Patellar tendinitis, which is a combination of several conditions, is also colloquially referred to as jumpers knee or jumper’s knee.
What is patellar tendinopathy?
In this condition, the knee is affected by an inflammatory process that is chronic, meaning it persists and constantly recurs once the original triggers are present again. In addition, patellar tendinopathy is a destructive disease. It is therefore referred to as degenerative and anatomically affects the patellar extensor apparatus. In patellar tendinopathy, this area specifically involves the bone and tendon junction that connects to the tip of the patella. A syndrome, or complex of impairments, occurs in patellar tendinopathy because so many individual components are affected. Basically, patellar tendinopathy is what is known as an overuse disorder.
Causes
Patellar tendinopathy occurs when too much stress is placed on the patellar tendon. Mechanical effects such as too intense and sometimes sudden stress due to a pulling force lead to patellar tendon syndrome. Activities typical of everyday life, which also include special sports that are characterized by the highest possible overstressing of the patellar tendon through traction and the execution of the movement on a non-sprung subfloor, can promote the development of patellar tendon syndrome. In addition to the triggers known as external causes, some internal factors also condition patellar tendinopathy. In this context, patients who have passed the age of 15 and suffer from a patellar herniation often complain of patellar tendinitis. Furthermore, decreased stretching ability of the lower extremity muscles and genetic weakness of the ligamentous slides may contribute to patellar tendinopathy. A typical condition that results in patellar tendinopathy is the health condition known as Osgood-Schlatter disease.
Symptoms, complaints, and signs
Patellar tendinopathy is characterized by pain on exertion in the knees. Even with normal movements, these can occur. It is a chronic complaint that usually lasts for months or years. Stretching the affected knee against resistance is also painful. Athletes who engage in sports that stress the knee, such as running, high jump, long jump, weight lifting, volleyball, basketball or jogging, are particularly often affected. The pain can be unilateral or bilateral. It is felt as pressure-like and is localized below the kneecap. In more than 20 to 30 percent of all cases, symptoms occur on both sides. The disease can be divided into four degrees. In grade 1, the pain occurs only at the end of a load. Without treatment, grade 2 of the disease occurs after some time. Here the pain starts already at the beginning of the knee load. During sporting activities, however, the pain decreases until it is painless. They then do not occur again until the patient is at rest. Grade 3 of patellar tendinopathy is characterized by persistent pain in the knees regardless of the current load. Finally, grade 4 results in a patellar tendon rupture. The knee joint can then no longer be extended. A prerequisite for the treatment of patellar tendinopathy is the immediate cessation of weight-bearing for six weeks to three months.
Course of the disease
At the onset of patellar tendinopathy, affected patients complain of painful symptoms that become more severe with more exertion and subside during periods of rest or normal exertion. In patellar tendinopathy, the pain is always felt at the tip of the kneecap. Depending on the progression of patellar tendinitis, the pain is severe at the beginning of the stress. If the holding apparatus of the knee is warmed up, then the pain decreases again. If the movement activity is discontinued, the pain may reappear. If left untreated, the pain persists and occurs with any exertion. The pain of patellar tendinopathy is described as shooting in and stabbing and occurs whenever the entire knee joint is in a certain angular position and is moved.Patellar tendinitis is known for its great persistence and persistent and constantly reappearing pain.
Complications
Patellar tendinopathy leads to various complaints in the patient. As a rule, those affected suffer from severe pain in the knees. This pain is stabbing or burning and can lead to a significant restriction in the patient’s quality of life. It leads to restrictions in movement and thus also in everyday life. It is also no longer possible for the patient to perform physical activities or sports without further ado. In many cases, patellar tendinopathy also leads to psychological complaints or severe depression. The pain can also occur without strain in the form of pain at rest and is particularly unpleasant at night. This leads to sleep complaints and thus also to irritability of the patient. Treatment of patellar tendinitis is usually not associated with complications. With the help of various therapies and exercises, the discomfort can be well limited. Further complaints do not occur. It cannot be generally predicted whether the affected person will be able to use his knees to their full function again. However, the patient’s life expectancy is not negatively affected by patellar tendinopathy.
When should you see a doctor?
Pain around the tip of the patella indicates patellar tendinitis. A doctor should be consulted if the discomfort does not subside or becomes more severe within a few days. If the pain occurs and persists during weight bearing on the patella, the syndrome may be advanced. At the latest then the doctor must be called in. Athletes are particularly susceptible to patellar tendinitis. They should consult their family doctor or a sports physician if the above-mentioned complaints recur. The physician can prescribe special patella bandages, which usually provide rapid relief from the symptoms. If the pain in the area of the tip of the patella does not subside despite all the measures taken, further therapeutic measures must be initiated. These include acupuncture or targeted pressure point massages. Depending on the severity of the condition, extracorporeal shock wave therapy may provide relief. Patellar tendinopathy is treated by an orthopedic surgeon or sports medicine specialist. Physical therapists are also involved in the treatment. In isolated cases, patellar tendinopathy requires surgical intervention of the knee.
