Tendonitis: Recovery Tips for Runners Preparing for a Marathon

Sports Injury: Tendinitis

Hello, doctor.
I have a regular habit of jogging and am currently preparing for a marathon.
Due to overtraining and insufficient stretching, I developed tendonitis extending from the inner side of my knee to the popliteal fossa.
I have seen a rehabilitation specialist and am actively using heat therapy and low-frequency electrical stimulation at home, while also stopping all exercise for nearly a week.
The original pain point is not as severe, but it seems to have transformed into a general soreness in the entire leg, especially in the hamstrings.
I can feel it when walking, but it’s not uncomfortable; it just feels strange.
Is this a normal condition during recovery? How can I determine if the inflammation is worsening? Additionally, how long does it typically take for tendonitis to heal? If the marathon is at the end of March next year (with no competitive goals, just aiming to finish), can I still participate? Thank you.

Ku Nao Xiao Li, 30~39 year old female. Ask Date: 2015/11/30

Dr. Xu Yongnan reply Rehabilitation

It may not just be tendinitis; please have a clinician evaluate for any lumbar spine issues.

Reply Date: 2015/11/30

More Info

Tendonitis, particularly in runners preparing for a marathon, can be a significant concern, especially when it arises from overtraining and inadequate stretching. Your experience of pain extending from the inner knee to the popliteal area indicates that you may be dealing with patellar tendonitis or another form of tendon inflammation. It’s encouraging to hear that you have sought medical advice and are actively engaging in rehabilitation practices such as heat therapy and low-frequency electrical stimulation.

Understanding Your Symptoms
The fact that the original pain has diminished but you are now experiencing a generalized soreness in the entire leg, particularly in the hamstring area, can be a normal part of the recovery process. When a specific area of the body is injured, the surrounding muscles may become tense or overworked as they compensate for the injured area. This can lead to a sensation of tightness or discomfort in those muscles, which is often referred to as "referred pain."

Signs of Recovery vs. Aggravation
To determine whether you are recovering or if the inflammation is worsening, monitor the following:
1. Pain Levels: If the pain is gradually decreasing and becoming less intense, it is a good sign. However, if you notice a sudden increase in pain or if the pain becomes sharp or debilitating, this could indicate that the condition is worsening.

2. Mobility: Improved range of motion without significant pain is a positive sign. If you find that certain movements are becoming increasingly difficult or painful, this may warrant further evaluation.

3. Swelling and Inflammation: Monitor for any signs of swelling or redness in the affected area. If swelling increases or if you notice warmth in the area, this could be a sign of aggravated inflammation.

4. Functional Ability: If you can perform daily activities without discomfort, this is a good indicator of recovery. However, if you find that walking or other activities become painful, it may be time to reassess your rehabilitation strategy.

Recovery Timeline
The recovery time for tendonitis can vary widely depending on the severity of the condition, the specific tendon involved, and your adherence to rehabilitation protocols. Generally, mild cases of tendonitis can take anywhere from a few weeks to several months to heal. Given that you are preparing for a marathon in March, you have a few months to work with, which is beneficial.

Preparing for the Marathon
Since your goal is to complete the marathon rather than compete for time, it is certainly possible to participate, provided you continue to manage your recovery effectively. Here are some tips:
1. Gradual Return to Activity: Once your pain has significantly decreased, gradually reintroduce running. Start with short distances and low intensity, and pay close attention to how your body responds.

2. Cross-Training: Engage in low-impact activities such as swimming or cycling to maintain your cardiovascular fitness without putting excessive strain on your knees.

3. Strengthening and Stretching: Focus on strengthening the muscles around your knee and improving flexibility. This can help prevent future injuries. Incorporate exercises targeting the quadriceps, hamstrings, and calves, along with regular stretching.

4. Listen to Your Body: Be mindful of any discomfort during your training. If you experience pain, it’s essential to stop and reassess rather than pushing through it.

5. Consult a Professional: Regular check-ins with a physical therapist or sports medicine specialist can provide you with tailored exercises and adjustments to your training plan.

Conclusion
In summary, your current symptoms can be a normal part of the healing process, but it’s crucial to remain vigilant about any changes in pain or functionality. With proper management, you should be able to participate in the marathon. Focus on gradual recovery, cross-training, and strengthening exercises to ensure that you are in the best possible shape for race day. Remember, the goal is to finish the marathon, and listening to your body will be key to achieving that.

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