Patella Tendinopathy

Rest, surgery or a combination - what cures patella tendon problems?

Dr Richard Steadman is the Colorado based knee specialist who successfully treated Alan Shearer and Ronaldo, when they were suffering from problems with their patella tendon. The American orthopaedic specialist has built a brilliant reputation by helping these high profile stars return from a condition that is notoriously difficult to treat.

Patella tendon problems are mostly due to repetitive overload and usually start as a minor discomfort, with the player able to continue to train and play matches. However, the pain does not often correlate with the amount of tissue damage, as the tissue damage has already started before the player feels any pain. Continuing to play makes the condition worse. This is due to the poor healing capacity of the patella tendon, owing to the tendon's poor blood supply. Injecting the area with corticosteroids only conceals the pain and adds to the degeneration of the tendon as it breaks down the collagen fibres that make up the tendon.

The collagen fibres that make up the patella tendon take 120 days to lay down and mature once the tendon has been damaged. Returning to sport before these collagen fibres have matured means that the tendon will lack its normal tensile strength and will be prone to re-injury. Returning to sport too early sets off a chronic cycle of tissue breakdown and partial recovery, which means that in most cases, unless the 120-day rest period is followed, the tendon will not fully recover.

Early diagnosis and rest are the key factors in the successful treatment of this condition, but this is not easy when football clubs have paid world record transfer fees for star names. The desire and enthusiasm of the player to play in matches further complicates the management of such a condition. Players may only get one chance to play in a World Cup Final or European Championship and this is what they have worked for all their lives. The current football calendar means there is very little time for the modern player to rest, since they usually play for 11 months of the year.

The club physiotherapists have the job of providing as many fit players as possible in order that the manager has a full squad from which to select on a week-to-week basis. But they also have an eye on the long term consequences of players continuing to perform with "minor" injuries. In the early stages of a patella tendon problem the player will almost certainly view the problem as minor and may not heed the advice of medical staff who advise him to rest. In many cases the player may not perceive the injury as a problem until it starts to affect his performance. This may manifest itself as an inability for the player to sprint or turn as fast as he usually does. Eventually the pain will prevent the player from continuing.

Enter Dr Richard Steadman, who is often asked his opinion at this stage by players who are desperate to get fit. In some cases surgery is required. The two most common operations are to remove a spur from the underside of the knee cap, which is thought to be causing irritation of the patella tendon; or a surgical removal of the scar tissue which has built up around the damaged tendon. Following either of these operations, the advice usually given is to undertake very gentle rehabilitation for 3 to 4 months before returning to sport. This means the magic 120-day rest period is provided for the patella tendon to repair itself, plus a little extra rehabilitation to allow the tendon to adapt to the demands of playing football.

This sensible advice has seen several top soccer stars return to play with their problems cured. But the question is, would the injury have healed with the long rest alone, and without surgery? Certainly the surgery may help to stimulate a healing response from within the tendon, and it may be necessary in order to stimulate a recovery. It is certainly much easier for the physiotherapist to tell the head coach that his star player has had surgery in the United States, and the surgeon has instructed the player not to train for 3 to 4 months, than it is for the physiotherapist to instruct the player to rest for 3 months, with no guarantee of an improvement in symptoms. Steadman's success rate with top players, and the uncertainty of conservative treatment of this condition, account for the transatlantic medical treatment of several top Premiership players.

Whether the player opts for a surgical approach or not, one thing is clear - the rehabilitation must be carefully gauged and progressive in nature. This is vital to allow the collagen fibres that make up the tendon to mature and gain the tensile strength that is required to play Premiership football. Overloading the maturing tendon can cause the problem to recur and adds to the pressure that the physiotherapy team are under when treating one of the team's (and the plc's!) prized assets. Alan Shearer, for one, appreciated the work undertaken by the physiotherapists at Newcastle United.

