I have been posting on here for a few weeks about some issues behind the back of my knees include tightness, a recurring cyst, etc. Another trip to the orthopedist and talking to my bike fitter and the diagnosis was popliteus and hamstring tendonitis (from a combination of factors including new shoes and a saddle that was too high). So what the hell does that actually mean?
Everyone throws around the word tendonitis, “Oh, I have some tendonitis in my shoulders, must be swimming too much” “Got some tendonitis in the elbow from playing tennis over the weekend.” What IS it? And the ortho prescribed a few weeks of physical therapy, ultrasound I believe? What does this do that promotes the healing over whatever tendonitis is?
as I understand it – an inflammation/irritation of the tendon. in some cases (ITB) when you aren’t properly stretched the irritation is caused because the tendon tightens and then is hitting up against bone during activity. so you have to let the irritation go down, then stay stretched to prevent it from happening again. i don’t know about hamstring tendonitis specifically though, maybe someone can speak more to that.
also sometimes i see it spelled tendinitis, don’t know which is correct though.
No one actually knows what tendonitis is?
Furthermore, what’s the relationship between the tendon that might be affected by the tendonitis and the corresponding muscle, ie. if you have hamstring tendonitis is this as a result of straining the hamstring muscle too much?
OK, as the anatomy/physiology teacher and PT I guess I have to take this one on. A tendon is the connective tissue portion of the muscle that attaches it to the bone. The connective tissue actually extends through the muscle, but the tendon has no muscle cells in it. Its microscopic structure is comprised of densely arranged strands of collagen, a fibrous protein, that run parallel to each other.
If you place excessive stress on a tendon you can cause small tears in the fibers. This triggers inflammation and the body attempts repair. The new tissue is not as strong because the fibers are more randomly arranged so when you go out to train the next time you cause more damage, which causes more inflammation and so on ad infinitum unless you remove the aggravating factors.
Ultrasound can speed up the repair process, increasing activity of repair cells or fibroblasts. It is important to allow the repair process to go ahead without causing further damage, so you may have to cut back on activities that make things worse.
KR
Thank you very much. So assuming it’s not a terrible case of tendonitis what are we talking about? 2 weeks of inactivity? 2 months? 2 years?
Thats kind of like asking “how long is a piece of string?” The answer is it depends. I find the worse you make things now, the longer it will take to heal. I wouldnt suggest total inactivity, because you need a **small **amount of stress to remodel the fibers. I have found that some deep water running and gentle stretching can help. Massage might also be helpfull. My personal guess would be 2 months, but its just that, a guess.
My wife had hamstring tendonitis at its origin onto the butt, wouldnt listen to me and kept on running. It then took her 3 years to get to the point where she could consider running again.
KR
Well the injury has been nagging for a month or two now so I am finally going to bite the bullet and actually take some time off. I have about 4 weeks of complete inactivity, other than some swimming, scheduled. Plus physical therapy 3 times per week for the next 2 weeks. After that I will reassess the situation. Cycling bothers it more so I may add the running in first and then the cycling.
If I were to get a massage what should I say to the therapist before going in?
More like 6 weeks if it is your achillies tendon.
Except last I looked the hamstrings and popliteus were a little more proximal than the achilles tendon!
4 weeks of swimming and PT should help. Make sure you find a good neuromuscular therapist who can evaluate you for muscle imbalances. The PT’s might be able to reccomend someone. If your hip flexors are very tight that can place more stress on the hamstrings. Make sure that you return to sporting activity gradually, if it starts to flare up again then you need more time.
I missed the entire '99 season with tendonitis, I learned the hard way to listen to my body and that a month off early on is better than a year off later.
KR
Yeah, there don’t seem to be any issues with my achilles tendon so that is good news.
What should I do to stretch my hip flexors to help ensure they aren’t stressing the hamstrings more?
“No one actually knows what tendonitis is?”
Ever heard of google?
“Ever heard of google?”
I live in China, our Google searches are limited and tendonitis is associated with the hegemony of Western superpowers so if I search for it I will end up in a forced labor camp.
Here’s the deal: You still don’t know what’s causing it. What makes you think that your return to activity in a few week’s time won’t result in the same pain again? You can theorize about recovery times and strategies and type like you’re being paid by the word on slowtwitch, but none of those things will solve whatever’s causing the problem.
- You changed shoes.
- Pain behind the knees is very commonly associated with a saddle that is too high, or with improper cleat placement.
- Different shoes have different stack heights, as well as other variances, and perhaps your new shoes require that you lower your saddle (I know you tried this, but maybe you didn’t lower it enough).
Just seems like you’re spending a lot of energy on everything but actually trying to solve the root cause of the problem, and doing so by taking on the most likely causes first.
Whoa, thanks for the advice, sorry to have peeved you so much. Just trying to take advantage of the knowledge of a large group of people.
I am going back to my old shoes. But only after following the advice of a knowledgable orthopedist about recovery time and physical therapy. Hopefully, a patient recovery and returning the the equipment and position I was in before the injury will have me all squared away. What more than that I can do, I don’t know. So I don’t know what you mean when you say "Just seems like you’re spending a lot of energy on everything but actually trying to solve the root cause of the problem, and doing so by taking on the most likely causes first. "
As I said, just getting as many opinions as possible, I didn’t even know what the popliteus was until Dan first brought it up in a thread about bike positions, so if nothing else, asking around was worthwhile for that bit of information.
Not peeved (well, except for asking someone else to define tendonitis for you when you’re capable of finding the answer yourself very easily - but it was early and I hadn’t had any coffee - my bad), it just seems like you’re trying to make this overly complicated. The injury you seem to have is very commonly caused by saddle height or cleat placement problems. Just go back to your original shoes, check and double-check your saddle height, (and make sure what you’re checking for is actually the correct height), and start over slowly.
That’s the plan, hopefully it will all work out. And I did do plenty of Google searches as well, it’s just nice to hear a description of a person who also understands how an injury or condition relates to the sport we do. Flying Wombat was very helpful and that’s kind of what a forum is all about.
Now if someone asked a question about economic statistics, that’s my field and I will try to help them out.