Patellar tendinopathy affects athletes in many sports and at all levels of participation, but has a particular affinity for elite, jumping athletes1. However, the condition also occurs in sportspeople who change direction and may occur in sportspeople who do not perform either jumping or change of direction2.
High impact sports are physical activities that place above normal force on joints, bones, tendons, and ligaments. These high impact sports include basketball, dance, volleyball, soccer, football, track and field (distance running, high- and long-jump), mountain climbing, figure skating, tennis and skiing3.
Risk factors that contribute to the injury of the Patellar Tendon are inflexibility of the Quadriceps and Hamstring muscles. Other risk factors include inappropriate quantity and intensity of training, hardness of the playing surface, and limited evidence of inherited biomechanical risk factors. Landing and jumping surfaces should be padded to assist in the process of reducing micro tears in tendons, ligaments, and muscle tissue3.
The patient complains of anterior knee pain aggravated by activities such as jumping, hopping and bounding. The most common site of tendinopathy is the deep attachment of the tendon to the inferior pole of the patella. The tendon is tender on palpation either at the inferior pole or in the body of the tendon. There is frequently associated thickening of the tendon2.
Patellar Tendinopathy is most commonly found in the sport of basketball. The overall occurrence of Patellar Tendinopathy among sporting athletes has been estimated at 15% with a higher prevalence of about 50% in elite jumping athletes, such as volleyball and basketball players3.
Patellar Tendinopathy may occur in males between the ages of 14 and 16 who experience a sudden growth spurt, which is characterised by the bones of the leg out-growing the tendons and muscles of the leg3.
Anterior Knee pain can also be caused by chondromalacia patellae, Quadriceps tendinopathy, fat pad impingement or pre-patellar bursitis2.
Physiotherapy treatment will consist of an exercise program in consisting of an eccentric strengthening program of the quadriceps, correction of biomechanics and soft tissue therapy.
Sclerosing injections and Aprotinin injections have been proven to have good long term and short term results. There has been mixed results regarding the effectiveness of surgery2.
1. What is the most appropriate treatment for patellar tendinopathy? J L Cook, K M Khan Br J Sports Med2001;35:291-294
2. Clinical Sports Medicine. Peter Brukner and Karim Khan with colleagues. Third edition (2006) pg. 524-532
3. Patellar Tendinopathy: Knee Pain Relate To “Jumper’s Knee” Larry W. McDaniel, Allie Winkle, Laura Gaudet, Allen Jackson. American Journal of Health Sciences – First Quarter 2012 Volume 3, Number 1 © 2012 The Clute Institute 1