Patellar tendinitis: Irritation of the patella tendon
Patellar tendonitis, also known as jumper’s knee, describes an irritation of the patella tendon. The syndrome is caused largely by constant overburdening of the knee joint. Athletes are frequently affected, as sudden turning, changes in direction, jumping, and corresponding hard landings subject to the joint to high levels of stress.
In many cases, patellar tendinitis can be treated successfully using conservative methods. When left untreated, sooner or later patellar tendinitis commonly leads to high and enduring levels of pain, resulting in prolonged breaks in training and/or reduced mobility.
The experts for sports orthopedics at ECOM® Excellent Center of Medicine are specialized in the treatment of knee joint diseases and disorders such as patellar tendinitis, and are recognized nationally and internationally as consultants of choice for the rapid restoration of mobility and athletic ability after sports injuries.
Symptoms of patellar tendinitis
Patients suffering from patellar tendinitis may experience one or more of the following symptoms:
- The affected tendon may be thicker than the healthy tendon
- Swelling may be experienced around the most painful areas
- The affected part of the patella tendon may be painful and/or sensitive to pressure while immobile as well as during movement
- Anterior and posterior pain may be experienced while palpitating the kneecap
- After physical activity and/or stress, pain or stiffness may be experienced
- Pain may be experienced when flexing the quadriceps
- After remaining in a static position for longer periods of time (either sitting or standing) patients experience the urge to move
Definition: What is patella tendinitis (Jumper’s knee)?
The patella tendon is, when seen from a medical point of view, not a tendon at all, as tendons actually connect muscles and bones. Because the patella tendon connects the kneecap to the shin (tibia), it connects bone with bone and as such must be classified within the ligament group. The patella tendon is located directly underneath the skin and can be felt and palpitated manually without great effort.
The patella tendon‘s main duties are composed of transmitting power from the thigh to the calf. As such, the patella tendon is exposed to high levels of stress, in particular during sporting activities. Sudden stop-and-go movements, for example during (tennis), rapid changes of direction (football and soccer) and extreme jumps coupled with hard landings (basketball and gymnastics) expose the knee joint and the kneecap to high levels of stress. If the tendon is irritated or injured at the base of the kneecap, this condition is known as patellar tendinitis.
Symptoms experienced from patella tendinitis are varied and may occur in one or both of the knee joints. Usually, symptoms are experienced primarily during athletic activity causing strain on the patella tendon, and lessen after a warm-up phase. If the infection/irritation of the patella tendon is an advanced phase, pain continues until physical activity has ended. In the most extreme cases, pain is felt continually, even in course of daily activity.
Effects of patellar tendinitis
Discomfort and pain caused by patellar tendonitis during and after athletic activity can be broken down into four classifications:
- 1st degree: pain is experienced only after athletic activity
- 2nd degree: pain is experienced before and during athletic activity, but lessens after a warm-up phase
- 3rd degree: permanent pain and discomfort , during athletic activity and daily doing
- 4th degree: the patella tendon is ruptured, and it is impossible to extend the knee joint without help
Therapy: How is patellar tendinitis treated?
In most cases, patellar tendinitis can be treated successfully using conservative methods. Surgery on the patella tendon is taken into consideration only after all conservative methods of treatment have been exhausted without success. Different causes for patellar tendinitis may thus be remedied. If the patella tendon has ruptured, surgery is strongly recommended.
1. Conservative therapy forms for patellar tendinitis
The most important measure for the treatment of patellar tendinitis is immobilization of the affected knee joint. Athletic activity should only be attempted if the patient is pain-free. As such, we recommend a respite from athletic activity at the beginning of therapy. In accordance with the level of pain/discomfort, athletic activity can subsequently be resumed and the level of stress placed on the joint increased.
Within the scope of treatment for patellar tendinitis, physical therapy plays a central role. Specialized physiotherapy helps to reduce strain on the tendon(s) and allows the patient to become accustomed to suitable forms of movement and exercise. Cryotherapy (localized “cold” therapy) and targeted practice routines help to support the regenerative process. Additionally, pain medication such as Ibuprofen may also be administered if required: these types of medication provide pain relief and have anti-inflammatory properties which help to support the healing process. However, side effects should be taken into consideration if such medication is administered for longer periods of time.
