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Anterior Knee Pain? You could be suffering from patellar tendinitis.

Patellar Tendinitis in AthletesAs the weather gets warmer, athletes of all ages begin summer training in preparation for the upcoming season. However, with this intense period of training comes the increased likelihood of an overuse injury that can impact the performance of the most determined athlete. Patellar Tendinitis is a condition characterized by the presence of pain, inflammation, weakness, and in severe cases, microscopic tears of the patellar tendon and is often caused by repetitive use. Recent studies have highlighted the prevalence of this condition in sports requiring frequent jumping such as basketball and volleyball; however, it can manifest itself in athletes of all ages and levels of experience. While patellar tendinitis is commonly thought of as an overuse injury, other risk factors include age, obesity, limited flexibility, poor quadricep/hamstring strength, and muscle imbalances. Studies have also shown that sport specialization and poor training technique increases one’s likelihood of developing this condition. As symptoms of patellar tendinitis develop, proper management is crucial to recovery and the prevention of a patellar tendon rupture.

Anatomy

The patellar tendon is band of dense regular connective tissue that connects the patella (kneecap) to the tibia (shin bone). Due to its attachment to the quadriceps tendon, the patellar tendon allows for the transmission of force from the quadricep muscles to the lower leg. The direct relationship between each of these structures allows for knee extension and the ability to walk, run, and jump.

Symptoms

  • Pain (localized inferiorly to the patella) with weightbearing movements such as walking, running, jumping, and squatting.
  • Inflammation
  • Hesitancy during athletic competition

Prevention

  • Strengthening of quadriceps and lower leg muscles
  • Stretching prior to physical activity

Treatment

While most tissues have a rich supply of blood, tendons and ligaments tend to be avascular. Therefore, patellar tendinitis often requires significant time to heal. Treatment options include:

Conservative Treatment

  • Rest/Ice
  • Nonsteroidal anti-inflammatory medications (NSAIDS)
  • Eccentric muscle strengthening
  • Bracing/Patellar Tendon Bands

 Invasive Treatment 

  • Platelet Rich Plasma Injections (PRP) – a procedure by which platelets and growth factors are separated from the patient’s blood and injected into the patellar tendon. This procedure is often not covered by insurance and its efficacy in treating tendinitis is still unclear.
  • Surgery – in severe cases, your physician may suggest debridement of the damaged tendon to promote healing. 

Due to the nature of athletics and the patient’s desire to return to competition, rest is not the answer that any athlete desires to hear. However, when combined with eccentric muscle strengthening and icing, rest allows for decreased inflammation and the opportunity for the tendon to heal. If immediate relief is needed, many athletes turn to knee braces and patellar bands which provide support and reduce the severity of the associated pain. Symptoms often return with prolonged use of these devices; therefore, PRP injections and surgical correction are often considered.

Unfortunately, every injury is different and the treatment plan is equally unique. If your knee injury needs evaluated, contact OrthoNeuro to schedule an appointment with one of our physicians to discuss your care and return to competition!

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Resources:

Patellar Tendon Tear – OrthoInfo – AAOS. https://orthoinfo.aaos.org/en/diseases–conditions/patellar-tendon-tear/. Accessed June 19, 2018.

O’Brien KB, ed. Jumper’s Knee (Patellar Tendonitis). KidsHealth. https://kidshealth.org/en/parents/jumpers-knee.html. Published June 2013. Accessed June 20, 2018.

Reinking MF. CURRENT CONCEPTS IN THE TREATMENT OF PATELLAR TENDINOPATHY. International Journal of Sports Physical Therapy. 2016;11(6):854-866.