What Is Patella Tendinopathy?
Patella Tendinopathy, often termed Patella Tendinitis or ‘Jumper’s Knee’, is a common overuse or repetitive strain injury. It predominantly affects the sporting population, particularly when jumping or impact activities are required i.e. basketball, athletics, runners, etc. but can be seen in people without sporting backgrounds to a lesser extent.
What Is The Patella Tendon?
The Patella Tendon is one of the thickest tendons in your body. It runs from the tip of the kneecap bone (Patella) to a bony bump called the Tibial Tuberosity at the top of your shin bone. This allows you to kick, run and jump – essentially acting like a big spring.
Research shows that the Patella Tendon can absorb as much as 5000 Newtons of force at it’s peak. That’s the equivalent of 500kg, or a grand piano or mini-caravan!! Pretty impressive. So why does it get injured if it’s so strong?
What Is Patella Tendinopathy?
As used in many medical terms, ‘itis‘ is latin for inflammation. So Patellar Tendinitis basically means inflammation of the tendon. Commonly there are 2 points on the Patella Tendon that are prone to becoming sore. Classically the mid-tendon (right in the middle), but also the point where the tendon attaches to the bone. Typically these can be more irritable and therefore take longer to heal, which is termed an Insertional Tendinopathy. Both occur due to overuse.
The Insertional Tendinopathy for Patella Tendon problems usually occurs at the tip of the kneecap bone (Patella) in adults, and more often on the shin attachment (Tibial Tuberosity) in adolescents, otherwise called Osgood-Schlatter’s Disease.
What’s going on?
In recent years we refer to the problem more as Patella Tendinopathy. ‘Opathy’ being latin for ‘disorder of’, which describes the chronic nature of the condition more correctly as commonly people will suffer for months if not treated. Tendons (and in general all soft tissue) are in a constant continuum of healing. When a tendon becomes painful in the first 3-6 weeks, be it a first time episode or a flare up of a persistent problem, we class this as the ‘reactive phase’. Typically when symptoms are more acute and irritable. For example when walking with every step or going up and down stairs.
Over time the inflammation becomes more degenerative in nature due to a build up of scar tissue. This is termed as a ‘disrepair’ of the natural healing process. Patella Tendinopathy symptoms in this phase include pain that is worse on the first few steps of walking downstairs in the morning or after a prolonged period of rest such as sitting. This can usually improve as you get more mobile but increase again when trying to run, jump or play sport.
Diagnosis
1 simple way to establish what stage of healing the Patella Tendon is in, and provide diagnosis confirmation is using Ultrasound Scans. Take a look here for more information on our specialist service for Ultrasound Diagnosis.
Patella Tendinopathy | Common Causes
As Patella Tendinopathy is an overuse or repetitive strain injury there are usually 3 potential reasons for why symptoms have come about:
- Form or technique – poor form during a sporting skill for example can cause certain structures such as tendons to get used poorly and ultimately cause pain such as running and jumping. Assessing functional movement is a big part of our Physiotherapy assessment. It allows us to spot the bits that need tweaking.
- Strength & Control – weaker muscles and poorly controlled joints can lead to tendons becoming overworked. Putting together bespoke training plans and rehab exercises is an essential part of Physiotherapy treatment and what keeps you injury-free for longer.
- Load management – regular exercise and movement is key to preventing and treating any muscle-skeletal injury. Your body likes variety and steady change. Sudden increases or decreases in the amount of exercises or movement you do can trigger off injuries such as tendon problems. Having a simple, structured training plan or weekly regime can significantly reduce your chance of injury.
Our next blog looks at What Is The Best Patella Tendinopathy Treatment?
