Patella Tendinopathy
By Laurence Schubert APAM
What isPatella Tendinopathy?
Pain just below your knee cap? Do you play sports suchas basketball, volleyball, football, tennis? Does your sport require repetitivejumping? If you answered yes, then it is likely that you are suffering from acondition commonly referred to as jumper's knee. The scientific term, patellatendinopathy is an overuse condition classified by pain at the base of thepatella (kneecap) that occurs during activities such as jumping/landing,squatting, sitting or going up and down stairs.
The patella tendon is responsible for absorbingextremely large amounts of force, especially during jumping and landing. It isestimated to be up to twelve times your body weight during jumping. Therefore,the patella tendon and quadriceps must be capable of managing heavy forces putthrough it during activity.
What arethe symptoms?
A sharp localised pain just below the knee cap willalmost always be present with patella tendinopathy. Activities that aggravatethe pain will include anything that places a load through the knee joint/patellatendon, such as those described above. A very common finding with thiscondition will include a sudden change in training load. Pain can appear tocome on quickly or gradually over time. Pain first thing in the morning isexpected, due to the condition's inflammatory nature.
How does ithappen?
As just mentioned, sudden changes in trainingloads/schedules are the most common cause of this pain. Over time tendons willadapt and become stronger, allowing increased force absorption capacity. However,this process occurs over a period of weeks to months. Therefore, if thishappens too quickly the adaptations would not have been made. If activitylevels are changed too quickly, the tendon is not yet capable of sustainingheavy repetitive forces.
Other factors such as muscle length, age, musclestrength, diet and overall health can also affect the health of tendons. Thiscondition is more commonly seen in men.
Why see aphysiotherapist?
There are other conditions that can masquerade as patellatendinopathy. Therefore, it is necessary to confirm the diagnosis. Throughoutthe assessment process, key information will be used to form part of thetreatment. Treatment will initially involve a modification of training load,depending on your sporting goals. Followed by an individualised rehabilitationprogram, which is embedded with your current training program. In this program,isometrics and eccentric exercises have shown to be important when loading thetendon appropriately. These two types of movements are useful for pain reliefbut also increasing the strength of your tendon. Other treatment modalitiessuch as manual therapy may be necessary if biomechanical abnormalities havebeen identified. Tendinopathies often require patience, as the rehabilitation willtake at least 4-6 weeks before significant changes occur. However, you can beconfident that this condition will improve if managed properly.
