Physiotherapy

Patellar Tendinopathy

Patellar tendinitis is the most common knee disorder found among competitive athletes. Known as “jumpers knee” it is most likely to affect you if you play high impact sports involving bursts of intense or repeated stress, notably basketball and volleyball. However, anyone from the casual jogger to contact sports players may develop the condition. 

Classically patellar tendinitis has been explained as chronic inflammation of the tendon connecting the kneecap (patella) to the main shin bone (tibia) with pain localised at the point of connection to the kneecap. Recent research has however revised our understanding of the condition and with it a change in terminology: the condition is now referred to as tendinosis not tendinitis. This reflects the understanding that the tendon pain does not come from inflammation, but rather degeneration of the collagen that makes up the tendon, as a result of failure of microscopic tendon damage to heal over time. 

Treatment Physiotherapy can stabilise the condition avoiding the need for surgery. Your physiotherapist will assess your biomechanics (how you move) ideally alongside a podiatrist to evaluate its contribution to your knee pain. Faulty movement patterns (most commonly the landing phase from jumping or running) where your knee is at an angled position will put increased loading on the patellar tendon and contribute to its breakdown. 

From analysing your biomechanics your physiotherapist will then test the flexibility and strength of key muscle groups such as the quadriceps (front of thigh), hip flexors and gluteals (buttock muscles). Your exercise protocol will involve progressive loading of the tendon as happens when performing a decline squat (performed on a decline board) as this helps to strengthen and “toughen” the tendon. 

Your rate of progress will depend on how bad the tendinosis is in the first place. The aim is to be able to perform the decline squat using the affected leg only with the correct movement pattern that your physiotherapist will assist you with so that eventually you should be able to return to your chosen sport, free of pain.

By Michael Davis B.Sc (Hons), Musculoskeletal and Sports Physiotherapist at HFS