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September 6, 2012 / ShapedforFitness

Lesson Learned – Importance of Recovery Workouts

I’ve learned a big lesson recently about the importance of recovery days and recovery workouts.

After 4 months of intense training, teaching, and working out, my knee pain has become so bad I can barely walk downstairs without wincing in great pain. I’ve had knee pain while exercising for over a year but the pain was tolerable and I could manage it by icing and taking Advil after workouts. But, slowly the pain progressed to a constant painful ache while sitting and sharp pain while bending my knee and supporting my weight. Plies were killing me.

My husband finally convinced me to go see a doctor and I found out I have Quadricep Tendonosis. It’s an overuse injury that has caused the quadricep tendon, which connects the quadricep muscle to the patella (kneecap), to become irritated, painful and weak. Any time I flex my quads while walking, running, squating, lifting up my leg, sitting, standing, etc, I have pain above my knee.

How did it happen?

From . . . ..

“There are extrinsic (outside) factors that are linked with overuse tendon injuries of the knee. These include inappropriate footwear, training errors (frequency, intensity, duration), and surface or ground (hard surface, cement) being used for the sport or event (such as running). Training errors are summed up by the rule of toos. This refers to training too much, too far, too fast, or too long. Advancing the training schedule forward too quickly is a major cause of quadriceps tendonitis.

Intrinsic (internal) factors such as age, flexibility, and joint laxity are also important. Malalignment of the foot, ankle, and leg can play a key role in tendonitis. Flat foot position, tracking abnormalities of the patella, rotation of the tibia, and a leg length difference can create increased and often uneven load on the quadriceps mechanism. Any muscle imbalance of the lower extremity (from the hip down to the toes) can impact the quadriceps muscle and affect the joint.”

Check, check, and check, sadly that’s me

I’ve had 4 physical therapy sessions and found out my quads and IT band are extremely tight and are pulling the quadricep tendon like crazy.  Bottom line, I overtrained my quadriceps and didn’t balance my intense training with intense recovery. The good news is that the pain should subside with physical therapy, reduced training and muscle rebalancing.

Physical Therapy

Now I’m going to physical therapy twice per week for about 1.5 hours per session. In physical therapy they heat up the muscles with a heating pad and then give me a DEEP (painful deep) tissue massage on my quads, IT band, hips and glutes. One therapist found the tightest spot on my IT band and when he dug into it I started to sweat. After the massage, I go through a series of leg, hip and butt stretches. And finally, to rebalance my leg muscles, I’m doing exercises to strengthen my hamstring and glutes, which is also retraining my body to be less quad dominant.

More Recovery Days and Workouts

Rest is another key factor to my recovery so I’ve reduced my own personal workouts during the week and have modified my teaching. I’m doing a lot less demonstration and reducing the intensity of the movements. Thankfully I have some awesome regular students who show the advanced and high intensity options on my behalf.

For recovery “workouts” I’m doing lots of foam rolling, yoga and stretching. My Flexible Warrior DVD has been a huge help too:

Once I get back to health and the pain has diminished in my knee, I will return to my workout routine but will change one thing. . . .

For every increase in exercise, I have to increase my recovery.



Leave a Comment
  1. Cait the Arty Runnerchick / Sep 30 2012 8:16 pm

    oh yes, most of us have found out the hard way not to cheat on our recovery days! i hope u heal up fast and be sure to stick to ur pledge here. it’s something people can start to ‘forget’ about once they are back up and running on all cylinders…but my coach had a saying, “if u don’t take a break…one will be provided for you.” sending healing vibes ur way!

  2. Kelly / Jan 24 2013 3:27 pm

    Hi! I just was googling “quadricep tendonosis” and came across your blog. I have this same thing! However, my PT sessions have been unproductive and after ultrasound therapy and iontophoresis therapy I’m being sent back to ortho for another consult. I was curious if your physical therapy treatment was effective. Are you healed up? I see you posted this in Sept. 2012 and I’d love to hear how your leg is feeling now! My injury has been bothering me since April 2012, and I am still in as much pain as I was then. 😦 Thanks for your post!

    • ShapedforFitness / Feb 1 2013 4:18 pm

      Hi Kelly! Sorry to hear you have a similar injury to me. When I first saw the sports med doctor, he thought I had quadricep tendonosis, but the MRI showed I had partially torn the quad tendon from over-use. After learning about the tears, my PT drastically changed and I had to cut out most exercising and teaching.

      This injury has been the LONGEST recovery. My pain started to get bad in May 2012 and I got the MRI in late August. Now in Feb, I’m finally starting to feel better. I did about 10 weeks of PT and it helped a little, but I still had a lot of pain. Like you, I also got the ultrasound therapy, plus tendon massage, stretching, and did exercises to strengthen my glutes & hamstrings so I’m less quad dominant.

      But, over the last 2 months I didn’t go to PT and that’s when I saw the biggest improvements. Frustrating, right? Rest was a huge factor for me and not pushing my knee to do any painful movements. I’ve been doing the elliptical 3 times per week for about 30-50 minutes, yoga 2 days per week, and TRX workouts 2 days per week. I think my knee is reacting well to the controlled movements and slow body weight exercises. I’m also very aware of which muscles I use and focus on my glutes and hamstrings to do a lot of work. Just this week I was able to get through a TRX workout without knee pain! So happy to see/feel progress!

      Unfortunately, the doctors can’t do much for this injury. Rest and time do a body good. I think the elliptical also helped me because it created blood flow to the knee, which helps healing. Such a tough injury!

      Let me know if you have any questions!

  3. sciatica bergen county / Feb 17 2013 11:25 pm

    Physical therapy is important in reducing pain and permitting a safe return to normal activities. It helps you to remove any kind of knee pain.

  4. aida / Oct 31 2013 5:58 pm

    Hi Bri!

    I wanna ask, i have suffered knee pain for several months. Both knees. But more severe on the right knee. The pain area is on top of my knee cap. Is that Quadricep Tendonitis? It’s very difficult to do squats and jumping. Can you suggest an exercise routine that could help lessen the pain and at the same time helps to heal the pain?

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