PT on the Net Research

Knee Tendonitis for Ex-Footballer


I am a 22-year-old ex-college football player. I have tendonitis in my right knee and am unable to train like I used to in order to develop leg growth. I have seen my leg development suffer because of the pain in exercises like squats and lunges. I seem to do the same exercises every time I enter the gym. They include leg presses, quad extensions and both standing and prone leg curls. I feel like I am not doing enough, nor am I shocking my muscles into growth. I wonder if incorporating Plyo's into my routine would increase production and development. Any suggestions?


There are a few things we should discuss prior to simply dishing out any exercises. Firstly, you are experiencing pain in the right knee, which you have attributed to tendonitis. My first suggestion is this: If this is a self diagnosis, I would seek the opinion of a medical professional ASAP and preferably one with a sports injury background. Moving on, if you are truly experiencing tendonitis, then there are several overlying issues that should be investigated prior to you continuing with you usual "hypertrophic" training regimen. Tendonitis may be defined simply as inflammation of a tendon. From a kinetic chain standpoint, let's look at what may have caused this inflammation and irritation.

Your body works in three planes of motion at all times (sagittal, frontal, transverse), especially during such dynamic movements as are required by football athletes. Traditional training methods still currently used for sports such as football often employ training methods that only adhere to the sagittal plane (i.e., leg presses, squats, leg extentions, leg curls, presses, etc). The problem with this type of training is that it does not teach the body to work in the other two planes and almost "locks" one into the robotic sagittal plane! Studies have shown that a vast majority of the current knee traumas are due to a NON-CONTACT injury, where the athlete was trying to decelerate, or land, in the transverse plane.

One must understand that the body's muscles work in synergies not in isolation. The muscle imbalances that can develop due to chronic isolationist sagittal plane training methods may very well be the underlying cause of such knee problems as tendonitis. These muscular imbalances may well lead to faulty movement patterns, causing micro-trauma at the problem joint and over time exposing themselves as injury and pain (tendonitis). So, what do you do? To prevent causing any further irritation to the injured joint, I would definitely stay away from plyometrics right now, as power training may simply reinforce the faulty movement patterns that have caused your problem in the first place.

I would begin with a corrective flexibility protocol, along with a core/neuromuscular (balance) training program that would appropriately progress you from stability-based exercise back up to strength and hypertrophic exercises. To do this, I would suggest once again that you seek the opinion of a medical professional. Next, if possible, find a fitness/performance professional who is familiar with integrated training techniques and kinetic chain concepts. Take time to read Mike Clark’s article series, “Essentials of Integrated Training.”

It is very difficult to give out specific exercises without having done an integrated kinetic chain assessment, but a great place to start is with your flexibility. Here are a few stretches to work on. Good luck, and remember, function first, aesthetics later!

These and other stretches can be found in the Exercise & Flexibility Library.