Patella Tendinopathy explained >




Recommended Products for Patella Tendinopathy





Jumpers Knee Straps


Basic Product

PhysioRoom.com Jumper's Knee Strap

PhysioRoom.com_Jumper_s_Knee_Strap

£4.99 inc VAT Was £10.99 Save £6.00 (55%)

Buy Now

BEST SELLER!Superb value adjustable knee strap to relieve the symptoms of Patella...
 (30 reviews)

More Details

 
 

Basic Product

Ultimate Performance Ultimate Patella Knee Strap

Ultimate_Performance_Ultimate_Patella_Knee_Strap

£7.99 inc VAT

Buy Now

The Ultimate Patella Strap relieves patella tendon pain by applying compression where it is needed...
 (1 review)

More Details

 
 

Basic Product

Ultimate Performance Ultimate ITB Strap

Ultimate_Performance_Ultimate_ITB_Strap

£14.99 inc VAT

Buy Now

The Ultimate ITB Strap provides effective relief against pain outside the knee associated with iliotibial band syndrome. ...

More Details

 
 

Basic Product

Ultimate Performance Ultimate Runners Knee Strap

Ultimate_Performance_Ultimate_Runners_Knee_Strap

£19.99 inc VAT

Buy Now

The three way compression provided by this strap gives relief against numerous knee complaints...
 (7 reviews)

More Details

 
Elite Product

PhysioRoom.com Elite Jumpers Knee Patella Strap

PhysioRoom.com_Elite_Jumpers_Knee_Patella_Strap

£11.99 inc VAT

Buy Now

The patella strap is a high quality adjustable knee strap that has been designed to help provide...
 (2 reviews)

More Details


 
Advanced Product

Cho-Pat Knee Strap

Cho_Pat_Knee_Strap

£21.99 inc VAT

Buy Now

BEST SELLER!The original patented knee strap. Use for painful overuse conditions...
 (1 review)

More Details

Elite Product

Aircast Infrapatella Knee Strap

Aircast_Infrapatella_Knee_Strap

£21.99 inc VAT Was £27.99 Save £6.00 (21%)

Buy Now

Completely relieves knee pain in 80% of patients with Osgood Schlatter's and Patella Tendonitis! ...
 (6 reviews)

More Details


Basic Product

Mueller Jumper's Knee Strap Blue

Mueller_Jumper_s_Knee_Strap_Blue

£11.99 inc VAT Was £14.99 Save £3.00 (20%)

Buy Now

Use for painful conditions such as Jumper's Knee (Patella Tendonitis) and Osgood Schlatter's...
 (2 reviews)

More Details




Orthotics & Insoles


 
 

Spenco Ironman Total Support Max Insoles

Spenco_Ironman_Total_Support_Max_Insoles

£29.99 inc VAT

Buy Now

These inserts have a more rigid foot stability cradle which provides advanced arch support when compared to the original Ironman...

More Details


 
 

Spenco Earthbound Replacement Insoles

Spenco_Earthbound_Replacement_Insoles

£21.99 inc VAT

Buy Now

Maximum-comfort insoles providing full foot support. Perfect for hiking and many other outdoor activities....

More Details


 
 

 
 

 
 

 
 

 
Advanced Product

Mueller Arch Support

Mueller_Arch_Support

£17.99 inc VAT

Buy Now

An arch support designed to relieve foot pain caused by Plantar Fasciitis....
 (1 review)

More Details


 
 

Basic Product

Noene 4mm Shock Absorbing Heel Pads

Noene_4mm_Shock_Absorbing_Heel_Pads

£15.99 inc VAT

Buy Now

Durable 4mm shock absorbing heel pads, with excellent 36 month life expectancy. Designed to wear...
 (1 review)

More Details

 

Spenco Ironman Total Support Thin Insoles

Spenco_Ironman_Total_Support_Thin_Insoles

£31.49 inc VAT

Buy Now

These inserts are thinner and lighter than the original Ironman Total Support insoles whilst still offering the same level of...

More Details


 
 

 
 
Elite Product

Footmedics Impact Gel Heel Pads

Footmedics_Impact_Gel_Heel_Pads

£22.99 inc VAT

Buy Now

NEW!Fabric lined gel cushion heel pads, to relieve heel pain during...
 (1 review)

More Details


Basic Product

Sorbothane Sport Heel Pads

Sorbothane_Sport_Heel_Pads

£10.50 inc VAT Was £10.99 Save £0.49 (4%)

Buy Now

Shock absorbing heel pads that provide extra cushioning, shock absorption and lift to the heel...
 (3 reviews)

