Patellar Tendonitis

Patellar tendonitis is an injury that affects the tendon connecting the kneecap (patella) to the shinbone. The patellar tendon, along with the quadriceps muscle and tendon, allows the knee to be straightened out, and provides strength for this motion. Patellar tendonitis is a common overuse injury that occurs when repeated stress is placed on the patellar tendon. The stress results in tiny tears in the tendon, which the body attempts to repair. But as the tears in the tendon become more numerous, the body can't keep up, causing the inflammation in the tendon to worsen.

When overuse is the cause of patellar tendonitis, patients are usually active participants in jumping types of sports, such as basketball or volleyball. Patellar tendonitis also may be seen with sports such as running and soccer. Also, some patients develop patellar tendonitis after sustaining an acute injury to the tendon, and not allowing adequate healing. This type of traumatic patellar tendonitis is much less common than in overuse syndromes.

Patellar tendonitis usually causes pain directly over the patellar tendon. Your doctor should be able to recreate your symptoms by placing pressure directly on the inflamed tendon. The other common symptom of patellar tendonitis is pain with activities, especially jumping or kneeling.

Diagnosis

The diagnosis of tendonitis requires a careful medical history and physical examination. To eliminate other possible reasons for the inflammation, additional tests are sometimes ordered. X-rays are usually taken to rule out abnormalities of the bones and arthritis, blood tests are used to rule out rheumatoid arthritis or diabetes, and aspiration (removal of fluid) of a swollen tendon is used to diagnose an infection or gout.

Treatment

Treatments for patellar tendonitis include rest, anti-inflammatory medications such as ibuprofen, stretching of the quadriceps, hamstrings, and calf muscles, ice treatments, and the use of support straps or braces. Surgery for patellar tendonitis is extremely rare but can be considered if there is little or no response to treatment over a six to 12 month period, or if a portion of the tendon can be seen as degenerative on an MRI.

Prevention

The following steps can be taken to help prevent the onset of patellar tendonitis:

• Proper conditioning
• Gradual introduction of activity
• Warm-up and stretching prior to exercise
• Wearing appropriate shoes for activity

Basic Rehabilitation

• Knee extension: Use a leg extension resistance-training machine. Begin the exercise seated with the knees bent at a 90-degree angle. Start with an amount of resistance that can be overcome with no pain. Fully extend the knees and hold this position for three to five seconds. Slowly return to the beginning position and rest for five seconds. Repeat this cycle a total of 10 times for three sets. Increase resistance from one training session to the next as pain permits.
• Knee flexion: Use a leg flexion resistance-training machine. Begin the exercise lying face downward with the knee extended. Start with an amount of resistance that can be overcome with no pain. Fully flex the knees and hold for three to five seconds. Slowly return to the beginning position and rest for five seconds. Repeat this cycle a total of 10 times for three sets. Increase resistance from one training session to the next as pain permits.
• Half-knee bends: Stand with feet shoulder width apart. Slowly lower the body weight by bending the knees. Do not perform a full squat, but rather stop at about half of the full squat position and then fully extend the knees. If there is pain before achieving the half-squat position, stop downward travel at that point. Repeat 10 times for three sets.