Patellar Tendinopathy or Jumper’s Knee: the knee pain that doesn’t get better with just rest!

Patellar tendinopathy, often referred to as jumper’s knee, is a common overuse injury that affects athletes and active individuals. Characterized by pain and dysfunction in the patellar tendon, this condition can significantly impact performance and quality of life. This article explores the causes, symptoms, diagnosis, and treatment options, offering evidence-based insights for effective management. 

The percentages of knee conditions that are considered patellar tendinopathy are approximately 14%. Many sports having activities like jumping and running within them. Having the knee work well and feel proper is tantamount within sports. 

Patellar Tendon

What is Patellar Tendinopathy or Jumper’s Knee?

Patellar tendinopathy refers to the degeneration of the patellar tendon, which connects the kneecap (patella) to the shinbone (tibia). Unlike tendinitis, which is primarily inflammatory, tendinopathy is associated with chronic degeneration of tendon fibers due to repetitive stress or overuse (Cook & Purdam, 2009).

Causes and Risk Factors

Patellar tendinopathy is caused by repetitive loading of the tendon, leading to microtears and degeneration. Common risk factors include:

  • Repetitive Activities: Sports involving frequent jumping, running, or kicking (Malliaras et al., 2015).
  • Sudden Increase in Training Intensity: A rapid escalation in exercise volume or intensity can stress the tendon.
  • Biomechanical Issues: Poor alignment, flat feet, or weak hip and core muscles can increase strain on the patellar tendon (Rudavsky & Cook, 2014).
  • Muscle Imbalances: Tight quadriceps and hamstrings contribute to abnormal loading patterns.
  • Metabolic Syndromes: Signs of high cholesterol were found to be a possible risk factor causing structural, inflammatory and mechanical changes in tendons.

Symptoms and Diagnosis of Jumper’s Knee

Common Symptoms

  • Localized Pain: Typically felt at the inferior pole of the patella.
  • Stiffness: Particularly noticeable after rest or in the morning.
  • Decreased Athletic Performance: Difficulty with jumping, squatting, or running.

Diagnostic Methods

  • Clinical Examination: A thorough history and palpation of the patellar tendon.
  • Imaging: Ultrasound or MRI is often used to confirm tendon degeneration (Visnes & Bahr, 2007).

Treatment Options

1. Conservative Management

  • Rest and Activity Modification: Reducing high-impact activities helps alleviate symptoms.
  • Eccentric Exercises: These have been shown to be particularly effective in tendon remodeling (Kongsgaard et al., 2009).
  • Physical Therapy: Focuses on strengthening the quadriceps, hamstrings, and gluteal muscles.
  • Class IV laser: the use of the class IV laser at ChiroMovement has shown great results at decreasing the inflammation and improving the symptoms and preparing the knee for rehab strengthening. 

2. Medical Interventions

  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Provide pain relief but may not address tendon healing.
  • Corticosteroid Injections: Controversial, as they may weaken tendons over time (Coombes et al., 2010).
  • Platelet-Rich Plasma (PRP) Therapy: Emerging evidence suggests PRP may promote tendon healing (Zayni et al., 2015).

Preventive Measures

Preventing patellar tendinopathy involves maintaining proper biomechanics, gradually increasing training intensity, and incorporating regular flexibility and strength training. Proper footwear and periodic evaluations by a physical therapist can also mitigate risks.

This is not the area to go over all of our knowledge or methods for rehab and strengthening of the knee and tendon. What you want to know is that a mixture of isometrics with both high and low intensity along with teaching kinematics of the foot with stability and strength at the hip all to help improve the forces at the knee. 

The time frame of healing for patellar tendinopathy may take several months, all depending on severity of symptoms. Though specific work and strength of the lower extremity is necessary. 

Conclusion

Patellar tendinopathy is a complex condition that requires a multifaceted approach to management. With early intervention and appropriate treatment, most individuals can return to their pre-injury activity levels. Ongoing research continues to refine our understanding of this condition, offering hope for more effective treatments in the future.

 

References

  • Cook, J. L., & Purdam, C. R. (2009). Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. British Journal of Sports Medicine, 43(6), 409–416.
  • Malliaras, P., Barton, C. J., Reeves, N. D., & Langberg, H. (2015). Achilles and patellar tendinopathy loading programmes. British Journal of Sports Medicine, 49(5), 268-271.
  • Rudavsky, A., & Cook, J. (2014). Physiotherapy management of patellar tendinopathy (jumper’s knee). Journal of Physiotherapy, 60(3), 122-129.
  • Visnes, H., & Bahr, R. (2007). The evolution of the patellar tendinopathy research literature. Scandinavian Journal of Medicine & Science in Sports, 17(6), 636-647.
  • Kongsgaard, M., Kovanen, V., Aagaard, P., Doessing, S., Hansen, P., Laursen, A. H., & Magnusson, S. P. (2009). Corticosteroid injections, eccentric decline squat training and heavy slow resistance training in patellar tendinopathy. Scandinavian Journal of Medicine & Science in Sports, 19(6), 790-802.
  • Zayni, R., Thaunat, M., Fayard, J. M., & Sonnery-Cottet, B. (2015). Platelet-rich plasma in management of chronic tendinopathy: A systematic review. Orthopaedics & Traumatology: Surgery & Research, 101(1), 91-97.
  • Yang Y, Lu H, Qu J. Tendon pathology in hypercholesterolaemia patients: Epidemiology, pathogenesis and management. J Orthop Translat. 2018;16:14-22. Published 2018 Aug 6. doi:10.1016/j.jot.2018.07.003

 

Wanting to learn more about the knee? Here is our previous article on it! Enjoy!

Watch this video as a starting point for any knee condition.