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Thursday, March 15, 2018

Expert Guide to Patellar Tendonitis


Worried you may have “jumper’s knee”? The all too common knee injury, patellar tendonitis, most often plagues athletes in high-impact sports like basketball, running, and volleyball, or people with knee-heavy hobbies like cycling.

What is Patellar Tendonitis?
Tendonitis, or the general term given for injury to any tendon in your body, is no stranger to the tendon which connects your patella (kneecap) to your tibia (shinbone). Working in conjunction with muscles groups like your quadriceps, the patellar tendon allows you to flex and extend your knee with motions like jumping, kicking, and running.

Repeated stress to the patellar tendon with physical activity causes microtrauma in the form of tiny tears that multiply over time. This leads to inflammation, pain, and tendon weakness which can affect your performance, workouts, you name it.

It’s not just overuse with knee-heavy activities that puts you at risk for this type of tendonitis, however. A muscle imbalance (stronger leg muscles in some areas and not others) can cause an uneven pull on the patellar tendon, and tight thigh muscles can also increase strain on it.

Sudden increases in the distance, duration, and type of jumping, running, or cycling activity you do can additionally stress the tendon as can something as seemingly innocuous as changing running shoes.

What are the Symptoms?

Initial stages of patellar tendonitis will feel like a pain at the front of your knee cap where the tendon rests, especially as you begin exercising or just after an intense workout or game. If pain grows to a point where you can no longer tackle your physical activity or even complete daily tasks with ease (like climbing stairs), it’s critical to rest and contact your doctor. Additional symptoms of redness, swelling, and tenderness around the knee joint can indicate that the tendonitis is worsening.

How is Patellar Tendonitis Treated?
The good news is that this type of tendonitis is often treated without invasive procedures. Icing the area will help to constrict blood vessels to reduce swelling and numb the nerves sending pain signals back to your brain. Also limiting the activity which led to the injury for a while will play an important role in your healing, though maintaining joint mobility is key. Low-impact activities like yoga, walking, and swimming will be good cross-training activities to tackle while you recover.

If you continue to play high-impact sports through the pain or take over-the-counter painkillers that inhibit your own sense of how much pain you are in, you could increase the amount and severity of the tears in your patellar tendon. A doctor may have to conduct imaging tests (like x-rays or MRIs) in addition to a manual exam and possible ultrasound to evaluate the degree of injury and formulate a treatment plan for you.

Prolonged tendonitis like that which lasts more than 3 weeks can transition into patellar tendinopathy and may require more comprehensive treatment methods including:
  • Physical therapy - stretching and strengthening exercises can help make your muscles and tendon more limber as well as reinforce weak thigh muscles that contribute to the strain on your knee joint.
  • Orthotics - wearing a knee tendonitis brace or “knee strap” during physical activity will also offer you more knee support and protection while you heal by distributing force away from your injured tendon.
  • Injection - a dose of corticosteroid injected straight into the sheath surrounding your patellar tendon can help minimize painful inflammation but may also contribute to tendon rupture.
  • Low electrical currents - a therapy called Iontophoresis uses low electrical currents to push a topical steroid ointment through your skin.
  • Surgery - in rare cases, surgery may be required. Small incisions around your knee allow surgeons to insert instruments to help repair the tendon.
Preventing Patellar Tendonitis
The truth is, like with most overuse injuries, patellar tendonitis is virtually completely preventable. Playing through pain is quite possibly the worst thing you can do, so at the first wince of exercise-related knee pain, ice the joint, rest, and limit your activity for a while that was causing the flare-up.

Stretching and strengthening key leg muscles to offset some of the stress placed on your knee joints plays an important role as well. Even a practice as simple as raising one leg at a time while sitting and slowly lowering it towards the ground can help.

If you are looking to up your running mileage, your basketball training schedule, or the slope on which you cycle, check with personal trainers at your gym or even online resources about best practices and good technique. Proper body mechanics when you play any sport are critical to avoiding common fitness injuries like this one.

This is a guest blog entry.

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