January 15, 2020

The Truth About Chronic Knee Pain: Patella Tendinopathy

The truth about knee pain and patella tendonitis

With a rise in activity level from fitness classes, it is not uncommon for physiotherapists to treat a wide range of knee conditions. Owing to the dynamic nature of these activities the stress on the knee joint can predispose one to tendon-related issues in the knee, of which Patella Tendinopathy/Tendonitis is generally the most common.

WHAT IS IT?

Jumper's knee, or Patella Tendinopathy is a clinical diagnosis of pain and dysfunction in the patella tendon. It is generally caused by repetitive high impact activities (e.g. box jumps) which can result in an overload of the tendon, resulting in pain. Over time and without adequate management of the knee, the pain can become persistent and chronic. It is one of the more common conditions we see at UFIT Clinic.

WHAT DOES IT LOOK LIKE?

It generally presents as a specific pain at the base of the knee cap (pictured below). You are usually able to pinpoint the area of pain with one fingertip. A localised swelling may be seen during the initial painful phase, and as the condition becomes more chronic, thickening of the tendon may be noted.

Patellar Tendonitis treatment withy physio

WHO GETS IT?

Generally, it is found in relatively young adults between the age of 18 and 40. Athletes who are involved in high impact jumping and landing sports (volleyball, netball, basketball), activities which place a high load on the knees (CrossFit and fitness bootcamps) and who play sport on hard artificial surfaces may be at risk for developing Patella Tendinopathy.

HOW DO I TEST IF I HAVE IT?

The condition manifests usually after a period where training and activity have been increased (such as pre-season training). Athletes tend to have pain on the knees which usually eases with a warm up, but returns at the end of the activity. It can be especially exacerbated by jumping activities (box-jumps). If you suspect yourself of having Patella Tendinopathy, a simple test called the Single Leg Decline Squat is very useful in determining whether or not you have Patella Tendinopathy. (pictured below)

Single leg decline squat to determine Patella Tendonitis


I HAVE PATELLA TENDINOPATHY, HOW DO I FIX IT?

Patella Tendinopathy has been characterised as being a difficult condition to shift. Previously, athletes were instructed to rest a painful tendon before returning to activity. In fact, resting a tendon actually reduces its load bearing capacity and will make the situation worse.

SO, IF I CAN'T REST, Can I STILL GO 100%?

Not quite. It is important that the athlete avoids any activities which will increase their pain levels. For the initial painful stages, isometric exercises have been shown to be really useful in reducing pain levels sufficiently. A Spanish Squat (video example below), held for 45s x 5 reps is effective in reducing pain levels immediately. Icing of a painful tendon may have an analgesic effect, as can offload taping to help with the pain in the short term.

Source

Once the tendon has settled, it is vital that a steady progressive strength training be commenced to improve the load bearing capacity of the tendon. Any issues which may have predisposed you to developing Patella Tendinopathy can also be addressed under the eye of a qualified physiotherapist.

5 TIPS FOR PATELLA TENDON PAIN:

  1. Don’t ignore it: continuing through the pain will result in your quads getting weaker and will increase the load on the painful area
  2. Don’t aggravate it: if your tendon is painful it's your body's warning light blinking to tell you you've done too much too soon
  3. Don’t rest it: commencement of early, specific rehab exercises will accelerate your return to performance
  4. Ditch the knee guards: knee guards may actually cause more issues as they can compress the patella tendon, causing more pain.
  5. Load it up: a strong tendon is a healthy tendon. Progressive strengthening will allow you to kick this painful condition to the kerb, and allow you to maximise your potential

Seeking professional help from a physio can also be helpful, at UFIT Clinic we will be able to assess your condition and provide the best course of treatment should you suffer from patella tendon pain.

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