Patellar tendonitis, typically referred to as jumper's knee, is an inflammation of the tendon or cord of fibrous tissue that attaches the quadriceps muscle to your tibia. Patellar tendinitis can be found in many different types of movements that don’t require jumping. The “patellar” in “patellar tendinitis” describes which tendon we are referring to. The “tendin” in “patellar tendinitis” describes what type of tissue we are referring too, and “it is” is a suffix which simply means inflammation. Patellar tendinitis has an incidence of about 20% in jumping athletes, including volleyball, basketball and handball athletics, although can affect anyone during daily movements such as squatting down to reach for something in the bottom cupboard or walking down the stairs. It is often accompanied by tenosynovitis, which is an inflammation of the lining of the tendon sheath. The cause of the inflammation may result from repeated trauma or excessive strain of the tendon. Chronic overuse of tendons leads to microscopic tears within the collagen matrix, which gradually weakens the tissue. It then becomes painful many different types of uses, depending on the level of severity.
What’s the best course of treatment?
Patellar tendinitis is, as we described before, an inflammation of the patellar tendon. The most typical cause is overuse, so the first, and most obvious course of treatment, would be to take a break from what is causing the pain to allow the damaged tissues to heal. The next step would be to figure out “why” this tendon is suddenly inflamed. If an athlete is properly trained, it is highly unlikely they will experience symptoms unless they are truly overusing their body without adequate rest. If this is the case, there will likely be many other issues going on as well, but that is a blog post for another day. The other, and much more likely, explanation is that the patellar tendon is bearing an abnormal amount of stress compared to its other load bearing joint and muscular counterparts above and below the knee, aka around the hip and the ankle. When this is the case, the next course of treatment would be to learn how to take the extra stress away from the patellar tendon and share it with your larger muscles above and below the knee joint.
How can physical therapy help me with patellar tendinitis?
Physical therapists are experts in human movement and have a trained eye for finding movement patterns that conflict with your body’s anatomy. Athletes are great compensators and when a certain muscle is not producing its necessary share of force, other muscles and joints will step up to recreate that force in other ways. Patellar tendinitis is very typically a perfect example of this. What we do, as physical therapists, is work with you to figure out which muscles are working too hard, and which are not working hard enough. We will, not only, teach you how to strengthen the weaker ones, but also teach you how to properly use them during your previously painful movements. Not only do we need to pay attention to strengthening, but we may need to work on lengthening as well. This will be addressed by learning to stretch the proper muscles to decrease early levels of tension on the tendon. Once your muscles gain the capability to work as a team with decreased initial stresses, they must learn to control these forces with proper movement mechanics and alignment. These new movement mechanics must be learned, trained, and slowly translated back to sport-like movements. Once all your muscles are working efficiently, greater output can be achieved and only this will allow you to be the best athlete you can be. If you are in the Mission Viejo area and think you, or someone you know, might benefit from physical therapy, please don’t hesitate to reach out!
1. Nikolovska, L., & Simic, B. (2020). Treatment of patellar tendinopathy. International Journal Knowledge, 40(5), 987-991.