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Patellar tendinitis is an injury to the tendon connecting the kneecap (patella) to the shinbone (tibia). The patellar tendon collaborates with the front thigh muscles to extend the knee, enabling activities like kicking, running, and jumping. This knee injury may cause mild to severe levels of pain and discomfort.
This knee problem frequently results from overuse. This condition is also known as jumper’s knee, since it commonly affects athletes whose sports involve jumping. However, patellar tendinitis can occur in persons who don’t engage in jumping sports.
Pain often becomes worse with time. If left untreated, pain and soreness can become severe. Physical therapy is the first step in treating patellar tendinitis since it stretches and strengthens the muscles around the knee.
Symptoms
Patellar tendinitis’ initial symptom is pain, felt between the kneecap and the area where the tendon attaches to the shinbone (tibia), which typically worsen over time. Patients may initially only experience minor knee pain, but it can increase and become more severe over time.
The patient may initially only experience knee pain right after an intense workout. If left untreated, patellar tendinitis can progress, making it difficult to participate in physical activities, and eventually the pain may cause discomfort when performing even everyday tasks such as getting up from a chair, climbing stairs, standing up or sitting.
Patient may initially try self-care techniques such as applying a cold compress to the affected area and temporarily reducing or avoiding activities that may worsen their symptoms.
Consult your doctor if you are experiencing:
- Persistent or worsening pain
- Disruptions in your daily routine due to the pain
- Swelling or redness near the affected joint
Causes
Frequent stress or excessive pressure on the patellar tendon can lead to patellar tendonitis. Activities such as jumping and rapid running put stress on the patellar tendon bands and can result in tiny tears and sprains that weaken and cause pain over time.
The cause of patellar tendinitis remains unclear. According to healthcare providers, two main factors that can harm tendon tissues:
- A sudden increase in activity
- A sudden full workout after a prolonged break.
Risk factors
Patellar tendinitis may occur as a result of following factors:
- Age: People over 40 are more susceptible than children or young adults as patellar tendinitis develops gradually over a long period of time.
- Physical activity: Patellar tendonitis is most commonly linked to activities such as running and jumping. Changing the running shoes or sudden increase in the intensity or frequency can also put stress on the tendon.
- Athletes: Competitors and elite athletes typically train harder and more frequently than amateur athletes, putting their muscles and tendons under higher strain.
- Tightness in leg muscles: Patellar tendon strain can be worsened by tight quadriceps and hamstrings.
- Muscular imbalance: The patellar tendon may be pulled more forcefully if certain leg muscles are significantly stronger than others. Tendinitis could result from this uneven pull.
- Other disease: Some disorders affects the tendon by obstructing the blood flow to the knee. It includes metabolic illnesses like diabetes, renal failure, and autoimmune conditions like lupus or rheumatoid arthritis.
Diagnosis
The following could help the healthcare provider diagnose patellar tendinitis:
- Physical examination: During the examination, the healthcare provider may apply pressure on the knee to evaluate the area of pain. The front of the knee just behind the kneecap is usually where patellar tendinitis causes pain. They will also assess the range of motion by having patients move their knee slowly in various directions.
- Imaging tests: The doctor may recommend one or more of the following imaging test to diagnose the issue:
- X-rays: This test helps to rule out any other bone issues that may contribute to knee pain.
- Ultrasound: This test uses sound waves to create an image of the knee that shows patellar tendon tears.
- Magnetic resonance imaging (MRI): This test uses a magnetic field and radio waves to produce detailed images that can detect small changes in the patellar tendon.
Treatment
Treatments for patellar tendinitis focus on relieving discomfort and strengthening the knee’s soft tissues. The healthcare professional will suggest to start out with conservative therapies such as resting. The following steps can be sufficient to ease the pain in minor circumstances.
- Home management: The RICE method (rest, ice, compression, and elevation) may help reducing the symptoms.
- Medications: Over-the-counter painkillers ibuprofen (Advil, Motrin IB, etc.) or naproxen sodium (Aleve, etc.) may provide temporary relief from the discomfort caused by patellar tendinitis.
- Physical therapy: The symptoms of patellar tendinitis can be improved using a range of physical therapy treatments, such as:
- Stretching activities: Regular, continuous stretching activities can extend the muscle-tendon unit and help minimize muscle spasm.
- Strengthening activities: Activities that build all of the leg muscles at once, like a leg push, as well as exercises that slowly drop the leg after it was extended, might be beneficial.
- Patellar tendon strap: This method reduces pain by applying pressure on the patellar tendon. A strap can help distribute force that travels through the strap rather than the tendon.
- Iontophoresis: A corticosteroid medication is applied to your skin during this therapy, and the medication is then pushed through your skin by a device that delivers a weak electrical charge.
- Surgery: The doctor may recommend additional therapies therapies if non-surgical treatment are ineffective, such as:
- Corticosteroid: The patellar tendon sheath can be injected with corticosteroids under ultrasound guidance to help with pain management. These substances, however, can potentially degrade tendons and increase the risk of tendon rupture.
- Platelet-rich plasma injection: Patients with severe patellar tendon issues have attempted this kind of treatment. The injections are expected to help in the healing of damaged tendons by encouraging the growth of new tissue.
- Oscillating needle: A healthcare provider uses ultrasound to guide a small, oscillating needle in removing the diseased area of a tendon while leaving the healthy tendon tissue intact. Local anesthesia is used during this procedure.
- Surgery. If imaging test show a tendon tear, the doctor may advise surgery to repair the damaged tissue. If non-surgical treatment fail to relieve symptoms, surgical debridement of the patellar tendon may be recommended. Small incisions around the knee may be used for some treatments.
