Patellar tendinitis
Patellar tendonitis is an injury to the tendon that connects your kneecap to your shinbone. This tendon helps you extend your knee and kick while running and jumping.
Jumper's knee is most common in athletes who frequently jump — such as basketball and volleyball players. However, anyone who does physical activity can get jumper's knee.
People with patellar tendinitis may need physical therapy to stretch and strengthen the muscles around their knee.
Symptoms
The first sign of patellar tendonitis is pain between your kneecap and the spot where the tendon attaches to your shinbone.
Initially, you might only experience pain when you begin physical activity or after a strenuous workout. Over time, the pain becomes worse and begins to interfere with your daily activities, such as climbing stairs or getting up from a chair.
When to see a doctor
If you are experiencing knee pain, try to take care of yourself first by icing the area and temporarily reducing or avoiding activities that aggravate your symptoms.
Call your doctor if your pain:
- Continues or worsens
- It will interfere with your ability to do everyday activities.
- Joint pain is associated with swelling or redness around the joint.
Causes
Patellar tendonitis is an common overuse injury that results from repeated stress on your patellar tendon. The stress tears tiny holes in the tendon which your body tries to fix.
When tears form in the tendon, it can cause pain from inflammation and weakening of the tendon. If this tendon damage persists for more than a few weeks, it's called tendinopathy.
Risk factors
Patellar tendinitis can develop due to a variety of factors, including:
- Physical activity.Patellar tendinitis is most commonly caused by sudden increases in how hard or how often you are running or jumping. Changing your running shoes can also add stress to the tendon.
- Tight leg muscles.Tight quadriceps and hamstring muscles can increase the strain on your patellar tendon.
- Muscular imbalance.If some muscles in your legs are stronger than others, the stronger muscles could cause tendonitis. This uneven force could pull on the patellar tendon.
- Chronic illness.Some illnesses can interfere with the flow of blood to the knee, which weakens the tendon. Some examples include kidney failure, autoimmune diseases such as lupus or rheumatoid arthritis, and metabolic diseases such as diabetes.
Complications
If you try to ignore your body's warning signs about knee pain, the problem may get worse and you may develop patellar tendonitis. This condition can persist if you don't take care of it, and it can lead to more serious problems such as patellar tendon rupture.
Prevention
Here are some things you can do to reduce your risk of developing patellar tendinitis:
- Don't play through pain.If you experience knee pain from exercise, ice the area and rest. Do not do any strenuous activity until your knee is pain-free.
- Build up your muscles.Strenuous thigh muscles are better able to handle stresses that can cause patellar tendonitis. Eccentric exercises, which involve slowly lowering your leg after extending your knee, are particularly helpful.
- Improve your technique.Before beginning a new sport or using exercise equipment, it is a good idea to consult with someone who is more experienced. Lessons or professional instruction can help ensure that you are using your body correctly.
Diagnosis
Your doctor may apply pressure to your knee to determine where the pain is. Pain from patellar tendinitis is usually located on the front part of your knee below your kneecap.
Imaging tests
Your doctor may suggest one or more of the following imaging tests: an x-ray, a MRI, or a CT scan.
- X-rays.X-rays help to determine if other bone problems are causing knee pain.
- Ultrasound.This test uses sound waves to create an image of your knee that reveals tears in your patellar tendon.
- Magnetic resonance imaging (MRI).MRI scans use a magnetic field and radio waves to create detailed images of the patellar tendon.
Treatment
Doctors typically start with less invasive treatments before considering more serious options, such as surgery.
Medications
Some pain relievers, such as ibuprofen or naproxen, can provide short-term relief from pain associated with patellar tendinitis.
Therapy
There are many physical therapy techniques that can help reduce the symptoms associated with patellar tendinitis, including:
- Stretching exercises.Stretching exercises can reduce muscle spasms and help lengthen the muscle-tendon unit. Do not bounce while stretching.
- Strengthening exercises.Having weak thigh muscles can cause the strain on your patellar tendon. Exercises that involve lowering your leg slowly after extending it are helpful, as are exercises that strengthen all of your leg muscles together such as a leg press.
- Patellar tendon strap.A strap that applies pressure to your patellar tendon can help to distribute the force more evenly, which may relieve pain.
- Iontophoresis.This therapy involves applying a corticosteroid cream to your skin and then using a device that delivers a low electrical charge to help the cream reach your skin.
Surgical and other procedures
If conservative treatments do not work, your doctor may suggest other treatments such as:
- Corticosteroid injection.A corticosteroid injection into the sheath around the patellar tendon may help relieve pain. However, this type of treatment can also weaken the tendon and make it more likely to rupture.
- Platelet-rich plasma injection.This type of injection has been tried in people with chronic patellar tendon problems. Studies are ongoing to see if it helps promote new tissue growth and repair damage.
- Oscillating needle procedure.This outpatient procedure is performed using local anesthesia. Your doctor uses ultrasound imaging to guide a small, oscillating needle that cuts away the damaged area while sparing healthy tendon. This procedure is relatively new, but results have shown promise.
- Surgery.In some rare cases, if other treatments fail your doctor might suggest surgical removal of the patellar tendon. Some procedures may be done through small incisions around your knee.
Lifestyle and home remedies
If you have knee pain, consider the following:
- Pain relievers.Some over-the-counter medications such as ibuprofen and naproxen can provide short-term relief from pain.
- Avoid activity that causes pain.If you play your sport often, you may need to reduce your frequency or temporarily switch to a less strenuous sport. Doing so can damage your patellar tendon.
- Ice.After activity that causes pain, apply cold ice to the affected area. Place ice in a plastic bag and wrap the bag in a towel. Or try an ice massage. Freeze water in a plastic foam cup and hold the cup against your skin for a few minutes.
Preparing for your appointment
If you are experiencing knee pain during or after physical activity but it does not improve with ice or rest, see your doctor. After an exam, your doctor may refer you to a sports medicine specialist.
Here is some information that will help you prepare for your appointment.
What you can do
- List your symptoms and when they began.
- Write down key medical information,This condition is related to other conditions you have, medications you take, and supplements you consume.
- Log your typical daily activity,To figure out if you have a sports injury, take into account how long and intensely you've been participating in your sport or other exercise. Also note how you are feeling right now, including how hard or often you are working out and what type of equipment you are using.
- Note any recent injuries that may have damaged your knee joint.
- Write down questions to askTalk to your doctor to figure out the best way to use your time together.
If you are seeing a doctor for possible patellar tendinitis, here are some basic questions you may want to ask. If you have any other questions, don't hesitate to ask.
- What could be causing my signs and symptoms?
- Do I need tests?
- What treatment do you recommend?
- How will treatment help me play my sport and how long will it take for the treatment to work?
- What type of exercise can I do safely while I am healing?
- What self-care measures should I take?
- Should I see a specialist?
What to expect from your doctor
Your doctor may ask you questions including: -What is the nature of your symptoms? -Do you have any other medical conditions? -Do you take any medications? -Have you experienced any changes in your mood or behavior recently?
- Are your symptoms getting worse?
- How severe is your pain?
- Are your pains always present before, during, or after your workouts?
- Do the knee swelling pain and stiffness lock or buckle when you move your knee?
- Are your symptoms interfering with your ability to exercise or move about normally?
- Do you have any at-home treatments? Have any of them helped?
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