Patellar tendinopathy (commonly known as patellar tendonitis or tendinitis) is an overuse injury affecting your knee. It’s the result of your patellar 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
Tendinitis (or Tendonitis): This actually means “inflammation of the tendon,” but inflammation is actually only a very rare cause of tendon pain. But many doctors may still use the term tendinitis out of habit.
The most common form of tendinopathy is tendinosis. Tendinosis is a noninflammatory degenerative condition that is characterized by collagen degeneration in the tendon due to repetitive overloading. These tendinopathies, therefore do not respond well to anti-inflammatory treatments and are best treated with functional rehabilitation. The best results occur with early diagnosis and intervention.
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.
How is Tendinopathy Treated?
In most cases, you can start treating a tendon injury at home. To get the best results, start these steps right away:
- Rest the painful area, and avoid any activity that makes the pain worse.
- Apply ice or cold packs for 20 minutes at a time, as often as 2 times an hour, for the first 72 hours. Keep using ice as long as it helps.
- Do gentle range-of-motion exercises and stretching to prevent stiffness.
- Have your biomechanics assessed by a physiotherapist.
- Undertake an Eccentric Strengthen Program. This is vital!