What is Patellar Tendonitis? The Symptoms & Treatment Options

According to the Australian Journal of General Practice[1], patellar tendon injuries commonly occur in people who participate in jumping sports, such as basketball, volleyball and football. For instance, 25.2% of professional Australian Rules Football players[2] will report patellar tendon pain, leading to 2.3% of all players missing competitive game time[2].

The term ‘patellar tendinopathy’ can sometimes be used in exchange with patellar tendonitis. Although tendinopathy refers to tendon pain without inflammation, these are almost identical conditions. Most patellar tendon pain is likely to be tendinopathy rather than tendonitis.

Read on to understand what you should know about patellar tendonitis; the risk factors, treatment options and expected recovery time.

What is patellar tendonitis?

Patellar tendonitis (aka Jumper’s knee) is a painful front knee condition due to inflammation of the patellar tendon. The patellar tendon is connective tissue underneath the patellar (kneecap) where the pain is usually located. Discomfort from patellar tendonitis can limit high-impact activities, like jumping and hopping.

What are the symptoms of patellar tendonitis?

The main symptom of patellar tendonitis is knee pain just below the knee cap (patellar) where the tendon attaches to the shin bone. People may also experience swelling and knee stiffness due to patellar tendonitis.

Common symptoms of patellar tendonitis

• Localised pain on the lower part of the kneecap

• Increase in pain during loading activities such as jumping and kicking

• Swelling around the kneecap

• Pain when bending or straightening the knee

• Tenderness below the kneecap

What causes patellar tendonitis?

Patellar tendonitis is usually caused by overuse and repeated stress on the tendon. Tiny tears accumulate, breaking down the tendon and causing inflammation and weakening of the tendon. This is commonly caused by jumping injuries or other high impact sports.

Common causes of patellar tendonitis

• A sudden increase in exercise intensity

• Tight leg muscles

• Muscle imbalance

• Running on hard surfaces

• Overuse (e.g. running long-distances)

Sports that increase the risk of patellar tendonitis

Sports that require a high loading of the patellar tendon can increase the chance of developing patellar tendonitis. Repetitive jumping and kicking motion creates a lot of stress on the knee and may result in inflammation of the patellar tendon. Below is a list of the most common sports that contribute to patellar tendonitis:

• Basketball

• Soccer

• Long jump

• Volleyball

• High jump.

How is patellar tendonitis diagnosed?

The short answer is patellar tendonitis requires a medical diagnosis.

There are several options available when it comes to diagnosing your knee pain as patellar tendonitis. One of the more common and most recommended by Australian GP’s is an assessment from a physiotherapist.

Patellar tendonitis is an injury that physiotherapists see regularly, and the process of diagnosing is straightforward. Like any other pain or injury, a physiotherapist will start with a detailed history of your activities and previous injuries. This is an interview-like process that is commonly referred to as a consultation.

A typical physiotherapy session will last between 30-60 minutes, and during this time, you will discuss the specific issues you are having related to your knee injury.

After establishing the history of your knee pain, the physiotherapist will (in most cases) conduct a hands-on assessment, performing a series of physical tests to determine the cause of your problem and rule out other conditions.

Following your initial assessment, the physiotherapist will tailor a treatment plan according to the severity of your injury and other factors. After this, they will establish how many sessions are required, what home exercises you need to do, and provide you with a timeline for how long a full recovery should take.

How is patellar tendonitis treated?

There are several options when it comes to treating patellar tendonitis. One of the more common options referred to by Australian GP’s is physiotherapy.

Patellar tendonitis is an injury that physiotherapists come across in their clinics frequently, and the process of treating it is straightforward. Following an initial consultation, the physiotherapist will be in the best position to determine your treatment plan.

Depending on the severity of your knee pain, a physiotherapist may provide you with a combination of the following types of treatments:

• Heat therapy - Improve blood circulation around the patellar tendon and decrease pain.

• Manual therapy - Hands-on technique your physiotherapist uses to reduce soft tissue stiffness and increase blood flow in the area.

