Patellar Tendinopathy

What is Patellar Tendinopathy?

Patellar Tendinopathy Overview

Patellar Tendinopathy Description

Patella tendinopathy, also known as jumper's knee, is a common overuse injury that affects the patellar tendon, which connects the kneecap (patella) to the shinbone (tibia). It primarily occurs in athletes involved in sports that require repetitive jumping or running, such as basketball, volleyball, or track and field, hence the term "jumper's knee."

Patella tendinopathy typically develops gradually over time due to repetitive stress and strain on the patellar tendon. It is characterised by pain, inflammation, and degeneration of the tendon tissue. The condition often affects the lower part of the patellar tendon, near its attachment to the patella.

• Patellar tendinopathy is a source of anterior knee pain, characterized by pain just below the knee cap.

• Pain is aggravated by loading and increased with the demand on the knee extensor muscles (quadriceps), especially in activities that store and release energy in the patellar tendon.

• Patellar tendinopathy is most commonly seen in young athletes aged 15-30 and is more in the male population.

• This condition is particularly seen in people that participate in sports such as basketball, volleyball, athletic jump events, tennis, and football, which require repetitive loading of the patellar tendon.

• The prevalence of this condition in elite volleyball and basketball players has been found to be over 40%.

Symptoms of Patellar Tendinopathy

Patellar Tendinopathy Presentation

Symptoms of patella tendinopathy may include:

1. Pain: Pain is the most common symptom and is usually felt at the front of the knee, just below the kneecap. The pain may be sharp or dull and may worsen with activity, especially jumping, running, or climbing stairs. Pain occurs typically at the start of activity, settles after warm-up and painful after activity when they have cooled down. Pain after exercise or the following morning.

2. Aggravated with activities that store and release energy in patella tendon (jumping, landing, cutting, pivoting, early to mid-squat.

3. Tenderness: Tenderness commonly just below the kneecap around the lower part of the patellar tendon, and occasionally at the top of the shin bone, may be tender to the touch.

4. Stiffness: Stiffness or tightness in the knee joint, especially after periods of inactivity, may occur.

5. Swelling: Swelling or inflammation may be present around the patellar tendon, although it is typically less pronounced compared to other knee injuries such as ligament sprains.

6. Weakness: Weakness in the quadriceps muscles (the muscles at the front of the thigh) may develop as a result of pain and disuse. Giving way occasionally due to quadriceps inhibition.

Managing Patellar Tendinopathy

Patella tendinopathy is diagnosed based on a combination of clinical evaluation and, occasionally, the use of imaging studies, such as ultrasound or MRI, which can help assess the extent of tendon damage and rule out other possible causes of knee pain.

Treatment for patella tendinopathy typically involves a combination of conservative measures aimed at reducing pain and inflammation, improving tendon strength and flexibility, and addressing contributing factors such as biomechanical issues or training errors.

Patellar Tendinopathy Treatment

• It is essential that people recognize that tendinopathy that has been present for months may require a considerable period of treatment associated with rehabilitation before symptoms disappear.

• Prognosis: A person presenting with persistent painful patellar tendinopathy for the first time may require 3–6 months to recover. A patient with a longstanding history may require 6–12 months to return, pain-free, to competition without recurrence.

• Common Patellar Tendinopathy treatment methods may include:

1. Rest: Resting the affected knee and avoiding activities that exacerbate symptoms, particularly those involving repetitive jumping or running.

2. Ice: Applying ice packs to the knee for 15-20 minutes several times a day to reduce pain and inflammation.

3. Physiotherapy: A structured physiotherapy program that includes stretching, strengthening, and exercises targeting the quadriceps and hamstring muscles, as well as addressing any biomechanical issues or muscle imbalances.

4. Bracing or taping: Using a knee brace or patellar tendon strap may help alleviate symptoms and provide support during activities.

5. Activity modification: Gradually modifying activities to reduce stress on the patellar tendon while it heals, such as decreasing training intensity or incorporating alternative exercises, and then slowly progressing back into normal activity. Including:

   • Load reduction

   • Strengthening exercises

   • Correcting biomechanical errors

6. Soft tissue therapy

Overall, early recognition and appropriate management of patella tendinopathy are essential for a successful recovery and a hastened return to pain-free activity. It's important to consult with a healthcare professional for an accurate diagnosis and individualised treatment plan tailored to your specific needs and circumstances.