Patellar Tendon Pain
By General Info
What is it?
This condition is characterized by localized pain just below the patella, or kneecap, along the patellar tendon. True “Tendon-ITIS”, is associated with an acute inflammation of the tendon tissue following activity. More chronic cases, with symptoms lasting for over 4-6 weeks, should more accurately be classified as “Tendon-OSIS”. In these cases true inflammation is no longer present; instead the tendon is actually degenerating at the fiber and cellular levels. This tendinosis is usually what physicians and physical therapists at Jacksonville Orthopaedic Institute see in their offices.
How do you get it?
Typically, the athlete will present with pain following repetitive, forceful contractions of the quadriceps muscles. The repetitive jumping demands of basketball or plyometric exercises are frequent causes of this condition. Eccentric contractions, contractions of the muscle while it is lengthening, that are sustained while running downhill or doing “negative reps” in the gym, can also cause these condition. Like most overuse conditions, ignoring the early signs of discomfort while doing these activities will contribute to its development.
Do I have it?
Athletes will complain of pain just below the bottom of the kneecap, or patella, along the patellar tendon. Initially, pain will be present at the onset of activity, will often subside during, and then return following completion of activity. More chronic cases will be painful with any quadriceps contraction. There may occasionally be swelling present over the tendon and in long standing conditions the tendon will be visibly thickened.
I have it. Now what?
Acute cases of tendonitis can be managed with one-two weeks of rest, ice, and anti-inflammatory medications. A counterforce strap brace that off-loads the tendon can be helpful with pain during activity while stretching of the hip and thigh musculature, especially the quadriceps can help to prevent its return and progression. Chronic cases of patellar tendinosis need more intensive treatment from a medical professional and may often take months to resolve completely. Aggressive soft-tissue massage such as the Graston Technique are effective interventions to help kick start the regenerative processes of healing. A specific and progressive eccentric strengthening program designed by a medical professional also helps to remodel and strengthen the degenerative tendon.
Drew Heideman, MPT, ATC,PES
Drew is a physical therapist at the San Marco Physical Therapy/Rehab Office