Therapy for Patellar Tip Syndrome

For some years now, taping has been increasingly used in various fields of medicine. Especially in sports medicine and physiotherapy, the technique enjoys increasing popularity and is used in the prophylaxis and treatment of various diseases. Depending on the technique used and the tape itself (the color of the tape also plays a role), the tape should have different effects on the target organ.

Although many doctors and physiotherapists swear by the tape, it must be emphasized that its effect has not been scientifically proven to date. Kinesiological tape is also widely used in the therapy of patellar tip syndrome. It is mainly used for prophylaxis of the disease as soon as the first signs of the syndrome appear.

The so-called patella tendon tapes and patella bandages (jumper knee straps) are used to avoid long breaks in sports. In the case of pronounced complaints, however, a longer period of absence from sport cannot be avoided even with tape. Furthermore, taping should enable a faster return to sport after a longer break due to patellar tendinitis.

In both cases it has the function of absorbing tensile forces on the tendon and instead transferring them to the skin on which it has been applied tightly. Patellar tendon syndrome is usually treated conservatively, i.e. non-surgically. In addition to various medications, physiotherapeutic and physical measures are mainly used.

These include massages, cold and heat therapy and high-energy extracorporeal shock wave therapy. The target organ, in this case the knee, rests on a plastic cushion filled with water, into which sound waves are introduced. The sound waves are bundled at the target location, i.e. the affected tissue of the patella tendon.

Shock wave therapy is used for various diseases, with the main focus being on calcifications and ossifications. A therapy session takes about two to five minutes and can be performed on an outpatient basis.The cost of extracorporeal shock wave therapy per session is between 50 and almost 400 euros. The best therapy for patellar tip syndrome, as well as for other consequential damage caused by overload, is good prophylaxis.

Warming up before sport, a slow increase in load and sufficiently long breaks between training sessions play an important role in this. However, muscle stretching is also important to prevent patellar tendinitis. Special attention should be paid to the front thigh muscles, especially the quadriceps femoris muscle (the largest thigh muscle).

For this purpose, a series of simple exercises are available, which should be performed especially after the training. In addition to prophylaxis, stretching exercises are also suitable to support the healing of an already existing patellar tendon syndrome. For this purpose, the exercises should be performed at low intensity several times a day for a few minutes.

However, it is important not to overload the tendon. In some cases, no satisfactory result is achieved despite a consistent break in training and correct conservative therapy. In these cases, surgical therapy remains the only option for restoring the patellar tendon.

There are various options for surgical treatment of patellar tendon syndrome. On the one hand, the tendon gliding tissue can be removed, thus removing the disturbing tissue. The area surrounding the tendons is cleared so that no disturbing cartilage or inflammatory signs rub against the tendons.

In addition, the tendon at the tip of the patella can be loosened. This reduces the tension of the tendon on the patella and thus improves the symptoms. In some cases, the tendons can be incised lengthwise with a laser.

This also reduces the tension of the tendons on the patella. All these procedures can be performed minimally invasive, arthroscopic. In addition, each procedure can be

Sports ability and
Freedom from complaints.
Single, but also in
Combination can be applied.

Which method is used depends on the extent of the tendon change.

In order to be able to determine the surgical procedure, a magnetic resonance imaging (MRI) is essential prior to surgery. If the change is only present at the tendon insertion, minimally invasive therapy using arthroscopy is recommended. In this case, the tendon can be partially detached and the altered part of the tendon removed.

In the case of a more severe or longer-distance tendon damage or partial necrosis of the tendon, open surgery is often necessary. Here, the surgeon must decide individually which surgical procedure to use and how much tendon tissue to remove. A postoperative treatment phase should always follow the operation.

What exactly this phase looks like must be decided individually. This depends on the findings and the operation performed. The following phases can be mentioned for orientation: On average, full athletic ability can be achieved after 2 to 6 months, depending on the findings.

For the first 3-5 days after the operation, the knee should be relieved by means of forearm crutches.
This is followed by light physiotherapy for about 2-6 weeks, which is slowly intensified by strength and coordination exercises.
Approximately 2 to 6 weeks after the operation, a light exercise on the bicycle ergometer can be started.
The first easy running exercises can be started after 4-8 weeks and then slowly increased individually.
After approx. 4-8 weeks the first strength exercises can be performed,
Jump training should only be started after 6 weeks – 4 months.