Patellar Tendinopathy: Causes and treatment
This article aims to offer valuable knowledge and guidance to individuals afflicted with patellar tendinopathy or those enduring discomfort in the kneecap region. It provides an in-depth comprehension of the condition and proposes effective self-care techniques, emphasising the importance of consulting with healthcare professionals.
Understanding the Patella
The patella, known as the kneecap, assumes a vital role in safeguarding the knee joint. Contrary to its appearance of separation, it is firmly attached to the muscles surrounding the knee joint through ligaments. Functioning as both a protector and a lever, the patella shields the knee joint while aiding leg movement by collaborating with the leg muscles.
The knee joints endure substantial stress throughout daily activities. The patella shields the knee from injury, absorbing the impact of blunt force trauma to protect the more delicate muscles, tendons, cartilage, and ligaments.
What is Patellar Tendinopathy?
Patellar tendinopathy develops when a tendon undergoes inadequate healing following an injury, frequently caused by excessive use. This condition manifests as pain, swelling, restricted mobility, stiffness, and frequently a noticeable limp. It specifically affects the tendon beneath the kneecap (patella), which connects the patella to the shin bone.
Also known as jumper’s knee, patellar tendinopathy triggers pain directly over the tendon, which can be exacerbated by running, kneeling, and jumping.
Prevalence of Patellar Tendinopathy
Patellar tendinopathy is a common issue among physically active individuals, particularly those involved in high-impact activities like netball, basketball, and running, which exert significant stress on the knees.
Causes and Risk Factors of Patellar Tendinopathy
Patellar tendinopathy is typically an overuse injury resulting from repeated stress on the tendon. This stress leads to small tears in the tendon, which the body attempts to repair. However, as the number of tears increases due to continued stress, the tendon weakens, causing pain and inflammation.
If the damage persists unchecked for several weeks, it evolves into tendinopathy, or in this case, patellar tendinopathy. Several factors can contribute to this condition, including:
Physical activity, such as running and jumping
Tight leg muscles, which can increase stress on the tendon
Muscular imbalance, which can cause tendinitis due to uneven pull from mismatched muscles
Symptoms and Treatment
The initial symptom of patellar tendonitis is pain between the kneecap and the shin bone. This pain:
Initially manifests only when physical activity is initiated
Intensifies as the activity continues
Eventually interferes with regular movements such as standing from a seated position and climbing stairs
The most common treatment for this condition involves ceasing the activity that caused the problem until the tendon heals. Ice packs can help manage pain and swelling, provided they are used for up to 20 minutes at a time and wrapped in cloth. Anti-inflammatories like ibuprofen can also help manage pain and reduce swelling.
Isometric Exercises
Isometric exercises can be beneficial in managing patellar tendinopathy. These exercises involve muscle contractions without any significant movement in the angle of the joint. Here’s a series of isometric exercises, each exercise is described in detail to ensure proper form and maximum benefit.
Seated knee extension
Sit on a chair. Use your hand to prop up the leg by supporting it at the back of the thigh. Push your toes against an object in front of you. Now try to straighten your knee and hold it against the resistance in mid-range.
Seated knee extension with the band
Sit on a chair and anchor an elastic band behind your injured knee. Now attach the other end to the base of your foot. Now try to straighten your knee and hold it against the resistance of the elastic in mid-range.
Front squats
In standing place your feet hip-width apart. Now try to lower your bottom towards the floor without moving your knees forwards as shown on the video. Hold the form at the midrange of the exercise for 30-45 seconds. Make sure to have the natural curvature of your spine throughout the movement.
Double leg decline squats
Stand on a 25-degree decline board and place your feet hip-width apart. Place one foot in front and try to balance yourself first. Then try to lower your bottom towards the floor without moving your knee forwards as shown on the video. Hold the form at the midrange of the exercise for 30-45 seconds. Make sure to have the natural curvature of your spine throughout the movement.
Leg Press
Sit on the machine with your back against the support. Place your feet slightly wider than hip-width apart. Your legs should form roughly an angle of 90 degrees from the knee. Push the plate platform away with your feet by extending the knees and hips, and pushing back into the seat. Bring your knees back towards your chest and allow the footplate to return to the starting position. Hold the form at the midrange of the exercise for 30-45 seconds.
Single leg decline squats
Stand on a 25-degree decline board and place one foot in front and try to balance yourself first. Then try to lower your bottom towards the floor without moving your knee forwards as shown on the video. Try to gradually increase the depth that you could cover. Make sure to have the natural curvature of your spine throughout the movement.
Hack squat
Place the back of your torso against the back pad of the machine and hook your shoulders under the shoulder pads provided. Position your legs on the platform using a shoulder-width medium stance with the toes slightly pointed out. Now straighten your legs without locking the knees. This will be your starting position. Begin to slowly lower the unit by bending the knees as you maintain a straight posture with the head up (back on the pad at all times). Continue down until the angle between the upper leg and the calves becomes slightly less than 90 degrees. Begin to raise the unit as you exhale by pushing the floor mainly with the heel of your foot as you straighten the legs again and go back to the starting position.