Exercises for Patellar Tendonitis
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Patellar tendonitis is a painful condition of the knee. This injury develops when the tendon that attaches the quadriceps muscle to the shin bone becomes overloaded and painful, and fails to repair itself. This state of disrepair is called tendonitis or tendinopathy. Because this injury occurs commonly in basketball and other jumping sports, it is also known as Jumper’s Knee. You can read more about the symptoms, causes and diagnosis in another article “Patella Tendonitis“.
James McCormack is a Physical Therapist who specializes in knee, foot & ankle injuries. www.james-mccormack.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com
Unfortunately, with a tendon there is no quick fix. The healing time of a tendonitis is typically 8-12 weeks to feel symptom relief, and 3-6 months for the tendon to fully fix. It is important that adequate rest time is taken to allow the tendon pain to settle before increasing the loading and strengthening exercises that will help heal the tendon.
There are two most used rehab protocols for patellar tendonitis, heavy slow resistance training and eccentric loading. Both work by strengthening the quadriceps muscle and patellar tendon. These are both discussed in another article, ‘Exercises for Patellar Tendonitis’.
In addition to these specific exercise protocols other exercises can help to facilitate the healing of the patellar tendonitis. Home exercises such as foam rolling and self-massage, which can be done with a massage gun, are helpful to relax the quadriceps muscle. And using strengthening exercises such as the bridge, clam and calf raises for the gluteals, calf and hamstring muscles that support to control of the knee joint are useful.
Ice can provide effective pain relief by temporarily reducing the circulation of blood and the conduction speed of the nerves in the area, so as to make it feel numb. On removal of the ice, blood floods back into the area often giving the area a red appearance. This rush of blood back is helpful in providing the nourishment to repair to the injured tissue.
These compressive supports are designed to provide compression around the whole knee. This can be helpful to improve proprioception, or awareness and control of the knee joint. This helps to feel more confident when moving. These are often used during activity to provide extra support.
These are small straps that attach around the top of the calf and apply direct pressure to the patellar tendon. The compression of the tendon aims to absorb the shock of impact and reduce pain.
Acupuncture is a traditional Chinese medicine that has been used to treat many ailments for thousands of year. It is now commonly used in traditional western medicine as its has been shown to be effective for the treatment of pain and to promote healing, as well as many other benefits.
Acupuncture needles can be used directly around the tendon to improve blood supply, and to the surrounding muscles to reduce the muscle tone and tension. Additional needle points can be used further away from the knee, such as in the hands and feet, for the effect that they have on the sensitivity of our nervous system.
Surgery is used less and less for treating patellar tendonitis. It involves debriding the tendon, which is cutting out the degenerative tissue, and research shows low rates of success.
However, if symptoms have persisted for 3-6 months there are other options. A new procedure called tendon scraping is much less invasive than surgery and has a greater success rate when combined with rehab, with up to 80% improvement. Scrapping removes the abnormal nerves that grow on the surface of the tendon and reduces pain.
Corticosteroid injections have been used for reducing inflammation and pain in chronic tendonitis. However, outcomes, when used for patellar tendonitis, are poor and in many cases can increase pain.
Similarly, platelet-rich plasma (PRP) injections are used with variable rates of success, but in general, are not very effective for patellar tendonitis.
It can take 6-9 months to recover from surgery. Recovery from tendon scraping is often as little as 2-4 weeks.
Shockwave is a treatment that uses soundwaves to reduce pain and encourage the remodeling phase of tendon healing.
There are small patches applied like plasters to the skin which release nitric oxide into the tissue. These can be used during rehabilitation and sport and there is good early evidence for their efficacy at reducing pain.
This is not medical advice. We recommend a consultation with a medical professional such as James McCormack. He offers Online Physiotherapy Appointments for £45.