About 6 or so months ago I got an MRI of my knee and the doc said it was patellar tendonitis. His advice was no extension type movement or any sort of strain on my quads for 2 months and I would be good as new.
Well that didn’t work and the sports medicine doc today said it has lead to my VMO to become atrophied which now is causing my knee to track improperly.
His advice was to do extensions with my foot pointing outward and wall squats with my back on a yoga ball. Basically any exercise that will strengthen my vmo without putting too much load on it.
Considering the shitty advice I got from the first doc any sort of advice on fixing this would be appreciated.
Tell that doctor to show me one study where “turning your toes outward” will help fire your vmo more than your other quad muscles.
If your tracking is off, find a qualified PT and get him/her to tape your patella in place. This will do nothing long term, but it will keep your patella steady while you work on your legs.
IF you do some Poloquin Step ups, it’s like a terminal knee extension where your working leg is angled downwards and you are focusing your push from the heel and ball of that foot, or even do some hack squats, that will help build VMO a little quicker than just pointing your toes outward.
Depending on the severity of the tracking problem, these exercises may cause pain if your patella isn’t taped, but try them out for a while. And be prepared to have no strength or balance initially on those step ups.
As for the patellar tendonitis, I have the same problem, but find that a Cho-Pat strap really helps keep the pain to a minimum. That first doctor pisses me off, sure there are a few movements you should probably stay away from initially, but I still play basketball, and run 10-12k/week as long as I am wearing the strap.
I am a post rehab specialist, and it really surprises me how many doctors just prescribe patients to “stop doing everything” whenever they have pain. I work with clients who are always in pain, and on more than one occasion, they have taken “breaks” from training because of something a chiro or family physician will say… Last time I checked, that kind of stuff was my job.
I also train more than a few doctors, hwo know absolutely NOTHING about exercise, muscles, the effect exercise has on the body… etc. It’s nice to switch their point of view so maybe they will stop giving out shitty advice like this.
In terms of decreasing patellar tendonitis/anterior knee pain, I encourage a lot of glute activation and strengthening exercises, while also working on hip flexor flexibility and general hip mobility. Check you ankle mobility as well as that can cause added stress on your knees during motions if the ankle can’t achieve proper dorsiflexion.