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Patella Tendinopathy (Jumper’s Knee)

What is Patellar Tendinopathy?

Patellar tendinopathy is the name for pain in the tendon that is located directly below the knee cap (patella). It is thought to be an overuse injury as a result of continuous stress on your patella tendon.

The gradual wear results in the tendon becoming weaker and more painful, making it less able to cope with ‘loading’ (the weight on it). It’s is often referred to as ‘jumper’s knee’ as the injury often occurs during sports that involve jumping.

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Symptoms of Patellar Tendinopathy

The main symptom of patellar tendinopathy is pain, or aching, just below your kneecap. The pain is generally a gradual increase rather than a sudden onset and usually starts after exercise.

The symptoms can vary depending on the type of tendinopathy that you have. In a reactive tendinopathy there can be some swelling accompanied with stiffness and pain in the morning. In more chronic cases (tendinosis) the morning stiffness can improve throughout the day.

Treatment & Management

If you injure your knee, you should follow the POLICE (protect, optimal loading, ice, compression and elevation) procedure to manage any type of soft tissue injury to your knee. You will need to reduce the amount of activity you that will put additional stress on the knee while you are recovering.

Following ice therapy to reduce the initial pain and inflammation, you can start on strengthening and stretching exercises to gradually get back your usual activity. Seek the advice of a physiotherapist for a detailed rehabilitation programme which is catered to your injury and recovery needs.

The best available evidence supports the use of a graded tendon loading programme that lasts for a minimum of 12 weeks. The exact management will depend on the severity, irritability and nature of your tendinopathy. There is building evidence that isometric ( the muscle contracts but does not change length)and isotonic (the muscle contracts and changes length) exercises loading the quadriceps muscle are effective in pain management of patellar tendinosis.

There is a lack of high quality evidence for the use of tape and tendon supports. Some patients report that tape and/or patella tendon supports reduce their pain during sporting activity but there is insufficient evidence to confirm this. Pain relief may be provided by ice and the use of pain relieving medication. Please consult your pharmacist for guidance, as for certain types of tendinopathies anti-inflammatories may have a negative effect.

References:

Cook JL, Rio E, Purdam CR, Docking SI. Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research? Br J Sports Med. 2016;50(19):1187-91.

Rio E, van Ark M, Docking S, Moseley GL, Kidgell D, Gaida JE, et al. Isometric Contractions Are More Analgesic Than Isotonic Contractions for Patellar Tendon Pain: An In-Season Randomized Clinical Trial. Clin J Sport Med. 2017;27(3):253-9.

van Ark M, Cook JL, Docking SI, Zwerver J, Gaida JE, van den Akker-Scheek I, et al. Do isometric and isotonic exercise programs reduce pain in athletes with patellar tendinopathy in-season? A randomised clinical trial. J Sci Med Sport. 2016;19(9):702-6.