Have you been struggling with pain just below one or both of your knees? Are you a runner, someone who puts excessive wear and tear on their legs or someone who may be prone to knee injuries? Your pain may be caused by patellar tendonitis.
WHAT IS PATELLAR TENDONITIS?
Patellar tendonitis is a condition involving the area around your knee. It occurs when the patellar tendon has been damaged in some way. The patellar tendon is the short, thick tendon that extends down from the quadricep (thigh muscle) and connects the patella (kneecap) to the top of the tibia (shin bone). The patellar tendon helps the leg muscles extend and straighten the knee, and gives greater movement to the knee joint.
Patellar tendonitis is also called “jumper’s knee” because it typically plagues athletes – in particular runners, track and field athletes and basketball players. The patellar tendon is overused constantly when you run and jump, especially on hard surfaces. Patellar tendonitis weakens and inflames your tendon and, if left untreated, can lead to more damage. Eventually, it can lead to serious rips and tears in your tendon.
WHAT ARE PATELLAR TENDONITIS SYMPTOMS?
The symptoms of patellar tendonitis may resemble those of other conditions and medical issues, so consult your healthcare provider for a proper diagnosis. Following are some of the most common symptoms of patellar tendonitis:
- Pain and tenderness around the affected area
- Pain when running, jumping or walking – especially downhill or down stairs
- Pain when bending your leg
- Sharp pain below the kneecap – pain coming from the tendon itself
- Stiffness in the lower knee
HOW IS PATELLAR TENDONITIS DIAGNOSED?
Your doctor may apply pressure to the areas around your knee to determine where the pain is coming from. Typically, the pain from patellar tendonitis will be on the front part of the knee, below the kneecap. The doctor may also request one or more of the following imaging tests:
- X-ray – to exclude other bone problems.
- Ultrasound – to create an image of your knee, revealing tears in your patellar tendon.
- Magnetic resonance imaging (MRI) – to create detailed images that can reveal changes in the patellar tendon.
HOW IS PATELLAR TENDONITIS TREATED?
The first thing to do when treating patellar tendonitis is to stop any activity that is causing the symptoms. Your healthcare provider should then begin with less invasive solutions when treating the condition. Pain relievers such as ibuprofen or naproxen sodium (NSAIDs) may provide short-term relief from pain associated with patellar tendonitis. Other treatments include rest, elevation and ice packs to reduce swelling. You may be advised to undertake a variety of other therapy techniques to help reduce symptoms, as well. These may include:
- Stretching exercises. Regular, steady stretching exercises can reduce muscle spasms and help lengthen the muscle-tendon unit. Don’t bounce during your stretch.
- Strengthening exercises. Weak thigh muscles contribute to the strain on your patellar tendon. Exercises that involve lowering your leg very slowly after extending it can be particularly helpful, as can exercises that strengthen all of the leg muscles in combination, such as a leg press.
- Patellar tendon strap. A strap that applies pressure to your patellar tendon can help to distribute force away from the tendon and direct it through the strap instead. This may help relieve pain.
- Iontophoresis. This therapy involves spreading a corticosteroid medicine on your skin and then using a device that delivers a low electrical charge to push the medication through your skin.
If conservative treatment and physical therapy doesn’t help, your healthcare provider may suggest more invasive therapies. These include:
- Corticosteroid injection. An ultrasound-guided corticosteroid injection around the patellar tendon may help relieve pain. These types of drugs, however, can also weaken tendons and make them more likely to rupture.
- Platelet-rich plasma injection. This type of injection has been tried in some people with chronic patellar tendon problems. It is believed that the injections might promote new tissue formation and help heal tendon damage.
- Oscillating needle procedure. This outpatient procedure is performed using local anesthesia. Your doctor uses ultrasound imaging to guide a small oscillating needle to cut away the damaged area while sparing healthy tendon. This is a relatively new procedure, but results have shown promise.
- Surgery. In rare cases, if other treatments fail, your doctor might suggest surgical debridement of the patellar tendon. Some procedures can be done through small incisions around your knee.
WHAT ARE RISK FACTORS FOR PATELLAR TENDONITIS?
Certain people are more at risk of developing patellar tendonitis. Although it occurs most frequently in athletes such as basketball players and runners, there are other factors that may make you more prone to the condition:
- Physical activity. Running and jumping are most commonly associated with patellar tendonitis. Sudden increases in how hard or how often you engage in the activity also add stress to the tendon, as can changing your running shoes.
- Tight leg muscles. Tight quadriceps (thigh muscles) and hamstrings, which run up the back of your thighs, can increase strain on your patellar tendon.
- Muscular imbalance. If some muscles in your legs are much stronger than others, the stronger muscles could pull harder on your patellar tendon. This uneven pull could cause patellar tendonitis.
- Chronic illness. Some illnesses disrupt blood flow to the knee, which weakens the tendon. Examples include kidney failure, autoimmune diseases such as lupus or rheumatoid arthritis and metabolic diseases such as diabetes.
WHAT ARE COMPLICATIONS FROM PATELLAR TENDONITIS?
When you ignore your body’s warning signs and try to work through the knee pain, you could cause much larger tears in your patellar tendon. Severe knee pain and reduced function can persist. If you don’t tend to or treat patellar tendonitis properly, it may progress to a more serious condition called patellar tendinopathy.
HOW CAN YOU PREVENT PATELLAR TENDONITIS?
To reduce your risk of developing patellar tendonitis or having the condition progress to a more serious stage, you can take these steps:
- Don’t play through pain. As soon as you notice exercise-related knee pain, ice the area and rest. Until your knee is pain-free, avoid activities that put stress on your patellar tendon.
- Strengthen your muscles. Strong thigh muscles are better able to handle the stresses that can cause patellar tendonitis. Exercises that involve lowering your leg very slowly after extending your knee are particularly helpful.
- Improve your technique. To be sure you’re using your body correctly, consider taking lessons or getting professional instructions when starting a new sport or using exercise equipment – especially if the sport or exercise involves the excessive use of your legs, knees and patellar tendon.
Preventing injuries to your body should always be your top priority. Remember, when you feel any knee pain while working out, playing sports, running or walking, make sure to immediately stop any activity. Treat the pain and swelling with NSAIDs and ice, and seek further medical treatment if the pain persists.
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