MRI - Patella Tendon -

Triathlon Forum
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This might be as much for me as anyone else, but maybe someone has an opinion as well. I’ll update as I get more information. Right now a bit gutted as this was supposed to be my season to go nuts with tri.

I’m headed to the Sports Doc on the 9th, so this is just conjecture until then. So I had a Osgood Schlatter as a kid, and it left me with a large bone spur that broke off and started floating in my patella tendon. It woudl hurt with any real running mileage. Through a series of events, I didn’t get it removed until the beginning of February 2025 by which time I had a 30% tear in the Patella tendon. They removed the loose body, but didn’t do anything about the tendon as it wasn’t tore enough to do anything with. I had PRP done as well during the surgury to hopefully have it heal better. Ortho Doc said I could start running after 8 weeks. Slowly ramped up after that, and in the last few weeks it really started hurting again. Had another MRI and radiologist report is as follows:

-Patellar tendon distal thickening and tendinosis with superimposed interstitial partial-thickness tearing along medial fibers involving 40-50% cross section over 2 cm height.

-Quadriceps mild insertional tendinosis without tear.

-Curvilinear and bandlike scarring at the anteromedial and deep aspects of Hoffa’s fat pad from previous arthroscopy. No loose body. Small to moderate-sized joint effusion. Baker’s cyst measures 5.8 cm height

I have Oregon in 3 week and Copenhagen in 7 weeks. I’m wondering the likelyhood of rupturing the tendon if I continue running on it, and whether PRP, shockwave, corizone, ???, might be something to consider?

Maybe we could just order new legs from Amazon?

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I’m 90% through a PhD on tendons if it helps…

Low risk of rupture. Most people who rupture interestingly don’t have pain prior. A rupture in an endurance sport would be very unusual
I’d avoid PRP
Shockwave is low risk but the evidence is not great for patella tendon (ie it is generally not helpful)
Corticosteroid can be good for a certain subgroup of tendon and can be good for short term (but not long term) symptom improvements
An exercise program might be a good adjunct

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Thank you so much for the reply. I’m going to a PT 1x a week, but will probably bump that up to 2x. The other item non mention is I have Crohn’s so I’m super suseptable to inflammation. Cortizone usually does wonders for me, but I was worried about a rupture with it.

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there is a theoretical risk of rupture with corticosteroid injection although (to my knowledge) it’s never been proven to increase rupture rate. Often the advice is to have 5 quiet days after an peritendon (around the tendon) injection in a reactive (acute flare up) tendinopathy.

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Sounds like if comes down to what you want, or you looking for reassurance here?
You want to be in pain and do a couple races or want to get these fixed in a timely manner and hopefully have a speedy recovery?
Pain sucks, it fucks up every aspect of your life.
How old are you?

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HI Mike, I hear you. I’m 55, so not a spring chicken. Like all of us I want it all, I want to race fast and hard and not be in pain. :wink: I think its to vent as much as anything. Ideal would be a cortizone shot and race out the season in minimal pain, but not if it is likely I would rupture the tendon. It really comes down to how risky that is. If it’s torn a fair bit more since surgury I’ll probably race Oregon in a few weeks here and then go into full rehab mode vs pushing on with the full 4 weeks after that. If it’s about the same I’ll do whatever the doc suggests either cortizone or eswt. I’ve read enough on PRP that I don’t think that is an option unless I’m done for the season.

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I broke down last fall and decided on getting surgery for my issues. I elected on aggressive treatment vs the lets treat the symptoms and ride it out. Once I decided on that all I did was hit the gym hard and packed on some muscle. I mentally tapped out of doing any swimming, cycling and running. I’m now 3 1/2 months post and in a pretty good return to run rehab program.
I get it on the venting part and with you for the most part on doing it here. I hope you have a Doc who is understanding and thinks out of the box so it goes along with your goals. Hope it works out for you.