Q&A With Brian
Hi Brian, I have quadriceps tendonitis, it has slowly come on and is worse in one knee than the other. There is no pain once warmed up can could train all day. The problem is when my quads/upper knee are not warmed up. Is the treatment for this different to R.I.C.E? Thanks, Pete
I'm really sorry to hear about your injury. The two most common causes of anterior knee pain in an athlete are the condition known as patellofemoral syndrome and patellar tendonitis. Differentiating between the two causes of anterior knee pain can be difficult since both often present with similar symptoms and signs. The difficulty is compounded by the fact that these two conditions frequently go together.
The type of activity which creates the pain gives the best indication as to which one of the above conditions is the cause. If the type of activity involves repetitive loading of the patellar tendon (knee cap) like basketball, volleyball, jumping then I’d lean towards patellar tendinitis.
On the other hand, if a distance runner, then more than likely the pain you are experiencing is patellofemoral syndrome. In your note you indicated quadriceps tendonitis as the diagnosis.
Treatment for both
Regardless of the diagnosis the treatment is similar.
1. Modify activity – I bet you didn’t want to hear this however in cases of moderate to severe tendonitis it is essential to modify activity levels. Pete I’d suggest to look at what training you are doing and modify it especially if it involves jumping and long distance running. Basically give you tendon an opportunity to repair with further assault.
2. Reduce inflammation – with regard to your original question about whether the RICE treatment plan is appropriate; certainly icing the area will be beneficial for reducing inflammation. The degree of inflammation present must be reduced to minimize pain.
3. Soft tissue therapy - can be very helpful for the tendon health as it will increase local circulation and decrease adhesions between the tendon fibers. Massage of the quadriceps will help too as this will reduce the pull of the tendon. An experienced physiotherapist or massage therapist will be able to help you here.
4. Stretching – tight muscles around the knee joint, especially the quadriceps and hamstrings, should be stretched.
Pete what you have is a preventable condition. If you follow my recommendations above and I’d seek professional treatment, you should be back to full speed very quickly.