I have to be honest, even though this group of conditions are all pretty similar, I chose “Runners Knee” as the title because I figured it would tantalize many of you who like to torture yourselves with this repetitive stress. All kidding aside most patellar tendon stress is caused by? Wait for it… A MUSCULAR IMBALANCE! By this point you should already know the answers to these questions because the answer is always the same. Lets run through some scenarios so you can see what I mean. Patient walks in, “My knee hurts!” Upon our analysis we find that the quads are strong and tight, but the hip flexors are weak.
This results in extra stress on the quad or patellar tendon. By the way, they are the same tendon. Above the patella it is known as the quad tendon, below the patella it becomes the patellar tendon. I know. Silly! I’m pretty sure a bunch of guys with pipes and handlebar mustaches back in the day were sitting around drinking absinthe and starting naming things with no rhyme or reason. “You know, Mortimer, lets change the name of the same tendon based on its location. That’ll keep them guessing!” Or something like that. Here is another scenario. For someone who jumps, or propels themselves forward or upward with any degree of force (Uh, that’s everyone) there is a maneuver called “Triple Extension,” which was coined for Olympic lifting. It transcends lifting and is applicable to all activity. To propel oneself, you must extend from the hips, extend from the knee and extend (plantar flex) at the ankle.
The muscles that create this triple extension are the Glutes, Quads and Calves. Generally speaking. If the patient cannot access their Glutes, their Quads may attempt to make up the difference causing more stress on those Quad tendons. See a pattern? Oh, and for Mr. Schlatter? Same mechanism of injury. The only difference is that we are talking about a skeletally immature individual whose growth plates have not yet fully fused. The Patellar tendon is pulling with great force (because of an imbalance) and its attachment, the tibial tubercle, pulls away a layer in its underlying growth plate. It is a cycle of pulling away and fusing, pulling away and fusing.
This eventually causes a larger than normal bump on the tibia just below the knee cap. How do you fix it you ask? Simple. You visit True Sport Care where you will learn which muscles are strong and which are weak. You will then perform the prescribed exercises and you will tell everyone how amazing you feel and how handsome and intelligent Dr. Marc happened to be.
