What is patella tendinopathy?
A tendon acts as a stretch and recoil mechanism to transmit force from muscle to bone. In simple terms it can be thought of as an elastic band. When the band has force applied to it then it will change shape and stretch but as the pressure releases it returns back to its original shape. We can think of a tendon like this and muscle exerts the stretching force onto the tendon. As it recoils back to its original shape it will release energy to move the associated joint. In this case the knee.
Tendinopathy involves a change in the structure of the tendon, (in this case the tendon that attaches the knee cap to the top of the shin bone) and thus its capacity to tolerate the loads applied to it as explained above can change. This change in structure also involves the release of chemicals that irritate nerve endings and cause pain and this then effects muscle activation patterns. This can occur due to a number of factors including peaks in training load, previous injury or weakness through certain muscles. Often there a combination of factors and spotting these is important for treatment so a detailed assessment by a physiotherapist is essential.
How does it present?
This is a condition that also comes under the umbrella of ‘anterior knee pain’. Pain is located in a focal area at the bottom of the knee- cap and often tracks along the mid-line towards the top of the shin bone. It can cause an intense ‘tooth ache’ type sensation. Pain is often worse when in sitting and eases with the leg is straight. Symptoms can ease when exercising only to worsen afterwards. Heavy impact sports often aggravate the problem hence the term ‘jumper’s knee’. The condition used to be referred to as tendinitis as it was though that inflammation was the primary cause of symptoms but research has recently changed this thought process.
How is it treated?
Patella tendinopathy is common in heavy impact/ explosive sports e.g. netball, basketball and volleyball. Treatment will involve settling pain through techniques including taping, load management, soft tissue techniques, acupuncture and specific exercises. Loading is the ‘gold standard’ treatment but how this is applied and progressed is very important. Tendons can be very sensitive and so management of their recovery is a challenge. Rest in this case is not the answer but knowing what to do, when and how is the secret to recovery.
What You Need To Know
- Commonly seen in those that play netball, volleyball, tennis and basketball.
- They can take on average 12 weeks to treat.
- If ignored activity levels will gradually reduce.
- The gold standard treatment is a bespoke, progressive exercise programme.