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Patellar Tendinitis (Jumper's Knee)


Disease: Patellar Tendinitis (Jumper's Knee) Patellar Tendinitis (Jumper's Knee)
Category: Bones, joints, muscles diseases

Disease Definition:

Patellar tendinitis is an injury of the tendon connecting the kneecap (patella) to the shinbone. This tendon has a major role in the function of one's leg, because this is the nerve that enables someone to extend the muscle of the lower leg which is used in actions like kicking, pedaling and jumping.


Patellar tendinitis is also called jumper's knee, for it is a common injury in sports that require jumping such as basketball, soccer and volleyball. Regardless of the name and the mentioned sports, anyone can suffer from a patellar tendinitis. Conservative approaches are the first line of treatment in patellar tendinitis.

Work Group:

Symptoms, Causes


The first symptom experienced by patients with patellar tendinitis is pain. The location of the pain is usually the section of the patellar tendon between the kneecap (patella) and the attachment point of the tendon to the shinbone (tibia). Running, jumping or other physical activates make the pain sharp, which transforms into a persistent dull ache after exercising. The pain of the knee might:


  • Be felt only in the beginning of a physical activity or just after an intense workout
  • Be proportional to the intensity of the activity
  • Develop to be felt before, during and after physical activity
  • Be more prominent while mounting or descending stairs
  • Cause difficulty sleeping for it becomes a constant ache


Upon the onset of the symptoms, the injured person should try some self care methods, such as applying ice to the painful area, along with avoiding unnecessary overwork of the knee. A physician's examination might be needed when:


  • The pain deteriorates
  • The pain is hindering one's performance of daily activities
  • There are signs of swelling or redness around the joint


Patellar tendinitis is usually developed as a result of overload, which repetitively stresses the patellar tendon, causing tiny tears in the tendon. Although the body tends to repair these tears, without treatment, the count of these tears increases causing deterioration in the inflammation of the tendon, for the repair rate of the body is no longer able to surpass the damage rate. Some factors make way to the development of tendinitis when combined. These factors are:


Intensity and frequency of physical activity:

As the name implies, this conditions is most attributed to people who jump repeatedly. The stress on the tendon is augmented proportional to the frequency and the intensity of the activity.


Being overweight:

Being obese obviously stresses the patellar tendon more than it is supposed to. There is some evidence that having a greater waist circumference or higher body mass index also have their effect in facilitating the occurrence of patellar tendinitis.


Tight leg muscles:

The strain on the patellar tendon is increased proportional to the tightness of the thigh muscles (quadriceps) and hamstrings.


Malalignment of the leg bones:

The strain on the patellar tendon is increased if the bones of the leg are not lined up as they should.


Raised kneecap (patella alta):

The strain on the patellar tendon is increased if the kneecap is located higher than it should be.


Muscular imbalance:

The strain on the patellar tendon is increased if there are muscles in the legs that are stronger than they should be, for they pull harder on the tendon, causing imbalance and resulting in tendinitis.


Although patellar tendinitis is commonly called jumper's knee, it is not only attributed to those who frequently jump; for this reason, the term is considered to be misleading. The recurring patellar tendinitis that results in further degeneration is referred to as patellar tendinopathy and patellar tendinosis.



Other complications can result from a damaged tendon when it is left untreated due to the patient's negligence towards the pain. These complications are:


Weak leg muscles:

The thigh muscles (quadriceps) and calf muscles can be weakened as the leg compensates for the pain of the knee.


Torn tendon:

When the natural repair process of the body is slower than the rate of the damage, the tears in the tendon tend to enlarge.


Chronic knee pain:

Unless treated, patellar tendinitis can lead to persistent knee pain.


Regardless of the type of treatment, the process spans over a long period of time. Depending on the severity of the injury, recovery can range from a few weeks to as long as a few months, even a year or more in case surgery is performed. Most cases of patellar tendinitis are treated and improved with conservative methods, for surgery is rarely needed and is recommended only for chronic patellar tendinitis often called patellar tendinopathy or patellar tendinosis. If someone has persistent signs and symptoms for a year, he/she should consult a physician for the case might be a chronic patellar tendinitis that may call for surgery.



The main idea of conservative treatment is first to relieve the tendon from the strain, then gradually restore its strength. There are several methods to achieve this and they can be:



This does not mean that the patient should abstain from all physical activity, but avoid those which increase the strain on the tendon, such as running and jumping. These activities are suggested by the physician, for they should not overload the tendon or cause pain.


Adjusting the body mechanics:

Upon the recommendation of a physical therapist, a patient is taught how to distribute the force he/she exerts in any activity, as is the case with improved techniques of taking off and landing for athletes who jump frequently.


Stretching the muscles:

The strain on the patellar tendon is increased in the case of inflexible muscles, particularly inflexible thigh muscles (quadriceps).


Strengthening the tendon:

Upon the recommendation of a physical therapist, some exercises are meant to strengthen the patellar tendon and the surrounding muscles, along with the quadriceps. It has been proven that certain exercises that strengthen the quadriceps (eccentric strengthening) can take part in the treatment of patellar tendinitis, even prevent it. One of these exercises is the seated knee extension exercise that involves raising a weight, then slowly lowering it.


Patellar tendon strap:

In this method, the force applied to the patellar tendon is directed through the strap instead of the tendon itself, relieving the patient from the pain.



In this method, a topical corticosteroid medication is applied to the affected area, where the medication is injected under the skin by the help of a small, electrical charge device. The application of iontophoresis can be carried out by the help of a physical therapist.


Corticosteroid injection:

This treatment method is meant to relieve the patient from the pain that prevents him/her from performing some strength exercises. Here, an ultrasound-guided corticosteroid injection is made into the sheath around the patellar tendon. Jumping and running among other activities are prohibited for at least three weeks after the injection.



The healing process is accelerated by massaging the patellar tendon.


Several weeks of conservative therapy and activity restrictions are expected for patients who have developed patellar tendinitis, before they are permitted once again to resume their normal activities. Healing would take longer if an injury to the tendon occurs in the recovery period.



If a patient with patellar tendinopathy is not recovering after a year of conservative therapy, surgery should be considered. The surgery procedure depends on the severity of the case and the preference of the surgeon, for there is no standard procedure that is applicable to all cases due to lack of research. In any case, surgery is meant to repair the tears in the tendon or remove the parts of the tendon that are damaged. In most cases of patellar tendinitis surgery, a patient can resume athletic activity within the six months following the operation. However, some severe cases may need up to 18 months.



There are other forms of therapy that might help in the relief of pain resulting from patellar tendinitis. A physician can try one of the followings, even though their effects are not thoroughly studied.


Pain medications:

The pain caused by patellar tendinits can be treated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids, though they are not recommended for the long term management of pain associated with patellar tendinits, for their side effects surpass their benefits.


Platelet-rich plasma (PRP):

In this method, one's own blood plasma is injected into the affected area, which is beneficial in pain relief. This has been proven to be useful in small studies; still, large scale studies are needed to understand its full effects, for this method is currently in the experimentation phase.


Extracorporeal shock wave therapy:

In this method, the tendon is stimulated to heal by the use of sound waves. There is some evidence that this method could efficiently treat the symptoms of patellar tendinitis.


Other physical therapy treatments:

Some of these use laser and ultrasound stimulation to relive the pain, but their capability to heal the tendon is yet unknown.


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