More Details

Advanced Product

Sorbothane Double Strike Insole

Sorbothane_Double_Strike_Insole

£17.03 inc VAT Was £18.99 Save £1.96 (10%)

Buy Now

NOW 30% LIGHTERShock absorbing insoles that provide extra cushioning for the heel...
 (3 reviews)

More Details

 

Basic Product

Spenco 3/4 Length Arch Cushion

Spenco_3_4_Length_Arch_Cushion

£13.03 inc VAT Was £14.99 Save £1.96 (13%)

Buy Now

3/4 length insoles with soft cushions for the arch of the foot, suitable for 'hard to fit' shoes. ...
 (3 reviews)

More Details

Advanced Product

Footmedics Impact Gel 3/4 Length Insoles

Footmedics_Impact_Gel_3_4_Length_Insoles

£22.99 inc VAT

Buy Now

NEW!A pair of 3/4 length Impact Gel insoles, to relieve foot pain in people who are on their feet all...

More Details

Elite Product

Noene Atlas Carbon Insoles

Noene_Atlas_Carbon_Insoles

£32.99 inc VAT

Buy Now

BEST SELLER!A 'cutting edge' shock dissipating material with a unique carbon...
 (1 review)

More Details


 
 
Elite Product

Tulis Pro Heel Cups

Tulis_Pro_Heel_Cups

£19.99 inc VAT

Buy Now

BEST SELLER!Ultra soft, high quality heel cups - provide the ultimate in shock...
 (3 reviews)

More Details





Rehabilitation Kit


 
 
Elite Product

PhysioRoom.com 5.5mx15cm Resistance Bands All Strengths 5 Boxes 5 Levels Of Resistance

PhysioRoom.com_5.5mx15cm_Resistance_Bands_All_Strengths_5_Boxes_5_Levels_Of_Resistance

£39.99 inc VAT Was £59.99 Save £20.00 (33%)

Buy Now

NEW This resistance exercise band pack features five boxes of which has varying levels of...

More Details


 
 
Elite Product

PhysioRoom.com Elite Aqua Rehab Pack - Aquabelt, Ankle and Wrist Weights and x3 Water Noodles

PhysioRoom.com_Elite_Aqua_Rehab_Pack_Aquabelt_Ankle_and_Wrist_Weights_and_x3_Water_Noodles

£34.99 inc VAT Was £59.99 Save £25.00 (42%)

Buy Now

The Aqua Rehab Pack contains everything you require for rehab and general exercises in the swimming pool. The Aqua Rehab Pack...

More Details


 
Advanced Product

PhysioRoom.com Elite Water Swimming Aid Noodles x18 (Red x6, Green x 6 and Blue x6)

PhysioRoom.com_Elite_Water_Swimming_Aid_Noodles_x18_Red_x6_Green_x_6_and_Blue_x6_

£59.99 inc VAT Was £74.99 Save £15.00 (20%)

Buy Now

The foam water noodles are ideal for rehabilitation and therapy exercises and also great for kids to use too....

More Details

 

 
Advanced Product

PhysioRoom.com Elite Water Swimming Aid Noodles x9 (Red x3, Green x3 and Blue x3)

PhysioRoom.com_Elite_Water_Swimming_Aid_Noodles_x9_Red_x3_Green_x3_and_Blue_x3_

£29.99 inc VAT Was £39.99 Save £10.00 (25%)

Buy Now

The water noodles can be used as floating and buoyancy aids and are also ideal for rehab and therapy exercises....

More Details

 

 
Advanced Product

PhysioRoom.com Elite Water Swimming Aid Noodles x6 (Red x2, Green x2 and Blue x2)

PhysioRoom.com_Elite_Water_Swimming_Aid_Noodles_x6_Red_x2_Green_x2_and_Blue_x2_

£19.99 inc VAT Was £24.99 Save £5.00 (20%)

Buy Now

The pack of six swimming aid noodles feature a variety of colours including x2 red, x2 green and x2 blue and are made from...

More Details

Elite Product

PhysioRoom.com Elite Water Swimming Aid Noodles x3 (Red, Green and Blue)

PhysioRoom.com_Elite_Water_Swimming_Aid_Noodles_x3_Red_Green_and_Blue_

£9.99 inc VAT Was £14.99 Save £5.00 (33%)

Buy Now

NEW The Elite water swimming aid noodles are made from lightweight, buoyant foam and are ideal for...

