Patellar Tendonitis in 17 year old basketball player

by Al
(Canada)

Hi. I am a 17 year old basketball player who has patellar tendonitis in both of my knees.

It all started about 4 months ago. However, I didn't think anything of it because I could still run jump and play without any pain.

The only pain would be when I pressed on my kneecap really hard.

I continued training throughout the summer because I didn't feel barely any pain, hoping it will go away but it hasn't.

The pain hasn't gotten much worse since then but my knees just get kind of sore during the workout or practice and I can feel the pain when I press hard after the workout.

I always ice my knees after practice and do massaging. Also, when I bend my knees or put my fingers on it, I feel a creaking movement. I don't hear an actual noise, but I can feel something, sometimes. I don't know what this means though.

A few weeks ago when I practiced, I was dunking and jumping and running but I didn't feel anything. There's times when there's absolutely no pain and there are times when there is some pain, but usually just soreness.

I am now on day 12 of resting my knees, where I am massaging, icing and stretching every day and doing nothing else.

I am looking to get back to playing next week. However, I am nervous if the pain comes back and is just like before, so basically I would have wasted 2 in a half weeks doing nothing, and my knees would make no progress.

Do you think I should incorporate any lunges, no-weight squats and other exercises that place pressure on my knees while I am resting or strictly stretching,ice and massaging?

I heard one-legged squats are good but if I am resting my knees , whats the point of doing those types of exercises that place pressure on my already-damaged knees.

Do you think that you can help me out in any way?

Also, when I get back to playing, should I incorporate weight training on my legs? I lifted weights over the summer but not my legs because I thought that it would damage it more.

If it persists when I start playing, should I keep playing? I am really dedicated to basketball and I have worked too hard and I am a good player and I am in my last year of high school so I want to get noticed by some schools and play on in university but these injuries are nagging me and will only get worse if I keep playing, but I have to keep playing because basketball is my passion and I don't know what else to do if complete rest won't get rid of the pain.

It is very frustrating not being able to run and practice with your team while everybody else is, knowing you will keep getting behind as each day passes.

Please respond if you can I need a lot of advice.



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Joshua Answers:

Hi Al.

Lots of great questions, I love it!

Ok.

1. My main suggestion is to get this ebook is about hip tightness and muscle balance and how it relates with patellar tendonitis.

Bart's a great athletic trainer, and I like and trust his info.


2. Related to that, you keep saying 'injury'. You're not injured. You're feeling symptoms.

Muscles too tight, hips and legs unbalanced so load isn't landing as it ideally should, nervous system getting more and more worried.

Change the balance and that pain can go away FAST.

Maybe you have some actual Patellar Tendonitis, but probably you just have a Tendonitis -dynamic-, which means there's mechanism but no actual damage.

Any time your body feels pain (even if YOU don't feel it) it kicks in a Process of Inflammation. And thus you start to feel Symptoms of Tendonitis.


3. Creaking. Part of that is from too tight structures. When I was in 10th grade, playing football, my knees hurt and literally squeaked. An acupuncturist my mom took me to told me to rub peanut oil on them and let it soak in.

I thought it was dumb, but did it anyway, and I'll be darned but the squeak went away after slathering peanut oil on my knees twice. Crazy.

Go get some peanut oil.


4. Sometimes pain, sometimes no pain. You body is always compensating and adapting. It's job is to take care of you and make things right.

Sometimes it wins, sometimes it loses.


5. 2 weeks resting, and self care. Great! Is it a waste of time if you get back to playing? It's all a learning experience Al. You have a career ahead of you, and a lifetime on your knees after that.

It's worth it to experiment and learn what works, and what doesn't.

2 weeks of icing and massage and stretching certainly can't hurt anything, and it absolutely does make the ecology healthier.


6. Weights and exercise that puts pressure on the knees. Pressure isn't the issue.

Poor body mechanics is the issue.


7. Should you do weight bearing exercise? Absolutely. Muscles do the work. And muscles are shock absorbers. If you want to keep pressure off your knee joint, then keep your muscles strong.

Having said that, it's important to keep your muscles and connective tissue loose.

