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The greatest level of stress through the patella tendon is during jumping and landing activities. During jumping, the quadriceps muscles provide an explosive contraction, which straightens the knee and pushes you into the air. When landing, the quadriceps muscle helps to absorb the landing forces by allowing a small amount of controlled knee bend.
Excessive jumping or landing strains the patella tendon. At first the damage may only be minor and not cause any problem. However, if the tendon is repeatedly strained, the lesions occurring in the tendon can exceed the rate of repair. The damage will progressively become worse, causing pain and dysfunction. The result is a patellar tendinopathy (tendon injury).
Patellar tendonitis usually affects athletes involved in sports such as basketball, volleyball, soccer, football, track and field (running, high and long jump), tennis, dancing, gymnastics and skiing.
In older people the main cause of patellar tendinopathy is a result of degeneration which results from repetitive micro-damage over time. Also, some patients develop patella tendonitis after sustaining an acute injury to the tendon, and not allowing adequate healing. This type of traumatic patellar tendonitis is much less common than overuse syndromes.
There are a number of factors which can contribute to the development of patellar tendinopathies. These include:
This can include poor foot posture, knee or hip control.
There are a number of different causes of anterior knee pain. Patellar tendinopathy is just one of the potential conditions. The correct diagnosis is vital since treatment can significantly vary.
Luckily, Dr Kuhn is a highly skilled professional who can quickly assess and diagnose your knee injury. Once confirmed, he will ensure the correct injury management and rehabilitation to get you back to sport in the quickest time possible.
In the early phase, Dr Kuhn with address the pain and inflammation using myofascial release, mobilizing the joint, dry needling and taping techniques or de-loading braces . Relative rest is advised from aggravating activity in the early stages. Your body is the best guide to know how much to rest the injured knee. If an activity hurts the knee then you should avoid doing it.
Complete rest is not usually necessary. If this is the case, Dr Kuhn can suggest some alternative exercise ideas which are low to no impact. This will allow you to maintain your cardiovascular fitness and maintain muscle strength without causing pain in your knee.
Stretching can also be started early in your rehab under instruction from Dr Kuhn to help with lower body flexibility. Even once your symptoms resolve you should incorporate a stretching program into your training to prevent re-occurrence.
As pain allows, Dr Kuhn will start and progress you on a specific strengthening program designed to improve the strength of your quadriceps and the patella tendon to allow them to cope with the loads involved with your sport. Tendinopathies respond best to an eccentric based program.
Osteopathic Sports & Spinal will be closed from Thursday 22nd December and open again on Monday 9th January.
We look forward to seeing you in the new year.
Dr Patrick Kuhn