Patellar Tendinopathy

Definition

Causes

Risk Factors

Patellar Tendinopathy

(Jumper's Knee; Patellar Tendonitis; Patellar Tendinosis; Quadriceps Tendonitis; Infrapatellar Tendinopathy; Patellar Apicitis)

by Cynthia M. Johnson, MA

Definition

The patellar tendon connects the kneecap to the lower leg bone. Tendinopathy is an injury to the tendon. It can cause pain, swelling, and limited movement. The injury can include:

Tendonitis—inflammation of the tendon
Tendinosis—tiny tears in the tendon tissue with no significant inflammation

Treatment depends on the severity of the injury.

Patellar Tendonitis

Causes

Tendinopathy is generally caused by overuse of a muscle-tendon unit. Over time, the strain on the tendon causes structural changes within the tendon.

Patellar tendinopathy occurs from overuse of the patellar tendon. Overuse may be caused by any activity that requires:

Intense running
Jumping
Frequent stops and starts
Frequent impact to the knee
Falls
Tendon weakness from certain diseases

Risk Factors

Physically active teenagers and young adults are at higher risk. Factors that increase your chance of developing patellar tendinopathy include:

An increase in the frequency of training
A sudden increase in the intensity of training
Changing from one sport to another
Training on a hard surface
Repeated improper movements while training
Muscle weakness or imbalance
Involvement in basketball, soccer, volleyball, or running

Symptoms

Symptoms may include:

Pain and tenderness in the patellar tendon below the kneecap
Pain or tightness in the knee when bending, squatting, or straightening the leg
Discomfort in the knee when jumping, squatting, or walking up stairs

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Images may be taken. This can be done with:

Treatment

Talk with your doctor about the best treatment plan for you. Treatment will depend on the severity of the injury. Options include:

Supportive Care

Your knee will need time to heal. RICE is often the main part of treatment:

Rest—Activities will need to be restricted at first to reduce shock or vibrations to the knee. Normal activities will be gradually introduced as the injury heals.
Ice—Ice therapy may help relieve swelling.
Compression—Compression bandages can provide gentle pressure to help move fluids out of the area.
Elevation—Keeping the affected area elevated can help fluids drain out or prevent fluids from building up.

A strap called a counterforce brace may be advised to help support the tendon and reduce pain.

Over-the-counter or prescription medications may be advised to reduce pain. Cortisone injections may also be used if other treatments do not reduce inflammation.

Physical Therapy

A physical therapist will assess the knee. An exercise program will be created to help recovery and to strengthen the muscle.

Surgery

You may need surgery if you have advanced damage to the tendon. Your doctor may also recommend surgery if you have not responded to other treatment methods over a period of several months.

Prevention

To reduce your chances of getting patellar tendinopathy, take these steps:

Avoid activities and sports that repeatedly stress the kneecaps, especially those that involve jumping.
Perform quadriceps muscle stretching and strengthening exercises.
Increase the frequency and intensity of your exercises gradually.
Learn proper techniques for sports.

RESOURCES:

The American Orthopaedic Society for Sports Medicine
http://www.sportsmed.org

OrthoInfo—American Academy of Orthopaedic Surgeons Ortho Info
http://www.orthoinfo.org

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org

Canadian Orthopaedic Foundation
http://www.canorth.org

References:

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Accessed March 27, 2018.

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Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.

O'Connor FG, Howard TM, Fieseler CM, Nirschl RP. Managing overuse injuries: a systematic approach. Phys Sportsmed. 1997 May;25(5).

Patellar tendinopathy. EBSCO DynaMed Plus website. Available at: http://www.dynamed... . Updated December 22, 2015. Accessed March 27, 2018.

Patellar tendon knee tear. American Academy of Orthopaedic Surgeons Ortho Info website. Available at:
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Updated February 2016. Accessed March 27, 2018.

Post WR. Patellofemoral pain: let the physical exam define treatment. Phys Sportsmed.1998;26(1).

Steunebrink M, Zwerver J, Brandsema R, Groenenboom P, Akker-Scheek Iv, Weir A. Topical glyceryl trinitrate treatment of chronic patellar tendinopathy: a randomised, double-blind, placebo-controlled clinical trial. Br J Sports Med. 2013 Jan;47(1):34-9.

Last reviewed March 2018 by EBSCO Medical Review Board Teresa Briedwell, PT, DPT
Last Updated: 4/29/2014

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