Anatomy: The patella (kneecap) is a small bone located in front of the knee. Tendons are fibrous tissue bands that connect muscles to bone. The strong Quadriceps muscles on the front of the thigh that straightens the knee, attaches to the upper portion of the patella by means of the Quadriceps tendon. This tendon covers the patella and continues down to form the Patellar tendon. The Patellar tendon in turn, attaches to the tibia (the shin bone). Thus, the Quadriceps tendon is attach ed to the tibia, via the Patellar tendon. The Quadriceps muscles straighten the knee by pulling up on the patella, and the tibia, via the Patellar tendon.
Symptoms: The symptoms of Patellar tendonitis (Jumper's Knee) are experienced just below the kneecap. During the early stage of Patellar tendonitis, the symptoms may only appear early in a work-out, "ease up a bit," only to become worse a short time after the work-out. After the work-out, the symptoms will subside quickly with rest. Another early sign of Patellar tendonitis is "stiffness" when walking up or down stairs. As this condition worsens, the following symptoms may occur:
- pain and tenderness in the patellar tendon just below the knee joint.
- pain and/or "tightness" in the knee when squatting, bending, or straightening the leg.
- pain in the knee when jumping or running.
- swelling in the front of the knee, and the area just below the knee joint.
- a feeling of weakness in the knee.
Causes: Patellar tendonitis, or Jumper's Knee, is an inflammation of the Patellar tendon due to overuse. Overuse injuries which may cause this condition are:
- intense running (such as long distance running)
- jumping (basketball , volleyball, and long-jumping)
- frequent starts and stops (tennis, high impact aerobics, soccer, and figure skaters)
- squatting (baseball catcher and supermarket shelf stockers)
- kneeling (such as a carpet layer or carpenter)
Predisposing factors, or those factors which increase your chances of developing this problem are included below; however, one of the most frequently seen factors is pronation. Pronation is a turning out of the foot at the ankle, so that one has a tendency to walk on the inner border of the foot. When the foot turns out, the lower leg and knee are forced to turn inward (internal rotation). This causes the Patellar tendon to twist, and pull abnormally on the tibia. The result is inflammation and pain in the Patellar tendon. Custom-made foot orthotics are needed to control pronation inorder to straighten out the pull of the Patellar tendon, and to permanently stop the knee pain. This treatment, along with preventive bracing, is discussed in a following section, Prevention. Other predisposing factors for Patellar tendonitis include:
- increase in the above activites
- changing from one sport or activity listed above to another
- performing the above activities on hard surfaces
- repeated improper movements
- muscle weaknesses or imbalances
Immediate "Self-Help" Treatment: (The best treatment is Prevention. For "must-do" information on how to prevent Patellar Tendinitis, see "Prevention" immediately following this section.) All self-treatments should be directed towards reducing the pain, swelling, and inflammation of the Patellar tendon. The use of the following techniques seems to work well:
• Protection: by gently limiting the movement of the Patellar tendon during all knee movements, healing will occur more quickly. This is best accomplished with the use of our Single Patella Strap or our Dual Action Knee Strap. These two braces help reduce pain and healing time! Not only are they effective in the treatment of Patellar tendonitis, but they are also recommend for preventing reoccurrences of this problem. For more information about these two truly unique braces, click here.
• Rest: just about every activity we engage in requires us to bend and straighten our knees. While we cannot completely stop all knee movements, we need to reduce those movements which aggravate the Patellar tendon most; and, these movements include:
- walking up and down stairs
- running and jumping
Whenever possible, sit with your leg extended straight, and avoid bending the knee.
• Ice: helps to reduce pain, swelling, and inflammation. Ice should be applied to the patella and the area below it, for 20 minutes every 4 hours. The ice should not be applied directly to the skin (place a cloth over the knee before applying the ice). The ice should "cool" the knee and be comfortableŠdo not freeze the area.
• Elevation: with the knee straight, reduces the "pull" on the Patellar tendon, and allows it to relax and heal. Elevation will also reduce swelling and inflammation.
•Gentle massage: with a topical pain reliever can help to provide comfort. By combining the pain relieving properties of Tripod Labs Flexstat Topical Pain Reliever with gentle massage, pain, swelling, and inflammation can be reduced or eliminated.
Prevention: If you are going to return to the activities that caused your Patellar tendonitis, and you do not want to permanently injure the tendon, or tear it, then you first need to do several things:
• Control the predisposing pronation of the foot, which causes the leg and knee to rotate inward. Pronation causes the Patellar tendon to twist when it pulls on the tibia. This twisting leads to the symptoms of Patellar tendonitis. Pronation is effectively controlled by the use of our custom-made orthotics. These orthotics are made exclusively for us by our award wining affiliate, OurFootDoctor.com. This treatment, more than any other, will help to prevent the return of Patellar tendonitis! For more information about this effective treatment click on Custom-Made Sports Orthotics.
Click here for information on how to order these uniquely effective custom-made orthotics for Patellar tendonitis.
• Protect the Patellar tendon from further micro-trauma, with a proper brace or strap. The two braces that we think will do this best are listed below. Click on them to find out why they are so effective in the treatment and prevention of Patellar tendonitis:
- Single Patella Strap
- Dual Action Knee Strap
• Gradually return to your full range of activities, once the pain has subsided. If an activity produces pain, stop it immediately.
• Flexibility and strengthening exercises for the quadriceps muscles should be performed on a regular basis. (See the exercises suggested above).
• Good common sense should be your guide during your rehabilitation period. Activities and durations should be increased very gradually, and as tolerated.
• Finally, if the pain will not subside, and swelling is constant, see your doctor immediately.