E-Consult

Patella and Quadriceps Tendonopathy

Tendons are strong cords of fibrous tissue that attach muscle to bones and the kneecap (patella) is attached to the quadriceps muscles at the top by the quadriceps tendon. The patella is attached at the bottom to the shinbone (tibia) by the patella tendon. Both of these tendons work with the muscles in the front of your thigh (Quadriceps) to straighten your leg.

Tendinopathies are most often overuse injuries that have a gradual onset of pain; although they can also develop following a direct blow to the tendon. Prolonged and repetitive stresses on a tendon can result in a reaction in the tendon causing pain and sometimes swelling/thickening.

In the patella and quadriceps tendon, tendinopathies often occur following a period of increased activity such as a change in work or a new hobby, or in people who run or do sports, a change in training schedule.

What is Patellar tendinitis?

Patellar tendinitis is an overuse injury affecting your knee. It is the result of your Patellar tendon, which connects your kneecap to your shinbone, being overstressed. The stress results in tiny tears in the tendon, which your body attempts to repair. As the tears in the tendon multiply, they cause pain from inflammation and weakening of the tendon. When this tendon damage persists for more than a few weeks, it's called tendinopathy.

A common name for it is Jumper's Knee.  It is common in athletes whose sport involves frequent jumping, ie, netball and volleyball but this is not exclusive.

For most people, treatment of Patellar tendinitis begins with physical therapy to stretch and strengthen the muscles around the knee.

What does it feel like?

Pain is the first symptom of Patellar tendinitis, usually between your kneecap and where the tendon attaches to your shinbone (tibia).  You might only feel it at the start of activity or at the end of a particularly heavy workout.  This worsens over time to the extent that even walking upstairs can cause pain.

Should I see a doctor?

If you are experiencing this type of pain, you should first REST until the knee is pain free avoiding any activity that puts a strain on your knee.    You might want to consult a physio to advise you on exercises to strengthen your thigh muscles, which in turn can help to deal with the stresses that can cause Patellar tendinitis.  A physio or personal trainer would also help you to establish whether you are using your body correctly for your chosen sport.

If you do not have an improvement, then an appointment with your GP would be advised.

If you do try to work through your pain, ignoring your body's warning signs, you could cause increasingly larger tears in the Patellar tendon. Knee pain and reduced function can persist if you don't tend to the problem, and you may progress to the more serious Patellar tendinopathy.

Can I do anything else to help?

At The Regenerative Therapy Centre we try to diagnose which stage of tendon disease you have.   This may be early stage reactive disease which may require rest , NSAID and ice packs or if we diagnose more advanced tendon disrepair we may advise hyaluronic acid injection or high volume saline injection.  For more advanced tendon disrepair and advanced stages of degenerative tendinopathy we would advise PRP therapy.