patellar tendonosis help would be appreciated


I was just wondering if anyone has any experience with patellar tendonosis? I had had this horrible condition for around a year and have not done any running since around May. As a keen 5-6 times a week runner this is depressing to say the least, it really is starting to get me down. I thought I would just reach out to other fellow runners to see if anyone has any experience in beating this condition, and the methods they used? Any advice would be appreciated it really is looking like I will never run again in in my current state L

Background is started to hurt around a year ago, although not very much, would hurt maybe 2 or 3 out of ten at the start of runs then often disappear. Oddly, the faster I ran the less it would hurt, I would do a slow 8/min mile recovery run one day and it would hurt, then a brisk tempo run the next day with barely any pain after the first few minutes. It almost seems once the knee is warmed up, the pain goes away.

Anyway, saw a physio for about 4 months, we did the usual, stretches, strengthening, wall squats, ice, ibuprofen gel, after 4 months n real change. The giveaway is if I do a single leg squat it gets considerably more painful as I go down, then is a bit sore for about a minute afterwards.  Never agony but maybe 5/6 out of ten Did 8 weeks of complete rest, no change. Ditched the physio as obviously I was not getting anywhere. Googled the condition and saw a decline board and 3x15 squats on that twice a day seemed to be the cure, started this early November.

These started as agony, really really painful, but alas after about a month things go much better,  I was on the mend! Unfortunately things just kind of stalled from November, I am kind of in limbo at with the pain been between about 1-3 out of ten. It is never or really painful, but never really fine always just hurts a little bit. I am keeping pain diary, swapping from the regime to doing 15x3 twice a day daily to every second day, and this seemed to help a little, but indeed even on this regime it is up and down, for no real apparent reason the pain just seems to go up and down on a daily basis.

Currently trying 1 X 15 twice a day, daily – was okay (mainly 2/10) pain then today, for no real reason it hurts a bit more.

As you can tell this is really starting to get me down. All I want is to go out and do a run!


Has anyone got any advice at all about how to sort the tendon out? I am not doing any exercise at all, so I would say it’s less about stretching/strengthening and more about just sorting the tendon out.

Any advice at all would be appreciated, squatting regime’s/other exercises, straps, injections? If anyone knows anything please let me know! Another thing I’m not 100% is expectations regarding pain, is it ever okay to run on if it’s a bit sore, could this just be something to live with? The pain I could easily live with, I just don’t want to make it worse of have something awful happen like it rupture. Does anyone have the condition and just manages it rather than trying to eliminate it?

Thanks in advance for any advice.




  • Have you been referred anywhere through your GP? I don't know how widely available it is but I've just had something called Platelet Rich Plasma Therapy, whilst I had it for a different thing all together when I was researching it lots came up about how effective it was at treating tendinitis. I feel your pain and hope you can find an answer soon.

    If you think you can or you think you can't you're probably right.
  • Thanks for the reply, I have seen the GP, I am waiting for a referral, never overly optimistic about the NHS though!

  • where exactly in your knee is your pain? It could be tendon, it could be fat pad, it could be a tracking issue?

  • Kind of hard to explain, I would say towards the front pretty much in the middle, certainly not at the side or on top or anything. I had been diagnosed s 2 physio's as the patellar but I would be interested to hear any other theories if you have any??

  • If you're doing all the right things for a recalcitrant tendon issue and you're not progressing, then expecting to get better by doing the same stuff doesn't really make sense.

    If the pain in under the kneecap (as in not deep, but anatomically below the kneecap) then it's either tendon or fat pad. They can look the same, smell the same but are looked after differently,

    Regardless, stay away from PRP jabs - the most recent research is very poor...

  • I've had  constant patellar tendon issues  for 2 years which was very sore at the start of a run eased up after 2 miles and was very sore about 1/2 hour after the run again .I was running a lot but it got to the point I couldn't run anymore and even walking hurt a bit .

    I had lots of physio  which worked fine as long as I didn't run but in the end an x ray showed I had a bone growth which was getting bigger (bone spur) within the tendon which was the real issue and had it cut out 2 months ago and the pain is gone (so far anyway only starting back running now).It was the size of a jelly bean !

    knee issues are probably the no 1 injury in runners though and it may well just be overuse etc but id try and get an xray to rule it out anyway.Bone spurs are common,many people have them and don't know and usually don't cause any pain until they start pressing on something ..After speedwork the pain was horrific image


  • I'd be very interested in a link to that research Six Physio.

    If you think you can or you think you can't you're probably right.
  • Thanks Both.


    Well I as I say I have consultation in the next few months we will see what happens. The odd thing is that I have had limited success from the squats/slant board. They really have made things get better, although success somewhat has stalled. 


    I have basically just decided to "start again" and take the really, really slow route, IE rather than doing 3x15 twice a day start at 10 x 1 one a day then add one on every few days, I had read quite a few forums etc which have said this is the way to go. I will be out for another 6 months or so (year in total) but at the moment I would be very very happy with that outcome will have to see how it goes. Thanks for your input. 

  • I know this thread is almost 3 years old but I’m curious to see if you ever got back to running...I have literally the exact description you gave of patellar tendinitis symptoms and despite rest and then eccentric decline squats it’s not improving. I’m losing hope that I’ll ever run again...going on 4 months now. Curious what else you tried and if it helped...thanks!
  • Hi Alison I too have just returned to running having had this condition . I saw a few disinterested physios who gave me the decline squat exercises then I got stuck in all around the knee firstly to release tightness. Also get into the adductors and hamstrings, they all play a part in the function of the knee. I used the Sling method programme (can be found on facebook) to strengthen core and reverse my anterior pelvic tilt . (an added bonus of this was my bilateral proximal hamstring tendonopathy improved!)
    Next I also got a good albeit very expensive gait analysis done which showed the impact of my forward head position (which was helping to create the anterior pelvic and it also showed how I was putting most of my weight through the right leg due to an imbalance created by my job!
    So as you can see you need to look broadly at the problem you need to get to the root cause, the knee is likely just bearing the brunt of dysfunction elsewhere. This injury does take time so be patient but dont give up.
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