Patella Tendinopathy
Does your knee remind you of any of the following?
- Pain just below the kneecap when sitting for a long time that gets worse the longer you keep the knee bent
- Knee pain that gets better once you warm up and then once you cool down feels stiff and painful
- Being afraid of what the next morning will be like with knee pain after training or playing sport?
- Going up and down stairs is painful even if it’s just a small number on steps
- Downhill walking – forget about it, too painful!
- Finding it tricky to train legs in the gym because of pain
- Struggling to feel the muscles on the front of the thigh working at all?
IF some/all of the above symptoms sound like what you’re experiencing, you may have a condition known as ‘Patellar tendinopathy’, also known as ‘Jumper’s knee.
A very brief anatomy lesson (with pictures)
The patellar tendon is a soft-tissue structure that connect the quadricep muscle (the thigh muscle) to the tibia (shin). When the quadricep muscle contracts the tendon acts as an intermediary that applies force to the tibia leading to the knee straightening. When we walk, run, jump or squat the quadricep muscle SHOULD be strong enough to prevent the tendon from trying to do to much
When we start to overload the body with activities that may involve repetitive jumping or running or bending IF our quadricep muscle isn’t strong enough our patella tendon can start to do MORE than what we would ideally like it to do.
IF the patella tendon becomes overworked and we fail to build strength in our quadricep muscle this can lead do tendon injury; called a tendinopathy.
Who is most likely to develop a patellar tendinopathy?
Patellar tendinopathy is very common in athletes whose sport requires a lot of jumping such as Basketball and Volleyball. A patellar tendinopathy is also very common in the post-surgical population that may not have regained the strength in their leg muscles after an operation.
Tendinopathy signs
- Pain is always in the same spot just below the kneecap
- Pain can be reproduced in activities that require muscle control on a bent knee such as a squat or lunge
- Pain that did go away when warmed up starts to linger longer and longer as weeks and months go on
- The next morning after exercise is a bad time to be a tendon!
Do I need imaging to confirm the diagnosis?
NO – your physio will be able to diagnose this condition following an assessment and some physical exertion testing.
Do I need surgery?
NO – there is excellent evidence regarding strength training and Physiotherapy in the management of patellar tendinopathy
Will it get better by itself IF I stop everything?
The funny thing with tendons is…symptoms actually increase when you stop! That’s why we say start your rehab early to fix the issue and get on top of the source of the tendinopathy.
What will my physio do?
Your Physio will work with you to develop a personalised exercise plan then progress this plan as you get stronger and more tolerant of different exercises. IF pain is a barrier to progression your Physio can also deploy hands on therapy such as massage; dry needling or cupping to allow ongoing training. Strengthening and loading your tendon in a controlled and precise way is crucial to stopping the cycle of pain.
How do I start?
Contact us at the clinic and let’s sort this knee together.
Speaking from experience we know how frustrating patellar tendinopathy can be. I wish I did it right the first time and I would have 2 more years of Basketball back. There is no quick fix to this; no injections or surgeries; if you put in the training and build your muscle strength and tendon load tolerance, we can fix it. On average we are looking at weeks- months to be at your best again; but if we don’t put in the effort, it won’t fix itself.
Don’t let pain stop you from doing what you want to do; make an appointment today to have your knee assessed, plan out your goals with your Physio and let’s get you back to doing whatever it is that you want to do!