Patella Tendinopathy
Patellar Tendinopathy or jumper’s knee is commonly an athlete’s injury affecting the tendon
connecting the kneecap to the shinbone.
What is Patella Tendinopathy?
Patellar Tendinopathy or more commonly known as jumper’s knee (patellar tendinitis or tendonitis) is an injury affecting the tendon that is connecting your kneecap (patella) to your shinbone. This tendon is responsible for working with the muscles in front your thighs for you to be able to kick, run or jump. Patellar tendinopathy is commonly seen in athletes who are engaged in sports like volleyball, basketball, soccer, track and field, gymnastics, dancing and tennis.
What causes Patellar Tendinopathy?
There are quite a number of factors which can cause Patellar Tendinopathy. This includes the following:
- Overuse injury from overtraning and overloading
- Sudden increase in sports that involve a lot of jumping, running or kicking
- Playing/ training on rigid surfaces
- Poor foot posture, knee or hip control
- Weak gluteal muscles and tightness of the muscles (specifically in the calves and hamstrings)
- In older people, it is a result of degeneration from repetitive micro-damage over time
What are its Signs and Symptoms?
- Knee pain over the patella tendon that is made worse when bending, running, jumping or kicking
- Prolonged pain during and even after activity
- Pain in the quadriceps muscle
- Area over the patella tendon (or below the kneecap) is tender
- Stiffness of the knee/s
- Weakness of leg and calf
What are the Treatment Protocols
for this Condition?
During the early stage of Patellar Tendinopathy, it is best for you to consult with a physiotherapist right away. Your physiotherapist will then determine the appropriate treatment for you depending on the pain and inflammation of your tendons. Usually the R.I.C.E method is advised.
- Rest – Rest is usually advised, as you do not want to overstress your tendons more. Remember: If an activity hurts your knee- avoid doing it. However complete rest is not necessary. Ask your physiotherapist for alternative exercise ideas, which usually involves little to no impact activities. This will allow you to maintain your cardiovascular fitness and maintain muscle strength without causing pain in your knee.
- Icing - Icing your knee can help alleviate pain and possible swelling
- Compression - Use a patellar tendon strap. This is a good support device that puts pressure on the tendon as well, which redistributes load throughout the tendon and reduces pain.
- Elevation
Some additional treatments are as follows:
- Eccentric Rehabilitation Program - After a period of time and as your pain allows it, your physiotherapist will start and progress you to an eccentric based program. This includes programs that are specifically designed to improve the strength of your quadriceps, gluteal muscles and the patella tendon. This will allow you to keep up with activities involved with your sport.
- Stretching - To avoid re-occurrence, you should continue with stretching programs. Physiotherapists usually recommend stretchbands for their patients. Since they are an easy way to stretch your muscles and maintain your flexibility.
What if the Treatment Fails?
Should the treatments mentioned above fail, autologous blood injection, or platelet-rich plasma injection may be performed. Although uncommon, it is possible to be required to undergo surgery to remove myxoid degeneration in the tendon. This is reserved for patients with debilitating pain for 6–12 months despite conservative measures.
Most patients with this condition who went through the proper physiotherapy usually recovers and returns to normal function in a number of weeks. Although there are instances when rehabilitation can take significantly longer in some patients. This may take many months especially in those who have had their condition for already a long period of time. That is why early physiotherapy treatment is recommended to all patients for them to able to recover and heal faster.
Extracorporeal Shockwave Therapy (ESWT) is used when conventional therapies have been ineffective in treating Patellar Tendinopathy.
What is the Duration of the Shockwave Treatement?
The use of medium energy at moderate frequency is the most popular method of Extracorporeal Shockwave Therapy (ESWT)
for treating Patellar Tendinopathy. Sessions can range from 2-3 sessions repeated over 5-7 days
