Patellar Tendinopathy (PT)

Knee Pain

Knee Pain

Patellar Tendinopathy (PT) –

also known as Jumper’s Knee 

 

Patellar Tendinopathy is an overuse injury that affects the knee and occurs as a result of the patellar tendon undergoing more stress than it is able to tolerate.  Pain is often felt into the front of the knee and is worse with activity. The person may have localised tenderness over the patellar tendon and the tendon often feels stiff first thing in the morning.

It occurs more frequently in skeletally mature adolescents or adults and varies in age ranging from 16-40 years. It tends to be equal in occurrence between males and females and there is up to a 22% incidence in the overall athletic population. Microtrauma can occur when the patellar tendon is subjected to extreme forces such as rapid acceleration, deceleration, jumping and landing.

Often activities such as running, jumping, kicking and landing aggravate the knee.

Sports such as volleyball, basketball, soccer and dancing involve a lot of the above activities and tend to be an at risk group for developing the problem. Weight lifters may also develop irritation in the knee as they often squat with heavy loads.

What is the process or how does it occur?

Acute tendinitis involves an active inflammatory process that occurs following an injury. If treated properly it may heal in 3-6 weeks. The longer this process continues and with continual irritation, a chronic inflammatory phase may occur. Chronic patellar tendinopathy presents itself after 6 weeks as degenerative changes occur in the tendon. These changes include the absence of inflammatory cells in the tendon, a tendency towards poor healing, and decreased quality and organisation of collagen fibers, which in turn may lead to a decrease in tensile strength.

Intrinsic and extrinsic factors play a part in the development of patellar tendinopathy. Some of the intrinsic factors include: Muscle strength, muscle imbalance, postural alignment, mainly hip stability and how it functions to maintain correct alignment of the knee joint, foot structure, reduced ankle dorsiflexion and lack of muscle flexibility.

The primary extrinsic factor and cause of patellar tendinopathy is – OVERUSE

An increase in physical load, repetition, intensity, frequency, and or duration of greater than 10% per week in the training schedule all contribute to this overuse syndrome. Additionally fatigue, poor technique, and training errors may play a role.

Other considerations for injuries may include improper training surfaces, insufficient footwear or inappropriate equipment. Progressing physical loading, high intensity training, or repetitive loading too quickly may contribute to the development of patellar tendinopathy.

Overuse in athletes who continue to push past pain may contribute to the development of a chronic and problematic condition or tendinopathy taking 3-6 months to heal.

Treatment often involves:

  • Controlled rest
  • Avoidance of aggravating activities that reproduces symptoms
  • Eccentric and controlled exercise without load
  • Patient education regarding activity and pathology
  • Modalities such as Ultrasound and cryotherapy may provide some pain relief
  • Improving lower limb flexibility with soft tissue work such as massage or stretching
  • Hip and knee strengthening exercises
  • The patient may progress to relatively pain free activities, such as stationary cycling or swimming if tolerated as this can help maintain physical fitness, and keep the tendon unloaded

Return to play or training can be initiated when the patient is pain free, have carried out sports specific drills and there are no latent effects of training or activity.

More information

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Or contact the clinic for details

danielleDanielle Gavaghan MISCP

 

 

 

 

 

 

 

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