what is patella tendinopathy?
Causes and treatments to resolve Patella tendinopathy (Patella tendonitis)
The patella tendon is below the knee and connects the kneecap (patella) to leg bone (tibia). The tendon is responsible below the knee and helps with jumping and cushioning your landing.
A combination of over use and micro-damage of the tendon from excessive stress can contribute to patella tendinopathy. They use to call this tendonitis which is “inflammation”, but we know that it is not usually inflammation but a certain amount of excessive stress to the tendon that causes the injury to the tendon which we call patella tendinopathy.
How do you know if you have patella tendinopathy?
Symptoms usually occur of pain and tenderness immediately below the kneecap. Patients report pain when holding the leg straightened, squatting, or going down stairs.
A good clinical exam with a diagnostic ultrasound can diagnose the severity of patella tendinopathy. Ultrasound is as effective as MRI for evaluating patella tendinopathy which can be performed in the clinic at a fraction of the cost.
What are treatment options for patella tendinopathy?
Nonsurgical options include activity modification including changing the way you land or squat or reducing activity that aggravates you such as jumping or going down stairs. A chopat brace as seen in the picture below, or physical therapy exercises can be helpful to strengthen the tendon to withstand the loads of jumping.
If physical therapy does not improve your pain or ability to perform activities, the next step is to consider injection. There are cortisone injections and orthobiologic injections. Cortisone can be injected into the fat pad or bursa to decrease inflammation but should not be injected into the tendon.
Other injections to consider are orthobiologics. Orthobiologics include Platelet Rich Plasma (PRP). Please speak with your physician to see if you are a candidate with these procedures. They can help with reducing pain and increasing function. PRP has been shown in several studies to be effective in patella tendinopathy.
Other treatment options that can be helpful include Tenex or tendon scraping. Learn more about tenex here. Tendon scraping is using a tool to separate the tendon and the fat pad so the tendon can glide easier.
If injections do not provide relief, the next procedure to consider is tendon repair. This is where they stitch the tendon back together.
