from mountain biking and plyometrics
by: Alvaro Hasbùn

Hi there Joshua.

Well, I just cant find any peanut oil, so Im using olive oil, I hope it works. And I'm doing the stretch with the rag too, but I'm not sure if I'm doing it right.

I'll let you know whatever it happens.

Thanks again.

Any other advice?

Alvaro


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Joshua Comments:

OOPS! I didn't mean to actually take a rag and do anything.

I meant that your tendon becomes tight and pulls/stretches over your structures, just like doing that with a rag. I changed my wording on the last post.

No rag stretches....unless it seems effective!


1. So, ice massage as much as possible. Dig in there and force cold in while massaging the dry crunchy sponge into a soft, squishy sponge.

2. Gently stretch your leg muscles. All of them. Make yourself watch tv for an hour or so and keep a constant, gentle stretch on the quads, hamstrings, adducters, hips, etc.

3. Do the olive oil a couple times a day for a few days. I'm curious to see what happens. My peanut oil experience is one of my favorite stories!

4. Ultimately, massage and stretching. And, you can create a stretch with your hands/fingers, digging in and pushing in various directions.

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