Patellar tendinopathy (commonly known as patellar tendonitis or tendinitis) is an overuse injury affecting your knee. It's the result of your patellar tendon being overstressed. A common name for it is Jumper's Knee.
Anatomy of the Knee
The patella tendon is located just below the patella (knee cap). It has attachments on the patella and the tibial tuberosity on the tibia (shin bone). The role of the patella tendon is to transfer the force of the quadriceps muscles, much like a rope around a pulley, as your knee straightens.
Your quadriceps is even more important when controlling your knee as you bend from a straight position leg to a bent position when walking down the stairs and landing after a jump. The quadriceps muscles are heavily involved in most sports, especially those which involve jumping, running and kicking.
Why is it Called Jumper’s Knee?
The greatest level of stress through the patella tendon comes when jumping and landing. While jumping, the quadriceps muscles provide an explosive contraction, which straightens the knee and propels you up. When landing, the quadriceps muscle helps to absorb the landing force by allowing a small and controlled knee bends.
Excessive jumping or improper landing strains the patella tendon. At first the damage may only be minor and not cause severe problems. However, if the tendon is repeatedly strained, the lesions occurring in the tendon can exceed the rate of repair. The damage will progressively become worse, causing pain and dysfunction. The result is a patellar tendinopathy (tendon injury).
Who Usually Suffers Patellar Tendonitis?
Patellar tendonitis usually affects athletes involved in sports such as basketball, volleyball, soccer, football, track and field (running, high and long jump), tennis, dancing, gymnastics and skiing.
In older people the main cause of patellar tendinopathy is a result of degeneration which results from repetitive micro-damage over time. Also, some patients develop patella tendonitis after sustaining an acute injury to the tendon, and not allowing adequate healing. This type of traumatic patellar tendonitis is less common than overuse syndromes.
Signs and Symptoms of Patellar Tendonitis
- Anterior knee pain over the patella tendon
- Pain when jumping, landing or running and sometimes with prolonged sitting
- Onset of pain is gradual and commonly related to an increase in athletic activity
- Localized tenderness over the patella tendon
- Often the tendon feels very stiff when waking up in the morning
- The affected tendon may appear thickened in comparison to the unaffected leg
Tendinitis (or Tendonitis): This actually means "inflammation of the tendon," but inflammation is actually only a very rare cause of tendon pain. But many doctors may still use the term tendinitis out of habit.
The most common form of tendinopathy is tendinosis. Tendinosis is a noninflammatory degenerative condition that is characterized by collagen degeneration in the tendon due to repetitive overloading. These tendinopathies, therefore do not respond well to anti-inflammatory treatments and are best treated with functional rehabilitation. The best results occur with early diagnosis and intervention.
What Causes Patellar Tendonitis?
There are a number of factors which can contribute to the development of patellar tendinopathies. These include:
- Rapid increase in training frequency
- Sudden increase in training intensity
- Playing/training on rigid surfaces
Lower Limb Biomechanics
- Tight quadriceps and hamstring muscles
- This can include poor foot posture, knee or hip control. Your physiotherapist can assess and treat these issues.
How is Tendinopathy Treated?
In most cases, you can start treating a tendon injury at home. To get the best results, start these steps right away:
- Rest the painful area, and avoid any activity that worsens the pain.
- Apply ice or cold pack for 20 minutes at a time, as often as 2 times an hour, for the first 72 hours. Keep using ice as long as it helps.
- Do gentle range-of-motion exercises and stretch to prevent stiffness.
- Have your biomechanics assessed by a physiotherapist.
- Undertake an Eccentric Strengthen Program. This is vital!
10 Patellar Tendonitis Exercises
***Enerskin does not take responsibility for any injury that may occur from performing these exercises. These are recommendations for how you can treat your patellar tendonitis. We highly suggest consulting with your physician before performing and diagnosing your knee.***
1) Standing Hamstring Stretch:
Put the heel of the leg on your injured side on a stool about 15 inches high. Keep your leg straight. Lean forward, bending at the hips, until you feel a mild stretch in the back of your thigh. Make sure you don't roll your shoulders or bend at the waist when doing this or you will stretch your lower back instead of your leg. Hold the stretch for 15 to 30 seconds. Repeat 3 times.
2) Quadriceps Stretch:
Stand at an arm's length away from the wall with your injured side farthest from the wall. Facing straight ahead, brace yourself by keeping one hand against the wall. With your other hand, grasp the ankle on your injured side and pull your heel toward your buttocks. Don't arch or twist your back. Keep your knees together. Hold this stretch for 15 to 30 seconds.
