Hi there, this is basically my last resort before I consider something like prolotherapy or even surgery.
I used to be a competitive Olympic weightlifter but had to stop because of a chronic tibial tuberosity pain on my left knee. It is now in danger of affecting my future career as I have to take certain fitness tests for this job, but simply cannot train adequately without pain and can't get my conditioning up to snuff.
It is only my left tibial tuberosity, and I did not have Osgood as an adolescent (I was quite active then). To be noted, I broke my left foot at 18 years old (three metatarsals) and had no knee pain before then, so it is my belief that over-pronation and subsequent poor bio-mechanics/knee tracking during exercises such as a squat/deadlift/etc eventually caused this problem.
I first felt this tibial tuberosity pain in May of 2011. I had some general patellar tendinitis (or osis) before this but it was a very minor discomfort, and never caused me to alter training or see a specialist. I remember one specific rep on the split jerk exercise, however, where I felt a twinge at the tibial tuberosity, like something tugged at it, and since then, I've had a tibial tuberosity pain that has not gone away. I even took three months completely off from leg work last year, and the pain came back and tenderness on the tibial tuberosity remained.
I've had an X-ray, which showed nothing. I've had an MRI which said not much at all either: "IMPRESSION: 1. Grade 2 chondral thinning of the posterior lateral tibial plateau with underlying bone marrow reactive change." I am getting a repeat MRI in 2-3 weeks.
I have seen two physical therapists (currently seeing one of them), and one orthopedist (seeing him as well). The first physical therapist said it was tender because my pes anserine/VMO were weak so she had me do exercises for those areas, and also said my lateral quad and rectus femoris were really balled up and had deep tissue massage done on it every session. This didn't really work for me after 3-4 weeks and the pain was still bad.
I then took three months off, and I saw my second physical therapist. He said basically jumper's knee/patellar tendinopathy, and did some Graston on the patellar tendon, had me do some decline single-leg eccentric squats (3x15 in the morning, 3x15 at night) adding weight every time. This seemed to work at first and I thought I was all cleared up, then I had a prolonged rest over the holidays (lots of sitting in the car as it was a road trip), and the pain came back. I tried doing the single-leg eccentric squats again but it did not work. I realize pain during the squats is a good thing, but before I was getting pain under the knee cap (not on the TT) and would actually feel better the next day. This time when I came back to the squats however, the pain was on the tibial tuberosity and not under the knee cap, and the pain was worse and worse. It's been a week since I last tried it and I still feel tenderness on the tibial tuberosity, even when I slightly push on the area.
So this is where I'm at currently. I saw my ortho again (fourth time) recently and he wants me to annoy it for 2-3 weeks, and then come in for an MRI at their place of business. I am going to see my physical therapist again in 1.5 weeks (he described my problem as acute-on-chronic). My ortho also referred me for an appointment with the chiropractor of an NFL team to see what he can do.
Is surgery or prolotherapy my only option at this point? It's starting to seem that way. Thanks for reading all this... I wanted to be as in-depth as possible so I realize all this text may be a bit of annoyance.
Asked by pbandy1 - 5 answers - 5 years 4 weeks ago