Reader Ario asked:

I ran my 1st marathon in May of ‘07 and shortly thereafter, began experiencing pain in my right knee. Each time I ran, climbed up stairs, or squatted, the pain could be felt.

I found an orthopedic specialist & had MRIs done. The diagnosis was patellar tendinitis. I’ve completed 6 weeks of physical therapy. The pain is still there and I’m thinking about seeking a 2nd doctor’s opinion before I consider something drastic like surgery.

I want to start StrongLifts 5×5, but don’t want to miss out on Squats, the backbone to your training regimen. I can squat down with no weight on my back several times without knee pain.

My current thinking is to just start with the bar and go from there. With the hopes that the exercises will help (and not hurt) my knee situation. I have a computer job and sit for large chunks of the day, but keep an active lifestyle outside of work.

Patellar Tendon. Image credit: MMG
Patellar Tendinitis. Ario has pattelar tendinitis: the tendon that attaches his quad muscles to his shin bone is inflamed. It’s hard to say what the cause of Ario’s patella tendinitis is. It could be various things:

• Overuse. Intensive preparation the months prior running his marathon. But without proper recovery.
• Muscle Imbalance. Quadriceps & hamstrings aren’t equally strong. This could increase the shear force on his patellar tendon.
• Improper Posture. Ario has a desk job & sits for large chunks of the day. Bad postural habits can cause tight hip flexors, lordosis, etc.
• Other. Bad running technique, bad shoes, hard surface running, etc.

Treatment. The worst thing you can do is immobilization. Accelerate the healing process by increasing the blood flow to your knee. In the meanwhile strengthen the surrounding muscles to help the weakened joint.

• Stop What Hurts. Avoid running for now. Some of the rehab exercises will hurt. Rate your pain from 0-10. Anything above 3, stop.
• Stretch. Stretch your hamstrings & quads. Both legs. Hold the position & wait for the muscles to relax. No bouncing, take it slowly.
• Squat. Squat with an empty barbell for 2 weeks. Then add 2.5kg every workout. Knees out, don’t bounce on your knees & break parallel.
• Posture. Sit with your feet flat on the floor, not with your feet crossed under your chair. Check for lordosis.

Consult Your Doctor. It’s hard to know why you’re injured. It’s even harder to diagnose yourself without knowing what’s happening on the inside. Ario could have had a teared meniscus: similar pain, different treatment.

You’ve got some pain that doesn’t go away? Do like Ario: consult your doctor.

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