Common Knee Injuries Part 3 – Patella Tendinopathy (Tendonitis/Tendinitis)

What is it?

Patella Tendinopathy is an overuse injury of the patella tendon, which connects the patella (kneecap) to the tibia (lower leg). It is common in athletes that are required to do a lot of jumping, and hence it is sometimes referred to as “Jumper’s Knee”. There are 4 different stages (or phases) of Patella Tendinopathy, however we won’t go into that much detail here.

What causes it?

This injury occurs when the tendon is unable to cope with the load that is being placed upon it. The tendon gradually becomes degenerative unless the load is reduced. Factors that increase the likelihood of this occurring include: quadriceps muscle imbalances, muscles tightness (quads, hams, ITB), weakness of the posterior or lateral muscle chains, hip dysfunction (loss of strength, motor control, ROM), and previous ankle/knee injury. How is it treated?

Initially treatment is all about de-loading the patella tendon. This is achieved by taping/bracing, reducing muscle tightness with soft tissue release and stretches, and avoiding aggravating activities. Following from this, the tendon needs to be facilitated to remodel and become strong again. Evidence has shown that eccentric exercises are the best for achieving this remodelling. Eccentric exercise means working the muscle (in this case the quadriceps) through the lengthening phase of the movement. Extracorporeal Shockwave Therapy (ECSW) has also been shown to be effective in accelerating this tendon remodelling process, and is therefore a useful adjunct to exercise therapy.