(Jumper's Knee; Patellar Tendonitis; Patellar Tendinosis; Quadriceps Tendonitis; Infrapatellar Tendinopathy; Patellar Apicitis)
DefinitionThe 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
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CausesTendinopathy 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
- Frequent stops and starts
- Frequent impact to the knee
- Tendon weakness from certain diseases
Risk FactorsFactors that increase your chance of developing patellar tendonopathy include:
- Being a physically active teenager or young adult
- 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
SymptomsSymptoms 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, squating, or walking up stairs
DiagnosisThe doctor will ask about your symptoms and medical history. A physical exam will be done.Tests may include x-rays or an MRI.
TreatmentTalk with your doctor about the best treatment plan for you. Treatment will depend on the severity of the injury. Options include:
Home CareTo reduce pain and swelling:
- Avoid activity that causes pain. Reduce shock or vibrations to the knee.
- Apply an ice pack for 15-20 minutes at a time, several times a day. Place a towel between the ice pack and your skin.
- Wrap your injured knee in elastic bandaging. Don't wrap the bandage too tight. It may cut off circulation.
- Elevate your knee above your heart.
MedicationTo help manage pain, your doctor may recommend:
- Over-the-counter pain relievers, such as acetaminophen or non-steroidal anti-inflammatory medication (NSAIDs)
- Topical pain medications that are applied to the skin
- Prescription pain relievers
Infra-patellar StrapThis strap, also called a counterforce brace, can help support the tendon and reduce pain. It is worn as a band just below the knee.
Physical TherapyPhysical therapy will help:
- Stretch and condition the quadriceps muscle, which attaches to the patella
- Maintain muscle strength, flexibility, and endurance
- Improve balance and range of motion
Cortisone InjectionsIf the treatments above do not reduce inflammation, your doctor may recommend that you consider a cortisone injection. Try to avoid repeated cortisone injections.
SurgeryYou 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.
PreventionTo reduce your chances of getting patellar tendinopathy, take these steps:
- Avoiding activities and sports that repeatedly stress the kneecaps, especially those that involve jumping
- Regularly doing quadriceps muscle stretching and strengthening exercises
- Gradually increasing the frequency and intensity of exercise
- Learn proper sporting technique
American Academy of Orthopaedic Surgeons Ortho Info
The American Orthopaedic Society for Sports Medicine
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
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10/26/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.
- Reviewer: Teresa Briedwell, PT, DPT, OCS
- Review Date: 03/2014
- Update Date: 04/29/2014
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