Tendonitis of the patellar tendon (jumper's knee): symptoms and treatment

Author: Sergey Yezhov - sports medicine physician.
2016-11-07

Inflammation of the patellar tendon, which runs between the kneecap and the prominence of the tibia, is called patellar tendonopathy or, more commonly, "jumper's knee."

The primary cause of the condition is acute or chronic overload of the knee joint. This is particularly common among athletes who frequently perform jumps in their professional activities (such as tennis players, track and field athletes, soccer players, basketball players, and volleyball players). The load during such movement involves a sharp and powerful, "explosive" contraction of the quadriceps muscle of the thigh, which is the key muscle for performing jumps.

Experiencing constant tension, the quadriceps tendon becomes overloaded, leading to micro-tears of the fibers that do not heal well. This results in nutritional impairment, inflammation, and degenerative changes in the tendon tissue.

(The percentage of load distribution during the contraction of the quadriceps.)

Main symptoms of patellar tendonitis:

1. Pain localized in the area of the kneecap, worsened by bending and straightening the knee, as well as when moving the kneecap by hand.
2. Swelling and puffiness around the knee joint.
3. Limited movement in the knee joint, and a feeling of weakness in the thigh muscle.

Treatment.

The principal rule for treating "jumper's knee" is to begin therapy as early as possible. The tendons in our body receive relatively poor blood supply. Therefore, the longer you prolong the process, the more pronounced pathological changes will occur in the tissue, which worsen the prognosis for recovery.

Conservative treatment includes the following:

• Offloading the affected joint by using a brace or knee support. The knee support should be worn at all times and can only be removed at night.
• Cold compresses during the first 24 hours after pain onset.
• Anti-inflammatory medications to relieve pain.
• To reduce swelling in the joint area, Troxevasin ointment can be applied locally 2-3 times a day.
• Physiotherapy (ultrasound, SMT, magnetotherapy). In recent years, shockwave therapy has been widely used and proven effective in treating the syndrome.
• Therapeutic exercise aimed at relaxing the thigh muscles.
• In severe cases, corticosteroid injections may be administered at the pain site. However, I do not recommend this method for athletes, as such medications can cause further degeneration of the tendon and lead to its rupture under load.

Surgical methods are resorted to when there is no positive result from conservative therapy carried out for 1.5 – 3 months. During the operation, there is a release of the patellar tendon, damaged tissues are carefully excised, and the tendon is fixed to the tibia with a special screw.