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Patellar tendinopathy

Contents

Introduction

The tendon (strong band of tissue) that connects the kneecap to the shin bone can become inflamed and painful if it is overused. This condition is known as patellar tendinopathy.

Patellar tendinopathy is sometimes called ‘jumper's knee’ because it can be brought on by sports that involve repeated jumping, like basketball. It is most common among athletes aged between their teens and 30s.

Many cases of patellar tendinopathy can be managed with self-care techniques, painkillers and physiotherapy. Surgery may be needed in some cases.

Symptoms

Patellar tendinopathy tends to cause pain just below the kneecap. It is often worse when you bend the knee or exercise for a long period of time.

If you have patellar tendinopathy your knee may feel tender to touch, and the affected area may be swollen.

The pain of patellar tendinopathy tends to get worse slowly over time. In its early stages, you may only have knee pain after exercising. However, as the condition progresses, you may start to feel pain when you first start exercising. Over time, this pain may become constant during exercise and appear when you are doing your normal daily activities.

As the condition gets worse, you may notice you can’t play sports or exercise as well as you used to.

Causes

Patellar tendinopathy typically occurs when you place a lot of stress on the patellar tendon over and over again. It is not clear exactly how this stress leads to patellar tendinopathy, but research suggests that repeated stress may cause the tendon tissue to wear or break down.

The condition is most commonly seen in people who play sports that involve repeated jumping, such as basketball and volleyball.

Diagnosis

Your doctor may suspect patellar tendinopathy after asking you about your symptoms, your medical history, and performing an examination of your knee.

If your doctor thinks you may have completely torn (ruptured) your patellar tendon or the diagnosis is unclear, they may organise the following tests:

Treatment

The main goal of patellar tendinopathy treatment is to reduce pain and help you return to your normal sporting activities.

If you don’t have treatment for patellar tendinopathy there is a chance that your tendon will eventually rupture.

Self-care

The following self-care techniques can be used at home to help treat the condition initially:

  • reduce stress on your knee - reduce jumping activities and those that trigger the pain
  • ice - apply ice to your knee for 15-20 minutes every two to three hours. Do not use ice before playing sports as this could mask the pain and put you at risk of further reinjury
  • wear a patellar tendon strap - a support that can reduce tendon strain by changing the amount of stress on the tendon
  • painkillers - ibuprofen and other over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) can help relieve pain and may also limit inflammation and swelling.

Some guidelines suggest you should avoid taking NSAIDs for the first 48 hours after the injury and you should only take them for a few days. This is because it is thought that NSAIDs may slow down the healing process. However, this theory needs further research. At present, there is no conclusive evidence that proves that NSAIDs should not be taken soon after an injury.

Some people with certain conditions (asthma, high blood pressure, kidney failure, indigestion, heart failure, or allergies to NSAIDs) may not be able to take NSAIDs, so always check with your doctor or pharmacist before taking new medicines after an injury.

Physiotherapy

Your doctor may refer you to a physiotherapist to help you strengthen and stretch your knee and the muscles around it. They will be able to tailor an exercise programme for you to follow. The exact exercises and how often you do them will depend on how severe your injury is. In many cases, physiotherapy for patellar tendinopathy involves a type of exercise called eccentric strength training.

Your physiotherapist may also recommend that you wear a special strap or brace to help support your knee when exercising.

Surgery

In rare cases, if you are still in pain despite treatment or if you have ruptured your patellar tendon, your doctor may refer you to an orthopaedic surgeon for surgery. This surgery usually involves a keyhole procedure (arthroscopy) to repair any ligament damage.

Outlook

In many cases, patellar tendinopathy gets better over time with appropriate physiotherapy and without surgery. However, the condition can recur and athletes may notice some pain even after treatment.

The main complication of patellar tendinopathy is a tendon rupture. It is more likely if you do not treat the patellar tendinopathy.

To find answers to any other health questions you might have, visit our Health A-Z.

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Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.

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