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Paula asked...

I have patellar tendinopathy.

I have patellar tendinopathy which was confirmed by MRI recently. I was a very active person prior to this injury which occurred when I was training for a half marathon in April.

I have done 4 months of physio and am continuing with it. I was wondering if there are any exercises that you would recommend to help with this, both for pain and treatment? I still want to be active and have been walking and swimming, but was wondering if there is other exercise that would be ok to still do and not aggravate the injury.

Also, any additional information around pattelar tendinopathy and the recovery time would be great. Also, shock wave therapy has been recommended, is this something you would also recommend?

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The answer

As the pain in your knee has gone on for more than 6 weeks, you have developed chronic patellar tendonitis. This type of condition often develops due to ‘overuse’ of the joint. You have already seen a physiotherapist about the best exercises to help heal and strengthen the area. Exercises that cause pain or ‘pushing past’ the pain should be avoided as this could be contributing to poor healing of the damaged tendon.

Individual recovery times vary so I am unable to give you an exact time frame. You are doing the correct thing by staying active. Stationary cycling and swimming are best because they do not put any ‘load’ onto the affected joint whilst helping you to maintain stamina. This is called ‘controlled rest’, exercising without load. Avoid jumping and running until the knee is pain free. Warming up and stretching will also help recovery. When your physiotherapist thinks you have recovered enough to return to training you should only increase the frequency and duration of exercise by a maximum of 10% per week to help avoid a similar injury. Soft tissue mobilisation may also help , ask your physiotherapist if they think it is suitable for you.

Shock wave therapy (ESWT) seems to be a safe and promising treatment that can have a positive effect on pain and function. There is not enough research available to give any more evidence about its effectiveness at present. It may be worth considering giving it a trial if all else fails.

Answered by Dr EmmaJane Down.


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