Patellar tendinopathy

The patellar tendon passes from the quadriceps muscle in the front of the thigh to attach to the bony bump at the top of the shin.  The knee cap (patella) lies superficially within the tendon at the front of the knee.  The patellar tendon complex has to withstand considerable forces as it provides a constraint or brake to the knee bending, as in coming downstairs or landing on the bent knee in sports.  Problems can occur in the soft tissues around the margins of the knee cap and the most common site for patellar tendinopathy is at the lower point of the knee cap where the condition is known as ‘jumper’s knee’.

The patient will complain of pain in the front of the knee, with tenderness, usually on either side of the point of the knee cap.  The pain comes on with overuse and will be felt on running, jumping and going downstairs.  Straightening the knee against resistance will bring on the pain.

Physiotherapy can help using a specific massage technique called friction across the tender area and teaching special high load exercises to restore tendon health.  Electrotherapy may be used, particularly ultrasound, to help to relieve pain and promote recovery.

If symptoms persist local injection with ant-inflammatory steroid can be used, that must be followed by a period of resting form the aggravating activity, and there is also some evidence that shock wave therapy can help with chronic tendinopathy.