More Details


 
 
Elite Product

PhysioRoom.com Ankle and Wrist Weights X2 1 Pound

PhysioRoom.com_Ankle_and_Wrist_Weights_X2_1_Pound

£11.99 inc VAT

Buy Now


NEW
The ankle and wrist weights weigh 1 pound and feature a soft,...
 (1 review)

More Details


 
 
Elite Product

PhysioRoom.com 5.5m x15cm Resistance Band Box - Choose between 5 Levels

PhysioRoom.com_5.5m_x15cm_Resistance_Band_Box_Choose_between_5_Levels

£9.99 inc VAT Was £14.99 Save £5.00 (33%)

Buy Now

NEW Latex Bands provide light, medium to heavy resistance during training...
 (1 review)

More Details


 
 
Elite Product

PhysioRoom.com Foam Rehab Water Aid Swimming Noodle

PhysioRoom.com_Foam_Rehab_Water_Aid_Swimming_Noodle

£3.99 inc VAT Was £7.99 Save £4.00 (50%)

Buy Now

NEW Made from buoyant, lightweight foam the Foam Water Noodle is ideal for use as a floating and...

More Details


 
 
Elite Product

PhysioRoom.com Resistance Band Exercise Loop

PhysioRoom.com_Resistance_Band_Exercise_Loop

£2.49 inc VAT

Buy Now

These multi-coloured tubes provide four levels of resistance, ideal for progressing strengthening exercises....

More Details


 
 
Elite Product

PhysioRoom.com Water Floatation Belt

PhysioRoom.com_Water_Floatation_Belt

£19.99 inc VAT Was £39.99 Save £20.00 (50%)

Buy Now

The Water Floatation Belt is ideal for early non weight bearing cardiovascular training as its...
 (1 review)

More Details


 
Advanced Product

PhysioRoom.com Resistance Exercise Band

PhysioRoom.com_Resistance_Exercise_Band

£3.49 inc VAT Was £5.49 Save £2.00 (36%)

Buy Now

NEW Latex Bands provide light, medium to heavy resistance during training...
 (1 review)

More Details

 

Basic Product

Mobilis Exercise Band Pack

Mobilis_Exercise_Band_Pack

£24.99 inc VAT Was £34.99 Save £10.00 (29%)

Buy Now

Superb value, 8 x 1m length resistance bands in all 4 varying strengths, for use during rehab exercises for the shoulder, ankle,...

More Details

 
Elite Product

Mobilis AquaJogger 100 Floatation Belt

Mobilis_AquaJogger_100_Floatation_Belt

£53.99 inc VAT Was £59.99 Save £6.00 (10%)

Buy Now

The AquaJogger 100 is a floatation belt. One particular benefit is that it allows an early return...
 (1 review)

More Details





Ice Packs & Cold Therapy


Basic Product

PhysioRoom.com Instant Ice Pack

PhysioRoom.com_Instant_Ice_Pack

    1+ £2.03
    6+ £1.49 (Save 27%)
  12+ £0.99 (Save 51%)
  24+ £0.69 (Save 66%)
  50+ £0.49 (Save 76%)

Buy Now

SAVE UP TO 75%!A mouldable pack that becomes an instant, single use ice pack,...
 (2 reviews)

More Details

 

Physicool Combination Pack

Physicool_Combination_Pack

£12.99 inc VAT

Buy Now

The Physicool combination pack supplies you with one specially formulated cooling bandage and one bottle of recharging coolant...

More Details


 
 

Physicool Cooling Bandage (12cm x 3m)

Physicool_Cooling_Bandage_12cm_x_3m_

£12.99 inc VAT

Buy Now

Physicool is a new and unique way to instantly apply cold therapy whilst on the move, this portable and reusable compression...

More Details


 
 
Elite Product

Aircast Knee Cryo/Cuff with Cooler

Aircast_Knee_Cryo_Cuff_with_Cooler

£107.99 inc VAT Was £146.99 Save £39.00 (27%)

Buy Now

Ultimate knee ice therapy. Provides 6 hours continuous cold and compression to minimise bleeding,...
 (13 reviews)

More Details

FREE Next Day Delivery




Newsletter

Receive our latest news and offers.