Diagnosis: Patellar Tendinopathy
What is Patellar Tendinopathy?
Patellar tendinopathy, also known as jumpers knee is an overuse injury resulting from overstretching the patella tendon, which connects from the kneecap (patella) to the shin (tibia)1.
Symptoms of Patellar Tendinopathy
Many people with patellar tendinopathy may experience one or more of the following symptoms:
- Pain at the front of the knee over the patella tendon1
- Pain is made worse with running, jumping or prolonged sitting1
- Knee feels stiff first thing in the morning2
- Pain comes on gradually and is related to activity2
- The tendon may look thicker on the affected side compared to the unaffected side1
How is Patellar Tendinopathy Diagnosed?
There are many causes of knee pain that all present very similarly such as Patellofemoral pain and quadriceps tendinopathy, therefore a clear diagnosis can be difficult. However, the physiotherapist may be able to determine patellar tendinopathy as the cause of symptoms based on the history of the pain and clinical tests2. Most people would indicate pain on the bottom of the kneecap, which comes on during activities such as running or jumping. On clinical examination, there is often difficulty with or pain on squatting or climbing stairs3. There may also be decreased strength of the quadriceps muscles of the affected leg. Loss in muscle mass misaligned foot posture, hamstrings and quadriceps inflexibility, and reduced ankle movements have also been linked to patellar tendinopathy, which the physiotherapist may examine2. In some cases an MRI or ultrasound may be required to assess the severity of the condition as well as rule out other possible causes of pain3.
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What Causes Patellar Tendinopathy?
Normally, when straightening or bending and leg the kneecap is pulled down and up through stretching the patellar tendon. When doing too much of an activity too often or starting a new activity the tendon becomes stressed and irritated causing pain. Also, activities that put a lot of repeating force on the tendon such as running, jumping or squatting are a common way for patellar tendinopathy to occur.
How is Patellar Tendinopathy treated?
In the early phases of patellar tendinopathy it is best to address the pain and swelling over the kneecap. This can be done using a combination of rest, ice and elevation of the knee. Also avoid strenuous activity such as running and jumping, however gentle low-‐level activity such as walking is encouraged2. The physiotherapist may also incorporate stretching exercises of the ankles and knees early on to help with lower body flexibility3. Strengthening of the quadriceps muscles is extremely important in terms of helping them cope with the high loads seen in running and jumping sports2. An example of a common exercise used is the declined single leg squat.
Shanam Nisha
Student Physiotherapist
Resources
- http://physioworks.com.au/injuries-‐conditions-‐1/patella-‐tendonitis-‐tendinopathy
- http://www.physio-‐com/Patellar_Tendinopathy#Clinical_Presentation
- http://www.jospt.org/doi/pdf/10.2519/jospt.2015.5987
