What is Patellar Tendonitis?
Patellar tendinopathy (or as it is commonly known patellar tendonitis or tendinitis) is an overuse injury affecting your knee. It is the result of your patella tendon being overstressed. A common name for it is Jumper’s Knee.
Anatomy of the Knee
The patella tendon is located just below the patella (knee cap). It has attachments on the patella and the tibial tuberosity on the tibia (shin bone). The role of the patella tendon is to transfer the force of the quadriceps muscles, much like a rope around a pulley, as your knee straightens.
Your quadriceps is even more important when controlling your knee as you bend from a straight position eg walking downstairs, landings. Your quadriceps muscles are heavily involved in most sports, especially those which involve jumping, running and kicking.
Why is it Called Jumper’s Knee?
The greatest level of stress through the patella tendon is during jumping and landing activities. During jumping, the quadriceps muscles provide an explosive contraction, which straightens the knee and pushes you into the air. When landing, the quadriceps muscle helps to absorb the landing forces by allowing a small amount of controlled knee bend.
Excessive jumping or landing strains the patella tendon. At first the damage may only be minor and not cause any problem. However, if the tendon is repeatedly strained, the lesions occurring in the tendon can exceed the rate of repair. The damage will progressively become worse, causing pain and dysfunction. The result is a patellar tendinopathy (tendon injury).
Who Usually Suffers Patellar Tendonitis?
Patellar tendonitis usually affects athletes involved in sports such as basketball, volleyball, soccer, football, track and field (running, high and long jump), tennis, dancing, gymnastics and skiing.
In older people the main cause of patellar tendinopathy is a result of degeneration which results from repetitive micro-damage over time. Also, some patients develop patella tendonitis after sustaining an acute injury to the tendon, and not allowing adequate healing. This type of traumatic patellar tendonitis is much less common than overuse syndromes.
Signs and Symptoms of Patellar Tendonitis
- Anterior knee pain over the patella tendon
- Pain made worse with jumping, landing or running activity and sometimes with prolonged sitting
- Onset of pain is usually gradual and commonly related to an increase in sport activity
- Localised tenderness over the patella tendon
- Often the tendon feels very stiff first thing in the morning.
- The affected tendon may appear thickened in comparison to the unaffected side
What Causes Patellar Tendonitis?
There are a number of factors which can contribute to the development of patellar tendinopathies. These include:
- Rapid increase in amount of training
- Sudden increase in training intensity
- Playing/training on rigid surfaces
- Tight quadriceps and hamstring muscles
Lower Limb Biomechanics
- This can include poor foot posture, knee or hip control. Your physiotherapist can assess and treat these issues.
What are the Symptoms of Tendinopathy?
Tendinopathy usually causes pain, stiffness, and loss of strength in the affected area.
- The pain may get worse when you use the tendon.
- You may have more pain and stiffness during the night or when you get up in the morning.
- The area may be tender, red, warm, or swollen if there is inflammation.
- You may notice a crunchy sound or feeling when you use the tendon.
The symptoms of a tendon injury can be a lot like those caused by bursitis.
How is Tendinopathy Treated?
Tendon injuries can take a long time to recover without appropriate rehabilitation. Successful recovery of the patellar tendon will comprise the following treatment components.
- Deloading of the affected structures
- Biomechanical cjges to address the casue of the inury
- A specific Muscle lengthening and strengthening program
- EWST Shockwave therapy to regenerate the damaged tendon tissue and reduce recovery times.