Quad Tendonitis

Hurt or injured? Unfortunately, injured. I have been dealing with some significant quad tendonitis over the past six months. When it is fully flared up, its debilitating with my entire left quad in spasms and it really painful to bend the knee, walk up and down stairs, get in and out of the car. I am usually able to massage and foam roll away the spasms within 24-48 hours of flare up.

I think it is a combo of overuse (been xc skiing like crazy lately) and weak hip and glute muscles. I'm going to PT twice a week for the latter and the former is what it is. I also try to do yoga 2x/week. Anyone else suffers from something similar? Anything different I could be doing, thinking about, etc.?

have you considered an Irn Bru?

I would consider an amputation and prosthesis.

You will be on your new (prosthetic) leg in less than 2 weeks.

Yoga? What, are you a mini van owner? Try deadlifts and wide stanced squats

PM Rontele.

Eccentric quad exercises, posterior chain work (glutes!!!) and IASTM to quad tendon (Instrument assisted Soft tissue work).

Not sure what you mean by quad tendonitis... where the quad connects to what? spasms would tell me more muscle fatigue and an imbalance maybe..

Ask the pt person?

My wife had hamstring / quad tendonitis issues when she started back up running recently.The doc told her to ease off the activity while getting healthy and doing PT.

Have you given birth lately or are you now pregnant?

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Originally Posted by grskier

Not sure what you mean by quad tendonitis... where the quad connects to what?

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The quadriceps tendon connects the quadriceps muscle to the patella. Quadriceps tendonitis is a pretty common malady.

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Originally Posted by OldSteve

The quadriceps tendon connects the quadriceps muscle to the patella. Quadriceps tendonitis is a pretty common malady.

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copy, vs. patella tendonitis?

Nevermind, googled it.. same same.

Too much masturbation is the cause


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Could not resist and sent a PM.

This time last year i was on a week of prednisone to calm down quad tendonitis caused by a bone spur. Hear you on quad spasms and frozen kneecap. Painfull, persistent and not fun at all.

Best advice i got was to stretch, stretch, stretch your quad when you get it settled down. Also find ways to use more glute and less quad.

Good luck and healing thoughts.

For tendinitis, in France, I had shock wave therapy. Two places, my wife one, elbow and shoulder, all times from climbing.

4 or 5 sessions, totally healed.

Not yet popular here in the states, but you can find places that use it.

Idea is that the mechanical shock will irritate the tendon, bring blood supply and heal it.

A whole bunch of research that shows it works.

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I know what you are going through. I go through a flare up every year or two.

Ice your knee every night + some ibuprofen.

Foam roll your entire leg, calf, hamstring, glutes, finish with quads. Then move on to stretching. Google for the Couch Stretch - this was a game changer for me.

Buy the book “Becoming a supple leopard”. I swear it’s not erotic. Great book that has so much info on weight lifting, stretching, and rehab exercises.






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In my experience

DO:
- progressive isometric strengthening of quads (e.g., wall sit) 3x/day every day
- after easy isometrics are mostly pain free, progressive concentric/eccentric strengthening of quads (e.g., squats, pistols, etc)
- Strengthen posterior chain: gluteals (esp glute med), hamstrings, and hip rotators. This should include

- complex, "functional" movements (e.g., straight-leg deadlifts, etc)
- single leg movements (e.g., single-leg romanian deadlift)
- isolated movements to ensure the small muscles you've forgotten about are firing (e.g., monster walks, banded x-walks, glute bridge, reverse hypers, side-lying leg lifts, etc).

- trigger point release the quad. Dry needling, massage, acupuncture, and cupping are all good, but you can get decent relief at home on a lax ball. Use your other leg to keep the weight on the ball light enough your quad doesn't tense up. If you get good at it (almost like meditation), your quad will spasm and release.
- couch stretch. Tight rectus femoris is often an issue
- eat a clean diet

DON'T
- try to control the inflammation with NSAIDS/ibuprofen (or ice, though that's not as bad a NSAIDs)
- think loads of rest will heal the tendinitis -- it will just flare up again after you return to sport
- do tons of eccentrics (decline, single-leg eccentric squats used to be the de-facto recommendation for quad tendinitis, but no longer)
- try to isolate and strengthen the VMO -- again, no longer really recommended

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Originally Posted by auvgeek

In my experience

DO:
- Strengthen posterior chain: gluteals (esp glute med), hamstrings, and hip rotators. This should include

- complex, "functional" movements (e.g., straight-leg deadlifts, etc)
- single leg movements (e.g., single-leg romanian deadlift)
- isolated movements to ensure the small muscles you've forgotten about are firing (e.g., monster walks, banded x-walks, glute bridge, reverse hypers, side-lying leg lifts, etc).

- isometric strengthening of quads (e.g., wall sit)
- after isometrics are pain free, progressive concentric strengthening of quads (squats, pistols, etc)
- foam roll quad, my favorite is on a lax ball
- couch stretch. Tight rectus femoris is often an issue

DON'T
- do tons of eccentric, incline squats (used to be the de-facto recommendation)
- try to isolate the VMO
- take NSAIDS/ibuprofen

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This is really good stuff. Rest has caused the quad tendonitis to heal a bit, but in the process of trying to use that leg less, I overused my right leg and currently dealing with some piraformis matters. I think a lot of the issues originate with how I work (sitting vs. standing -- I do both) and migrating away from a strength training program in recent years.

