Hi. I had to laugh when I saw...that bloody tibial tuberosity! I agree! I had a surgery on my left knee 40 years ago where they took the whole tendon and it's insertion in the tuberosity and moved it across the front of my knee from the outside to the inside to correct a laterally tracking kneecap. Worse surgery I've ever had. Pain like you wouldn't believe and 3 months in a cast. And then came word that new research had shown that the kneecap was SUPPOSED to move the way mine did. They actually undid a good kneecap and made it worse. The pain I had was from something else all together. Now the tuberosity is on the inside of my knee and I can't kneel down without excruciating pain.
Anyhow...your knees. Since the patellar tendon inserts into the tuberosity, I'd imagine that tendinitis is a good probability. I get it all the time and it can be very localized and not where they usually expect to find it. There is also a protective fat pad behind it that can become inflamed. And in between is a bursa but that is slightly above. I bet it's a very bad localized tendinitis and fat pad inflammation that has set up inflammation at the base of the tendon along with the bone. When I had my knees replaced they had to cut through the area of the old surgery and it was really painful so the area alone hurts with any injury.
So what would I do? I'd start with applications of heat as often as you can. Ice is good when it first starts to reduce swelling but that area has a lousy blood supply so heat will help to restore the blood supply and reduce inflammation. Try wrapping one of those thermal heat wraps around it especially at night. Use an ACE bandage during the day to help you remember to keep your leg as straight as possible for a week or 2. If you don't bend the knee, you don't use the tendon and it can't get inflamed. Try taking ibuprofen regularly, like 200 mgs to 400mgs 3-4 times a day(take with food) to reduce the inflammation further. After a couple of weeks, start slowly stretching the tendon by carefully bending it....no squats. Exercising the quad muscles will help too to strengthen the whole leg and take the pressure off the tendon. You should be able to find quad exercises on the web.
What will this do? One, it should knock down the pain and maybe even knock it out. If it does, you know it's a tendon inflammation. Then you can repeat this as necessary as soon as the pain returns. Takes persistence to get rid of a deep seated tendinitis. Treat as soon as possible as aggressively as possible.
If the pain doesn't go away, then you've eliminated tendinitis and i'st time to see a Sports Medicine specialist...usually an orthopedic doc who specializes in these types of repetative injuries and inflammation that others may not be aware of.
But don't let it go. Stay on top of it. The changes in the tendon or bone may just have not shown up yet.
But from personal experience(14 knee surgeries and counting) I've found that the best docs will ask YOU what is wrong as you know your body best. They will listen and develop a personalized treatment program for your knees. Not all knees are the same.
In the meantime, try what I suggested and see if it makes any difference at all. That is a start. And I'll do some research too.
Hang in there..................Jenny
