Patellar Tendonitis 

Patellar Tendonitis, also known as jumpers knee, is an injury to the tendon that connects your kneecap to your shin bone (tibia). The role of the patellar tendon is to extend your knee. At times a lot of stress is placed on the tendon during jumping and high impact movements.

Cause 

During high impact movements (running, jumping, kicking) tiny tears may begin to develop in the tendon, resulting in tiny tears. Overtime these tears will begin to multiply and grow, leading to pain and inflammation at the sight of the patellar tendon (patellar tendonitis.)

Risk Factors 

Physical Activity:

• The type of activity and intensity at which you’re performing an exercise are important. If you’re new to exercise it is important to ease into your routine. Gradually increase your activity level and place more stress on the body over an extended period of time.
• High impact exercises are susceptible to being performed with poor form, as a result placing a great deal of stress on the patellar tendon. For example, the burpee is an exercise I will never have any clients perform. The  risk to reward doesn’t make any sense. As you do burpees your form starts to gradually break down (if it was proper, to begin with) and your mechanics are all over the place. As a result of poor mechanics and muscle imbalances, you leave yourself open to an injury.

Muscular Imbalance: Many of us present some type of postural dysfunction and or muscular imbalance. This is normal. No one has “perfect” posture or symmetry. Those symmetrical and muscular imbalances can often lead to over and under active muscles. For example, in this particular circumstance, your IT (Iliotibial) band and/or your VMO (Vastus Medialis Oblique) muscle may be overactive, whereas your glutes and hamstrings are likely underactive. This may lead to more stress and pulling placed on the patellar tendon.

Improper Form: Form should always be placed ahead of load/intensity. ALWAYS! In this case, let’s use a jumping movement as an example. When performing a jump you’re placing stress on your patellar tendon when both jumping and landing. Hence, it is very important that you perform this movement properly. Take a look at the illustration below which is an excellent example of how to properly squat, jump, and then stick the landing. In the 1st and 3rd image, the distributed weight is placed on the glutes and hamstrings. As a result this leads to an increased amount of stress being placed on the glutes and hamstrings and less stress on the patellar tendon.

Symptoms 

• Pain at the sight of the patellar tendon is the main symptom experienced with patellar tendonitis
• If not properly treated, pain can lead to inflammation and swelling of the patellar tendon
• Pain when squatting and going up the stairs

Treatment 

When considering treatment for patellar tendonitis, many people will recommend some sort of compression sleeve or wrap. While this may temporarily relieve some pain and symptoms, it’s more important that we get down to the bigger issue.

When you first experience patellar tendonitis, the best plan of action is to use ice to reduce inflammation and then rest. Give the tendon time to heal and rest. After that, it’s best to meet with a physical therapist who can help pinpoint any muscle imbalance you may present.

At that point, it’s best that you highlight those muscles and work on strengthening them while also introducing and reinforcing proper biomechanics with certain movements.

This will lead to longterm pain relief through reinforcing proper mechanics and muscular hypertrophy.

Stretches 

Stretching is an important part of the process of recovering from patellar tendonitis. Here are three stretches that will help with your recovery.

1. Standing Hamstring Stretch
2. Quadriceps Stretch
3. Rectus Femoris Stretch

Strengthening 

When it comes to strengthening exercises, we need to think about targeting the under active hamstrings and glute max, while also maintaining a focus on strengthening the quadriceps as well.

1. Wall Squat with Ball Squeeze 
2. Bridges 
3. Prone Hip Extension
4. Single Leg Extensions
5. Single Leg Sliding Leg Curl

For more exercises and information regarding patellar tendonitis, check out this PDF from the Boston Sports Medicine & Research Institute.

Sources:

1. https://professional-rehab.com/pages/patellar-tendonitis-jumpers-knee
2. https://www.rothmaninstitute.com/stories/news-and-blog/patellar-tendinitis
3. https://www.mayoclinic.org/diseases-conditions/patellar-tendinitis/symptoms-causes/syc-20376113
4. https://muscleandbonenyc.com/blogs/news/jumper-s-knee-fix