One of my athletes that is planning on competing in an upcoming triathlon. He has been complaining of patellar pain for some time and the question is: “What can he do to make it more tolerable?” Notice I didn’t say “How could he make it go away?” If you are an endurance athlete, it is going to beat up your body by the very nature of the activity. Think about this for a minute….lets say I squat 500 pounds, sounds heavy right? Many coaches don’t want their athletes lifting heavy weights like this for fear of injury. Instead, these coaches have their football players go out and run 2 miles!!!! First, this has nothing to do with football and secondly, every time your foot strikes the ground, 3-5x your body weight in force is being transferred back up through your body. So if I way 200 pounds, every time I contact the ground, 600-1000 pounds is being transferred for every rep!!! Now how does that 500 pound squat sound? Any, enough of that tangent. If we examine the nature of triathlons, biking does not involve an eccentric contraction, only a concentric. So the issue of tendinosis/tendonitis arises (yet to be determined, I believe it to be tendinosis which is more chronic). This athlete has just rececntly started his strength training in November and has recently begun doing upper/lower splits. If we add in exercises such as the TKE to activate the tracking of the knee cap and heavy weights and make sure we utilize the eccentric contraction. Interestingly, he told me that he started doing leg extensions and it seemed to get better. Not the best choice in my opinion because of the torque it will cause around the patella tendon, but it does make him work the eccentric contraction. So we can see that an eccentric contraction is a must when trying to help alleviate patella tendinosis. A little Sherlock Holmes for ya.!