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Patellar Tendonitis

by Matt Dumigan, MD

Patellar Tendonitis is a common overuse condition seen in competitive and recreational athletes. Commonly referred to as "jumper's knee," patellar tendonitis causes inflammation of the tendon that connects the kneecap (patella) to the shin bone (tibia). Although this condition frequently affects athletes involved in basketball, volleyball and soccer due to repetitive stress from running, jumping and landing, anyone can develop patellar tendonitis. The most common cause is increased frequency and intensity of physical activity. Poor flexibility of the quadriceps and hamstring muscles, and imbalance in strength of the muscles around the knee can also contribute to this problem.  

The most common presenting symptom is pain localized directly over the tendon. Usually there is no specific history of injury and the pain will progress with continued physical activity. The pain is due to tiny tears that develop in the tendon due to overuse, followed by inflammation that occurs when the body attempts to heal the damaged tendon.  In more severe cases, the healing process is unable to keep up with the ongoing damage in the tendon. This can lead to replacement of normal tendon tissue with scar tissue.

The cornerstone of treatment for patellar tendonitis is rest and activity modification. Icing and anti-inflammatory medications are also used to help settle down the acute pain. Physical therapy is used to help address poor flexibility and muscle imbalance in addition to helping athletes improve jumping and landing techniques. Surgery for this condition is reserved only for severe cases with more extensive tendon damage and often has a slow recovery time. Injection treatments that we perform in the office setting have shown great promise in patients who have continued pain despite conservative treatment, and usually result in a much quicker and predictable recovery.