• Ultrasound treatment - Ultrasound waves accelerate the healing of the patellar tendon. It can also be used to deliver analgesic effects using corticosteroid medicine.

• Taping - Specialised techniques that provide added stability and distribute force away from the patellar tendon.

• Stretching exercises - Stretching exercises to reduce muscle spasms and keep the optimal length of the thigh muscles.

• Therapeutic exercise - Exercises to strengthen your muscles and correct impairments that may be causing your injury.

After treatment from a physiotherapist, it is not uncommon for patients to feel the benefits in just one session.

Next step - Creating a treatment plan made for you.

After your initial assessment, your physiotherapist will create a detailed treatment program to maximise your recovery based on your activity level.

Self-care for patellar tendonitis

At home or self-care treatment usually focuses on pain reduction.

Here are the best things you can do from home:

• Ice

It is important to use ice and a compression bandage around your knee after high-impact activities to reduce the signs of inflammation.

• A patellar strap

Apply the patellar strap under the kneecap to support the knee and distribute the load away from the patellar tendon.

• Rest

Patellar tendonitis is an overuse injury and requires proper pacing of your activities. You will need enough rest period for your tendon to recover.

• Wear knee supports

Wear knee supports to help prevent further injury to the patellar tendon.

• Exercise

As your body heals, you should strengthen your leg muscles and the patellar tendon to prevent deconditioning and improve the resilience of your tendon to stress.

Things to avoid when dealing with knee pain in general:

• Avoid running on a hard surface

Running on a hard surface can aggravate your pain and cause excessive stress on the knee.

• Avoid high-impact activities

Avoid high-impact activities for a few days or weeks, and let your tendon heal properly first.

Do I need a specialist or surgery?

Your GP may order a diagnostic ultrasound test to screen for soft tissue changes in the patellar tendon and confirm patellar tendonitis diagnosis.

Pain medications such as NSAIDs may be given to help you manage the pain, although it has been reported to slow down soft tissue healing. Also, corticosteroid injections can offer some pain relief if the pain is severe.

Depending on the severity of your condition, you may require a knee brace to keep your leg in an extended position and allow proper healing of the patellar tendon.

Your doctor may refer you to a physiotherapist for treatment to begin rehabilitation.

What is the recovery time / prognosis for patellar tendonitis?

Ultimately, recovery time is dependent on your proactiveness to seek professional treatment and the severity of your knee pain and injury.

In some cases, patients begin to feel the benefits of manual therapy in just one session. Typically, full recovery for mild patellar tendonitis can be three weeks, while the more severe cases can take six to eight months or more.

Important factors in recovery include:

• Sticking to your rehabilitation program and regularly exercising

• Resuming your sports activity gradually

• Paying attention to pain, and resting as necessary.

Can patellar tendonitis be prevented?

Guaranteeing prevention can be impossible; however, you can decrease the risk of patellar tendonitis through some of these techniques.

• Warm-up: A proper warm-up prepares your muscles and tendon for high-intensity activities.

• Stretch frequently: Stretching allows your muscles to relax and prevent stiffness.

• Strengthen your lower body: Strengthening critical muscles of the lower body such as the quadriceps, hamstrings, and glutes can help prevent knee injury.

• Wear knee supports: Wearing knee support can offer additional protection from knee injuries when playing sports.

• Train proper running and jumping techniques: Faulty and problematic running and jumping techniques increase your knee injury risk. Talk to a sports physiotherapist to discuss your running or jumping mechanics.

Outlook and the main takeaways

Patellar tendonitis results from accumulative tears on the patellar tendon. Resting and activity pacing will give your knee time to heal.

It is important to be mindful of ongoing pain in your knee to prevent the condition worsening. Book a visit to a physiotherapist today and start your recovery immediately.

Anatomy of the knee

The force generated by the contraction of the quadriceps muscles acts through the patellar ligament, which causes knee extension.

Excessive stress and repetitive loading of the patellar tendon can cause microtears which leads to inflammation over time. Chronic inflammation on the patellar tendon can further weaken the tendon and cause complete rupture.