Patella Tendinitis is a troublesome knee musculoskeletal injury, known as ‘jumper’s knee’. This injury is often a result of increased loading around the tendon of the anterior (front) knee.
Presentations are found amongst high performing athletes competing in high knee loading (eg. jumping or landing) sports such as; football, basketball, tennis and dancing. Similarly, it can present in recreational athletes who have recently started or increased activity.
The patella tendon can have multiple factors contributing including but not limited to:
- Increased training sessions
- Poor movement patterns with exercise
- Inadequate recovery time
- Commencing a new activity or sport
- Insufficient strength of the muscles surrounding the knee and lower leg
- Stiff ankle rage of motion
Common features of Patella tendinopathies (tendinitis) include:
- Morning stiffness and/or pain
- Pain initially with activity that can or may not ease throughout a session
- Pain increased with knee bending
- Pain on a single leg squat
5 tips to fixing my Patella Tendinitis
It is important to get an experienced sports Physiotherapist to get you on the right path for your patella tendinitis. Our 5 yey area’s to address are:
- Relative Rest. Avoiding high impact activities initially (eg. jumping, landing) to settle some of the ongoing symptoms.
- Strengthening (quads). Exercises targeted to build strength around the quadriceps to in turn reduce the load in the tendon it self. This should be at least 3x per week with 4×6-10 reps each session as a minimal. The load should be heavy and really challenge your quad muscles. A good base line target is 1.5x your body weight on a single leg press for 4×8 reps or 50% of your body weight on a single leg leg extension machine.
- Strengthening (the kinetic chain) Targeting weak muscles that may be contributing to poor movement patterns such as the hips and calves. You should be able to do 30 single leg calf raises and can train this three times a week. We measure hip strength and have specific targets to hot relative to your body weight.
- Technique correction: Movement re-education around running or landing technique such as taking more load through the hips when landing and less through the knee.
- Get your loading right: It is imperative to get your training loads and strength structured well to ensure you avoid any flare ups. This may include scheduled days off, tracking jump numbers and ensuring your strength targets are maintained.
Evidence has shown that quads strengthening with heavy loading is a safe and effective way of progressively loading the patella tendon and should be integrated with a comprehensive rehabilitation program.
Seeing an experienced physiotherapist to put all this information together in a program that suits the athlete, their sport and their symptoms is imperative to ensure a return to full function and sport pain free is achieved.
Josie Wilson
References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2971642/
https://bjsm.bmj.com/content/48/7/672.1
