Knee Injuries: Patella Tendinitis
The most common tendinitis about the knee is irritation of the patellar tendon. Commonly called “jumper’s knee,” patella tendinitis is an inflammation of the tendon that attaches the patella (kneecap) to the tibia (shin bone). This condition is commonly seen in people who participate in basketball, volleyball, distance running, long jumping, mountain climbing, figure skating, tennis, or high impact aerobics.
In many cases, you will notice a sudden onset of aching and pain in the area just below the kneecap after sports or recreational activities. You may notice pain when landing from a jump or when going up and down stairs. There is sometimes pain at rest, particularly after sitting with the knees bent for a period of time. Swelling in the area just below the kneecap is common, as well as a feeling of weakness at the knee when pain is felt.
The patellar tendon becomes inflamed and tender due to overuse. Overuse injuries of the patellar tendon occur when you repeat a particular activity (usually running, jumping or high-impact) until there is micro-failure of the tissue that makes up the substance of the tendon. Swelling, inflammation and pain follows. In the early (acute) stage of patellar tendinitis, the pain and inflammation subside with rest. There may be pain at the beginning of activity, but this pain often disappears after a period of warm-up and then re-appears after the completion of the activity. If you continue with your activity in the presence of pain, you initially can continue to exercise or perform at a normal level. However, if you continue to exercise and don’t rest, the pain will become more persistent and will be present before, during and after activity. At this stage, you can do permanent damage to the tendon if you continue your activity and it will take a long time to heal.
Treatment has two objectives: to reduce the inflammation and to allow the tendon to heal.
When the knee is painful and swollen, you must rest it. Avoid stair climbing and jumping sports. Keep your knee straight while sitting, and avoid squatting. Let pain be your guide. You are aggravating the condition if you continue activities while experiencing pain. Mild discomfort or ache is not a problem but definite pain is a cause for concern.
Ice your knee for 20 minutes, two or three times a day and after any sporting activities–apply a bag of crushed ice over a towel. This reduces swelling, inflammation and pain.
Aspirin, Aleve, or Advil sometimes helps to relieve pain and reduce inflammation.
A physical therapist or physician can recommend exercises to strengthen the muscles. Exercises can also be used to stretch and balance the thigh muscles.
In some cases surgery may be indicated.
Use your judgment. When your knees hurt, avoid sports that may aggravate your knee problems. Total rest may be required. When your knee is better after treatment, you should be able to enjoy many sports.
Sports that aggravate patellar tendinitis:
- Distance running
- Weightlifting (squats)
Sports that may or may not cause symptoms:
- Cycling (it is best to keep the seat high and avoid hills)
Sports that are easiest on the knees:
- Cross-country skiing
- Swimming (especially with a flutter kick)
- Walking (avoid up and down hills)
Do NOT do the following exercises:
- Leg extension machine
- Stair-stepper machines
The following exercises are OK to do if they cause no pain, grinding or swelling:
- Straight-leg lifting exercises
- Stationary cycle (seat high, resistance low)
- Leg press (do not let the knees bend past 90 degrees)
- Hamstring curl machine