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What is patellar tendinitis?
Patellar tendinitis, or jumper’s knee, is an overuse injury of the patellar tendon – the tendon that connects the patella (kneecap) to the tibia (shinbone). The patellar tendon, together with the thigh muscles, work together to facilitate movements such as extending the knee, jumping, kicking, and running. If left untreated, patellar tendinitis can weaken the tendon, causing it to tear and eventually rupture.
What causes patellar tendinitis?
Patellar tendinitis is an overuse injury typically caused by chronic or repetitive pressure and stress on the patellar tendon in the knee. This excessive stress causes small tears in the tendon. In the absence of sufficient rest and continuous strain, the body is unable to heal these tears or cannot sufficiently heal them. When this happens, the tears accumulate and multiply, resulting in tendon irritation, characterised by pain and inflammation.
Patellar tendinitis typically occurs gradually, with injury and inflammation occurring over time and with repeated stress and strain. There are two main activities that stand out as key culprits of patellar tendinitis, these are:
- Sudden and significant increase in activity levels
- Returning to full intensity of play instead of slowly easing back after a break in activity (for example, after injury)
What are the symptoms of patellar tendinitis?
Pain is typically the most prominent and noticeable sign of patellar tendinitis; other symptoms of patellar tendinitis include:
- Swelling and tenderness at the kneecap (where your patellar tendon attaches to the shinbone)
- Pain or dull ache under the kneecap, above the shinbone
- Knee stiffness after periods of rest or inactivity
- Pain that worsens over time or with certain activities like squatting
Who is at risk of patellar tendinitis in Singapore?
Patellar tendinitis is a common injury among athletes; however, it can affect individuals of any activity level. There are several risk factors that increase an individual’s risk of developing patella tendinitis; these are:
- Athletes: individuals who participate in sports with repetitive jumping and running, such as basketball, volleyball, and football, are at an increased risk of developing patellar tendinitis. In addition to the repetitive actions, these activities involve quick and sudden changes in direction, another cause of patellar tendinitis.
- Age: patellar tendinitis is an injury that occurs due to wear and tear over a period of time. Hence, individuals over 40 are more prone to this condition.
- Tight or stiff leg muscles: stiff hamstrings and thigh muscles can increase the strain and pressure on the patellar tendon due to uneven muscle loading, thus increasing the risk of patellar tendinitis.
- Medical conditions: some medical conditions, such as kidney failure, rheumatoid arthritis, and diabetes, can lead to reduced blood flow to the knee. This affects the healing of the patellar tendon, increasing the risk of patellar tendinitis.
- Obesity: excess weight increases the strain and pressure on the patellar tendon, hence leading to an increased risk of patellar tendinitis.
How is patellar tendinitis diagnosed?
Diagnosis of patellar tendinitis typically involves a comprehensive evaluation, including:
- Medical history: your pain specialist will inquire about the onset and duration of symptoms, possible injuries that may cause similar symptoms, and other medical conditions.
- Physical examination: the patellar tendon will be palpated to check for tenderness and swelling. The area will also be assessed for range of motion and to evaluate knee stability and function.
- Imaging studies: X-rays may be ordered to rule out other potential causes of knee pain, such as fractures or arthritis. In some cases, an ultrasound or magnetic resonance imaging (MRI) may be recommended to visualise the extent of tendon damage and inflammation.
What are the treatment options for patellar tendinitis in Singapore?
Treatment of patellar tendinitis typically focuses on relieving pain, reducing inflammation, and promoting tendon healing. Depending on the severity of symptoms, treatment options for patellar tendinitis include:
- Rest: give your body time to heal and avoid activities that exert stress on the patellar tendon.
- Ice therapy: apply ice packs to the affected knee for 15-20 minutes several times a day to reduce pain and inflammation.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs may be prescribed to help reduce inflammation and alleviate pain.
- Physical therapy: special exercises to improve flexibility and strengthen hamstrings and thigh muscles can help reduce the strain and load on the patellar tendon. This allows it to heal and prevent future injuries.
- Patellar tendon straps or braces: supportive devices can help offload and reduce pressure on the patellar tendon, providing symptomatic relief during physical activity.
- Corticosteroid injections: corticosteroid injections can be administered into the affected tendon for severe cases of patellar tendinitis resistant to conservative treatment.
- Extracorporeal shock wave therapy (ESWT): ESWT is a non-invasive treatment that utilises low or high-energy shock waves to stimulate tendon healing and alleviate pain.
Implementing appropriate interventions and modifying activity levels can help individuals with patellar tendinitis successfully return to their desired level of physical function and athletic performance.
Frequently asked questions
The fastest way to heal patellar tendinitis is to rest. Stop all activities that put excessive strain and pressure on the patellar tendon and ice the area to reduce inflammation.
Yes, it does. However, the amount of time required for healing depends on the severity of the condition. Mild patellar tendinitis can heal in six weeks with enough rest and time for the tendon to heal. However, severe cases of patellar tendinitis can take months to heal.
Total Pain Specialist