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
Typically, tendon injuries occur in three areas:
- musculotendinous junction (where the tendon joins the muscle)
- mid-tendon (non-insertional tendinopathy)
- tendon insertion (eg into bone)
Non-insertional tendinopathies tends to be caused by a cumulative microtrauma from repetitive overloading eg overtraining.
Common Patellar Tendonitis Treatment
In the early phase, your physiotherapist with address the pain and inflammation using electrotherapy modalities, cryotherapy (ice) and taping techniques or de-loading braces. Relative rest is advised from aggravating activity in the early stages. Your body is the best guide to know how much to rest the injured knee. If an activity hurts the knee then you should avoid doing it.
Complete rest is not usually necessary. If this is the case, your physiotherapist can suggest some alternative exercise ideas which are low to no impact. This will allow you to maintain your cardiovascular fitness and maintain muscle strength without causing pain in your knee.
Stretching can also be started early in your rehab under instruction from your physiotherapist to help with lower body flexibility. Even once your symptoms resolve you should incorporate a stretching program into your training to prevent re-occurrence.
Stretchbands are a fun and easy way to stretch and maintain your flexibility. They are available from our online store in three sizes. More info: Stretchband
As pain allows, your physiotherapist will start and progress you on a specific strengthening program designed to improve the strength of your quadriceps and the patella tendon to allow them to cope with the loads involved with your sport. Tendinopathies respond best to an eccentric based program.