2. Surgery for patella tendonitis
If all conservative methods of therapy have been tried and proved unsuccessful, patellar tendinitis may be remedied via surgery in order to free the patient of symptoms and restored athletic ability. Surgery is usually performed using minimally-invasive arthroscopy. Quite often, inflamed, infected or damaged areas of the patella tendon are removed during surgery. In order to prevent renewed inflammation, portions of the tendon may be removed or the entire tendon be detached. After surgery, consistent and rigorous follow-up treatment and therapy support recovery and facilitate rapid return to sporting activity and daily doing.
Patella tendon rupture
A patella tendon rupture is a rare disorder of the patella tendon. A patella tendon rupture describes the tear of the tendon which connects the kneecap to the shin (tibia). In most cases, the patella tendon tears from the lower surface of the kneecap. The most common causes are sporting injuries experienced during skiing or while playing tennis. However, these sorts of injuries are usually facilitated by a previously experienced disorder or disease of the patella tendon.
A patella tendon rupture occurs when degenerative processes have caused previous and permanent damage to the patella tendon. Patella tendon ruptures to a completely normal and healthy tendon are very uncommon. A healthy and functional patella tendon is capable of withstanding the stress presented by the majority of situations in daily doing or athletic activity. When a patella tendon ruptures, patients feel a cracking sensation accompanied by pain and swelling. As a result, patients can no longer extend the knee and have difficulty lifting the leg up and/or walking.
Normally, a patella tendon rupture is treated surgically, as torn structures within the tendon itself are only capable of healing without help in small measure. The most common method of treatment is surgery using arthroscopy, in which a new tendon is inserted and attached; this can be an autologous tendon taken from the patient’s leg, for example.
Patellar tendinitis: Internal and external causes
Jumping, turning, and sudden stopping movements required and common in such sports such as volleyball, basketball, long jump, pole vaulting, tennis and soccer cause extreme stress and strain to the knee joints. If overburdening leads to chronic pain on the underside of the kneecap, this condition is referred to as patellar tendinitis
There are diverse internal and external factors which can lead to patellar tendinitis or jumper’s knee. These factors may be independent of one another or influence each other interdependently.
1. External influences leading to patellar tendinitis
External influences represent all physical and athletic activity which may directly affect or lead to patellar tendinitis. Foremost among these external influences are the types of sporting activities in which the knee joints are exposed to extreme stress caused by jumping or sudden stopping and turning movements, resulting in overburdening and constant inflammation/irritation of the patella tendon. The frequency and intensity of this stress/overburdening and, in some cases, unusual or unaccustomed movements (when beginning a new type of sports) play an important role.
2. Internal influences leading to patellar tendinitis
Internal influences represent any and all factors which cannot be changed by the patient’s behavior. Among these factors are the patient’s age, raised kneecaps (Patella alta), a previous Morbus Osgood-Schlatter condition, shortened or stiff leg muscles with accompanying reduced flexibility, hereditary ligament weakness (ligament laxity), joint misalignment (bowed legs and knocked knees) as well as obesity.
Your specialists for patellar tendinitis, patellar tendon ruptures and other forms of treatment
“Innovative, minimally-invasive methods such as arthroscopy for the treatment of patellar tendinitis help patients quickly resume athletic activity and daily doing”.
Dr. Erich Rembeck
Specialist for orthopedic, sports medicine
„The patient is often traumatized or in a state of shock. Targeted diagnostics and individual therapy are key factors for successful treatment“.
Dr. Alexander Rauch
Specialist for orthopedics and trauma surgery, sports medicine, specialized trauma surgery
„Arthroscopic surgery has revolutionized the field of hip surgery and has paved the way to new, minimally invasive forms of treatment.“
Prof. Dr. Hans Gollwitzer
Specialist for orthopedics and trauma surgery
Specialist for orthopedics, sports medicine, chiropractic therapy
Consultation and contact for questions regarding patellar tendinitis or patella tendon ruptures
Do you have questions regarding treatment and/or therapy for patellar tendinitis or patella tendon ruptures? Our experts, Dr. Erich Rembeck and Dr. Alexander Rauch will be happy to provide you with more information within the framework of a personal appointment. Please make an appointment here. We are looking forward to hearing from you.