Patellar tendinopathy

What causes Patellar Tendinosis? Patellar tendinosis is often caused by repetitive overuse of the knee that causes irritation and inflammation of the patellar tendon and is most common in athletes that engage in sports involving a great deal of jumping or changing direction rapidly, such fooball, tennis, running or dance. Repeated jumping or an increase in intensity, duration or frequency of activity can stress the tendon. The condition, however, is not solely an overuse injury and can also be seen in individuals that have a muscular imbalance in their legs, a raised knee cap, tight leg muscles, or a difference in the alignment of bones in the leg, all of which can place stress on the patellar tendon. It can also be caused by a direct trauma to the joint, can occur in conjunction with other conditions and injuries, or can be caused by some medical conditions, such as rheumatoid arthritis.

What are the symptoms of Patellar Tendinosis? The primary symptom of patellar tendonitis is a sharp pain that is felt in the front of the knee below the knee cap during physical activity (especially jumping) followed by a dull ache when the activity is completed. When the condition first develops, the pain may only be felt when activity first begins or just ends or when the level of intensity of a workout is increased. Eventually the pain will remain throughout all physical activity and a constant ache may always be felt even when at rest. In addition to pain, there may also be swelling, tenderness and inflammation near the knee cap. In some cases, the inflammation and pain can cause partial or full immobility of the joint or make it extremely painful to move the knee.

How is Patellar Tendinosis diagnosed? A medical professional will take a complete medical history and will perform a physical exam. Questions will be asked about when the symptoms started, what increases or decreases pain and swelling, and what types of activities you regularly engage in that may stress the injured area. A physical exam will include testing the area for pain, swelling, inflammation, tenderness, redness and warmth. The degree of pain will be assessed when certain movements are performed and range of motion will also be determined. In some cases, x-rays may be used to see if there is another injury, such as a fracture or bone spur, causing swelling and pain. An MRI, ultrasound or CT scan can provide more information regarding the soft tissues, including the extent and location of the damage to the tendon.

When should I seek care for Patellar Tendinosis? If you experience pain, tenderness or swelling in the knee joint that does not go away with a short period of rest, avoidance of activities that exacerbate pain, application of ice and over the counter anti-inflammatory medication, you should seek medical advice. If the symptoms are caused by a direct trauma to the area, the pain is severe or increases suddenly, or if there is redness and warmth accompanying the swelling, you should seek prompt medical attention.

What will the treatment for Patellar Tendinosis consist of? Treatment for patellar tendonitis is focused on diminishing pain and inflammation and reducing strain on the tendon, and is generally a long term process. Initial treatment typically includes rest and avoidance of activities that exacerbate symptoms, application of ice, and nonsteroidal anti-inflammatory medications. Physical therapy is recommended and includes stretching and strengthening exercises for the patellar tendon and the muscles surrounding the tendon. Strengthening and stretching other muscles in the leg, especially in the quadriceps, can also help reduce stress on the tendon and are recommended. In some cases, corticosteroid injections will help to ease inflammation and pain so that strengthening exercises can be performed. Iontophoresis (a topical corticosteroid medication using an electrical charge to deliver the medication through the skin) and massage can also help healing. Surgery is rarely indicated for the treatment of patellar tendonitis, but may be a last resort option.

Which muscle groups/joints are commonly affected by Patellar Tendinosis? Patellar tendonitis occurs in the knee joint when stress is placed on the patellar tendon.The pain is most noticeable in the front of the knee, below the knee cap.

What type of results should I expect from the treatment of Patellar Tendinosis? Conservative treatments will typically be effective in eliminating or reducing the inflammation, irritation, and pain caused by patellar tendonitis, but treatment may take weeks or months to be effective. The severity of the condition, how long it was going on before treatment began, and whether or not activities that exacerbate symptoms have been eliminated or modified, will determine how long it will take for a full recovery to be achieved and whether the condition will return. If repetitive activities and movements that caused the initial condition are not modified and surrounding muscles are not strengthened, there is a high likelihood of re-injury.