My patellar tendonitis began during my senior college soccer season (fall 2016), and I’ve been battling it on and off ever since.
Even before my knee surgeries, I had severe tendonitis that turned in to a partial tear. Of course, I continued playing on it and eventually had to take about 6 months off to deal with it. Right before tearing my ACL and then dealing with two knee surgeries.
Since my ACL surgery with the patellar tendon graft, and then my partial meniscectomy, my tendonitis has not gone away. Instead, it is something that is always in the background, fluctuating with intensity.
However, I now have a pretty good handle on it, and feel confident pursuing my next professional soccer season. In this post, I will explain how I manage my patellar tendonitis as a professional soccer player.
Listen to My Body
If these three long-term injuries and two surgeries have taught me anything, it is to listen to my body. Back in 2016/2017, I refused to listen. I was under a lot of pressure, with a huge opportunity in front of me. I refused to take a step back or let my body rest until I absolutely had to.
Now, I am more aware. I try to listen to what my body tells me to manage patellar tendonitis. If I feel my knee getting sore, I have to adjust my training. Taking even a couple of days off does wonders for managing my tendonitis.
Softer Surfaces Help Manage Patellar Tendonitis
According to a study by the South African Journal of Physiotherapy, “training on hard surfaces is a risk for PT because of the load on the tendon. It has been suggested that softer training surfaces may reduce the risk.”
Anecdotally, this is absolutely true for me to manage patellar tendonitis. I absolutely cannot train on concrete, and softer surfaces work best for my tendonitis and my knee as a whole.
While in Germany during COVID-19 this past season, the field was shut down and we ended up training on our own on concrete. After a couple of weeks I was in crippling pain (mostly along my medial joint line, but some anterior pain as well).
To manage my tendonitis and knee after two surgeries, I have to stick with softer surfaces.
Proper Footwear for the Surfaces
Another big mistake I made before was to wear the wrong training shoes for the surface. While in Kansas City as an FCKC reserve, I normally wore my regular cleats on turf. Every. Day. Looking back, I do not think this helped my knee.
Turf shoes and Artificial grass cleats are made for that surface. Regular firm ground cleats are too high for that surface, and put more stress on my knee. I never wear FG cleats on turf or artificial grass anymore, and it definitely helps. I wear the Nike Tiempo Legend turf shoes or my recent purchase, the Nike Tiempo Legend AG cleats, which are made for that surface.
Heat Before Activity
Contrary to the popular recommendation, I do not ice my knee anymore. I apply heat using a heating pad. Heating my knee helps to warm up the tendon and often leads to less pain for me during and after activity. It also helps with recovery and in the long term will promote healing of that tendon.
According to the Mayo Clinic, “After the first three days, heat may provide a better benefit for chronic tendinitis pain. Heat can increase blood flow to an injury, which may help promote healing. Heat also relaxes muscles, which promotes pain relief.”
Diversify My Workouts
There’s no doubt that running is critical for soccer, however running is not the only way to work on your cardiovascular health or conditioning. I am now in a place where I simply cannot handle the same amount of impact as I could in college. To be able to play, I have to sacrifice in some other areas. For me, this means trying to condition using some other ways and incorporating other modalities into my training.
If I can spend X hours a week with impact, I want those hours to include the ball. Instead of spending my limited ability running for hours, I try to condition 1. with the ball and 2. in other ways. Some other things I’ve added to my workout plan in recent years include:
- Stationary bike
- Arc machine
- No-impact or low-impact HIIT workouts (I love the ones by Natacha Océane)
Knee Tape or Strap
I do not always do this, but if my knee is flaring up, I may tape it with K-tape or add a patellar tendon knee strap while playing. The K-tape can stay on for a few days, but I will only wear the strap during the activity. I learned how to tape my knee for patellar tendonitis from a former athletic trainer, but it is similar to the method in this video.
Isometric Lifting to Manage Patellar Tendonitis
During my recovery from ACL surgery and then my recovery from meniscectomy, I struggled to gain quad strength without irritating my patellar tendon. Every action meant to strengthen my quad (squats, leg extension, step ups, etc) bothered my tendon. Irritating the patellar tendon inhibit the quad. How could I work on strengthening without bothering my tendon? Isometrics.
Isometrics involve holding a position, rather than going through the range of motion for reps. Imagine doing a squat. Normally, you would load the weight and then go up and down for reps. With isometric squats, you would load the weight, go down in the squat position, and hold for a number of seconds before returning upright and racking the weight.
A study from the Clinical Journal of Sports Medicine and my former strength and conditioning coach recommend isometrics for strengthening the leg with tendonitis, and for even relieving the pain of tendonitis.
Supplements I Take for Tendonitis(Collagen)
I’ve mentioned it previously, but I also take a supplement to help with my joint health and patellar tendonitis. In addition to daily multivitamins, I take the Vital Proteins Collagen Protein Powder. This was recommended by my former strength and conditioning coach and I’ve been using it for over 6 months now. I plan to repurchase it soon. Evidence for collagen supplements for knee joint health is inconclusive, but one study I found suggests that it is helpful for supporting joint health and reducing pain.
Patellar Tendontis FAQ
How long have you had patellar tendonitis?
I have had anterior knee pain associated with the patellar tendon on and off for four years. Unfortunately, I had an ACL surgery (patellar tendon graft) and then meniscus trim which do not help with that issue.
Why did you get the patellar tendon graft if you had tendonitis?
I informed my surgeon of my history with patellar pain and the partial tear I had previously. She said the tear was fully healed, and still recommend that graft for its strength and reliability. Additionally, I pulled my hamstring 2 weeks prior, so it did not make sense to choose the hamstring graft. Cadaver was not an option for me as an elite athlete.
How do you get rid of patellar tendonitis?
I have not been able to fully get rid of my patellar tendonitis or anterior knee pain. For me, it is about managing and limiting the pain as much as possible.
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