Patella Baja/Contracted Patellar Tendon and Heavy Squats

[EndlessNameless]

I did a search for this and couldn't find anything, which isn't a surprise as it's a pretty rare condition from what I understand, and am looking for some info, especially from the doctors around the forum on this issue. I'm a 35 yo male, 5'10", 186 lbs at the moment, up from about 170 or so in October. This is my second go at SS after doing the program 2 years ago and getting sidelined by an Appendicitis and falling off the wagon until now.

A brief rundown of my issue:

Knee injury in 2012 (I was 30) required surgery for a ligament reconstruction, which led to major complications with Arthrofibrosis (massive scarring). I went through multiple surgeries to remove adhesions. My range of motion was greatly restricted, but improved with 1 1/2 years of PT. It was a total nightmare, I was facing being pretty much disabled my knee was so locked up. Flexion went from 10 degrees to ending up with about 120 degrees. I still lack ~5-10 degrees of knee extension, but I can walk pretty much normally now. The end result was a contracted Patellar tendon (Patella Baja).

My range of motion is good enough to do a proper below parallel squat. I have limited Patella mobility and the Patella sits lower in the knee joint. I have no pain or discomfort squatting, though when I'm not lifting if I force end range of motion it definitely hurts and I can feel a lot of tension across my bad knee and Patellar tendon when I flex my quads, but not necessarily pain. I was able to get to about 265 lbs on squat and 300 on deadlift last time around on SS with no problems with the knee before the appendicitis. I'm currently at 210 on squat and 275 on DL and plan to progress as far as possible. No issues with the knee while lifting currently. I wore a brace with patella support below the patella last time but am going without the brace this time.

My question is do I have to worry about the contracted Patellar tendon the heavier the weights get and the stronger and more force my quads can produce through it? Is there any risk of tearing the tendon? I seem to remember during the time I was going through the surgeries reading that once the Patellar tendon contracts there is no stretching it out without major surgery, though I don't seem to understand this as it is a soft tissue which should be able to stretch, unless a pathological fibrotic tendon is different. Will the tendon adapt to the stress as I go?

Any help is greatly appreciated. I've just been curious about this and have kind of started to psych myself out that the tendon will suddenly snap under heavy loads.

[Tom Campitelli]

Your situation is unique and largely above my pay grade. However, in general, patellar ligaments and quad tendons don't just snap. That you are not in any pain is also instructive. My guess is that you can continue to train. I suspect you would have some warning before you entered potentially injurious territory. The body adapts to stress.

[EndlessNameless]

Thanks for the response. That was my inclination that there would be symptoms before any problems. I realize my problem is unique. I actually had to leave my original surgeon because he had no idea what to do for me to get my knee moving again. This complication is rare and most surgeons have never dealt with it. I had to find my next surgeon on my own through a website with a forum with a small group of the rare few who have this problem. They compiled a list of docs who know how to deal with this issue and luckily one was near me. Had I not found that forum I would have pretty much been disabled. Imagine being stuck with a knee that is stuck almost completely extended. It made walking and even sitting nearly impossible. My heel couldn't even touch the floor when I would drive. I spent a year and a half doing PT with the most brutal pain Ive ever experienced to get my knee back. Hours and hours of stretching, patella mobilizations and E-stim. It was horrible but I got my knee functional again.

I'm thankful that I can still lift and will hopefully continue to make progress. I'm not sure if my knee will limit my potential for strength in the end but we'll see.

[Tom Campitelli]

Good luck to you, man. Let us know how things go.