Patellar Tendon Talk - Ask An Expert - With Alex Nicholson, APA Sports and Exercise Physiotherapist

What is patella tendonitis and what does it feel like?

Patella tendonitis may also be referred to as patella tendinopathy or Jumper’s knee. Patella tendonitis refers to pain just under the knee cap, usually at the top of the patella tendon where it inserts onto the knee cap. This tendon is usually very tender to touch. Squatting, jumping, hopping are very painful. Sports such as volleyball and basketball, which involving a lot of repetitive jumping on hard surfaces, are associated with a higher incidence of patella tendinopathy.

Despite what some people may think, it is actually not a very common condition of the knee, especially in populations that do not do a lot of jumping (hence the name Jumper’s Knee). I have seen many patients over the years who have been diagnosed previously with patella tendonitis, when the pain is actually coming from the patellofemoral joint. So if you have diagnosed yourself on Google, it might be a good idea to see an experienced physiotherapist to get their opinion.

What is the cause?

The most common cause that I see is a sudden increase in high impact exercises for the patella tendon such as hopping and jumping. Occasionally I do see someone with patella tendonitis that has been caused by a direct blow to the tendon, however this is quite rare. Other factors that may increase the likelihood of getting patella tendonitis include weight gain, or in adolescents, a sudden growth spurt.

 How do you treat patella tendonitis?

The first line of treatment is to unload the tendon. This may include modifying exercise levels and activities for a period of time to allow the overloaded tendon to settle down. Anti-inflammatories may also be helpful in the early stage, but you should consult with your doctor before taking any medications. Taping techniques for the tendon can also provide pain relief.

Isometric quadriceps exercises are usually implemented quite early in rehabilitation to improve pain, muscle activation and reduce deconditioning. Isometric leg extensions or a Spanish squat are common exercises used. Once the tendon starts to settle down, a progressive strengthening program needs to be undertaken, starting with slow heavy resistance exercises and then progressing to faster, more explosive and sport-specific exercises over time as appropriate.

 What is the recovery time?

Like any injury, recovery times vary greatly and the amount of time that you have had the injury for may influence the recovery time, particularly if you have significant muscle wasting and deconditioning. As a result, I would anticipate a minimum of 3 months of rehabilitation and possibly up to 6 months.

Should I use a strap or a brace?

There are several braces available and taping techniques, that can be helpful. If a brace or taping improves your pain with a functional activity (e.g. squatting), then I recommend that you use it as it will also help to keep your muscles working in a more normal pattern (e.g. it may stop you limping for example) and allow you to strengthen them up, which in turn will assist in your expediting your rehabilitation.

Is it ok to walk and still exercise?

Yes, it is ok to walk. However, as a general guideline I would not want you to do any activity that flares you up the next day. If you are stuck and finding that your current activity levels are flaring you up, or you are failing to improve, you are well overdue to see a physio with expertise in treating tendon problems who will get you back on track.

If you would like someone to help make sense of your pain, please call us at (02) 8411 2050. At Thornleigh Performance Physiotherapy, we can give you an accurate diagnosis and treatment, to help you get back in action as soon as possible. We are conveniently located near Beecroft, Cherrybrook, Hornsby, Normanhurst, Pennant Hills, Waitara, Wahroonga, Westleigh, West Pennant Hills, and West Pymble.