I'm on pure rest at this point with stretching and foam rolling only. I may go out for a light xc ski this weekend, but that seems to be an activity that is causing a lot of these issues.

Also, CBD cream is a godsend,.

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Originally Posted by Rontele

I'm on pure rest at this point with stretching and foam rolling only. I may go out for a light xc ski this weekend, but that seems to be an activity that is causing a lot of these issues.

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Rest never healed any type of tendinitis for me. It felt better temporarily, but resumed hurting upon return to sport. IME, the only thing that will heal tendinitis is progressive strengthening until full return to activity. If I were you, I would skip the xc ski this weekend and focus on strengthening glute med and isometrics for quads. For isometrics, I would start with wall sits 3 times a day and increase time when they are less intense. It will hurt first, but it will get way better within 3 weeks.

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Originally Posted by auvgeek

Rest never healed any type of tendinitis for me. It felt better temporarily, but resumed hurting upon return to sport. IME, the only thing that will heal tendinitis is progressive strengthening until full return to activity. If I were you, I would skip the xc ski this weekend and focus on strengthening glute med and isometrics for quads. For isometrics, I would start with wall sits 3 times a day and increase time when they are less intense. It will hurt first, but it will get way better within 3 weeks.

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I'd tend to agree although my knowledge is with regards to climbing and elbow tendinitis/tendinosis. After it becomes chronic rest doesn't do much and you need to strengthen the area.

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Originally Posted by concretejungle

I'd tend to agree although my knowledge is with regards to climbing and elbow tendinitis/tendinosis. After it becomes chronic rest doesn't do much and you need to strengthen the area.

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Unfortunately, I seem to be prone to tendinopathy. I've had it in elbows, wrists, knees, lower leg (peroneal), etc. They're all treated basically the same way, and so far, they've all vastly improved.

The advice I got in high school was always: rest, ibuprofen, ice, return to sport. That does actual damage to your tendons and makes them way harder to heal vs taking time off from sport to follow what I outlined above (not to mention the damage ibuprofen does to your gut bacteria).

You have to figure out what strengthening and tissue-work (lax ball, dry needling, acupuncture, massage, etc) schemes work best for you to avoid overly irritating the injured tendon, but also realize that some pain during progressive strengthening is to be expected, especially when you first start but for up to 3 weeks. The longer and more painful the issue, the longer you should expect to be in pain while strengthening and the longer you need to continue strengthening after return to sport.

The exercises for the actual tissue should be done daily at low intensity/high reps (at least to start), while the exercises for the supporting muscles may be done less frequent at higher intensity since they are not already irritated. A caveat to that is if your supporting muscles (i.e., hip rotators and posterior chain for patellar tendonitis) are very weak, then some caution is required to avoid overloading those tendons as well. It sucks to end up with hamstring tendonitis because you overtrained hamstrings while trying to solve your quad tendonitis.

Guys, shock wave therapy really works.

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Originally Posted by rod9301

Guys, shock wave therapy really works.

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Link? When I google "shock wave therapy," I just get links to e-stim machines. My parents bought the wife and me an e-stim machine for Christmas two years ago (Marc Pro Plus), but it sounds like that's different than what you're talking about.

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Originally Posted by auvgeek

Link? When I google "shock wave therapy," I just get links to e-stim machines. My parents bought the wife and me an e-stim machine for Christmas two years ago (Marc Pro Plus), but it sounds like that's different than what you're talking about.

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I found a lot of links, here's one

https://en.m.wikipedia.org/wiki/Extr...ckwave_therapy


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Better link

https://www.shockwavetherapy.eu/subpage



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So I have been dealing with this since Jan. Been to numerous practitioners and PT's. Had an MRI which came back negative for anything major, except Quad Tendinitis. Tried dry needling, tons of rolling on vibrating foam roler and hyperice vibro ball.
Went to my chiro today, he hammered the area with deep tissue, using a metal bar. Hurt a shit ton but feels so much better now. He broke down a ton of scar tissue.

Checking in. Has time helped heal your quad?

i have had another PRP shot, 2 in 2 months. Been back to xfit nut not doing much on the legs. Riding here and there.

Started yoga today.

Still hurts and i know i could not ski on it if i wanted to. I am thinking i am going to have to live with this for a while.

2nd PRP shot seems to have done the trick, with a shit ton or stretching. In case anyone cares.

Great.

BTW, 15 years ago, before prp, i had patellar tendinitis, bad, didn't ski for a year!!! And I had an operation to clean it up, worked

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I find stretching out all my hip muscles helps the minor vastus medialis (teardrop, inside lower quad) tendinopathy I get a couple times a year, more than actually stretching the VM through a normal quad stretch.


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Glad to hear you guys are on the mend. I managed mine through a 50 day ski season. Spent a some afternoons in the bar when I was skiing more than a few days in a row. Feeling great now in MTB season but If I slack off on stretching that spur reminds me its there.

I just finished 5 courses of shock wave therapy (one more to go) on my shoulder that was diagnosed with tendonitis and calcification.

It’s the best it’s felt in 10 years and some of the best money I have ever spent.

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Originally Posted by Darren Jakal

I just finished 5 courses of shock wave therapy (one more to go) on my shoulder that was diagnosed with tendonitis and calcification.

It’s the best it’s felt in 10 years and some of the best money I have ever spent.

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Yeah, this stuff really works

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