Overview

Patellar tendonitis occurs from overuse of the knee tendon. Overuse may be caused by any activity that requires:

• intense running
• jumping
• frequent stops and starts
• frequent impact to the knee

Patellar tendonitis is more common in the following sports: basketball, soccer, volleyball, and running.

Risk factors that increase your chances of getting patellar tendonitis include:

• an increase in the frequency of training
• a sudden increase in the intensity of training
• changing from one sport to another
• training on a hard surface
• repeated improper movements while training
• muscle weakness or imbalance

Diagnosis

Symptoms of patellar tendonitis include:

• pain and tenderness in the patellar tendon below the knee
• pain or "tightness" in the knee when bending, squatting, or straightening the leg
• discomfort in the knee when jumping, running, or walking

The doctor will ask about your symptoms, physical activity, and how the injury occurred. The doctor will also examine your knee, and may ask you to perform certain movements. He may also take X-rays of your

Treatment Options

Treatment includes:

• ice
  Apply ice or a cold pack to the knee for 15-20 minutes, every 4 hours, for 2-3 days. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin.
• medication

  Take one of the following drugs to help reduce inflammation and pain:

  • ibuprofen (Motrin, Advil)
  • naproxen (Aleve, Naprosyn)
  • acetaminophen (Tylenol)
  • aspirin
• infra-patellar strap
  This strap (also called a counterforce brace) can help support the tendon and reduce pain. It is worn as a band just below the knee.
• Eccentric Exercises
  Eccentric exercises is when the muscle contracts and actually lengthens as it does so (usually a muscle contracts and shortens). These exercises help condition and train the quadriceps muscle to absorb force and become a controlling force, thereby limiting and controlling the force through the patella tendon. This has become the mainstay of treatment for this condition.
• cortisone injections
  If the treatments above do not reduce inflammation, some doctors may recommend cortisone injections. Check with your doctor to determine what is best in your case.
• PRP (platelet rich plasma) injections
  Injecting PRP (see PRP section under Biological healing) stimulates healing of the scar tissue in the patella tendon by injecting growth factors into the tendon
• surgery
  Surgery may be necessary if there is advanced inflammatory damage to the tendon or if there is little or no response to other treatments over a 6-12 month period. During surgery, the damaged portion of the patella tendon will be removed through a small incision in the skin. Eventually, scar tissue will form and repair this damaged area.

Patellar tendonitis may be prevented by avoiding activities and sports that repeatedly stress the kneecaps and by increasing the frequency and intensity of exercise gradually.,/

It is advised that you return to high-impact physical activity gradually. Sufficient healing has occurred when:

• The knee can bend and straighten without pain.
• You are able to jump on the injured leg without pain.
• You are able to jog in a straight line without pain.
• Swelling is gone.
• Normal strength of the quadriceps muscles has returned.

How can I prevent patellar tendonitis?

The simplest way to avoid another episode of patellar tendonitis is to avoid the activity that caused it; of course, this may be impossible for the serious athlete. For these people, frequent breaks from the causative activity should become routine. It's also wise to reduce or stop the activity at first sign of pain and to ice the knee following each training session or game.

You can help prevent patellar tendonitis by following these simple recommendations:

• Rest your knees regularly by stopping to stretch your legs. You may also wish to consider switching activities on a regular basis to avoid prolonged stress on your knees.
• Increase the frequency and intensity of exercise gradually.
• Eccentric exercises maintain the conditioning of the quadriceps muscle and absorb the force through the patella tendon thereby preventing the condition. One should continue these exercises as a baseline.

Improving Sports Performance

The key to improving sports performance after a diagnosis of patellar tendonitis is proper a rehabilitation program, and adhering to some of those same principles after the injury is gone. Continue to perform the exercises in the rehabilitation section to strengthen the leg muscles around the knee, and also refer to the prevention section for important information on how to keep you in the game and perform to your fullest potential.

Remember that the single most important aspect of improving performance is stretching before and after you step onto the field, court, ice, or golf course, and also knowing when to take a rest.

Benefits derived from stretching include:

• increased physical efficiency and performance
• decreased risk of injury
• increased blood supply and nutrients to joint structures
• increased coordination
• improved muscular balance and postural awareness
• decreased risk of lower-back pain
• reduced stress
• enhanced enjoyment