What is Patellar Tendinopathy?
The patellar tendon connects the bottom of the kneecap (patella) to the top of the shin bone (tibia) and is mainly comprised of tightly packed collagen fibres. Patellar tendinopathy is a condition where there is pathology to the patellar tendon, meaning that there is degeneration that causes pain in the anterior (front) of the knee.
Pain is often aggravated when there is a load applied to the knee and when there is an increased demand of the knee to flex and extend. Patellar tendinopathy is common in younger individuals (15-30 years of age) and primarily in athletes. There is also some evidence stating that males are more likely to develop patellar tendinopathy compared to females.
How did I get Patellar Tendinopathy?
The main cause of patellar tendinopathy is tendon overload from repetitive and heavy loading. During normal activity, such as stair climbing, the load on the patellar tendon can reach up to 3 times that of an individual’s body weight!
This can cause microtrauma to the tendon. Over time, the microtrauma can accumulate as the tendon cannot repair fast enough to keep up with the damage with the tendon presenting with degenerative changes.
Another name for patellar tendinopathy is “Jumper’s Knee”. Hence the name, this diagnosis is often seen in athletes who perform sports involving jumping such as basketball, volleyball, football, track and field, and soccer.
Symptoms of Patellar Tendinopathy
The most common symptom that occurs with patellar tendinopathy is anterior knee pain that is worsened by activity and potentially prolonged knee flexion (bent-knee position). Often, the pain will present near the bottom of the kneecap (patella). Pain also may be worsened with prolonged sitting, squatting, and stair climbing/descending. A clear sign of patellar tendinopathy is pain that is specifically experienced with activity when there is a load on the knee, and this pain stops when the load is removed.
How is Patellar Tendinopathy diagnosed?
If you think you may have patellar tendinopathy, you will likely have a full knee and lower limb examination done by your doctor/physiotherapist. Refer to the following link for what to expect during a knee examination: https://www.physio-pedia.com/Knee_Examination
Ultrasounds can be done to identify pathology to the patellar tendon, though, imaging is not often needed to confirm a patellar tendinopathy diagnosis.
Treatment of Patellar Tendinopathy
The first course of treatment for patellar tendinopathy is to correct any predisposing factors. For example, if you are performing activities with a lot of jumping, it is important to stop that activity as soon as possible. It is crucial to avoid aggravating activities that put a lot of load on the knee to give the tendon a chance to heal and repair. After this initial period of “unloading” to reduce pain and promote healing, there will be a slow, gradual return to loading to maintain the structure of the tendon and remodel the collagen.
Another treatment involves strengthening the quadriceps muscles and correcting any biomechanical issues with the lower limb such as “knock knees” (genu valgum) or a high arch of the foot (over-supination) that may cause increasing loads on the knees.