By Laurence Schubert APAM
What is Patella Tendinopathy?
Pain just below your knee cap? Do you play sports such as basketball, volleyball, football, tennis? Does your sport require repetitive jumping? If you answered yes, then it is likely that you are suffering from a condition commonly referred to as “jumpers’ knee”. The scientific term, patella tendinopathy is an overuse condition classified by pain at the base of the patella (kneecap) that occurs during activities such as jumping/landing, squatting, sitting or going up and down stairs.
The patella tendon is responsible for absorbing extremely large amounts of force, especially during jumping and landing. It is estimated to be up to twelve times your body weight during jumping. Therefore, the patella tendon and quadriceps must be capable of managing heavy forces put through it during activity.
What are the symptoms?
A sharp localised pain just below the knee cap will almost always be present with patella tendinopathy. Activities that aggravate the pain will include anything that places a load through the knee joint/patella tendon, such as those described above. A very common finding with this condition will include a sudden change in training load. Pain can appear to come on quickly or gradually over time. Pain first thing in the morning is expected, due to the condition’s inflammatory nature.
How does it happen?
As just mentioned, sudden changes in training loads/schedules are the most common cause of this pain. Over time tendons will adapt and become stronger, allowing increased force absorption capacity. However, this process occurs over a period of weeks to months. Therefore, if this happens too quickly the adaptations would not have been made. If activity levels are changed too quickly, the tendon is not yet capable of sustaining heavy repetitive forces.
Other factors such as muscle length, age, muscle strength, diet and overall health can also affect the health of tendons. This condition is more commonly seen in men.
Why see a physiotherapist?
There are other conditions that can masquerade as patella tendinopathy. Therefore, it is necessary to confirm the diagnosis. Throughout the assessment process, key information will be used to form part of the treatment. Treatment will initially involve a modification of training load, depending on your sporting goals. Followed by an individualised rehabilitation program, which is embedded with your current training program. In this program, isometrics and eccentric exercises have shown to be important when loading the tendon appropriately. These two types of movements are useful for pain relief but also increasing the strength of your tendon. Other treatment modalities such as manual therapy may be necessary if biomechanical abnormalities have been identified. Tendinopathies often require patience, as the rehabilitation will take at least 4-6 weeks before significant changes occur. However, you can be confident that this condition will improve if managed properly.