Updated: Jul 26, 2019
Patellar tendinopathy is a common overuse injury typically occurring in athletes who
participate in sports that require jumping, including basketball, volleyball, tennis, and football, it is more commonly known as “Jumper’s knee”.
For the purpose of this blog article we will use the term ‘tendinopathy’ as an encompassing term to include tendonitis (acute) and tendinosis (chronic).
To differentiate between the two terms
Tendonitis; acute inflammation of the tendon that results from micro-tears occurring in the musculotendinous unit as it is repeatedly overloaded.
Tendinosis; is degeneration of the tendon’s collagen in response to chronic overuse.
The patella tendon connects the lower end of the patella (kneecap) to the tibial tuberosity (shinbone). Its main function is to transfer the forces from the quadriceps muscles to the lower leg, as your knee straightens.
The greatest level of stress through the patella tendon is during jumping and landing activities. During jumping, the quadriceps muscle create an explosive contraction, which straightens the knee and elevates the body off the ground.
Risk factors for patella tendinopathy include:
· Repeated intense training sessions over short periods of time, where the body can’t recover.
· Training on hard surfaces, i.e. concrete, where forces must be absorbed by the body.
· Misalignment through the Pelvis/knee/ankle or foot causing a biomechanical dysfunction.
· The elasticity of the tendons diminishes with increasing age.
Patellar tendinopathy is an overuse injury, with the onset typically characterized by no single specific traumatic injury event, but gradually increasing tendon pain. In some cases, there may be a specific traumatic event (i.e. a contact injury to the tendon) that isn’t given enough time to heal and develops into a tendinopathy via repeated stress through a weakened tendon.
Initially, the pain is usually only felt after activity. As the condition progresses pain will be felt at the start of exercise, that eases once warmed up and aches more intensely afterward. In advanced cases pain will be felt throughout exercise and during everyday activities.
The signs and symptoms of patella tendinopathy include:
· Anterior knee pain over the patella tendon (localised to the inferior pole of the patella)
· Pain aggravated by jumping, landing, or running activities
· Pain experienced during everyday activities including climbing stairs and prolonged sitting.
· Pain & Stiffness in patella tendon first thing in the morning.
· History of patellofemoral pain syndrome or dysfunctions
· Clinically, it is noted that dose-dependent pain is a key feature. For example, pain should increase when progressing from a shallow to a deeper squat, and from a smaller to a greater hop height.
Patella tendinopathy is a common condition and can generally be managed conservatively by your chiropractor or physiotherapist. A well-rounded treatment plan should include the following:
1. A period of rest from the aggravating activity to reduce the load through the tendon and allow healing to begin. This may include complete rest or a reduction in overall training volume including intensity, frequency, & duration.
2. Tape and/or knee brace to correct patellofemoral joint alignment and unload the tendon
3. Graston and soft tissue therapy to reduce tendon tightness in the muscles surrounding the hip and knee.
4. Full foot posture and pelvic stability assessment to biomechanical integrity.
5. Progressive stretching of the quadriceps, hamstring and calf muscles.
6. Structured eccentric exercise program for the patella tendon
7. Strengthening of the pelvic and lower limb muscles.
8. If indicated, foot orthotics, to help restore foot and lower extremity alignment.
Where patella tendinopathy is concerned prevention is always better than cure and much less time consuming. So 5 tips to you can employ to help minimise the risk of patella tendon injury include:
1. Minimise running, hopping, skipping and jumping on hard (i.e. concrete) surfaces, especially during the early stages of return to training.
2. Ensure correct supportive footwear during all exercise to optimise biomechanical alignment
3. Make sure you engage in a progressive increase in training volume to avoid acute overload.
4. Always perform an active warm up and cool down (including stretching) before and after exercise sessions.
5. Seek help sooner rather than later. If you experience pain through the front of the knee during or after training on 3 consecutive exercise sessions, see your healthcare professional.
So that’s a brief overview of how patella tendinopathy occurs, If you have any questions or comments please e-mail us at firstname.lastname@example.org and we will be happy to answer them for you.
If you suffer from pain through the front of the knee following exercise or first thing in the morning, feel free to call us on (08) 9486 8653 and our therapists will be happy to chat with you.