Patellar Tendinopathy — Jumper's Knee

Patellar Tendinopathy

Patellar tendinopathy, also known as jumper's knee, is a condition characterized by pain and dysfunction in the patellar tendon, which connects the patella or kneecap to the tibia. This overuse injury frequently affects athletes involved in sports that include repetitive jumping or high-impact activities.

Causes and Risk Factors:

The main cause of patellar tendinopathy is repetitive stress/trauma to the patellar tendon, primarily during activities involving frequent jumping.

Basketball and volleyball players, or those who require explosive movements, are particularly susceptible. Contributing factors include inadequate muscle warm-up, lack of flexibility, muscle imbalances, and biomechanical issues.

Symptoms:

The characteristic symptom is pain in the front of the knee, especially below the kneecap, which worsens during activities such as jumping, running, or squatting. Stiffness, swelling, and palpable thickening of the tendon may also occur in more severe cases.

Diagnosis:

Diagnosis involves a detailed medical history, physical examination, and imaging studies, such as ultrasound or MRI, to assess the extent of tendon damage and rule out other possible causes of knee pain.

Non-Surgical Treatment:

• Rest and Activity Modification:

- Temporarily ceasing activities that worsen symptoms. - Modification of training techniques.

• Physiotherapy:

Strengthening exercises for quadriceps and other muscles. Eccentric exercises to improve tendon load.

• Anti-inflammatory medications:

NSAIDs for pain and inflammation relief.

• Biomechanical Interventions:

Analysis and correction of factors that contribute to tendon overload. Orthotics or modifications to footwear.

• Shockwave Therapy:

Shockwave therapy to stimulate healing.

• Corticosteroid Injections:

- Temporary relief of pain and inflammation in some cases.

Surgical Options:

When conservative measures do not provide relief, surgical intervention may be considered. Surgical options include:

• Arthroscopy:

- Removal of damaged tissue and assessment of the joint.

• Tenotomy or Tendon Debridement:

Partial removal of the patellar tendon.

• Tendon Transfer:

- Transfer of a healthy tendon to replace the damaged tendon.

• Platelet-Rich Plasma (PRP) Injection:

- Injection of concentrated platelets to reduce pain and inflammation.

Rehabilitation and Prevention:

Rehabilitation involves a gradual return to activities. Prevention strategies include regular exercise, appropriate management of training load, and prompt addressing of biomechanical issues.

Conclusion:

Patellar tendinopathy presents a challenge, especially for athletes. Early recognition, appropriate treatment, and a structured rehabilitation program are crucial for a successful recovery.

Surgical options are considered when conservative measures prove ineffective. Individuals with persistent knee pain should seek guidance from their knee orthopedist.

What about PRP (platelet-rich plasma)?

PRP — platelet-rich plasma obtained from the patient’s own blood — has gained a meaningful role in patellar tendinopathy that does not respond to conservative care. By concentrating growth factors, it aims to create a biological environment more favourable to tendon repair.

Current evidence positions it as a second-line option: when progressive loading exercise, properly carried out over several months, has not resolved symptoms — and never as a replacement for rehabilitation. The best results come from ultrasound-guided PRP while keeping the exercise programme going.