Patellar tendonitis occurs when the tendon that connects the patella, or kneecap, is injured or inflamed. Also known as jumper’s knee, the patellar tendon helps your body kick, run, and jump by working with the muscles at the front of your thigh to extend your knee, and connects the kneecap to the shin bone (tibia).
What are the symptoms of patellar tendonitis?
The first initial symptom of patellar tendonitis is pain, which typically starts in the knee and can be mild at first. However, it can worsen over time, interfering with daily movements. According to Dr. Vladimir Alexander, Founding Partner of Alexander Orthopaedics, “Generally, patellar tendonitis causes pain in the front of the knee, pain with direct pressure over the knee, pain when you kneel, pain with any pressure that’s applied.”
Other symptoms of patellar tendonitis, or jumper’s knee, include:
- Tenderness around the patellar tendon and lower part of the kneecap
- Pain and stiffness when jumping, running, or walking
- Pain and stiffness when bending or straightening the leg
What causes patellar tendonitis?
Patellar tendonitis is an overuse injury caused by repeated stress on the patellar tendon, which results in tiny tears in the tendon. As those tears in the tendon grow, the inflammation and weakness causes pain.
Dr. Alexander states that, “Patellar tendonitis generally happens in people who are exercising. It can also happen in people who have tendinopathy, or a propensity for the tendons to be irritated or inflamed.”
Risk factors for patellar tendonitis include:
- Sports: Since running and jumping are most commonly associated with patellar tendonitis, people who play sports like basketball and volleyball can be at risk for patellar tendonitis. According to the Journal of Physiotherapy, 14.4% of recreational volleyball players have jumper’s knee. This percentage jumps to 40-50% of professional volleyball players.
- Physical activity: Patellar tendonitis is not always a sports-related injury. Other activities, such as suddenly exercising more or training on hard surfaces, can increase risk. The Journal of Physiotherapy states that overload, or activity above what the tendon has adapted to, is the main reason for pain onset.
- Age: Jumper’s knee is more common in people in their teens, 20s, and 30s.
- Gender: Males are significantly more likely to develop patellar tendinopathy than females.
Muscular imbalance or tightness: Having uneven muscle strength or tightness in the leg muscles can cause patellar tendonitis.
- Chronic illness: Having a chronic disease that weakens the tendon is also a risk factor.
- Obesity: Having more weight places an increased pressure on the knees, which can increase risk.
How to prevent patellar tendonitis
The following can help prevent the development of patellar tendonitis, according to the Mayo Clinic:
- Don’t play through pain: If you notice yourself feeling knee pain during or related to exercise, rest and apply ice to the area. Until the pain stops, limit activities that put stress on the patellar tendon.
- Strengthen your muscles: Build strength in the thigh muscles to help handle the stresses that can contribute to jumper’s knee.
- Improve your technique: Make sure you are using the correct technique when engaging in sports or exercise by consulting a professional or taking lessons.
How is patellar tendonitis diagnosed?
To diagnose jumper’s knee, the doctor will first record your medical history and conduct a physical exam. For athletes, the Journal of Physiotherapy states that the VISA-P (Victorian Institute of Sports Assessment for the Patellar tendon) can be completed as a baseline to monitor pain and function. This brief questionnaire assesses symptoms and tests the ability to participate in sports.
The physician may also confirm the diagnosis using X-rays, which can help exclude bone problems or other sources of pain, such as a fracture. An MRI can reveal damage to soft tissue.
How is patellar tendonitis treated?
Rest, Elevation, & Ice
Stopping any physical activity that is contributing to the jumper’s knee is the first step in healing, along with resting and elevating the knee. Ice packs on the knee can also help reduce swelling.
Pain relievers such as naproxen sodium or ibuprofen can help provide short-term pain relief.
Under the guidance of an experienced physical therapist, stretching and strengthening exercises can help reduce muscle spasms and strengthen the muscles. “Physical therapy is typically recommended for strengthening of the hamstrings, which is the back of the knee,” says Dr. Alexander. “Most people have an imbalance where, in the front of the knee, the muscles are stronger than the hamstrings, and that can lead to patellar tendonitis in athletes, so we ask them to strengthen their hamstrings.”
According to the Journal of Physiotherapy, “Intervention is aimed at initially addressing pain reduction, followed by a progressive resistive exercise program to target strength deficits, power exercises to improve the capacity in the stretch-shorten cycle, and finally functional return-to-sport training.”
If pain is severe, then corticosteroid injections to the affected area can help reduce pain more effectively than over-the-counter drugs. However, there is also a risk of weakening the tendon and rupture, according to Dr. Alexander.
“Cortisone injection is generally avoided with tendonitis because cortisone has been associated with ruptures of the tendon if you inject into a tendon or into a peritendinous space, a space close to the tendon, so we generally try to avoid cortisone in these scenarios.”
Surgical treatment is not an option with patellar tendonitis. However, patellar tendonitis typically heals, according to Dr. Alexander. “The good news is, I’ve never seen a case of chronic patellar tendonitis where it doesn’t go away.” Physical therapy and anti-inflammatory medication will, eventually, relieve symptoms in most cases.
What is the patellar tendonitis recovery process?
Leaving patellar tendonitis untreated can lead to tears and other more severe complications. For professional athletes, leaving patellar tendonitis untreated can be career-ending. So, it’s essential to contact a physician or sports medicine specialist if your knee pain persists.