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Patellar Tendonitis (Jumper's Knee)

  • What is patellar tendonitis?

    Patellar tendonitis

    Patellar tendonitis, also known as jumper’s knee, is an injury affecting the patellar tendon that connects the kneecap (patella) to the shin bone. Its function is to assist the muscles during movement of the lower leg, in actions such as jumping, kicking and pedalling. Patellar tendonitis is characterised by pain and inflammation which weakens the tendon, creating small tears.

    The resulting pain can interfere with daily activities, such as climbing stairs or sitting in a car, as well as sports activities.

  • Patellar tendonitis (jumper's knee) is usually caused by overuse of the knee joint and repeated stress on the patellar tendon. It is more common among people who play sports that involve squatting and jumping movements such as basketball and volleyball.

    Risk factors for patellar tendonitis

    • Tight thigh and hamstring muscles can increase the strain on the patellar tendon
    • Uneven leg muscle strength or muscular imbalance, with stronger muscles pulling harder on the patellar tendon.
    • Abnormal alignment of the legs, ankles and feet, including conditions such as bow legs, knock knees and flat feet
    • Increased tension in the patellar tendon, which can occur when tendon growth cannot keep up with the growth of the lower leg. Known as Sinding-Larsen-Johansson disorder, the tendon pulls on the bottom tip of the kneecap.
    • Obesity, which places increased pressure on the knee joint
    • Chronic illness such as kidney failure, rheumatoid arthritis or diabetes which can affect blood flow to the knee and weaken the tendon
    • Poor jumping and landing technique, due to the way the quadricep muscles contract.

    Reducing the risk of patellar tendonitis by:

    • Stretching and warming up thoroughly before exercise
    • Cooling down and stretching after exercise
    • Wearing knee support devices while playing sports
    • Strengthening the leg muscles that support the knees
    • Practicing good technique while jumping and especially while landing
    • Avoiding jumping or landing on hard surfaces such as concrete
  • Symptoms of patellar tendonitis include:

    • Pain and tenderness at the base of the kneecap, especially while kneeling or getting up from a squatting position
    • Sporadic pain that worsens as the damage to the tendon gets worse
    • Swelling or burning sensation in the kneecap
    • Bruising or redness, especially if there has been an injury
    • Discomfort from daily activities that require bending and straightening of the knee
  • Patellar tendonitis may be diagnosed based on:

    • Physical examination

      Your doctor will ask about your symptoms and conduct an examination to review the location and severity of your pain. You will also be asked to demonstrate your range of movement by bending and extending your leg.
    • Magnetic resonance imaging (MRI)

      An MRI can help to reveal damage to the tendon or any of the soft tissues around the knee.
    • Ultrasound

      An ultrasound is another imaging test that can help to reveal damage to the tendon or any of the soft tissues around the knee.
    • X-ray

      An X-ray allows your doctor to see if there is any bone damage such as a fracture or displacement of the kneecap.
  • Treatment for patellar tendonitis includes:

    • Rest, ice, compression and elevation (R.I.C.E.)

      This combination is a simple technique to reduce pain and inflammation.
    • Medication

      Over-the-counter or prescription medication can help to reduce pain and inflammation.
    • Corticosteroids

      A corticosteroid injection directly into the area surrounding the patellar tendon can help to reduce severe pain, though there may be a risk of tendon rupture. Corticosteroids can also be administered by applying it topically and applying a low electrical charge to enhance absorption. This process is known as iontophoresis.
    • Knee straps or brace

      A knee strap or brace can help to relieve the pain and provide support to avoid further damage to the tendon. Crutches may also help.
    • Physiotherapy

      Specific exercises can help to stretch and strengthen the muscles that support your knee.
    • Ultrasound or electrical stimulation

      These methods are used to ease knee pain and inflammation, and encourage recovery.
    • Orthotic devices

      Corrective devices such as shoe inserts may be given to support flat feet or correct knock-kneed posture.
    • Extracorporeal shockwave therapy

      This involves sending electrical impulses into the tissues surrounding the knee cap, targeting damaged tissues.
    • Surgery

      A torn or ruptured tendon may require surgical repair.

    Knee pain can be caused by many conditions and require different forms of treatment. As your condition may get worse without treatment, it’s best to have your knee pain medically diagnosed so you can receive appropriate treatment.

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  • Complications of patellar tendonitis include:

    • Continued damage to the patellar tendon

      If you continue with the activities that led to patellar tendonitis, damage to the tendon can worsen.
    • Increased pain

      As pain gets worse, you may end up restricting your daily activities.
    • Limited or reduced functioning of the knee joint

      Progressive damage can increasingly limit your range of movement and daily activities.
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