Patella Tendinopathy

Patella Tendinopathy

This injury is also known as ‘Jumper’s knee’ as it is common in jumping sports such as basketball, but is also commonly seen in runners. The patella tendon attaches the knee cap to the shin bone so it is under a lot of force during the landing phase of running gait. Like any other tendinopathy, when a tendon is repeatedly loaded and the load becomes more than the tendon can withstand it can start to degenerate.

The three stages of tendinoapthy are reactive, disrepair and degenerate tendinoapthy, and the stage will determine the extent of rehabilitation required. It is always best to catch a tendinoapthy in it’s early stages because this is when the least tendon damage has occured and it is most responsive to treatment with less chance of the injury reoccurring.

Symptoms

Pain presents on the front of the knee just below the knee cap and is usually gradually onset and worsened by jumping, landing and running. The patella tendon can be tender to palpate and appear thickened when compared to the other side. Initially pain and stiffness can be worse first thing in the morning and at the start of the run but will ease once warmed up. If the injury has progressed further, pain may continue throughout the run and ache afterwards.

Causes

Tendon injuries occur as a result of gradual wear and tear to the tendon by repetitive loading which causes micro-trauma and breakdown of the tendon matrix. Tendons are made to withstand high repetitive loads but certain factors can cause the load to become too much leading to development of a tendinopathy. These include:

  • Rapid increase in intensity of training or mileage
  • Training on hard surfaces
  • Poor flexibility particularly through the quadriceps and hamstrings
  • Lower limb biomechanical fault including weak hip stabilisers or over-pronation at the foot
  • Poorly fitted or worn-out footwear

Prevention and Treatment

To best treat a patella tendon injury, it should be identified as early as possible to stop progression of tendon damage. Rest, ice and gentle stretching can help settle the initial pain, however it is always best to have the condition assessed by a physiotherapist to firstly ensure the correct diagnosis is made and then most appropriate treatment can be prescribed.

The Front Runner physiotherapists are highly skilled in diagnosis and management of patella tendon injuries and will typically use soft tissue release, taping techniques and prescription of stretching and strengthening exercises to address and correct the causes of the injury. Tendon injuries respond best to eccentric based strengthening programs so this will more than likely form part of rehabilitation.

Prevention is always the best treatment so ensure that you are training smart, varying your training surfaces, wearing foot wear with an appropriate fit and cushioning and stretching/foam rolling regularly. It is also a great idea to have a biomechanical assessment with your physiotherapist to address any potential problem areas.

Other Running Injury info:

  1. Plantar Fasciitis
  2. Achilles tendinopathy
  3. Patello-femoral pain syndrome
  4. Patella tendinopathy
  5. Calf Strains

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