Patellar Tendonitis
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Patellar Tendonitis

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

En Español (Spanish Version)

Definition

Patellar tendonitis is inflammation of the patellar (knee) tendon. This tendon connects the patella (kneecap) to the lower leg bone (tibia).

Patellar Tendonitis

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Causes

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

  • Intense running
  • Jumping
  • Frequent stops and starts
  • Frequent impact to the knee

Patellar tendonitis is more common in the following sports:

  • Basketball
  • Soccer
  • Volleyball
  • Running

Risk Factors

A risk factor is something that increases your chance of getting a disease, condition, or injury. Risk factors for patellar tendonitis 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

Symptoms

Symptoms include:

  • Pain and tenderness in the patellar tendon below the knee
  • Pain or "tightness" in the knee when bending, squatting, or straightening the leg
  • Discomfort in the knee when jumping, running, or walking

Diagnosis

The doctor will ask about your symptoms, physical activity, and how the injury occurred. The doctor will also examine your knee, and may ask you to perform certain movements.

Tests may include:

  • X-ray —to rule out other conditions that may be causing your symptoms

Treatment

Treatment includes:

Ice

Apply ice or a cold pack to the knee for 15-20 minutes, every four hours, for 2-3 days. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin.

Medication

First talk to your doctor if you have any questions about using medications. Over-the-counter drugs that are commonly used to reduce inflammation and pain include:

  • Ibuprofen (Motrin, Advil)
  • Naproxen (Aleve, Naprosyn)
  • Acetaminophen (Tylenol)
  • Aspirin

Infra-patellar Strap

This 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 Therapy

Physical therapy will help:

  • Stretch and condition the quadriceps muscle, which attaches to the patella
  • Maintain muscle strength, flexibility, and endurance

Cortisone Injections

If the treatments above do not reduce inflammation, some doctors may recommend that you consider a cortisone injection. (This should be used only for chronic tendonitis that has not responded to other treatments that have been used for at least two months.) Check with your doctor to find out what is best for you. Avoid repeated cortisone injections.

Resuming Exercise

Return to high-impact physical activity gradually. Healing has occurred when:

  • The knee can bend and straighten without pain.
  • You are able to jump on the injured leg without pain.
  • You are able to jog in a straight line without pain.
  • Swelling is gone.
  • Normal strength of the quadriceps muscles has returned.

Surgery

You may need surgery if there is:

  • Advanced inflammatory damage to the tendon
  • Little or no response to other treatments over a 6-12 month period

During surgery, the damaged portion of the patella tendon will be removed through a small incision in the skin. Eventually, scar tissue will form and repair this damaged area.

Prevention

You may prevent patellar tendonitis by:

  • Avoiding activities and sports that repeatedly stress the kneecaps
  • Increasing the frequency and intensity of exercise gradually
  • Regularly doing quadriceps muscle stretching and strengthening exercises

RESOURCES:

American Academy of Orthopaedic Surgeons
http://www.aaos.org/

The American Orthopaedic Society for Sports Medicine
http://www.aossm.org/tabs/Index.aspx/

National Institute of Arthritis and Musculoskeletal and Skin Diseases
http://www.niams.nih.gov/

CANADIAN RESOURCES:

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

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

References:

Aronen JG, Garrick JG. Sports-induced inflammation in the lower extremities. Hosp Pract . 1999;34:51.

Bursitis and tendinitis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Bursitis/default.asp#3_3 . Updated April 2007. Accessed June 13, 2008.

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

Orthopedics Hyperguide tutorial. Orthopedics Hyperguide website. Available at: http://www.ortho.hyperguides.com/faq.asp . Accessed October 11, 2005.

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



Last reviewed October 2007 by Robert E. Leach, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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