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Old 08-26-2013, 06:17 AM   #1
Joe Bernard
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Knee tendinosis advice

I was doing yoga two weeks ago and during a pose I felt something in my knee given way and it has been bugging me ever since. I got an MRI done Saturday and these arethe results:

Mild tendinosis at the medial insertion of the quadriceps and medial origin of the patellar tendon. There is also peritendinitis and a small amount of reactive endema in the patella at the medial origin of the patellar tendon. No tear. There is also a trace Baker's cyst, which is unlikely to be of clinical significance.

Given the results of this, would a PRP shot be worth it or is this proble curable through PT and some rest? What have you guys who have had a similar diagnosis done to resolve an issue such as this? How long did you take a break from squats and deadlifts for? I'm seeing an orthopedic doc Friday about this, but I just wanted to get some opinions of CFers since many docs out there are still stuck in the "squatting to/below parallel is bad for you knees" mindset.
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Old 09-02-2013, 08:40 AM   #2
Daniel Pope
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Re: Knee tendinosis advice

Hey Joe, just curious if this has gotten better for you? Sounds like you acutely aggravated your knee. Sometimes this will calm down in a few weeks by itself and you resume normal activities as tolerated. Did the doc recommend PT? Not sure that PRP is the answer right now, especially if the knee has been feeling better. I recorded a podcast about generic knee pain with another therapist some time back that may be helpful WFS.

Keep us updated!
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Old 09-03-2013, 08:04 AM   #3
Ari Sherwood
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Re: Knee tendinosis advice

KStar's got some good knee stuff:

http://www.youtube.com/watch?v=-RYMV0salw8 {WFS}
http://www.youtube.com/watch?v=2ENgwxb4zFA {WFS}
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Old 09-03-2013, 07:21 PM   #4
Joe Bernard
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Re: Knee tendinosis advice

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Originally Posted by Daniel Pope View Post
Hey Joe, just curious if this has gotten better for you? Sounds like you acutely aggravated your knee. Sometimes this will calm down in a few weeks by itself and you resume normal activities as tolerated. Did the doc recommend PT? Not sure that PRP is the answer right now, especially if the knee has been feeling better. I recorded a podcast about generic knee pain with another therapist some time back that may be helpful WFS.

Keep us updated!
It's weird, some days my knee feels good and other days it does not. Just walking around with my suit pants on I can feel my knee at times and it can feel unstable, but I can squat and deadlift no problem which doesn't make sense. I've stopped squatting and deadlifting for the time being, which is frustrating because I love doing them. I talked with my doc about it and he recommended I do an eccentric strengthening program, which I started this morning with the help of a PT. He didn't think PRP was necessary yet, he wants me to do PT for 6 weeks and come back to see him to assess how it's going. Thanks for the podcast link, I will listen to it tomorrow and get back to you about it. In general, is eccentric stuff the best bet for resolving patellar tendinosis?

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Originally Posted by Ari Sherwood View Post

Thanks for the links Ari. I've seen the voodoo floss one before and I'm wary of it because it seems too good to be true. I'd happily pay for the bands if I knew they would work though.
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Old 09-04-2013, 04:44 AM   #5
Ari Sherwood
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Re: Knee tendinosis advice

Understood re:the voodoo floss, though you can also grab an old bicycle tire and try it without spending much cash.

As for eccentric exercise, I have used it to pretty good effect on shoulder tendonosis, and research is showing some benefit on certain types of tendonopathies:

http://www.ncbi.nlm.nih.gov/pubmed/23669088 {WFS}
http://www.ncbi.nlm.nih.gov/pubmed/23669814 {WFS}
http://www.ncbi.nlm.nih.gov/pubmed/17289855 {WFS}
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Old 09-04-2013, 08:45 AM   #6
Joe Bernard
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Re: Knee tendinosis advice

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Originally Posted by Ari Sherwood View Post
Understood re:the voodoo floss, though you can also grab an old bicycle tire and try it without spending much cash.

As for eccentric exercise, I have used it to pretty good effect on shoulder tendonosis, and research is showing some benefit on certain types of tendonopathies:

http://www.ncbi.nlm.nih.gov/pubmed/23669088 {WFS}
http://www.ncbi.nlm.nih.gov/pubmed/23669814 {WFS}
http://www.ncbi.nlm.nih.gov/pubmed/17289855 {WFS}
Old bicycle tire would work, I'll see if I can get one. Thanks again for the links. It's interesting, I've seen the decline slant board mentioned alot in resolving patellar tendinosis, might be something I should get. I will ask my PT about it today. What exercises did you do for your shoulder? I have shoulder issues as well, stemming from an injury last April, and have been doing banded rotator cuff work everyday since last week to try and address it.
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Old 09-04-2013, 10:20 AM   #7
Ari Sherwood
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Re: Knee tendinosis advice

I continually battle some supraspinatus and biceps tendinosis from impingment (overhead lifts, kipping, etc.) and basically do some of the following:

- eccentric portion of (light) weighted bicep curl
- eccentric portion of a (light) weighted standing single-arm shoulder press
- eccentric portion of a wall push-up

Hope that helps!
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Old 09-04-2013, 08:12 PM   #8
Joe Bernard
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Re: Knee tendinosis advice

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Originally Posted by Ari Sherwood View Post
I continually battle some supraspinatus and biceps tendinosis from impingment (overhead lifts, kipping, etc.) and basically do some of the following:

- eccentric portion of (light) weighted bicep curl
- eccentric portion of a (light) weighted standing single-arm shoulder press
- eccentric portion of a wall push-up

Hope that helps!
Thanks for this list. I am able to bench press and press, but I do notice some tightness afterwards. Are you able to do overhead stuff and bench press?

Also, Dan, I didn't get a chance to listen to your podcast today but I will do it tomorrow, seems like it contains a wealth of information.

Last edited by Joe Bernard : 09-04-2013 at 08:32 PM.
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Old 09-08-2013, 06:01 AM   #9
Ari Sherwood
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Re: Knee tendinosis advice

Yes, I'm able to do overhead stuff, but when I do a lot of volume plus pull-ups, I do get some tightness and soreness in that bieps tnedon, supraspinatus and bursa.
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Old 09-09-2013, 07:52 AM   #10
Daniel Pope
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Re: Knee tendinosis advice

Hey Joe, the eccentric stuff is definitely helpful for tendinosis/tendinopathy. Newer research is showing that it doesn't necessarily have to be just eccentrics. Using the concentric portion is as or more effective (and much more specific to what you need in my opinion).

That being said, as a therapist I'd have to make sure that the pain you're feeling is definitely coming from the patellar tendon. You can have some radiographic (MRI) findings that aren't really the cause of your pain. A lot of the eccentric exercises can really overload the knee if you're already pretty painful.

That being said it really looks like you're on the right track though. You've seen a doc and a PT and now you're on the path to success. Let me know what happens in the future!

P.S. keep in mind that true a tendinopathy can take 6 weeks or more just for the pain to get better.
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