Patella Tendinopathy – Blog by Christian Bonello
The patella tendon is a continuation of the quadriceps tendon and has a role in connecting the quadriceps femoris (4 quadriceps muscles at the front of the thigh) to the tibial tuberosity of the shin. The patella tendon has a principle role in transmitting force through the lower limb, particularly in powerful jumping movements.
Patella tendinopathy is defined as a pathology or injury of the patella tendon, commonly due to overuse mechanisms. For further information please refer to the “What is a tendon and tendinopathy” blog.
The main symptoms of a patella tendinopathy is pain and tenderness localised to the inferior pole of the patella (ie bottom of knee cap). Patients often report load-related pain that increases with the demand on the knee extensors. Notably this includes activities that store and release energy in the patellar tendon such as jumping and change of direction activities.
Patella tendinopathy is highly common in jumping athletes with a 45% prevalence reported in basketball players, 32% reported in volleyball players and is common in AFL ruckman. Conversely patella tendinopathy only has a 2.4% prevalence in “in-season” soccer players due to the altered demands of the sport.
The largest risk factor for developing a patella tendinopathy includes acute changes in load for jumping based tasks. Often such load changes include competing in a tournament, increased playing/training frequency, alterations in shoe-wear or alternations in playing surfaces. Weight gain can also be a contributing factor as this places extra load onto the joints. Patella tendinopathy is a highly prevalent condition in younger, jumping athletes, less than 30 years old.
Patella Tendinopathy is medically diagnosed by a physiotherapist.
A physiotherapist will conduct a strength and lower limb power assessment to highlight any differences between the symptomatic and unaffected side, and as a comparison to dominate limb function. Palpation may reveal localised pain and tenderness over patella tendon.
In rare cases, ultrasound may be utilised in the diagnosis of the condition, however is not often required as there is a poor correlation between imaging findings and patient reported symptoms and level of function.
Multiple interventions can be utilised in the treatment of a patella tendinopathy but should primarily be gym based. As the condition can become chronic and often debilitating, treatment is most successful when commenced early.
Your physiotherapist will guide the appropriate management based on your assessment findings and the severity of symptoms which may include:
– Rest from aggravating exercises
– Graduated strengthening exercises (starting with static contractions and building through range with resistance to power based activities)
– Load management strategies or advice
Blog by Christian Bonello (Physiotherapist)