What is it?
Patella Tendinopathy is an overuse injury involving the knee. It is often referred to as Patella Tendinitis, or more commonly Jumpers Knee, and is most prevalent in athletes involved in sports or activities which require excessive jumping.
Anatomy and Biomechanics
The Patella Tendon is located below the patella (knee cap) and is a tough tendon connecting the knee cap to the tibial tubercle on top of the shin bone as shown in the figure. Above the knee cap is a continuation of the Patella Tendon, which connects the quadriceps muscle to the knee cap and is often referred to as the quadriceps tendon.
Together, the quadriceps and patella tendon work to transfer the force of the quadriceps muscles to straighten the knee with the knee cap acting as a rope over a pulley.
The role of the quadriceps become even more important when controlling the knee as you bend from a straight position, such as squatting, walking downstairs, running and particularly with jumping and landing.
When jumping, the quadriceps muscles produce an explosive contraction to straighten the knee and propel you into the air. When landing, the quadriceps muscles work even harder to absorb the forces by controlling a small amount of knee bend.
The patella tendon is designed to withstand high, repetitive loading, however if you do too much activity too quickly the tendon becomes damaged quicker than the body can repair, resulting in a Patella Tendinopathy. The Patella Tendon can then become degenerative, and in the worst case can lead to a tear or rupture.
What are the signs and symptoms?
- Anterior knee pain localised over the patella tendon
- Pain aggravated by jumping, landing or running
- Gradual onset of pain often related to an increase in activity
- Morning pain and stiffness over the patella tendon
- Thickening through the affected tendon
The development of a patella tendinopathy can be attributed to poor lower limb biomechanics, including foot posture (flat or high arched feet), lack of knee or hip control, and reduced flexibility in hamstring and quadriceps muscles, typically resulting in poor alignment and tracking of the knee cap. Training errors such as sudden increase in duration, frequency or intensity of an activity (particularly a new activity) and training on hard surfaces may also provoke a patella tendinopathy.
The Physiotherapists at Pro Physio SA are able to diagnose a patella tendinopathy by inquiring about your symptoms and exercise regime, and a physical examination will confirm the presence of the condition.
When deemed necessary, an Ultrasound or MRI scan would accurately highlight a patella tendinopathy.
During the early stages, our Physiotherapists will help remedy the pain and promote healing with a combination of ice and heat, taping or bracing, dry needling, electrotherapy and shockwave therapy.
Using pain as a relative guide, our Physiotherapists will address the relevant biomechanical factors and training errors contributing to your tendinopathy. If you suspect you may have issues regarding your patella, please get in contact with one of our Physiotherapists at your local Pro Health Care clinic.
Marco Mittiga, Physiotherapist