Ann is a 24 year old female who came to our office with pain just below her left knee cap.
She was a runner and was training for a half marathon. She reported a similar pain in the past, but it was mild and transient. This pain had been present for two months and seemed to be slowly getting worse. Ann told us that the pain improved as she ran, but after each run it returned with a vengeance. Her goal was to be able to compete in the marathon, which was ten weeks away.
Ann was generally in excellent health. However, examination revealed a shortening of the quadriceps and calf muscles on both sides.
It also revealed restricted joint motion in her ankles and left sacroiliac joint. When she balanced on one leg, she was very shaky and unstable bilaterally. Direct pressure on the patellar tendon revealed tenderness, indicating a diagnosis of patellar tendonitis.
Our team put together a plan including the use of a patellar tendon strap, joint manipulation, myofascial release to the left quadriceps muscle and patellar tendon, therapeutic ultrasound to the patellar tendon, and specific exercises for muscle lengthening and improved balance. Ann was to lay off running for one week, after which she would gradually reintroduce her training to her tolerance.
She followed our plan and recovered wonderfully. She was able to compete in the race and actually set a personal best time.