Understanding Patellar Tendonitis: A Sports Medicine Perspective

As a sports medicine physician, I’ve seen countless cases of patellar tendonitis—a very common condition among athletes and active individuals. Having dealt with this myself over This article will provide some insights into the causes, symptoms, diagnosis, treatment, and prevention of patellar tendonitis, so that we can help you manage and prevent your knee pain effectively.

What is Patellar Tendonitis?

Patellar tendonitis or jumper’s knee, is an overuse injury that affects the tendon connecting the kneecap (patella) to the shinbone (tibia). This tendon plays a crucial role in activities involving jumping, running, and sudden directional changes. Repeat stress on the tendon can lead to inflammation, micro-tears, and pain, which is commonly felt just below the kneecap.

Causes of Patellar Tendonitis

The primary cause is repetitive stress on the patellar tendon, often due to:

1. Overtraining: Excessive running, jumping, or weightlifting without adequate rest.

2. Improper Technique: Faulty biomechanics during sports or workouts.

3. Muscle Imbalances: Weak quadriceps or tight hamstrings can increase strain on the tendon.

4. Inadequate Warm-Up or Stretching: Skipping a good dynamic warm-up can make the tendon more susceptible to injury.

   
   

Recognizing the Symptoms

Symptoms of patellar tendonitis usually develop gradually and may include:

1. Pain and tenderness in the anterior knee, just below the kneecap.

2. Swelling or inflammation around the tendon or just above the kneecap.

3. Stiffness in the knee, especially after periods of inactivity or sitting.

4. Pain during or after physical activity, particularly jumping or running.

5. Decreased strength and function of the affected leg.

Diagnosis

Diagnosing patellar tendonitis typically involves:

1. Clinical Examination: Assessing pain, tenderness, and range of motion.

2. Imaging Tests: I often use my ultrasound machine to scan the tendon itself and evaluate the extent of tendon injury. In a few cases, I may even order an MRI.

3. Patient History: Understanding training routines and recent activities to identify contributing factors.

Treatment Options

Effective management of patellar tendonitis involves a combination of approaches:

1. Rest and Activity Modification: Reducing high-impact activities to allow the tendon to heal.

2. Inflammation Management: Applying ice to reduce inflammation and pain. Sometimes you may even need oral or topical anti-inflammatories

3. Physical Therapy: Focusing on strengthening the quadriceps, stretching tight muscles, and correcting biomechanics.

4. Extracorporeal Shockwave Therapy (ESWT): Using targeted sound waves to stimulate healing in the tendon.

5. Platelet-Rich Plasma (PRP) Therapy: Injecting concentrated platelets to promote tissue repair and healing

6. Surgery: In severe cases, surgical intervention may be necessary to repair significant tendon damage or to remove enthesophytes (calcifications within the tendon).

Prevention Strategies

Preventing patellar tendonitis requires attention to training habits and physical health. Consider these strategies:

1. Progressive Training: Gradually increase activity intensity to avoid overloading the tendon.

2. Proper Warm-Up and Stretching: Always prepare your muscles and tendons before activity.

3. Strength and Flexibility: Incorporate exercises that strengthen the quadriceps and hamstrings while improving overall flexibility.

4. Listen to Your Body: Avoid pushing through pain and allow adequate recovery time.

5. Footwear and Equipment: Use proper shoes and equipment suitable for your sport or activity.

When to Seek Medical Attention

If pain persists despite rest and conservative measures, or if you experience significant swelling and decreased knee function, consult a sports medicine professional. Early intervention can prevent further damage and expedite recovery.

Conclusion

Patellar tendonitis is a manageable condition when addressed early with proper care and prevention strategies. By understanding its causes and symptoms, you can take proactive steps to maintain your performance while safeguarding your knee health. If you’re dealing with persistent knee pain or have questions about injury prevention, don’t hesitate to make an appointment. Your knees will thank you!

Author: Neel Kotrappa, MD CAQSM

Board Certified in Family & Sports Medicine