Quad/Patellar Tendonopathy Help

Hey all,
Here is some basic info about me:
42 years old (ya im old)
Training since about 28 years old
Natural never taken anything but creatine
6’0"
192lbs (been on a slight cut since december lost about 18lbs and then stabilized)
Probably 13-15% bodyfat as a guess
I have trained powerlifting style primarily for the last 4-5 years. I do blocks of higher volume here and there. Have only competed once, 1201lbs total, competed a second time but had a slight tear in my abductor on my first squat attempt and couldn’t continue.
Best in gym lifts (not that it matters much)
595lbs sumo deadlift (probably 525-535lbs conventional right now)
430lbs squat
275lbs bench

I am a long limb person with a +4 ape factor on my wingspan 6’4". Legs are long as well so squatting requires a good bit of lean for me. I have a short torso. These combos is what I suspect makes me stronger at sumo, hence the reason its much higher than other lifts. Never have had a lot of pressing strength with my upper body…My legs aren’t very big around either…

6 months or so ago i began to get patellar tendonitis in my right knee right at where the tendon meets the knee cap. I reduced load somewhat, but kept most training the same. It grew in its inflammation and pain slightly and eventually i believe while compensating for the pain level there i caused some slight quad tendonitis in my left knee. Again, right at where the tendon meets kneecap.

Its been 3-4 months like this. I haven’t squatted over 275lbs in this time. Ive tried what feels like everything. Initially working through pain, then dropping load and volume more and more. Ive tried stopping squatting all together also in that time.

So far ive tried 3-0-3 squats, pause squats, knees over toe front squats, banded wall sit(whatever its called), pistol squats, bulgarian split squats, step ups, single leg leg press, leg extensions with 3 second holds, and more.

Ive tracked pain as best I can to try and see what works and doesn’t. Tried taking fish oils, icing several times a day, and have tried to treat each leg specific to what i would need (being one patellar and one quad). Not been doing any NSAIDs.

The pain seems random. i wake up during the night with them aching a good bit. they hurt sometimes right after a workout, but then feel good the next day. then they’ll hurt they day after that. Then the next workout they feel good after the workout but hurt the day after. Ive tried training through the pain, and maybe that is my answer? I can deal with a good bit of pain there, but it seems like i go too far with that approach.

Overall I want to return to normal life where when i go to sit on the toilet or chair i don’t have to support myself due to pain of knee flexion. Both are quite tender and i can push on the tendon and tell it hurts and is inflamed.

Would like some direction if you guys have anything to offer. At this point im thinking of maybe given it another 3 months and then trying some medicinal solution with cortizone or other shot or maybe a doctor prescribed steroid (not TRT lol)? Im just pretty bummed that I can’t train normally (i am able to deadlift fine) and that i am dealing with random throbbing pain that comes and goes. It is always slightly painful to bend my knees past 45deg from straight right now.

Thanks for any help!

Hi there,

Sorry to hear about this issue. I’d start out by checking out our free resources on the topic here:

Beyond these articles and the recommendations they contain, it sounds like you’ve tried quite a lot of things. I do not think that steroid injections would be wise in this situation. Rather, setting up a consultation with our rehab team and some guided training would be my approach, if I were in your situation.

Thank you for the reply Austin. While I have found some of your articles I hadn’t seen these, so I will review. I suspect that maybe I need to keep working to find that entry point, and maybe that means further reducing intensity and volume for now. If that doesnt work after a few weeks I may reach out to y’all for some guided rehab. THANKS!