Probably if you do a squat, your knees go over your toes. Tight soleus, tight hamstrings.


8. Yes, you can play with pain. IF you know good self care. Icing, self massage. Again, you likely don't have damage, you have IRRITATION. You can learn to limit and decrease irritation.



Get Barton's ebook, do what it says. Then get back to me.


Also, more questions, more answers.





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Please reply using the comment link below. Do not submit a new submission to answer/reply, it's too hard for me to find where it's supposed to go.
And, comments have a 3,000 character limit so you may have to comment twice.
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Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com
















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Comments for Patellar Tendonitis in 17 year old basketball player

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Oct 02, 2013
Rating
starstarstarstarstar 		23 year old with knee pain after jumping and squats
by: Alex

I am 23 years old and I am training for the USAF Spec Ops. This condition is really starting to worry me because I need to be at my best before I leave.

I understand you withdrew the Q-form and are swamped but I thought I'd throw up a hail marry anyhow.

I have a pain above my knee in my quad tendon. The pain began about 4 months ago during a backpacking trip to Russia. I hadn't worked out in a couple weeks and was more than likely chronically dehydrated before I began an intense plyometric workout with a lot of jumping and squats. I more than likely had less than perfect bio mechanics that probably included a lot of 'knees over toes'. This created a couple weeks of bad pain and now four months later, still noticeable nagging pain.

The pain is most onset when my knee is flexed and pressure is added in activities such as squatting to parallel. During periods of inactivity like sitting, my knee gets stiff.

My current situation doesn't allow for too much fitness deviation, but I have cut out some activities that hurt like burpees and buddy carries. My current regimen includes a lot of running and swimming, as well as foam rolling and stretching my legs and hip flexors.

I don't think rest has helped, and I don't foresee rehab exercises like eccentric squats off of a stair helping a strong athlete.

What would you recommend I do in regards to:
Activity modification, rehab movements, and other ideas?

I have been trying to tackle any poor movement patterns that could be affecting this as well, but to no avail.

At this point I'm open to any suggestions, and would really appreciate your advice!


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Joshua Comments:

Hi Alex.

You're right, rest isn't going to fix anything. And it's not like you can just take a month off and not exercise.

1. See: Magnesium For Tendonitis
That's a MUST for athletes and pain.


2. Where exactly is the knee pain? All over? On the side?


Answer that and we'll go from there.
Oct 16, 2013
Rating
starstarstarstarstar 		23 year old with knee pain after jumping and squats
by: Alex

1. I have started supplementing with Magnesium citrate.

2. The pain is directly above my knee cap, where the quad tendon is. The less the knee flexion, the less the pain. Deeper squats hurt more. Often wake up to dull pain at night too.


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Joshua Comments

1. How much?

2. Massage or have massaged the quads and the TFL (tensor fascie latte). Specifically, you want to lengthen the connective tissue that shrink wraps the muscle.

Quad connects to tendon that crosses the knee joint. Too tight quads = compression and disfunction adn pain.

TFL controls the IT band, too tight and it pulls the balance of the knee out of whack and makes other structures work harder. It's a play in lots of different kinds of knee pain.
Oct 16, 2013
Rating
starstarstarstarstar 		23 year old with knee pain after jumping and squats
by: Alex

1. I've been taking ~700mg of magnesium citrate in powdered form. I'm willing to bump that up if necessary.

I have been doing daily foam rolling of my quads/ITB/TFL and lax ball work too. I have just started to throw in a bunch of quad/hip flexor stretches too (specifically 'the couch stretch').

Do you think there is an excess inflammatory component? Or is the pain most likely being triggered by tight muscles, making icing a waste of time.

I appreciate the help! Very frustrating having some good decent days then some worse ones and not knowing how to progress.


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Joshua Comments:

Hi Alex.

1. Icing is never a waste of time. Iceing brings new blood in and takes old fluid out. That's always a good thing. And chances are if you have pain, you have an inflammation process (this isn't always true, but it's a good guiding principle).

2. With our lifestyle these days, yeah, it's a safe bet you have too much inflammatory process in your body. Causes of inflammation: processed oils, sugar, gluten, etc. Not enough sleep, exercise, exercise when muscles aren't operating optimally, etc.

