Patella Tendinopathy

What is Patellar Tendinopathy?

A tendinopathy occurs when a tendon fails to heal after an overuse injury. This causes pain and swelling of the tendon and often results in a limp, lack of function and stiffness.

The patella tendon lies below the knee-cap and connects it to the front of the top of the shin bone.  Patellar tendinopathy (sometimes called “jumper’s knee“) can affect the tendon where it attaches to the knee cap (insertional tendinopathy) or in its middle (mid-substance tendinopathy).  Patellar tendinopathy, sometimes referred to as jumpers knee, causes pain directly over the tendon and this can be worse with activity, jumping (hence “Jumpers Knee”) and with kneeling.  The tendon is tender when pressed and may be a little swollen.

This common tendinopathy is seen in people who participate in sports activities that involve a lot of jumping. It is seen particularly in runners and in basketball and netball players.

How is it diagnosed?

The diagnosis of the condition is usually fairly straightforward but we often recommend an ultrasound scan and sometimes an MRI scan to confirm the degree and the exact location of the abnormal area of tendon and to exclude a fat-pad problem which can mimic patella tendon pain.

How is Patellar Tendinopathy Treated?

Rest, icing, anti-inflammatory tablets and painkillers can help symptoms. Specific physiotherapy stretches and exercises (eccentric programme) may also be recommended. Some people find an patellar strap helpful in reducing pain.

Unfortunately, the condition can often fail to respond to these measures, and we see many patients who have suffered with the condition for over a year and who have been unable to participate in their usual recreational activities and whose daily lives are made difficult because of the pain.

What if these don’t work?

In longstanding (chronic) cases that have not responded to the above treatments, we first recommend shock wave therapy as it involves no needles, no anaesthetic and is performed in the out-patient clinic. It is also very safe. We often use focussed shock-wave therapy in insertional tendinopathy. We have found it to be successful in relieving pain in 60-70% of cases which is a little lower than in some other conditions.

Other treatments are available for chronic tendinopathy, such as PRP (platelet-rich plasma) injections.  This works by injecting healing cells derived from the persons own blood into the affected area.

As a last resort, mini-incision day-case surgery can be considered.  We use modern technology to carefully remove tiny bits of diseased tendon.