Down with Quadriceps Tendonitis

It turns out that it is not a simple Quadriceps Strain. Worse, it is a Quadriceps Tendonitis (QT) — “the inflammation and irritation of the quadriceps tendon.” It is the tendon that connects the large quadriceps muscle to the knee (see picture below taken from a website).
Source: eorthopod.com

Source: eorthopod.com

 When It Started. I felt the pain hours after the RUNew event. The pain was concentrated just above my left knee. It was most painful when I tried standing up from a seated position. I immediately drank a prescribed anti-inflammatory medicine to relieve me of the acute pain. The pain did subside but I knew I had to see a doctor. I have learned a valuable lesson that is is best to immediately consult a doctor at the onset of pain.

I went to see an orthopedic doctor 2 days after (not the one I regularly see at Medical City). He examined my injury and he concluded that it was a quadriceps strain. He advised me to rest and do lots of stretching. He said that it should be gone by 1 week. I strictly followed what he said — warm compress and lots of stretching. However, the pain was still there. It did subside a bit but it got me worried that it might not be just a strain.

Last Saturday, I decided to see my orthopedic doctor at Medical City, the one I regularly see. I purposely did not tell him that I went to see a different doctor to see if the diagnosis would be the same or not. He examined my left knee by pressing and putting pressure below it, on the side and above. Again, I felt the pain just above the knee. Finally, after lots of Q&A and examination, he concluded that it was Quadriceps Tendonitis.

Doctor’s Explanation. He explained that the pain I feel is consistent with QT. It might have been aggravated when I ran too fast on a downhill. But the doctor further explained that it was an accumulation of the activities that I do that might have contributed to the injury — sudden increase in the intensity of the bike & the additional weight put on while doing leg exercises. The downhill run was just what triggered the injury. In summary, it is caused mainly by overuse.

Doctor’s advise. After the diagnosis, comes a litany of advises and precaution.

  • As expected, doctor asked me to rest from running. I can bike (stationary bike) at a very easy effort. Hopefully, it should fully heal by 2-3 weeks.
  • “Fully heal” are the operative words that I must keep in mind. If I run too soon, chances are it would just recur and I would just be going back to the same resting routine. At its worst, the tendon might rupture/tear and surgery would surely sideline me for at least 6 weeks.
  • Do a lot of stretching of the quadriceps
  • Drink 1,000 mg of Vitamin C once a day to help in the healing of the tendon
  • Do not drink anti-inflammatory drugs for now as it sometimes delay the healing

In Danger of Missing the Condura Run. The injury did come at an unfortunate time when I had made very good progress for the 21K Condura Run. I am now into my 2nd week of no running. The pain has considerably subsided with rest and lots of stretching. But I do not know if it is still feasible for me to run 21K considering that I can, potentially at least, get back into running by Mar. 16, the Condura Run week. Right now, I am taking it one week at a time and hope that my condition improves. At the same time, I am preparing to accept the fact that I might not be able to run 21K. It is quite saddening to think about it but the consequences (e.g. tendon rupture, surgery, at least 6 weeks of no running) are far more severe.

There you have it. Whether I can run or not, see you at the Condura Run. Happy Running!

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A Heart’s Tale: Sinus Bradycardia and Right Bundle Branch Block

During my month-long sabbatical from running (due to an injury) last December 2008, I also decided to have a complete blood work-up. I had a hunch that I had high levels of uric acid. I consulted the company doctor and after reviewing my medical history, she recommended that I also take an ElectroCardioGram (ECG). (Fortunately, I can have all those tests for free courtesy of the health insurance benefit in the office).

 

True enough, I had high levels of uric acid, which can be treated by a prescription drug. What got me really worried was the result of my ECG. I was intimidated by the diagnosis: Severe Sinus Bradycardia and Incomplete Right Bundle Branch Block. I sat for a while and pondered what those things mean. I guess, anyone would get nervous when the “heart” is associated to the words “severe,” “incomplete” and “block.”

 

I immediately called my brother, a doctor at Medical Center Manila. His explanation was that I had a low resting heart rate but the beat or rhythm was regular (which is good). The reading in my ECG was 45 beats/minute (bpm), below the normal of about 70 bpm. He did mention that it is also common to those who exercise (or run) regularly and may indicate a healthy heart.

 

I then informed my wife of the result and mentioned to her the explanation of my brother. After several minutes, she sent me an email that also gave a comforting explanation. An excerpt of it read (from a Q&A article from The American Running Association website):

 

“In general terms, the presence of a mild sinus arrhythmia is really a finding of increased vagal tone. This can be a feature of athletes’ hearts.”

 

“Incomplete right bundle branch block is a common normal variant found on electrocardiogram and is also another finding that is often associated with an athletic heart and is of no consequence.”

 

“Overall, the findings of an incomplete right bundle branch block and mild sinus arrhythmia are signs of an athletic heart, and they are not likely to develop into an unhealthy condition. I believe you should forget about it and continue with your excellent running.”

 

Just the same, and upon advice from my wife and brother, I took a half-day off from work the following day and went to my cardiologist. This visit proved to be very comforting and reassuring. He said:

  • That I have nothing to worry about because, like my brother said, it is a sign of a healthy heart.
  • That my condition also allows me exercise and do long-distance and endurance runs because it takes longer for me to reach my maximum heart rate (MHR).
  • He advised me to continue going to the gym and with running.
  • However, he also said that once I feel any dizziness and/or chest pains, I should immediately see him. That while there are advantages, there are also some symptoms to watch out for that may cause me to faint.

Looking back, I am glad that I made the decision to have that check-up. It seems pretty intimidating but, at least, I now know my limits and I know how to go about it. From now on, I will make it a point to have this kind of checkup at least twice a year. I guess, it’s always better to be on the safe side.

 

PS: Sharing some articles I’ve read about the topic:

 

http://www.medterms.com/script/main/art.asp?articlekey=19707

http://emedicine.medscape.com/article/760220-overview

http://www.merck.com/pubs/mmanual_ha/sec3/ch47/ch47f.html

http://emedicine.medscape.com/article/894927-overview

http://www.merck.com/mmhe/print/sec03/ch027/ch027k.html

http://en.wikipedia.org/wiki/Right_bundle_branch_block

 

Happy Running!