Patella tendon pain is a common occurrence within the active community and most particularly among distance runners. When dealing with knee pain of this type, it is important to consider how the lower limb is functioning globally. Movements from the foot to the hip or the hip to the foot must be considered.
In most cases, the pain experienced in the knee cap (patella) is due to a lateral pulling placed on it. There are two main structures that can contribute to this lateral pull. The iliotibial band (ITB) and the vastus lateralis (outer quad muscle). Tensions placed onto the ITB from hip muscles such as gluteus medius and maximus and the tensor fascia latae will contribute to the ITB pulling onto the patella. With regards to the vastus lateralis, the main reason believed to contribute to its lateral pulling onto the patella is the ineffective use of the vastus medialis (inner quad muscle).
Therefore treatment should consider both an increase of flexibility to reduce tensions placed onto the patella as well as improvement in function of the above hip muscles and quad muscles. Speaking from experience, over the last couple of years, due to an increase in long distance running (and my running technique!) I began to experience patellar pain in both of my knees. Last October I decided to get on a rehab regime.
I worked on my function from my hip down to my foot and received regular treatment to reduce tensions onto the patella. After a couple of months I have been able to reduce the pain I experience during daily activities and just recently I went for my first run. In that run I changed my running style, working on my pelvic positioning and used a mid to forefoot foot strike. Allowing time for these changes to occur has seemed to be very beneficial for my knee pain.
Unfortunately for me, my calves are screaming at me because of my new found running technique! Does anyone know a good sports therapist!?
Yes, that is right, even us therapists go through it!