Patellar tendonitis is an injury that affects the tendon between the kneecap and tibia. The condition is most common in people who practice sports that involve frequent jumps (Basketball, soccer, volleyball). Because of this, the patellar tendonitis disease is also called “the jumper’s knee”. However, the patellar tendonitis disease can affect any person.
Tendon injuries range from patellar tendonitis (tendon inflammation) to tendon rupture. When the tendon is used excessively (dancing, cycling, running) the tendon stretches and becomes inflamed. Sudden movements such as the attempt to prevent a fall may cause excessive contraction of the quadriceps muscle above the patella with quadriceps tendon rupture or of the tendon below. This type of injury happens most likely in the elderly, whose tendons are weaker. Patellar tendonitis inflammation is sometimes called “jumper’s knee” because it occurs due to sports that require jumping, such as basketball, where muscle contraction and the force of falling to the ground after a jump create tendon tension. Tendon can become inflamed or tore after repeated stress.
Patellar tendonitis is a common disease. It occurs when the patellar tendon is overloaded. The overload causes small tendon ruptures which the body is trying to heal. When the tears become too numerous, the body cannot handle their healing and the tendon inflammation worsens. The causes of patellar tendonitis disease can be:
Intensive and frequent physical activity. Repeated jumps are the most common cause of patellar tendonitis.
Obesity. Obesity increases the stress on the tendon.
Faulty alignment of the leg bones.
Diseases of the kneecap. Your kneecap may be above the knee where the normal position should be, which causes additional tension in the tendon
Muscle imbalance. Some of the leg muscles can be stronger than others and they can pull the patellar tendon harder. This uneven “pull” can cause patellar tendonitis.
Symptoms and diagnosis
People with patellar tendonitis often have swelling of the tendon at the insertion point in the bone. They also show the pain when doing fast moves such as running, fast walking or jumping. A complete rupture of the quadriceps or patellar tendon is painful resulting in a difficult flexion movement, extension or lifting of the foot. If the swelling is not very big, the doctor can detect a defect in the tendon near the lesion, during physical examination. A radiographic examination will show the patel in a position lower than normal in the quadriceps tendon tear and a superior position in case of patellar tendonitis. The doctor may use the MRI to confirm the partial or total rupture.
Treatment for patellar tendonitis
Initially, the doctor will recommend rest, local application of ice, keeping the leg in an elevated position and medication with aspirin or ibuprofen to reduce pain, inflammation and swelling.
Corticosteroid injections are applied around the tendon. However, there are some risks associated with this type of treatment. Repeated injections may weaken the tendon, increasing its risk of rupture. Also, corticosteroid medications should not be injected directly into the tendon, as this can contribute to the tendon rupture. As an alternative to injections, a corticosteroid solution may be applied to the painful area and absorbed through the skin using a light electric current through a procedure called Iontophoresis.
If the quadriceps or patellar tendon is completely broken, the surgeon will reattach its ends. After surgery, the patient will have the foot in plaster for 3-6 weeks and will use crutches. If the tear is partial, the doctor will choose the cast without surgery previously.
A partial or complete rupture of the tendon requires an exercise program of recovery similar to, but less vigorous than the one in the crossed knee ligament injuries. The aim of the exercise is to restore knee movement and the ability to prevent a repeat knee injury. Rehabilitation may take up to six months, although the patient may perform many activities before then.