What is Patella Tendonitis?
Patella Tendonitis is a constant repetitive overuse injury of the patella tendon. Which leads to localised pain and inflammation of the tendon. This condition is commonly known as “Jumper’s Knee”. This is due to the greatest level of stress is placed through the knee with landing and jumping activities. Excessive jumping and landing overtime can strain the patella tendon and if left untreated leads to inflammation of the inferior pole of the tendon.
Activities that involve jumping, bounding, hopping and or changes in direction such as high jump, netball, ballet and stair climbing can contribute to patellar tendonitis. Other contributions can be weakness in the quadriceps muscle and poor biomechanics of the patellofemoral joint.
Signs and Symptoms
- Localised tenderness of the inferior pole of the patella (anterior knee pain)
- Tenderness on palpation through the patella tendon
- Tight quadriceps and hamstrings
- Pain with squat or a hop
Patients with this condition must be patient and this condition can require months of a multifaceted approach and rehabilitation before the symptoms subside. Conservative management of this condition entitles:
- Cryotherapy: ice treatment
- Decreases the load through the tendon
- Strengthening rehabilitation program
- Soft tissue treatment
- Correcting poor biomechanics
Cortisone injection or surgery is indicated if the treatment continues for months and the conservative management program has failed to reduce the patient’s pain and inflammation.
Patella Tendonitis Eccentric Program
The key to the rationale behind eccentric drills is that they are the best way of promoting tendon remodelling: the regrowth and reordering of collagen tissue in place of the oedematous (fluid filled) degenerative tissue typical of tendinosis.
The athlete needs to be taught eccentric exercises (See table 1). A 45-degree slope is required and (at a later stage) a weights bar. Initially the athlete stands straight on the slope, then flexes his/her knees to 90 degrees, returning to a straight position again (see illustration below left).
Table 1: Decline squat progressions