3. Keep up all the work you're doing. See what happens. That's not the best thing in the world to hear, but you're doing the right things, and realistically, trial and error is required.

4. How many times a day are you taking the mag that equals 700mg?
Oct 21, 2013
Rating
starstarstarstarstar 		23 year old with knee pain after jumping and squats
by: Alex

Currently I'm taking two doses of 350mg each morning and evening, or after workouts. I know giving supplemental nutrition advice is often blurred, but would there inherently be a benefit of upping the dosage / to what extent?

I think I have a good new regimen of exercise and corrective posture that I'm going to follow. I'll be sure to update with results and insight.


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Joshua Comments:

The body needs as much magnesium as it needs.

See the Magnesium Dosage link off the Tendonitis For Magnesium page (link in an earlier comment).

If the muscles don't have the magnesium they need, they can't operate optimally. If you haven't had enough magnesium, have been exercising, muscles get tight and stay tight and cause problems...you still need to deal with the tightness etc, -and- you still need enough magnesium.

Let us know how the new regimen goes.
Dec 11, 2013
Rating
starstarstarstarstar 		23 year old with knee pain after jumping and squats
by: Alex

So checking back in here after pretty much eliminating all of my pain.

What did the trick for me was dedicating at least 30 minutes a day to smashing and stretching my quads and hip flexors. Use the foam roller, and then when you can, upgrade to the barbell or a softball to smash out your quads and hip flexors. If you can get your hands on voodoo floss, or make your own, you should check that out. Floss your supra-patella pouch, and your high hip.

After the smash session, do the wall / couch stretch for 2 minutes each leg. Do this twice a day, and one day you'll just realize your pain has disappeared.

Here are a few links (provided I have permission to post them) on how to do some of these drills:

The Couch Stretch
https://www.youtube.com/watch?v=-ZX1QMTdAC4

Barbell Quad Smash
https://www.youtube.com/watch?v=c57xVyqTEjw

Voodoo Flossing
https://www.youtube.com/watch?v=-RYMV0salw8

How to Roll Quads
https://www.youtube.com/watch?v=5nlarY4AdQw

Excessively tight quads & HF (I'm looking at you rectus femoris) will put that unwanted constant tug on your knee.

If your pain is on the top of the knee, pay special attention to the rectus femoris. If it's on the outside of your knee, pay attention to your TFL and ITB. And if it's on the inside, pay attention to your adductors. Lastly, it's not a bad idea to smash out our anterior tibialis and claves, as that can pull on your knee too.

Good luck!


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Joshua Comments:

Go Alex!

Good news/bad news, as you've illustrated, it takes some work to get the body back in gear.

S/he who works hardest/smartest gets the rewards.
Feb 13, 2014
Rating
starstarstarstarstar 		23 years old basketball player with knee pain
by: 23 years old basketball player with knee pain

Hello Expert. I am 23 years old basketball player who has left knee pain for 2 years. My pain is mild and doesn't interfere much with basketball when i am fully warmed-up.

But it never goes away.

I feel this pain when my knees are half-flexed position exactly when I push my leg before jumpshot and exactly at the time when I land after I release. Few years back I've bumped my patella with some other player's knee and my knee cap became sore and it also felt like it has moved somewhat.

I limited the movement and pain and tenderness went away without a trace.

The actual cause of my pain is my imbalanced shooting technique. After I realized that I am trying so hard to fix it and I am doing massage and stretch everyday on a consistent basis.

But this mild pain is not going away. Ketoprofen NSAIDs' oilments and gels are not fixing it. What can I do to get rid of it completely.


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Joshua Comments:

Hi 23.

It's not the jump shot so much as various phyisical factors, like chronic inflammation, nutritional insufficiency, and too tight muscle and connective tissue.

Stretching is great. Massage is great. (If done effectively, of course.)

Anti-inflammatories like Omega 3 fatty acids, tumeric, etc, are smart options.


Do you do any icing at all? If so, how?

How are you stretching?

How are you massaging?

How's your nutrition?

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