Patella Tendinopathy

Patella tendinopathy, also known as jumper's knee, is a condition that affects the tendon connecting the patella (knee cap) to the tibia (shin bone). It is a common overuse injury in athletes, particularly those who participate in activities involving jumping or sudden changes in direction.
Anatomy of the knee - Anterior View
Anatomy of the Knee - Medial View

Introduction 

Patella tendinopathy, also known as jumper’s knee, is a condition that affects the tendon connecting the patella (knee cap) to the tibia (shin bone). It is a common overuse injury in athletes, particularly those who participate in activities involving jumping or sudden changes in direction. The prevalence of patella tendinopathy varies depending on the population being studied, but it is estimated to affect up to 20% of athletes at some point in their careers.

Overview of Patella Tendinopathy: 

Patella tendinopathy is characterised by pain and tenderness in the front of the knee, often accompanied by swelling and inflammation. The condition can range in severity from mild to severe, and if left untreated, it can lead to decreased strength and range of motion in the affected knee.

Causes of patella tendinopathy: 

Several factors can contribute to the development of patella tendinopathy. The most common cause is overuse or repetitive strain on the knee tendon, which can occur due to training errors or an increase in the intensity or duration of physical activity. Improper form or technique during exercise can also put unnecessary strain on the knee and lead to patella tendinopathy.

Weak hip or thigh muscles can also contribute to the development of patella tendinopathy, as these muscles help to support and stabilise the knee joint. Flat feet or high arches can alter the alignment of the lower leg and put extra strain on the knee tendon. Tight muscles or imbalances in muscle strength can also lead to patella tendinopathy, as they can affect the way the knee moves and puts additional stress on the tendon.

Symptoms of patella tendinopathy:

The most common symptom is pain and tenderness in the front of the knee, especially when jumping or climbing stairs. This pain is often described as a dull, aching sensation that can be felt during or after physical activity. Swelling or inflammation in the knee may also be present in some cases, there may be a creaking or cracking sound when the knee is moved.

As the condition progresses, individuals may experience decreased strength and range of motion in the affected knee. This can make it difficult to perform certain activities, such as running or jumping and may affect overall athletic performance.

Diagnosis of patella tendinopathy:

A physiotherapist typically diagnoses patella tendinopathy through a physical examination and a review of the individual’s medical history. The physio will assess the knee for tenderness, swelling, and range of motion and may perform provocative tests to determine the location and extent of the tendon injury.

Imaging tests, such as an MRI, may also be ordered to rule out other conditions and better understand the injury’s level. These tests can help the healthcare provider determine the appropriate treatment plan.

Treatment of patella tendinopathy:

Treatment for patella tendinopathy typically focuses on reducing pain and inflammation and improving the strength and flexibility of the muscles around the knee. Rest and avoidance of activities that exacerbate symptoms are often recommended, as is physical therapy to stretch and strengthen the muscles around the knee.

Orthotic inserts, placed in the shoes to correct foot mechanics, may be recommended for individuals with flat feet or high arches. Non-steroidal anti-inflammatory drugs (NSAIDs) can be used to reduce inflammation and pain, and corticosteroid injections may also be recommended to decrease inflammation.

Surgery may be recommended in extreme cases as a last resort for severe cases of patella tendinopathy that do not respond to other treatments. The type of surgery will depend on the extent of the injury and may involve repairing or removing the damaged tendon tissue. Surgery can effectively relieve pain and improve function, but it carries risks such as infection and scarring.

Prevention of patella tendinopathy;

To prevent the development of patella tendinopathy, it is important to gradually increase the intensity and duration of physical activity to allow the body to adapt to the demands being placed on it. Using proper form and technique during exercise can also help reduce the risk of injury.

Stretching and warming up before physical activity can help to loosen tight muscles and improve overall flexibility while wearing proper shoes and support for foot abnormalities can help correct any imbalances in the lower limbs. Strengthening the hip and thigh muscles can also help to improve overall lower limb stability and reduce the risk of patella tendinopathy.

Conclusion:

Patella tendinopathy is a common condition caused by overuse or improper form during exercise. Early diagnosis and treatment can help prevent the condition from worsening and improve overall function. Proper prevention techniques, such as gradually increasing physical activity and using proper form, can help reduce the risk of developing patella tendinopathy.

References:

  1. Lian, O. B., Risberg, M. A., & Bahr, R. (2009). Patellar tendinopathy: Pathogenesis, diagnosis, and treatment. American Journal of Sports Medicine, 37(9), 1775-1782.
  2. Mafi, P., Lorentzon, R., Alfredson, H., & Ekstrand, J. (2012). Risk factors for patellar tendinopathy in young male basketball players. The American Journal of Sports Medicine, 40(1), 60-66.
  3. Schmitt, L. C., Best, T. M., & Wojtys, E. M. (2009). Patellar tendinopathy in the athlete. Journal of the American Academy of Orthopaedic Surgeons, 17(11), 721-729.
  4. McCurdy, K., & Malliaropoulos, N. (2022). Patellar tendinopathy: A systematic review and meta-analysis of treatment effectiveness. Sports Medicine, 52(4), 313-335.
  5. Chen, H., Chen, L., Wang, L., & Chen, X. (2021). Efficacy of shock wave therapy for the treatment of patellar tendinopathy: A systematic review and meta-analysis. Medicine, 100(18), e25723.
  6. Olmstead, L. C., Hurd, W. J., & Smith, B. L. (2020). Patellar tendinopathy: Pathophysiology and current treatment options. Current Reviews in Musculoskeletal Medicine, 13(3), 345-352.
  7. Nedelec, M., & Cloutier, M. (2019). Patellar tendinopathy: A review of current treatment options. Journal of Orthopaedic & Sports Physical Therapy, 49(8), 651-665.
  8. Sayana, M. K., & Wilson, D. M. (2018). Patellar tendinopathy: A review of current treatment options. Current Reviews in Musculoskeletal Medicine, 11(1), 23-31.

Disclaimer

The information provided on Sportsfizzio.com.au is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek your doctor’s advice or another qualified healthcare provider with any questions regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on this blog. The information on this blog is not intended to diagnose, treat, cure, or prevent any disease. The information provided on this blog is for educational purposes only.

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Miles Browning Physiotherapist
Miles Browning Physiotherapist
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