Patella Tendinopathy

What is it?

Patella tendinopathy, also known as jumper’s knee, is an overuse disorder characterised by pain at the base of the patella (kneecap) with activities such as squatting, sitting or going up and down stairs. The condition is known as jumpers’ knee because it commonly affects athletes involved in sports that require jumping and repetitive loading of the patella tendon, such as basketball, volleyball, football and tennis.

Landing and jumping activities put a great amount of stress on the patella tendon. This tendon is responsible for transmitting the full force of the quadriceps muscles to the lower leg and during activities such as jumping and landing, this force can actually be many times more than your body weight.

What are the symptoms?

The hallmark sign of patellar tendinopathy is sharp, localised pain in the patellar tendon just below the base of the patella. The pain is usually aggravated by activities that increase load through the quadriceps muscles such as squatting and jumping.  Pain associated with patellar tendinopathy usually occurs gradually, often when a person has been very active for a long period of time or if they have recently increased their training schedule. The pain will often start as a small niggle, gradually becoming more noticeable and there may also be a feeling of stiffness with movements of the knee or first thing in the morning.

How does it happen?

Patellar tendinopathy is not a traumatic condition rather, it usually develops gradually over time due to prolonged overloading of the tendon. Like other tissues in the body, tendons are dynamic and can adapt to be able to withstand more force with training. However, if a tendon is unable to adapt to increased load quickly enough, it can develop micro tears leading to pain and dysfunction, known as tendinopathy. The risk of developing this condition can be increased by external factors, such as the type of sports chosen, training volume and the hardness of the training surface.

Intrinsic factors such as bone structure, muscle length, diet, age, muscle strength and overall health can also affect the ability of a tendon to adapt to forces. Anything that impairs the tendon’s ability to absorb force can lead to the development of tendinopathy. In general, men are affected by this condition more often than women.

How can physiotherapy help?

As with all conditions, the first step to effective treatment is an accurate diagnosis. Your physiotherapist will be able to correctly identify this condition and any factors that have led to its development. Treatment for any tendinopathy will involve a degree of rest and reevaluation of your training schedule. Treatment of the tendon itself has been shown to be most effective with a targeted exercise program involving isometric and eccentric muscle contractions. These types of movements have been shown to help stimulate healthy tendon tissue to increase strength and support the damaged tissue, ultimately reducing pain. Tendinopathies can be notoriously difficult to resolve without patience and commitment to a rehabilitation program guided by a physiotherapist.

None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.

The Four Biggest Mistakes You Can Make After A Muscle Tear

Our muscles play an important role in the movement of our body. Without our muscles, we wouldn’t be able to bend our elbow or straighten our leg. As our muscles are soft and designed for flexibility, they are also prone to injury and if you have ever had a muscle tear, you know that they can be surprisingly painful.

In the period following a muscle tear, there are a few mistakes we see people make, that can actually make their injury worse and delay healing times. Here are a few of the most common mistakes we see.

1. Stretching

After a muscle tear, the damaged fibres slowly begin to heal and reattach to each other. This process can be quite fragile and during the early stages, aggressive stretching of recovering tissue can impair healing or even lead to more tearing. While gentle stretching a few days after the injury can have a positive effect, you should check with your physiotherapist to ensure you’re not stretching too far and causing further damage.

2. Applying H.A.R.M.

Most of us are aware of the acronym R.I.C.E (rest, apply ice, compress the area and elevate) as the recommended treatment in the early stages of an acute injury. The acronym H.A.R.M is less well known and is used to remember the things you shouldn’t do after an injury. This stands for applying heat, drinking alcohol, running or massage. All of these activities can increase swelling, pain and increase the damage of the injury in the first 48-72 hours.

3. Failing to see a physiotherapist

The diagnosis of a muscle tear might seem straightforward, however, there might be more going on than you realize. Many conditions can mimic a muscle tear, or you may have suffered a tear due to an underlying weakness or pathology. Having a physiotherapist confirm your muscle tear or identify another condition is vital to ensuring you recover fully.

Your physiotherapist is also able to identify any factors that could lead to further injury and is able to help restore your tissue to its previous level.

4. Returning to sport too early

One of the most confusing things about muscle tears is that often they become less painful while the tissues are still not completely healed. Many people suffer another tear simply because they return to sport too early. While you may feel as though your tissues are back to full strength, the muscle fibres can still be healing and vulnerable to a tear. It is important to test your injury gradually, starting with gentle exercise and building up to high-intensity activities.

Your physiotherapist is able to guide you with a full rehabilitation program. This can help to restore strength, flexibility and control to your damaged muscle, keeping you injury free for the future.