Patellar tendinosis, also known as jumper’s knee, causes inflammation and pain in the patellar tendon, the tendon below the kneecap that connects the quadriceps muscles to the leg. The patellar tendon is important for straightening the knee and controlling the knee during bending or squatting.
Patellar tendinosis is usually a Grade 1 or Grade 2 strain of the tendon. A Grade 1 strain is mild, with microscopic tendon tearing and no loss of strength. A Grade 2 strain is moderate, with tearing of tendon fibers and decreased strength. A Grade 3 strain is a complete rupture of the tendon.
What Is Patellar Tendinosis?
Patellar tendinosis involves inflammation and pain of the patellar tendon.
The condition is usually caused by strain from a sudden increase in the amount or intensity of activity or by overuse of the quadriceps muscles and patellar tendon. It may also occur after a direct blow or injury to the knee or tendon.
Symptoms commonly occur near the lower portion of the kneecap or at the tibial tubercle, the bump on the upper part of the lower leg.
Causes and Risk Factors
Patellar tendinosis may result from:
- A sudden increase in the amount or intensity of activity
- Overuse of the quadriceps muscles and patellar tendon
- A direct blow or injury to the knee or patellar tendon
Risk factors include:
- Sports requiring sudden, explosive quadriceps contractions, such as jumping, quick starts, or kicking
- Running sports, particularly running downhill
- Poor physical conditioning, including weak quadriceps or tight hamstrings
- Flat feet
Symptoms
Common signs and symptoms include:
- Pain, tenderness, swelling, warmth, or redness over the patellar tendon, most often near the lower part of the kneecap or the tibial tubercle
- Pain and, occasionally, loss of strength when forcefully straightening the knee
- Pain when jumping or rising from a seated or squatting position
- Pain when completely bending the knee, such as during squatting or kneeling
- Crepitation, or a crackling sound, when the tendon is moved or touched
Treatment
Initial treatment may include medication and ice to reduce pain, stretching and strengthening exercises for the quadriceps and hamstring muscles, and modifying the activity that caused the symptoms.
These treatments can often be performed at home, although referral to a physical therapist or athletic trainer may be helpful.
Additional treatment may include:
- An arch support (orthotic) or patellar tendon brace to reduce stress on the tendon
- Rarely, a leg cast for 10 to 14 days to immobilize the tendon and allow inflammation to settle
- Uncommonly, crutches for the first several days to weeks until quadriceps control improves and the patient can walk without a limp
Nonsteroidal anti-inflammatory medications such as aspirin or ibuprofen, or other pain relievers such as acetaminophen, may be recommended as directed by a physician. Cortisone injections are not given because they may weaken tendons.
Surgery to remove inflamed tendon lining or degenerated tendon tissue is rarely necessary and is considered only after at least six months of adequate rehabilitation and rest.
Recovery and Outcomes
Patellar tendinosis is usually curable within approximately six weeks when treated appropriately with conservative treatment and adequate rest.
Cold may be used to relieve pain and reduce inflammation. Heat may be used before stretching and strengthening exercises as directed by a physician, physical therapist, or athletic trainer.
Potential complications include:
- Prolonged healing if the condition is not treated appropriately or is not given enough time to heal
- Recurrence if activity is resumed too soon, with overuse, after a direct blow, or when using poor technique
- Tendon rupture requiring surgery if the condition is left untreated
When to See Dr. Chudik
If patellar tendon pain, swelling, weakness, or other symptoms persist or worsen, schedule an evaluation with Dr. Chudik.
Call 630-324-0402, schedule online, or email contactus@chudikmd.com.