Do you have the itis?.. first off let me say no I am not an MD nor am I a DPT — I’ve just got well used joints and some titanium parts. I’d say every year I get a case of patellar tendinitis that puts me out for 6+ weeks. I give anyone experiencing pain or discomfort the same guidelines.. give it two weeks, if it starts to feel better, give it two more!
The first step is to try and figure out what caused it. Have you had tendonitis before? Did you start a new training program with too much volume/intensity? Are you doing new exercises you are unfamiliar with that you could be doing wrong?
Temporarily reducing or eliminating (this is my go to method) whichever movement causes you pain is ultimately next. I’ve had stints where I could still work through some power variations and I’ve also had some months where I couldntdemo an air squat or a box step up. So unfortunately “working through it” or “going lighter” sometimes isn’t in the cards.
Warm Up & Stretching
Raise your hand if you’ve ever felt personality victimized by a warmup — now lets ask.. are you understanding the purpose of a proper warmup? It blows my mind when those who do little to no warmup experience joint pain or an injury and can’t understand why. Targeting your warmups to fit your needs is very important.
I’ll always start on a bike for a few minutes to get the blood flowing, nothing crazy just a comfortable pace to get the knees warm.
Next I’ll grab a foam roller, targeting my Quads and my Adductors for about a minute per leg.
Generally tightness of the quad (as it runs down the knee and through the hip) causes a majority of knee pain for Weight Lifters, CossFitters and Powerlifters. A Couch Stretch is great for releasing tension/tightness through the quad.
If you have VooDoo Floss, lightly wrap the joint from 1” below the knee to 1” above the knee. Walk around as normal as possible for 2-3 minutes. What does this do exactly? We are making positive subjective changes to our joints and soft tissues through compression + tension + movement.
A low-level way to perform an isometric for the patellar and quad tendons is a wall sit. With your back against a wall and feet out in front of you, slide down the wall and sit with your knees bent. We want to stay above parallel for now, knees should be roughly at a 60º angle. Perform 5 repetitions of a 45-second hold. If this is too easy, try performing the wall sit with one leg.
2.) Spanish Squat
Spanish squats allow you to really sit back into the squat while keeping the shins vertical. While this is far from a “normal” squat for most, it does allow for heavy loading of the quads with decreased patellofemoral pain, making this a great exercise to use for quad hypertrophy or during rehab.
The resistance band makes the lockout much tougher on the quads and let’s you shift center of gravity far behind knee as you descend. Both load the quads more! Note how I keep shins close to vertical in the bottom and lean back slightly into the band at the top. This is probably my favorite variations when rehabbing knee pain.
Perform 3-5 sets of 10 Reps with about a minute of rest.
3.) Box Squat
The squat is a great way to start loading the patellar and quad tendons. If you can squat to full depth without pain, by all means go for it — remember to keep your weight and ego in check. However, if extreme pain has limited your ability to squat to full depth, limiting your squat descent to a predetermined height will be a needed step.
For me the box squat is great when rehabbing through knee pain; once I allow myself to squat. I get the feeling of a bar on my back, I can get some solid volume in and start to push the weight a little bit.
Perform anywhere from 3-5 sets with 5-10 Reps depending on weight.
No two athletes are the same, some drills may work for others while some may not. If you’ve been experiencing knee pain, have given it time to heal and still have not found relief, be an adult and go see a medical professional. Remember to keep that ego in check when you return to training. Just because it feels better does not mean you should be going 100% right away. Still include your rehab exercises in your training at least one day a week, the more we take care of our joints with “prehab” the less we will be forced to take extensive time off for rehab.