Can Patellar Tendonitis Lead To A Tendon Tear
Yes. Patellar tendon tears are acute injuries that happen suddenly. In some cases, repeated overuse over a long time can cause the patellar tendon tissue to abruptly tear.
Patellar tendon tears often happen when you land from a jump or suddenly change direction while running. A rip may go partway or all the way through tendon tissue.
Prolotherapy And Platelet Rich Plasma Therapy
In treating tendonitis, which is occasionally misdiagnosed as bursitis, we recommend stimulating tendon repair and strengthening any weakened or lax ligaments with MEAT treatment, which consists of movement, exercise, analgesics and treatment, as well as herbal supplements. This approach will encourage the damaged tissues to heal as quickly as possible.
Comprehensive Prolotherapy to the knee involves multiple injections of a dextrose-based solution directed at the affected tendons, ligaments and other affected structures of the knee. This causes a mild and localized inflammatory response which triggers the immune system to initiate repair of the injured tendons and ligaments. Blood supply dramatically increases at the injured area. The body is alerted that healing needs to take place and reparative cells are sent to the treated area of the knee that needs healing. The body also lays down new collagen at the treated areas, thereby strengthening the weakened structures. Once the tendons and ligaments are strengthened, the joint stabilizes and the tendonitis or tendinosis condition resolves.
Platelet Rich Plasma Therapy is the use of a patients blood platelets and healing factors to stimulate repair of a tendon it is considered when tendon damage is more severe.
1 Lubowitz JH. Editorial commentary: biologic enhancement of muscle and tendon healing. Arthroscopy. 2015 May 31:1016. doi: 10.1016/j.arthro.2015.02.037.
Restore Normal Muscle Length
Tightness in the calves, hamstrings, and quadriceps muscles can contribute to tendon overload. So we will stretch these muscles. If your tendons are easily irritated you need to be careful with the quadriceps stretch. Skip it if necessary.
Ive also recorded a video on how well stretching works for patellar tendonitis, based on feedback from participants of my Tough Tendons course. Here are the results:
With these first two steps we can take some stress off the tendon, but to make it strong enough for sports we need to do more.
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Reason #1 It Rarely Gets Better
The first thing a doctor will tell you is that you need to rest the painful area. Unfortunately, rest usually works only with the mildest forms of tendonitis. As we mentioned earlier, most people are unaware that they have a problem until it reaches the moderate stage.
While resting your arm or foot will help, even if the tendon has moderate amounts of damage, it probably wont take care of the inflammation.
You will also need to do some sort of stretching/strengthening/rehabilitation to the area, otherwise, when you return to your normal activities you are only going to overuse that tendon again.
Imagine hitting your hand with a hammer over and over. Yes, putting down that hammer for a few weeks will help stop the pain, but when you return to hitting yourself with the hammer, do you think all that rest will make your hand stop hurting?
This is why most people who simply rest the affected dont see improvement, at least, not for very long!
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Why Do People Get Patellar Tendonitis
People often get patellar tendonitis because of the overuse of the tendon. When there is constant stress with insufficient recovery time the tendon begins to change. You can think of this similiar to a rope beginning to fray. For instance, an overactive basketball player who plays basketball for several hours every day without sufficient rest may begin to develop this condition. This is often compounded by fatigue, diet, training errors, and muscle imbalances. Individuals who suddenly change their activity may also develop this condition. For instance, an office worker who was previously sedentary begins training for a 10km run with her colleagues is prone to developing patellar tendonitis. For some individuals, changes in footwear may cause the onset or aggravate this condition. It is important to have proper foot which match your individual foot structure if this is the case. It is always important to ascertain the root cause of this injury. If not, it is extremely likely to recur or worsen.
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Treatment For Knee Tendonitis
Knee tendonitis, also called patellar tendonitis, is an inflammation of the tendon that links your patella to your tibia . People who have knee tendonitis usually experience worsening pain in the knee area until they receive treatment.
