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Anatomy of patella tendonitis x-ray of patella tendonitis

Patellar Tendinopathy

Patellar tendinopathy is the name for pain in the tendon that is located directly below the knee cap.

Symptoms:

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.

Aggravating Factors

Jumping, kneeling or an increase in sporting activity

Easing Factors:

Avoiding the aggravating activities

Onset:

Gradual after an increase in jumping, kneeling, sports that involve jumping e.g. basketball and volleyball or sports that involve quick changes of direction e.g. football, squash and tennis.

Management:

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.


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