Patellar tendonitis
Tendons are like ropes which connect muscles to bone. The patellar tendon connects the kneecap (the patella) to the shin bone (the tibia). Patellar tendonitis is the condition that arises when the tendon and the tissues that surround it become irritated and painful from overuse, especially from jumping activities. This usually occurs in older teens and adults who participate in sports that have a lot of jumping, including volleyball and basketball; however patellar tendonitis can also be seen in sports such as running and soccer.
How it occurs
Patellar tendonitis is a common injury caused by overuse and stress on the patellar tendon. The repetitive stress causes tiny tears deep in the tendon that the body attempts to repair. Occasionally the symptoms may be caused by sudden injury to the tendon; however this is much less common.
Signs and symptoms
Patellar tendonitis usually causes pain directly over the patellar tendon, just below the kneecap. Most people have increased sharp pain during activities and pain may continue as a dull pain after activity. The tendon is often sore with pressure as well.
Diagnosis
This condition is diagnosed by your doctor based on your symptoms, the history of your pain and activity pattern and by physical exam. Your doctor may consider getting an x-ray an ultrasound or an MRI of your knee if the diagnosis is unclear or if other causes of pain need to be ruled out.
Treatment
- Rest: The most important step in treatment is to avoid the activities that are causing the pain.
- Strap or brace: Your doctor may provide a support strap (called an infrapatellar strap) or knee brace to wear during activity. This helps take pressure off the tendon.
- Ice: Icing the area of inflammation after activity or sport will help to control inflammation and swelling.
- Anti-inflammatory medications: Pain control with anti-inflammatory medications (such as ibuprofen or naproxen) can help decrease inflammation and pain.
- Stretching: Stretching exercises focusing on the quadriceps, hamstrings, and calf muscles may help take pressure off the patellar tendon.
- Surgery: Rarely, patients undergo surgery for this condition. Your physician may recommend surgery if conservative approaches are not working after 6 months or so of treatment.
Returning to activity and sports
The decision to return to sports will be determined by your doctor based on the severity of your pain and your injury. Modifications to your usual activity may be needed to help decrease the stress placed on the tendon.
Preventing patellar tendonitis
Stretching the quadriceps, hamstring, and calf muscles to maintain flexibility will help prevent recurrence of the problem.