PATELLAR TENDINOPATHY: SYMPTOMS, DIAGNOSIS, AND TREATMENT
Running, jumping, climbing up stairs - all seemingly harmless, everyday activities. But when we constantly perform these actions and push our bodies to do more, it can lead to a painful knee injury.
Patellar tendinopathy or tendinitis is a knee injury that causes inflammation and pain, often interfering with your ability to use your knee. Knee tendinitis can affect anyone. However, it’s typically an overuse injury common in elite athletes and physically active people.
Symptoms of patellar tendinitis are typically relieved with rest and conservative treatment. When left untreated for too long, it can cause a tendon tear and require surgical repair. With proper treatment and rehabilitation, you can relieve patellar tendinitis and strengthen your knee at the same time.
Keep reading to learn more about patellar tendinopathy, its symptoms, and the various ways you can treat it.
What Is Patellar Tendinopathy?
Your patellar tendon connects your kneecap to your shinbone. The patellar tendon also works together with your thigh muscles to help you extend your knee, allowing you to kick, run, and jump.
Patellar tendinopathy or patellar tendinitis is an inflammatory condition that affects your patellar tendon. Patellar tendinopathy occurs when you repetitively strain your knees during physical activity. Frequent stress irritates your patellar tendon, causing inflammation and pain.
Tendinitis and tendinopathy have separate definitions but are often used interchangeably. Tendinitis or tendonitis is the inflammation of tendons, while tendinopathy is a broader term that includes painful tendon conditions.
What Are The Symptoms of Patellar Tendonitis?
The first symptom of patellar tendonitis is a pain in your knee. Initially, the tendon pain is only apparent with movement or exercise; however, it can worsen over time.
These are a few symptoms of knee tendonitis:
- Pain or soreness around your knee cap
- Swelling on your knee
- Pain with jumping, running, or walking
- Tendon pain increases when bending or extending the affected knee
The pain and symptoms of knee tendonitis will progress if left untreated. It will eventually interfere with your ability to perform normal activities that require you to use your knee, like squatting down or climbing stairs.
The severe pain and weakness from patellar tendinitis often prevent professional athletes in basketball or volleyball from competing.
What Causes Patellar Tendinopathy?
Patellar tendinopathy is typically an overuse injury. Frequent and repetitive stress on your knee joint can strain the patellar tendon and lead to tiny tears on the tissue. If it persists, the tears can multiply and weaken your tendon, eventually causing inflammation and pain.
Knee tendinopathy is a common condition among athletes who frequently jump, earning the name Jumper’s Knee.
Repetitive stress from training and competition, like running and jumping, can impact the patellar tendon. A study conducted among volleyball athletes noted that jump frequency was a significant risk for developing patellar tendonitis.
Risk Factors Of Patellar Tendinopathy
Anyone can get knee tendinitis. However, certain risk factors increase your likelihood of developing patellar tendinitis.
- Physical Activity: Frequent running and jumping are usually linked with patellar tendinitis. Abrupt increases in how hard or how often you perform the exercise also increase the pressure on your tendon. Improper running shoes can also contribute to your chances of getting patellar tendinopathy.
- Tight Leg Tissues: Cramped or tight thigh muscles and hamstrings can further increase the tension on the patellar tendon, putting you at a higher risk of developing tendinopathy.
- Muscular Imbalance: If some of your leg muscles are stronger than others, they can have an uneven pull on your patellar tendon. This unequal muscle strength is a risk factor for patellar tendinitis.
- Chronic Disease: Certain chronic diseases can disrupt the blood flow to your knee, weakening your patellar tendon. These diseases may include kidney failure, rheumatoid arthritis, and diabetes.
Complications Of Patellar Tendinopathy
Patellar tendinopathy can progress if proper medical treatment is not applied. If you ignore the signs and symptoms of knee tendinitis, you may severely damage your tendons by causing a patellar tendon tear.
In most cases, the painful tendon can significantly limit your daily activity. And when left untreated, patellar tendinitis can lead to weakness or even loss of function. For elite athletes, patellar tendonitis can be a career-ending injury.
How Is Patellar Tendinopathy Diagnosed?
Your doctor must evaluate your medical history to determine any factors contributing to your patellar tendinopathy, such as your physical activity and current medication, among other factors.
They also perform a physical exam to assess the signs and symptoms. Your doctor will press along your knee to find the source of your pain. Moving your leg in different directions will also help your doctor gauge your knee extension and range of motion.
Your doctor may also order different imaging tests to examine your kneecap and tendon. These tests help determine if there's any long-term damage to either the tendon or bone.
- X-ray: An X-ray can help rule out the possibility of a kneecap fracture or other bone problems.
- Magnetic Resonance Imaging (MRI): MRIs offer a clear view of your tendon to assess any damage or abnormalities.
