My client has bilateral patella tendonitis. She developed this problem 10 years ago when she was quite active and took part in karate and dance. It hinders her to the point where it is painful even at night when she is lying down. I was wondering if working in eccentric phase would help.
Thanks for your question. Bilateral patella tendonitis is a very common yet general diagnosis. The diagnosis is defining the problem but not the cause. In response to your eccentric question: yes, you must eccentrically move. In fact, efficient movement is impossible without eccentrically stimulating the body first (we load to unload during all functional movements of life). In addition to your question, my strong suggestion is to define what function you need to assess in an attempt to uncover the CAUSE of her problem. The assessment selection should be based on what your client needs to do. For example, select from the following fundamental movement patterns: walking, jogging, running, hopping, skipping, lifting, shifting, transferring, pivoting, squatting, stepping. Of course, there are many, many ways to perform each motion listed – select the motion and direction based on your client’s needs. I would pay close attention to the foot/ankle and hip complex seeing as they are part of the knee complex. First assess to see if she has the motion. If yes, can she transform the motion from one direction to the next efficiently, and where are her successes (what movements are successful versus inefficient)? Once you have determined where she is successful, you will have a baseline to start (review the list of movements). Continue to reassess her ability to function efficiently WHILE paying attention to her symptom. The key with all clients is to search for the cause and compensations while decreasing the symptoms or complaint. To learn more about function of the patella femoral joint assessment, rehabilitation and conditioning for prevention, please see Gary Gray's Functional Video Digest on Patella Femoral. Gary and Dr. Tiberio will walk you through the complexities in an easily understandable and yet practical way. Good luck!