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Patellar tendonitis


Jumper’s knee or patellar tendonitis is an overuse injury that is caused by too much running or jumping activities that results in pain at the front of the knee. This pain is generally localized towards the bottom of the kneecap. The actual injury is inflammation or degeneration of the patella tendon, which connects the kneecap (patella) to the shinbone. The patellar tendon is located at the front of the thigh and working with the muscles, allows the knee to extend for kicking, running and jumping activities

Patellar tendonitis is  associated with athletes who participate in sports such as basketball and various track and field competitions such as pole vaulting. 

The tendonitis is caused by repeated stress on the patellar tendon. This common overuse injury stresses the tendon and results in tiny tears in the connective tissue. The body attempts to repair these tears, but as the tears in the tendon multiply, they cause pain from inflammation and weakening of the tendon. When this tendon damage persists for more than a few weeks, it's called tendinopathy.



Here are some specific symptoms of patellar tendonitis. 

  • Knee Pain: The primary symptom of patellar tendonitis is pain, usually between the kneecap and where the tendon is attached to the shinbone (tibia). This knee pain may at first be present only at the beginning of physical activity or just after an intense workout. Often it worsens until it interferes with playing sports. Eventually it may interfere with daily movements such as climbing stairs or rising from a chair.

  • Tenderness:The bottom of the patella will be very tender and may appear larger or thicker than the unaffected side.

  • Post-workout Stiffness :The athlete is likely to experience aching and stiffness after exercise and pain when contracting the quadriceps muscles in acute cases. In particular jumping activities are likely to cause most pain or discomfort.

Jumper’s knee is graded 1 to 4. Grade one being only mild pain after training and a grade four resulting in constant pain.


Risk factors

A combination of factors may contribute to the development of patellar tendonitis:

  • Physical activity : Running and jumping are most commonly associated with patellar tendonitis. Sudden increases in the frequency or intensity of the associated activity can add stress on the tendon.

  • Tight leg muscles: Tight quadriceps (thigh muscles) and or hamstrings can increase strain on the patellar tendon.

  • Muscular imbalance :  If some muscles in the legs are much stronger than other muscles, the stronger muscles could pull harder on the patellar tendon. This uneven pull can cause tendonitis.



Some people may ignore the body's warning signs by trying to work through the pain. This could cause increasingly larger tears in the patellar tendon. Knee pain and reduced function can persist and may progress to a more serious patellar tendinopathy which can become a chronic condition.



Pain on the front part of the knee and just below the kneecap. During an exam, the physician may apply pressure to the anterior portion 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,  treatment typically begins with options such as home selfcare, over the counter pain medications, and physical therapy. When first developing knee pain, apply ice to the area and avoid 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.


Physical Therapy

  • Stretching exercises : Stretching exercises applying a constant, steady stretch on the affected tendon can reduce muscle spasm and help lengthen the muscle-tendon unit.

  • Strengthening exercises:   Strengthening weak muscles that contribute to the strain on the patellar tendon.

  • Patellar tendon strap : A strap that applies pressure to the patellar tendon when worn can help change the angle of the patllar tendon decreaseing pain and inflammation.

  • 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. 


     Other treatments:

  • 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 surgical repair of the patellar tendon may be necessary. 


Preventive Treatment options

To reduce the risk of developing Patellar tendonitis, 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.  Avoid those activities that put stress on the patellar tendon.

  • Muscle strengthening. Strong quadraceps muscles reduce the risk of patellar tendonitis. 

  • Proper technique. Proper body mechanics and form are essential in preventing any injury. 

 If you have knee pain visit Excel Rehabilitation Services at 2251 S Burnside Ave. in Gonzales, Louisiana.





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