Patella Tendinopathy

Rachel Miller is a highly experienced podiatrist who treats many patients with patella tendinopathy.

Patella Tendinopathy, Jumper’s Knee, is often described as an overuse injury affecting the knee joint’s patellar tendon. The patellar tendon is a thick band of tissue that connects the knee-cap (patellar) to the shin bone (tibia). Jumping activities place high strains on the tendon and the condition is common in basketball players, tennis players, volleyball players, track and field athletes, as well as football players.

Please see below if you want more detailed explanation patella tendinopathy, its symptoms, causes and treatment.

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Patella Tendinopathy

Your patella tendon transmits the force from your quadriceps muscle to the tibia and uses it to straighten your knee, hold your knee in a position against a load or gradually control leg bending when a load is trying to bend it quicker.

Symptoms of patella tendinopathy

Symptoms of patella tendinopathy include:

  • A gradual onset of pain, possible swelling, just below the knee-cap.
  • Pain can be worse with prolonged activity and can become constant.
  • Pain getting up from a squat or from kneeling.
  • Pain descending or ascending stairs.
  • Often one knee is affected but it can be both knees.
  • Stiffness worse in the morning on getting up.

Causes of patella tendinopathy

The cause of pain is not completely understood but if the patella tendon is repeatedly stressed this can lead to microscopic damage and when the tendon tries to heal itself it can become thickened and painful. This can cause a gradual onset of pain below the kneecap often worse activity.

Factors that may contribute to the development of patella tendinopathy include:

  • Overuse – especially participants in sports involving high impact activities like running or jumping.
  • Poor training – not stretching before activity can help cause injury as well as incorrect techniques.
  • Prior injury – not allowing relative rest to aid healing.
  • Misaligned feet, ankles and legs – may cause excessive motion across the knee, overloading the patella tendon.
  • Muscle tightness or weakness – tight thigh and leg muscles may reduce the flexibility at the knee joint and increase the strain on the tendon.
  • Unsupportive or unstable footwear – with poor shock absorption and inadequate stability.
  • Poor pelvic stability or core strength –  hip and other muscle strengthening may help improve biomechanics and diminish patella tendinopathy.
  • Uneven leg muscle strength – may strain the tendon and strength training may help reduce muscle imbalance.
  • Patella alta – a higher than normal kneecap position may increase the strain and risk of injury to the patellar tendon.

Risk factors that may affect the health of your tendon include:

  • age; teens – 30
  • hereditary factors
  • general health and lifestyle factors
  • weight; taller and heavier people can be more susceptible
  • the surface a sportsperson is playing on
  • certain medical conditions

Treatment of patella tendinopathy

Treatment of patellar tendinopathy will depend on the severity and duration of your symptoms and the factors that may have contributed to the condition.

For some acute soft-tissue injuries or when symptoms flare up, the PEACE & LOVE framework may be helpful during recovery.

For the first 24–72 hours, follow PEACE:

P – Protect
E – Elevate
A – Avoid anti-inflammatory modalities
C – Compress
E – Educate

After the first few days, follow LOVE:

L – Load
O – Optimism
V – Vascularisation
E – Exercise

PEACE & LOVE is not suitable for every cause of knee pain. An experienced podiatrist or other appropriate medical professional can assess your symptoms and advise whether these principles are appropriate for your specific condition.

Other treatments for patellar tendinopathy may include:

  • modifying activities that aggravate symptoms
  • a period of relative rest or deloading
  • gradually reloading the tendon as symptoms improve
  • tailored stretching exercises
  • progressive strengthening exercises
  • massage where appropriate
  • medication where appropriate
  • orthotic insoles

A biomechanical assessment from an experienced podiatrist can help identify possible contributing factors and assess your lower-limb biomechanics. This can help guide an appropriate treatment plan. Non-invasive, conservative treatment may help reduce symptoms and improve function.

A gradual programme of tendon loading and strengthening is often an important part of rehabilitation. Your activity and exercise levels should be increased progressively, taking into account your symptoms and the stage of your recovery.

 Call the Clinic for an appointment

Rachel Miller is a highly experienced podiatrist specialising in biomechanics who sees many patients for patella tendinopathy.  Her clinic, Highgate Podiatry, is in Highgate Village, 14 Pond Square, N6 6BA, London. Clinics are held every Wednesday, Thursday, Friday and Sunday. Please contact the clinic for an appointment on 020 8348 5553. For the clinic’s address, map and directions see the Contact page and for information about orthotic insoles and biomechanics see the Biomechanics page.

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