This is a frequent injury among athletes, which is why its often called jumpers knee. It is usually due to overuse or repetitive stress on the knee. Small tears develop in the tendon and become inflamed, eventually weakening the muscle and causing pain.
What Are The Common Options For Treating Tendonitis In The Knee
Mild cases of tendonitis may not require a visit to your pain treatment clinic. There are a few things you can try at home:
- Rest and avoid the activity that led to your tendonitis. For example, take a break from running and stay away from sports that require a lot of jumping.
- Apply ice packs to bring the swelling in your knee down. Do at least two 15-minute sessions per day.
- Elevate your knee so that it is higher than your heart. This improves blood flow to the area and helps with reduction of swelling.
- Use an elastic knee bandage to reduce swelling and pain.
- Try over-the-counter anti-inflammatory pain relievers such as ibuprofen and naproxen. However, this comes with caveat. If your case is mild, these pain relievers may completely resolve your pain, giving you the false impression that you are ready to return to running and other activities that stress your tendons. Dont make the mistake of jumping back in too soon.
It can take up to six weeks for a full recovery from knee tendonitis, and it is important that you continue to be gentle with your joints during this period. Once you are completely healed, return to your normal activities gradually to ensure you dont have a relapse.
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How Is Patellar Tendonitis Treated
Patellar tendonitis treatments mostly focus on managing your symptoms and strengthening the soft tissues in your knee. At first, your provider may ask you to try conservative therapies, such as rest. In minor cases, these measures may be enough to relieve your pain.
If the condition doesnt go away, your provider may recommend you:
- Take it easy: Avoid the activities or movements that trigger your symptoms. Pushing through pain may cause more damage to tendon tissues.
- Rest: Stay off your feet as much as you can. Rest gives your body time to heal.
- Apply ice: If you have swelling around your knee, placing an ice pack on the area for 15 minutes at a time, a few times a day, may reduce inflammation.
- Take pain relievers: Taking over-the-counter anti-inflammatory medicines as needed may be enough to relieve minor aches or knee pains.
- Support your knee: Your provider may recommend you wear a support device over the knee, such as a knee brace. Support devices may relieve the pain.
- Try physical therapy: A trained professional will guide you in doing special exercises and stretches. These motions slowly increase the strength and flexibility of injured tendon tissues. Physical therapy may also relieve some of your discomfort.
- Have surgery: Surgery to treat patellar tendonitis is rare. However, if imaging tests show a tendon tear, your provider may recommend surgery to repair the damaged tissues.
What Causes Knee Tendonitis
Jumpers knee is an overuse injury and the result of repetitive micro-trauma to patellar tendon. Usually such micro-trauma is caused by activities that include a lot of jumping, running and cutting.
Sports such as basketball, volleyball and tennis have a high incidence rate of this injury, but it is not limited to these groups.
A common theme among people who suffer from knee tendonitis is playing through pain or regular overexertion on the court. Heres what happens if it is left untreated:
Initially, tendonitis will just be a minor pain in the tendon below the kneecap, but with repeated overuse tissue damage cellular degradation will set in.
If the overuse continues the body will be unable to repair the damaged tissue and tendonitis turns into tendinosis: a painful chronic condition that will take months, sometimes years to heal.
Ignore tendonitis and your pain will get worse and your condition will get more chronic. Act early and you could be back to sports in a few weeks.
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Treatments For Patellar Tendinopathy
The initial treatment for patellar tendinopathy is to reduce your pain and inflammation. You can do this with rest, ice and medicines. Further treatment includes stretching and strengthening exercises with physiotherapy to gradually get you back to your usual activities. You may need surgery if your patellar tendon ruptures.
You may find it helpful to see a sports medicine professional, such as a physiotherapist or a sports doctor. Your GP may refer you, or you can book an appointment with a physiotherapist yourself.
Theres no quick fix for patellar tendinopathy. You may need a long period of rest and rehabilitation before your symptoms go completely.
