Patellar Tendinitis (Jumper’s Knee) - Causes, Symptoms, Diagnosis, and Treatment

What Is Patellar Tendinitis?

Patellar tendinitis, otherwise called jumper's knee, is an injury that occurs when the patellar tendon, which is the tendon that connects the kneecap to the shinbone, is overstressed. When a person kicks, run or jump, this patellar tendon helps in extending the knee by working with the muscles in the front of the thigh. This injury is more common in athletes who jump or land heavily on their knee, for example, volleyball players, basketball players, and long jump athletes. But this injury can also affect people not involved in jumping sports.

Treatment for patellar tendinitis includes physical therapy, which focuses on stretching and strengthening the muscles around the knee. When the person lands heavily on the knee, it results in excess stress on the tendon, causing tiny tears. These tears cause inflammation, which usually heals fast. But repeated injury can result in permanent damage.

Jumper's knee often develops gradually, and it does more damage every time a person injures the tendon. Therefore, rest the knee well after each injury to give the body time to heal adequately. Apart from the jumper's knee, patellar tendinitis is also called patellar tendinosis, patellar tendonitis, and patellar tendinopathy.

What Causes Patellar Tendinitis?

Patellar tendinitis is caused by overuse or repetitive stress on the knee. The most common causes include sports or exercise. This repetitive stress results in tiny tears in the patellar tendon, which inflames and weakens over time.

What Are the Risk Factors for Patellar Tendinitis?

Some factors that increase the risk of patellar tendinitis are:

• Tight muscles in the legs.

• Nonuniform muscle strength in the legs.

• Feet, ankles, or leg misalignment.

• Obesity or overweight.

• Wearing shoes with not enough padding.

• Playing on hard surfaces.

• Conditions that affect the tendons.

Jumper's knee is more commonly seen in athletes who run, jump, or squat, as it puts more force on the tendon in the knee. However, running puts almost five times the weight on the knees.

What Are the Common Signs and Symptoms of Patellar Tendinitis?

Individuals experience symptoms differently. But the common signs and symptoms of patellar tendinitis or jumper's knee include:

• Pain and tenderness around the knee.

• Knee swelling.

• Pain while walking, running, or jumping.

• The lower part of the kneecap feels tender.

• Pain on bending or straightening the leg.

A complete or large tear in the tendon is considered to be a serious injury. If a person has knee pain or hears a tearing or popping sound, consult a doctor immediately. Immediate medical assistance is required if the pain worsens, interferes with daily routine, and the knee is swollen or red.

How Does the Doctor Diagnose Patellar Tendinitis?

The doctor will ask the patient the following questions, such as:

1. How much and what physical activity does the patient do?

2. The symptoms that the patient is experiencing.

3. What makes the symptoms worse?

4. When does the patient experience these symptoms?

Then the doctor will conduct a physical examination to see if the patient has knee pain while moving the knee or will check for knee swelling. In some cases, the doctor might suggest getting imaging tests done to see if the kneecap or tendon is damaged or to rule out other knee conditions that can result in similar symptoms. The following test might be needed, such as:

• X-rays - To rule out other bone problems resulting in similar knee pain.

• Ultrasound - Sound waves are used to produce images of the knee, which will help diagnose a patellar tendon tear.

• Magnetic Resonance Imaging (MRI) - Strong magnetic and radio waves produce detailed knee images.

What Are the Treatment Options for Patellar Tendinitis?

Most cases of patellar tendinitis get better with rest, ice application, compression, elevation, and painkillers. The treatment options include:

I. Home Remedies:

• Painkillers - Over-the-counter drugs like Ibuprofen and Naproxen relieve pain. However, the discretion of the examining doctor is advised to avoid side effects.

Do not perform activities that worsen the pain. For example, running and playing sports with the pain can worsen and permanently damage the tendon.

Applying ice will help reduce pain. Ice can be wrapped in a plastic bag or towel and applied to the knee. This can be done for 20 minutes four to five times a day.

• Medications - The doctor might prescribe painkillers, such as Ibuprofen, Naproxen, or other nonsteroidal anti-inflammatory drugs (NSAIDs). If a patient has severe pain, the doctor might prescribe more potent painkillers, apply an immobilizer or give a temporary slab.

II. Physical Therapy:

• Stretching Exercises - Regular stretching exercises help reduce muscle spasms and lengthen the muscle and tendons. Avoid overstretching the joints.

• Strengthening Exercises - Exercises to strengthen the thigh muscles prevent strain on the patellar tendon. Leg press strengthens all of the muscles in the leg.

• Iontophoresis - Here, corticosteroid medicine is applied to the skin, and a low electrical charge is applied with the help of a device to help push this medication through the skin.

• Patellar Tendon Strap - These straps apply pressure to the patellar tendon, which distributes the force through the strap and away from the tendon.

Other Procedures:

• Corticosteroid Injection - Corticosteroid injection is given into the sheath surrounding the patellar tendon. This helps relieve pain. The side effects include weak tendons that can rupture. This is not given in acute cases. Whenever there is chronic pain, this may be considered. Surgeon discretion is also advised.

• Oscillating Needle Procedure - Here, the doctor will use a small oscillating needle to cut away the damaged parts of the tendon using ultrasound imaging.

• Polidocanol Injection - Polidocanol is a local anesthetic agent. It is injected into the tendon to reduce pain.

• Hyperthermia Thermotherapy - Deep-tissue heating and a surface cooling device are used to relieve pain.

• Extracorporeal Shockwave Therapy - Low-energy shock waves are used to reduce pain.

• Platelet-rich Plasma (PRP) Injection - This is a relatively new treatment option in which platelets are separated from the blood and injected into the damaged tendon. This injection is believed to promote new tissue formation and healing.

• Surgery - If all other treatment options fail, the doctor might surgically debride the patellar tendon. It is done by making small incisions around the knee.

What Are the Preventive Tips to Avoid Patellar Tendinitis?

• Stretch and warm up properly before exercise.

• Stretch and cool down after exercise.

• Perform strengthening exercises to strengthen the muscles of the leg.

• Wear knee support or braces while playing sports.

• Do not jump and land on rigid surfaces.

• Wear shoes with proper padding.

Conclusion:

Patellar tendinitis is not severe and can be controlled by taking some necessary steps. However, if the treatment is not provided on time, it can be serious and result in permanent damage. Therefore, patients should be aware of their symptoms and seek medical advice when they notice knee problems.