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Athletic Training

Soreness in patella tendon & area behind knee

12/11/2006

Question:

For the past 3-4 weeks I have been dealing with a soreness or burning feeling in my patellar tendon and area behind my knee, especially after prolonged periods of sitting in a normal position. When I walk, I hardly notice it, and when I go for a normal long run, I hardly notice anything then either. When I wake up in the morning from sleep I don`t feel anything, it`s just when I am sitting or afterwards. For a little history on what I feel may have caused this includes this: From June to the end September I was building my mileage very gradually from 25 miles a week to 45-50 miles a week. I was just going for normal long runs and nothing else. At the beginning of October I wanted to revamp my training to prepare for the indoor track season. I decided to go for a 40 minute fartlek run. Where I ran at a comfortable pace for 8 minutes and then surged for 1 minute. So the run had 4 surges in it. I felt fine for the rest of the day of that run. However the next day after sitting for about hour and half, when I was walking back to my dorm, I noticed a shooting pain in my patellar tendon where it hurt to bend down and lift my knee up. I decided to just sleep on it and the next day the sharp pain was gone but a slight soreness still lingered. I took a week off, but not much changed and I decided to continue running, but take it easier. I went for another fartlek run about after a week of solid running, except this time the pain seemed to be behind the knee and it was after the last surge, 4th surge of my run. I then decided to take another week off and see what happened. I even went to physical therapy starting from this point on too. During that week off I noticed that my knee got aggravated when I sit in a normal position for too long. After a week of rest, not much changed like before and I decided to run every other day while still goign to physical therapy and while doing everything they told me too. The pain isn`t sharp but I would consider to it be very annoying, and it seems to be behind the knee and on the patellar tendon and only seems to be really noticeable after long periods of sitting. After my runs, when I feel my patellar tendon, it feels tender, and my knee has some soreness but goes away within 20 minutes after the run. One thing that I feel caused it was the fartleks. This is because my long runs from June to September never bothered me and I could sit without any pain in my knee or patellar tendon. With my fartleks, one thing that I did change was the way I ran. I lifted my knees, and extended my stride to get the most out of my pickup, something I have not done in a long time, say about a year. I dont` think the fact that I was going faster was as much of the cause as the fact that I was going through a much wider range of motion to try to go faster which I feel really jostled or shook the area up. After doing high knees, one day after a run I noticed a small increase in pain in the knee and patellar tendon the day after. Another piece of information that I feel might benefit you is how last year, I had gotten patellar tendonitis. And it did go away after about 2 and half months of physical therapy and no running. But the pain was very chronic and sharp and hurt whenever I bent my knees, lifted my knees, or put pressure with my hand on the patella tendon. Also, when I feel one patella tendon, my left one versus my right one, it feels as though the left patellar tendon has less tissue in comparison to the right patellar tendon which feels a little thicker than the right, or that the bone is more prominent when I feel my left patellat tendon.

Anyway based off all this information, I was wondering what you could diagnose this is as, and what I steps I would need to take to treating and managing this injury or problem to make all this pain and soreness go away.

Answer:

To have these symptoms properly diagnosed, you will need to see a health professional.  You may require a physical examination. 

Here is some background information that may be helpful when talking with your health care provider:  Inflammation can occur in a number of places.  Commonly in distance runners, there will be discomfort and inflammation of the patella tendon.  Additionally, with the increased impact of distance running the under surface of the patella and the back side of the knee can also be sore and inflamed.

With your current efforts of training modifications, physical therapy, and rest, a physician visit may be an appropriate next step.  At that point, they can decide if they would like to make any additional modifications to your training.

Best of luck with your training.

Related Resources:

AOSSM Directory: Find a Doctor (American Orthopaedic Society for Sports Medicine)

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Response by:

Alex K Wong, MS, ATC Alex K Wong, MS, ATC
Assistant Athletic Lecturer & Trainer
College of Medicine
The Ohio State University