- Ultrasound: An ultrasound allows your doctor to examine your tendons for soft tissue damage, such as tears.
Treatment Options For Patellar Tendinitis?
Treatment for patellar tendonitis depends on the severity of your condition. Mild cases of tendonitis are typically treated with non-surgical options, while severe patellar tendinitis will probably require surgical treatment.
Non-surgical Treatment
Medication For Patellar Tendinitis
Over-the-counter drugs, such as ibuprofen, naproxen sodium, and acetaminophen are quick ways to reduce inflammation from tendinitis and provide short-term pain relief. A corticosteroid injection is another way to deliver anti-inflammatory medication directly into your knee joint.
Physical Therapy (PT) For Patellar Tendinopathy
The aim of physical therapy for knee tendinopathy is to reduce pain and inflammation. Your physical therapist develops an exercise program specifically designed to improve symptoms of patellar tendinopathy.
Physical therapy for patellar tendinopathy usually involves eccentric exercise to strengthen your leg and thigh muscles. A PT session may comprise:
- Stretching
- Strengthening exercises
- Massage therapy
- Ultrasound and electrical stimulation to ease knee pain
For painful patellar tendinitis, your physical therapist may prescribe a knee brace or crutches to prevent further damage to the tendon.
Alternative Treatments For Patellar Tendinopathy
If you have noticed no improvement in your condition, there are various alternative treatments for patellar tendonitis that are excellent if you want to avoid surgery.
- Platelet-Rich Plasma (PRP) Injections: Platelet-rich plasma injection therapy is an effective non-surgical treatment for patellar tendinopathy. PRP injections use a concentration of platelets extracted from your blood to boost natural healing in your tendons. A clinical study revealed that two consecutive PRP injections effectively treated patellar tendonitis.
- Extracorporeal Shock Wave Therapy (ESWT): ESWT is a non-invasive treatment for patellar tendonitis. A pain specialist uses a device to deliver sound waves or shock waves to the injured tissue. The shock waves stimulate physiological reactions that reduce pain and promote tendon healing.
Surgery
When other treatments cannot ease your pain, your doctor may recommend surgical treatment to repair your patellar tendon.
Arthroscopic surgery is a standard surgical procedure to treat patellar tendinopathy. Your surgeon creates an incision and inserts an arthroscope into your knee joint. An arthroscope is a lighted instrument that allows your surgeon to view the internal structures of your joint. They remove any damaged tissue and repair the injured patellar tendon.
Arthroscopic surgery for patellar tendinitis is a quick outpatient procedure with a short recovery time. You’ll need a cast while your knee heals but, with some rehabilitation, you can restore normal function to your knee in no time.
Outcome of treatment
The recovery time for mild patellar tendinopathy can take at least 3 weeks. For severe tendonitis, recovery can take about 6 to 8 months.
Treating patellar tendinopathy primarily aims to manage your symptoms and strengthen the tissues in your knee. Physical therapy, alternative treatments, and surgery all have a proven track record for treating patellar tendinopathy. Athletes have even bounced back from knee tendonitis after rehabilitation alone.
Just remember that healing takes time. Rest as much as you can and avoid pushing your body before it fully heals to prevent further damage to your patellar tendon.
FAQs
What is the fastest way to heal patellar tendonitis?
There is no single cure for patellar tendonitis. Treatment is usually focused on pain management and relieving symptoms of tendonitis. If you’re in pain and need immediate pain relief - rest the affected leg and apply an ice pack to reduce swelling. You can take anti-inflammatory medicines or painkillers to relieve pain.
Is it OK to walk with patellar tendinitis?
Stick to light walking as much as possible. Strenuous activities can strain your knee, further tendon damage, and worsen the pain from patellar tendinitis.
What happens if patellar tendonitis is left untreated?
If left untreated, this condition can lead to a partial or complete tendon tear, a painful and disabling injury. If you notice any signs and symptoms of patellar tendinopathy, seek medical treatment immediately.
Is heat better for patellar tendonitis?
Heat therapy is an excellent treatment for soothing patellar tendinitis pain. Heat can increase the blood flow to the injured tendon. The increased circulation can reduce inflammation and speed up healing in your tendon tissue.
What should you not do with patellar tendonitis?
Avoid physical activities that can strain your patellar tendon. Pause any sports training and working out to allow your knee to heal.
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- Physiotherapy management of patellar tendinopathy (jumper's knee)
- Platelet-rich plasma as a treatment for chronic patellar tendinopathy: comparison of a single versus two consecutive injections
- Jump frequency may contribute to the risk of jumper's knee: a study of interindividual and sex differences in a total of 11 943 jumps video recorded during training and matches in young elite volleyball players
- Treatment of Tendinopathy: What Works, What Does Not, and What is on the Horizon
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