Treatment and therapy
Several options are offered for the treatment of patellar tendinopathy. In addition to the initial conservative approach, the surgical approach is a possible treatment modality. As part of the conservative measures, comprehensive rest is important and may last for 3 to 6 months. In the case of acute occurrence of patellar tendinitis, a combination of physiotherapeutic and physical as well as medicinal treatments is indicated. In addition to the application of heat or cold, electrostimulation, ultrasound-assisted treatments, the so-called friction massages and physiotherapeutic exercises, as well as shock wave therapy are considered useful. Medications of choice for patellar tendinitis include both nonsteroidal anti-inflammatory drugs and anti-inflammatory and analgesic drugs. Direct administration of the medications to the affected area of inflammation can also treat patellar tendinitis. If a patellar tendinitis cannot be treated with the conventional therapeutic measures, then a surgical intervention follows in order to achieve freedom from symptoms. Both individual surgical activities and combined procedures are used in this context.
Outlook and prognosis
The prognosis after patellar tendinopathy depends on the extent of the injury. Particularly in athletes, it is possible that some may be able to return to their usual level of performance after treatment, while other athletes may suffer from chronic discomfort. In the case of mild patellar tendinitis, the patient usually recovers after three weeks. However, for severe injuries, the recovery process can take at least six to eight months. If the patient abstains from sports for a certain period of time, conservative treatment is considered promising.To prevent relapses, the use of relieving orthoses, tape bandages or soft shoe soles is considered helpful. The prognosis is also positive after surgical treatment of patellar tendinopathy. The success rate ranges between 70 and 90 percent. However, athletes often have to expect a lower level of return to their sport. If the patient suffers from patellar tendinitis for the first time, he improves his chances of recovery if he significantly reduces or even completely restricts his physical exertion. In this way, the inflammation within the knee can be healed again. Sometimes this gentle procedure is already sufficient to achieve a cure. If surgical intervention is necessary, it takes about two to six months before full sporting activities can be performed again. In severe cases, however, the end of a professional sports career is also possible.
Prevention
To avoid patellar tendinopathy, it is always a good idea to avoid overloading the knees. In addition, good shock-absorbing footwear and an intensive warm-up and stretching phase before any sports activity apply to prevent patellar tendinitis. To cushion shoes optimally, well-sprung shoe soles and soft insoles as well as so-called tape bandages are already sufficient. These are applied in addition to orthoses specifically against patellar tendinitis. In view of the patellar tendinitis syndrome, it becomes clear how important it is not to overstrain the knee joints, to deal responsibly with the body during sports and to pay attention to maintaining health and to save oneself extensive discomfort and time-consuming therapies.
Aftercare
In patellar tendinopathy, the measures of aftercare are relatively limited in most cases.First and foremost, a quick diagnosis followed by treatment is very important to relieve and limit the discomfort. For this reason, the affected person should see a doctor very early in this disease and also arrange for treatment. Most of the sufferers depend on the measures of physiotherapy and also physiotherapy for the patellar tendinitis. Here, these exercises should be performed regularly, and repetition at home is also possible. This can alleviate most of the discomfort. Likewise, the intake of various medications is also very important. The affected person should always follow the doctor’s instructions and pay attention to the correct dosage and also to the regular intake of the medication. If there are any uncertainties or questions, a doctor should always be consulted first. Unnecessary exertion or heavy physical strain should also be avoided. In general, a healthy lifestyle with a healthy diet and the avoidance of excess weight can also have a positive effect on the further course of patellar tendinitis. In this regard, the syndrome itself does not usually reduce the patient’s life expectancy.
Here’s what you can do yourself
Depending on the cause and the symptoms, different approaches to therapy may be useful. If there is already a therapy, then it can be supported with metabolism-stimulating and blood circulation-promoting measures. Whether a cold or warm stimulus is used is a matter of subjective feeling. For a cold stimulus, for example, an ice cube can be rubbed around the painful area or dabbed briefly. The same approach applies to the heat stimulus. This can be set with a hot-warm gel pad or a hot-warm-wet cloth. It is important that the direct cold stimulus is not set for more than 2-3 minutes to really achieve an increase in local metabolism. Another option is intensive stretching of the anterior thigh muscle. For this, the heel is pulled towards the buttocks and held there. The knee is bent to the maximum. The stretch should then be held for 20-30 seconds, the side is changed and the whole thing is repeated two or three times. Stresses such as descending stairs, kneeling for long periods of time, or deep squatting should generally be avoided. Nevertheless, physical activity is recommended and can be very helpful for recovery despite initial pain. If the symptoms have been present for longer than three months, professional counseling and therapy is recommended.
