Conditions and treatments
Patellar Tendinitis
Patellar Tendon
One of our largest thigh muscle is connected to the lower leg through the knee cap. It connects to the patella through the quadriceps tendon, and the patella is connected to the leg through the patellar tendon. To straighten the leg the quadriceps pulls the patella which in turn pulls the tibia through the patellar tendon, being most forces transmitted through the patellar tendon. In our daily life, as we walk, run or jump, the patellar tendon is a core structure in our movement, so quadriceps fine tuning is of utmost importance to avoid overloading structures.
What causes a patellar tendinitis?
With increased jumping, running or up/downhill activities, stresses and strains may inflame the tendon or even lead to microtraumas which normally heal. Where overload or repetitive strains takes place, the tissue may be damaged and unable to bear the load. If action is not taken, the tendon’s tissues may weaken, developing a so called tendinopathy.
What are the symptoms and how is it diagnosed?
Pain located over the tendon after jumping, kicking or running sports that eases next day is the most commonly reported symptom. As the condition persists, the pain may become constant and impair daily life activities such as climbing stairs, kneeling or seating for a long period of time. Diagnosis is usually made through a clinical interview and examination. Some cases an ultra-sound or MRI might be needed to provide further characterisation of the tendon’s quality.
How is it treated?
Options mostly depend on ongoing symptoms and their intensity. Most cases, active strengthening targeting the quadriceps, pain management and a period of resting from sports specific movements/drills resolve symptoms. However, for them not be recurrent in athletes, exercises show be integrated in their training programme, focusing also in core muscles, hip abductors to improve the lower limb biomechanics. Where symptoms are recurrent or do not respond well, ultra-sound guided injections may be indicated.
In refractory cases, surgery may be needed to improve the tissues’ quality. Most often drilling of the lower pole of the knee cap is performed and a part of the ill tissue is removed. In very selected cases where the tendon is severely damaged, a tendon graft may be needed to augment the patellar tendon in its function.
