Patellar tendinopathy (jumper’s knee)
What is it?
Often referred to as ‘jumpers’ knee’, patellar tendinopathy refers to inflammation within the tendon which lies just below the knee-cap (patella).
How does it happen?
Patellar tendinopathy is a common injury in sports predominantly involving jumping and landing, and results from overuse of the patellar tendon. The function of the patellar tendon is to transmit force produced by the large thigh muscle (quadriceps) to the shin and bone (tibia) to produce movement of the knee joint. Repetitive use of the quadriceps muscle and, therefore, the patellar tendon can lead to microscopic tears or stress within the substance of the tendon. Gradual degeneration of the tendon may occur as a result. Factors which may contribute to patellar tendinopathy include a recent change in training (including frequency, duration, intensity, training surfaces), reduced rest times, biomechanical abnormalities, and decreases in muscle flexibility. These factors can lead to increased stress on the patellar tendon, microtears and subsequent tendinopathy.
How does it feel?
Patellar tendinopathy results in pain felt just below the kneecap. The pain may be aggravated by activities such as jumping, hopping and bounding and typically develops gradually. Initially, the tendon may only be painful following exercise. Associated with the pain may be stiffness or tightness in the region of the kneecap. Typically, these initial signs of patellar tendinopathy are ignored as they disappear quickly with walking about or applying heat (i.e. a hot shower) over the knee cap region. However, as you continue to exercise, the tendinopathy progresses and the pain within the tendon becomes more intense and more frequent. In the earlier stages, this pain during exercise may initially disappear as you warm up, only to return when you cool down. However, as you continue to exercise the tendinopathy worsens and your pain may begin to be present for longer periods during exercise until it is present all of the time. This may interfere with your performance.
What should you do?
Patellar tendinopathy generally does not get better on its own if the cause is not addressed and you continue to exercise. If you have or suspect you have patellar tendinopathy, you should consult your nearest sports medicine professional. In the meantime, you can begin initial treatment. This should consist of icing following exercise and deloading by modifying your jumping, hopping or running. Icing should consist of crushed ice wrapped in a moist towel applied just below the kneecap until the skin is numb.
What shouldn’t you do?
If you have or suspect you have patella tendinopathy you shouldn’t ignore the problem. Your pain may get better as you exercise, however, the exercise you are doing may interfere with the healing process and be causing further damage. This can lead to your injury getting worse such that your pain does not ‘warm up’ and you feel it throughout exercise. If this occurs, your recovery may be prolonged and it may take a number of months for you to return to your activity or sport.
Could there be any long-term effects?
Patellar tendinopathy does not produce any long-term effects, as long as it is properly diagnosed and appropriately treated. If not, it can lead to prolonged pain in the region just below the kneecap and a prolonged lay-off from exercise and sport.
Management
The assistance of a Sports and Exercise Physiotherapist is important in the treatment of patellar tendinopathy. Initially, they can assist in diagnosing the problem and its severity. Then your Sports and Exercise Physiotherapist will be able to determine an appropriate treatment plan. This may involve activity modification, soft tissue treatment such as massage and the progression through a series of specific strengthening exercises. The Sports Physiotherapist will also be able to assess and determine why you developed patellar tendinopathy and address this during your recovery to prevent a re-occurrence when you return to full activity.
Tom is a physio in Balgowlah who is highly trained in the assessment and management of patella tendinopathy. For a complete understanding of your knee pain, you will need an assessment face-to-face. To see the most highly regarded physio in Balgowlah, book here.
Brukner & Khan (2012) Clinical Sports Medicine.