How To Treat Patellar Tendonitis
Patellar tendonitis can worsen without proper treatment. It can eventually result in degeneration of the tendon. This condition is common in many athletes and affects more than 20 percent of all jumping athletes. If you feel any pain in the knee area, consult with your doctor. Waiting will just increase the severity of the injury.
Your doctor may prescribe over-the-counter pain relievers, a patellar tendon strap, or cortisone injections. In rare cases, surgery may be recommended. You will be required to stay off the knee as much as possible while it heals, significantly limiting your activity.
Below are a few actions you can take at home to help reduce your risk of developing a knee injury like jumpers knee:
· Warming up and cooling down before and after exercise.
· Wearing appropriate shoes based on the activity.
· Increasing intensity of workouts gradually.
· Stretching appropriate muscles.
· Icing when necessary.
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Gradual Increase In Pain
Arthritis pain usually starts slowly, although it can appear suddenly in some cases.
At first, you may notice pain in the morning or after youve been inactive for a while. Your knees may hurt when you climb stairs, stand up from a sitting position, or kneel. It may hurt just to go for a walk.
You may also feel pain when youre simply sitting down. Knee pain that wakes you up from sleep can be a symptom of OA.
For people with RA, the symptoms often start in the smaller joints. They are also more likely to be symmetrical, affecting both sides of the body. The joint may be warm and red.
With OA, symptoms may progress rapidly or they may develop over several years, depending on the individual. They can worsen and then remain stable for a long time, and they can vary by days. Factors that may cause them to worsen include cold weather, stress, and excessive activity.
With RA, symptoms usually appear over several weeks, but they can develop or worsen in a few days. A flare can happen when disease activity increases. Triggers vary, but they include changes in medication.
With OA, this can be:
- hard swelling, due to the formation of bone spurs
- soft swelling, as inflammation causes extra fluid to collect around the joint
Swelling may be more noticeable after a long period of inactivity, like when you first wake up in the morning.
This is because RA is a systemic disease, which means it affects the whole body. OA, meanwhile, only has a direct impact on the affected joint.
Surgery For Tendonitis Of The Knee
If non-surgical treatments do not help enough, you may need a surgery to relieve symptoms. Before going forward with a surgery, an MRI is obtained to assess the integrity of the tendon. After failing non-surgical treatment, it may be likely that the damage to the tendon is irreversible which will be seen on the MRI scan. If irreversible tendon damage is seen on the MRI scan, a patellar tendonectomy surgery would be recommended. During this procedure, a small incision is made to allow visual inspection of the damaged portion of the tendon where it is then removed. Along with the removal of the damaged tissue, the surgeon will surgically stimulate the remaining viable tendon to allow for tissue regeneration. A light dressing and Cryo/Cuff is applied after surgery to minimize swelling and reduce pain. Physical therapy starts soon after surgery done independently at home before following up in the clinic with a physical therapist 5-7 days post op
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Tendonitis Is A Confusing Diagnosis
Please see our article Tendinopathy injections and treatments for a general discussion on what is Tendinopathy.
New research says imaging studies confuse the diagnosis.
Australian doctors writing in the Journal of Orthopaedic & Sports Physical Therapy suggest that while damage of the tendon is frequently diagnosed and managed with the clinical use of ultrasound and magnetic resonance imaging there is no direct link between what the MRI says and clinical symptoms, with findings on imaging potentially creating a confusing clinical picture.5
How Is Knee Tendonitis Treated
People who suffer from knee tendonitis will have a wide number of treatment options at their disposal. The treatment approaches for jumper’s knee range from medications to surgery of the knee joints. The treatment is selected based on the extent and severity of the injury to the tendons of the knee.