3) Side-lying Leg Lift:
Lie on your uninjured side. Tighten the front thigh muscles on your injured leg and lift that leg 8 to 10 inches (20 to 25 centimeters) away from the other leg. Keep the leg straight and lower it slowly. Do 2 sets of 15.
4) Rectus Femoris Stretch:
Kneel on your injured knee on a padded surface. Place your other leg in front of you with your foot flat on the floor. Keep your head and chest facing forward and upright and grab the ankle behind you. Gently bring your ankle back toward your buttocks until you feel a stretch in the front of your thigh. Hold 15 to 30 seconds. Repeat 2 to 3 times.
5) Straight Leg Raise:
Lie on your back with your legs straight out in front of you. Bend the knee on your uninjured side and place the foot flat on the floor. Tighten the thigh muscle on your injured side and lift your leg about 8 inches off the floor. Keep your leg straight and your thigh muscle tight. Slowly lower your leg back down to the floor. Do 2 sets of 15.
6) Prone Hip Extension:
Lie on your stomach with your legs straight out behind you. Fold your arms under your head and rest your head on your arms. Draw your belly button in towards your spine and tighten your abdominal muscles. Tighten the buttocks and thigh muscles of the leg on your injured side and lift the leg off the floor about 8 inches. Keep your leg straight. Hold for 5 seconds. Then lower your leg and relax. Do 2 sets of 15.
7) Clam Exercise:
Lie on your uninjured side with your hips and knees bent and feet together. Slowly raise your top leg toward the ceiling while keeping your heels touching each other. Hold for 2 seconds and lower slowly. Do 2 sets of 15 repetitions.
Stand with the foot of your injured leg on a support 3 to 5 inches (8 to 13 centimeters) high --like a small step or block of wood. Keep your other foot flat on the floor. Shift your weight onto the injured leg on the support. Straighten your injured leg as the other leg comes off the floor. Return to the starting position by bending your injured leg and slowly lowering your uninjured leg back to the floor. Do 2 sets of 15.
9) Wall Squat with a Ball:
Stand with your back, shoulders, and head against a wall. Look straight ahead. Keep your shoulders relaxed and your feet 3 feet (90 centimeters) from the wall and shoulder's width apart. Place a soccer or basketball-sized ball behind your back. Keeping your back against the wall, slowly squat down to a 45-degree angle. Your thighs will not yet be parallel to the floor. Hold this position for 10 seconds and then slowly slide back up the wall. Repeat 10 times. Build up to 2 sets of 15.
10) Knee Stabilization:
Wrap a piece of elastic tubing around the ankle of your uninjured leg. Tie a knot in the other end of the tubing and close it in a door at about ankle height.
- Stand facing the door on the leg without tubing (your injured leg) and bend your knee slightly, keeping your thigh muscles tight. Stay in this position while you move the leg with the tubing (the uninjured leg) straight back behind you. Do 2 sets of 15.
- Turn 90 degrees so the leg without tubing is closest to the door. Move the leg with tubing away from your body. Do 2 sets of 15.
- Turn 90 degrees again so your back is to the door. Move the leg with tubing straight out in front of you. Do 2 sets of 15.
- Turn your body 90 degrees again so the leg with tubing is closest to the door. Move the leg with tubing across your body. Do 2 sets of 15.
Hold onto a chair if you need help balancing. This exercise can be made more challenging by standing on a firm pillow or foam mat while you move the leg with tubing.
How Does the Enerskin Knee Sleeves Help Patellar Tendonitis?
Enerskin offers protection and recovery from injuries on multiple levels starting from our Patented silicone printing technology. Enerskin’s silicone taping system conforms on top of your patellar tendon and surrounds your knee cap, securing it in place and preventing hyperextension. Our unique, durable and flexible GASTEX compression fabric conforms around your knee, contouring every part of it for a noticeably compressive fit, ensuring your great patellar & knee cap support to help regain confidence in your knees capabilities. With a very flexible design Enerskin encourages your knees natural movements so you can workout and regain the strength in your knees.
Jumper's Knee Sports Injury Clinic
Patellar Tendonitis exercises via MassGeneral.org
Evidence-supported Rehabilitation of Patellar Tendinopathy
Patellar Tendonitis Exercises via Summit Medical Group
Patellar Tendonitis Exercises via Kaiser Permanente
The evolution of eccentric training as treatment for patellar tendinopathy (jumper's knee): a critical review of exercise programmes