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Patellar tendonitis, Part 2

Last week, we began an in-depth examination of Patellar tendonitis, also known as “Jumper’s knee”, an overuse injury that is caused by from too much running or jumping activities that results in pain at the front of the knee.

In Part 1, we discussed common causes and symptoms, and risk factors for patellar tendonitis.

This week in Part 2, we will delve into the diagnosis and treatment options for this condition, and preventive measures that can be taken to avoid injuring the patella tendon.

 

Diagnosis

Pain from Patellar tendonitis is on the front part of the knee, just below the kneecap. During an exam, the doctor may apply pressure to parts of the knee to determine if the source of the pain is located in this area.

There are a number of imaging tests that can help a doctor diagnose the injury. These include one or more of the following:

  • X-rays. This test helps to exclude other bone or joint problems that can cause knee pain.

  • Ultrasound. Using sound waves to create an image of the knee, this test reveals tears in the patellar tendon.

  • MRI (Magnetic resonance imaging). MRI uses a magnetic field and radio waves to create detailed images that can reveal subtle changes in the patellar tendon.

 

Conventional Treatment Options

As with most orthopedic injuries, appropriate typically begin with conventional treatment options, such as home self-care, over-the-counter pain medications, and physical therapy before considering more invasive treatment, such as surgery.

Home remedies. When the patient first develops knee pain, he can try self-care measures first, such as icing the area and temporarily reducing or avoiding activities that causes pain.

  • Avoid activities that trigger symptoms. The patient may need to take a break from playing the sport causing the pain or temporarily switch to a lower impact sport. Working through pain can further damage the patellar tendon.

  • Ice. Applying ice after the activity that causes pain has been found to be effective in many cases. Simply placing ice in a plastic bag and wrapping the bag in a towel will effectively do the trick.

  • Medications. Pain relievers such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others) may provide short-term relief from pain associated with Patellar tendonitis.

If the pain continues or worsens, interferes with the ability to perform routine daily activities, or is associated with swelling or redness about the joint, it’s time to call a doctor.

 

Physical Therapy

Generally, the first type of treatment for Patellar tendonitis the doctor will order is physical therapy to stretch and strengthen the muscles around the knee. There are a variety of physical therapy techniques can help reduce the symptoms associated with the condition, including:

  • Stretching exercises. Stretching exercises applying regular, steady tension on the affected tendon can reduce muscle spasm and help lengthen the muscle-tendon unit.

  • Strengthening exercises. A physical therapist will often suggest exercising the weak muscles that contribute to the strain on the patellar tendon may be particularly helpful.

  • Patellar tendon strap. A strap that applies pressure to the patellar tendon when worn can help to distribute force away from the tendon and direct it through the strap instead. This may help relieve pain.

  • Iontophoresis. This therapy involves spreading a corticosteroid medicine on the skin and then using a device that delivers a low electrical charge to push the medication through the skin. A physical therapist can provide this option without requiring a special trip to the doctor.

 

Surgical and other procedures

If less invasive treatments don't help, a doctor may enlist other therapies, such as:

  • Corticosteroid injection. A corticosteroid injection guided by ultrasound into the sheath around the patellar tendon may help relieve pain. Note: these types of drugs can weaken tendons and make them more likely to rupture.

  • Platelet-rich plasma injection. This experimental type of injection has been tried in some people with chronic patellar tendon problems. It is hoped the injections might promote new tissue formation and help heal tendon damage, but studies are ongoing.

  • Surgery. In rare cases, if other treatments fail, surgical repair of the patellar tendon may be necessary. A doctor might suggest surgical procedures, some of which can be done through small incisions around the knee.

 

Preventive Treatment options

To reduce the risk of developing Patellar tendonitis, those athletes most at risk can take these steps:

  • Don't play through pain. As soon as exercise-related knee pain occurs, ice the area and rest. Until the knee no longer hurts, avoid those activities that put stress on the patellar tendon.

  • Muscle strengthening. Strong thigh muscles are better able to handle the stresses that can cause Patellar tendonitis. Eccentric exercises, which involve lowering the leg very slowly after extending the knee, are particularly helpful.

  • Proper technique. Proper body mechanics are essential to preventing injury when taking up a new athletic regimen. When starting a new sport or using exercise equipment an athlete should consider taking lessons or getting professional instructions.

 

If you are experiencing pain in your knees, don’t wait for your family physician; visit Excel Rehabilitation Services on Burnside Ave. in Gonzales, Louisiana. You will receive personalized care from an experienced, professional physical therapist!

 

 

Sources:

http://orthoinfo.aaos.org/topic.cfm?topic=A00512

http://orthoinfo.aaos.org/topic.cfm?topic=A00512

http://www.mayoclinic.org/diseases-conditions/patellar-tendonitis/basics/definition/con-20024441

http://www.webmd.com/fitness-exercise/jumpers_knee#1

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