Doctors may perform extensive diagnostic tests. A physical examination will be the first step, based on the signs and symptoms a patient reports. This alone is often sufficient to diagnose knee tendonitis. Further tests such as MRI scans, ultrasonography, and other advanced imaging techniques may be advised if a severe injury is suspected or to rule out the presence of any other associated conditions of the knee. Imaging techniques will also be performed prior to surgery.
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What Is Tendonitis Knee Symptoms To Watch Out For
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Tendons are the tough fibres that connect your muscles to your bones. Most tendon injuries happen near joints, such as your shoulder, elbow, knee or ankle. A tendon injury may seem to have happened suddenly, but they are actually usually the result of repeatedly overloading your tendon. Patellar tendonitis is one such injury, commonly caused by putting repeated stress on your patellar tendon. As a result of this stress, tiny tears appear in the tendon, which your body tries to repair. As use and stress continue, however, these tears cause your tendon to weaken and become inflamed. If left untreated, this leads to tendonitis.
Everything I Learned Since 2011
Recovering from tendonitis is difficult, especially if you start from scratch. Ive struggled with it myself so I know how easy it is to waste months on conflicting advice only to land back on square one.
Even though Im not a doctor Ive dedicated a huge part of my life to helping people with patellar tendonitis get back into sports. Ive and recently created an in-depth online course.
And Id love to work with you too.
If youre ready to make some real progress, sign up below to get started today.
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Other Risk Factors For Jumpers Knee Can Include:
- Being overweight places pressure on the knee
- Unaligned legs, ankles, or feet
- Unequal leg strength that may come about from favoring the dominant leg
- Poorly padded or fitted shoes, along with regular physical activity on hard surfaces
- Chronic illness or disease that decreases tendon strength
Its important to understand and recognize the signs and symptoms of jumpers knee. This is because early on, pain or soreness in the knee may dissipate once a persons body gets warmed up.
However, if left untreated the condition is likely to worsen and possibly lead to a more severe torn patellar tendon or patellar tendinopathy.
Risk Factors For Knee Tendonitis Include:
- Excessive tightness in the thigh muscles
- Imbalance muscle use between the hips, quads, and hamstrings
- Chronic illnesses that affect overall tissue health such as rheumatoid arthritis, Diabetes, and Lupus.
- Overuse with high impact activities like running and jumping
- High impact sports such as volleyball, basketball, and football
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What Is Patellar Tendonitis
Patellar tendonitis happens when the patellar tendon tissue becomes inflamed or irritated. Overuse usually causes this knee injury. It typically affects athletes at the height of their game.
Patellar tendonitis may cause minor to severe knee pain. Pain tends to worsen over time. Left untreated, pain and soreness may become debilitating. Patellar tendonitis pain may affect your athletic performance. In severe cases, it may stop you from participating in an activity altogether.
Knee Sprains: Causes Risk Factors And Symptoms
Have you ever landed funny when making a jump shot in basketball and felt something pop inside your knee? Or maybe youve smacked your knee hard on a coffee table been checked against the wall playing hockey or twisted, pivoted, or side-hopped awkwardly while skiing, dancing, or playing any number of sports.
Suddenly you find your knee hurts and its buckling under your weight. Maybe you even go down, tripping in the stairs or collapsing on the playing field or court. Within a few hours, you may notice swelling and tenderness, and possibly some limited mobility in the knee.
If this has happened to you recently, you may have a knee sprain: an injury affecting one of the four main ligamentsstrong bands of connective tissuethat pass through the knee joint and connect your upper leg bone to your lower leg bones.
The Four Ligaments of the Knee
The four ligaments of the knee are:
- Posterior cruciate ligament . Anterior means front. Posterior means back. The PCL crosses through the joint and controls the backward motion of the shin. Its a stronger ligament than the ACL and is less commonly injured. PCL sprains are usually not as painful and disabling as ACL sprains. Often they can heal on their own.
The knee is at the crux of everything active people do: walking, running, jumping, climbing, bending the leg, kneeling, and kicking. Thus its the most commonly injured body part among athletes, especially high school athletes.
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