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Patellar Tendinopathy

Summary:


Patella Tendinopathy is pain below the knee cap, characterised by inflammation of the patellar tendon




Contents

What is Patellar Tendinopathy?

  • Also known as jumper's knee
  • Tendinopathy is an injury to the tendon. The injuries can include:
    • Tendonitis—an inflammation of the tendon
    • Tendinosis—microtears (tiny breaks) in the tendon tissue with no significant inflammation
    • Patellar tendon is located between the knee cap and the shin bone (Fig.1). It transfers force of the quadriceps muscles to the shin bone


What are the common causes?

Tendinopathy is generally caused by overuse of a muscle-tendon unit. Over time, the strain on the tendon causes structural changes within the tendon itself.


Patellar tendinopathy occurs from overuse of the knee tendon. Overuse may be caused by any activity that requires:

  • Intense running
  • Jumping
  • Frequent deceleration and acceleration
  • Frequent impact to the knee


Patellar tendinopathy is most common in the following sports:

  • Basketball
  • Soccer
  • Volleyball
  • Running (long distance/ sprints)

What are the signs and symptoms?

  • There is pain in the patellar tendon below the knee which is worsened by activity
  • The focal areas of degeneration feel tender to touch
  • Often the tendon feels very stiff first thing in the morning
  • The affected tendon may appear thickened in comparison to the unaffected side
  • Pain or tightness in the knee when bending, squatting, or straightening the leg
  • Discomfort in the knee when jumping, running, or walking

What are the risk factors?

  • Sports that involve intense jumping and running activities such as baseball, bowling, soccer, rugby, volleyball, track & field, freerunning, basketball, and gymnastics, etc
  • Tight musculature – quadriceps, hamstrings and ITB
  • Weak musculature – quadriceps, gluteus medius
  • Abnormal patella mobility
  • Flat foot or high-arched foot
  • Improper footwear
  • An suden increase in the frequency and intensity of training
  • Changing from one sport to another
  • Training on a hard surface with inadequate cushioning
  • Repeated improper movements while training

What types of treatment are available?

Medication

  • Pain kiler and anti-inflammatory drugs

Physiotherapy

  • Ice therapy to decrease pain
  • Electrical Stimulation if necessary
  • Stretching of tight structures
  • Strengthening of lower limb and core muscles
  • To wear a infra-patellar strap, it helps to support the tendon and reduce pain

Surgical

  • You may need surgery if there is:
    • Advanced damage to the tendon
    • Little or no response to other treatments over a 6-12 month period

What can I do to help myself?

  • Avoiding activities and sports that repeatedly stress the tendon
  • Stick to your home exercise program as prescribed by your physiotherapist
  • Modify your training regime as necessary
  • Wear the correct footwear
  • Shock Absorbing Insoles can be helpful, as they reduce the stress on the patellar tendon during running
  • Return to high-impact physical activity gradually. Healing has occurred when:
    • The knee can bend and straighten without pain
    • You are able to jump on the injured leg without pain
    • You are able to jog in a straight line without pain
    • No swelling

FAQ

1. How long do I need to rest from sports?

  • Depending on the stage of your condition, you may either continue or modify your activity or you may need to rest from the activity.
- Last updated 2 Dec 2011,4:24 pm




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