Orthopedics: Conditions

Patellar Tendonitis

Patellar tendinitis is characterized by inflammation and pain at the patellar tendon (the tendon below the kneecap). This structure is the tendon attachment of the quadriceps (thigh) muscles to the leg, which is important in straightening the knee or slowing the knee during bending or squatting. Patellar Tendonitis is typically a grade 1 or 2 strain of the tendon. A grade 1 strain is a mild strain. There is a slight pull without obvious tearing (referred to as microscopic tendon tearing). There is no loss of strength, and the tendon is the correct length. A grade 2 strain is a moderate strain, which involves tearing of tendon fibers within the substance of the tendon or at the bone-tendon junction. The length of the tendon is usually increased, and there is decreased strength. A grade 3 strain is a complete rupture of the tendon.

Common Signs & Symptoms of Patellar Tendonitis

  • Pain, tenderness, swelling, warmth, or redness over the patellar tendon, most often at the lower pole of the patella (kneecap) or at the tibial tubercle (bump on the upper part of the lower leg)
  • Pain and loss of strength (occasionally) with forcefully straightening the knee (especially when jumping or when rising from a seated or squatting position) or bending the knee completely (squatting or kneeling)
  • Crepitation (a crackling sound) when the tendon is moved or touched

Patellar Tendonitis Causes

  • Strain from a sudden increase in amount or intensity of activity or overuse of the quadriceps muscles and patellar tendon
  • Direct blow or injury to the knee or patellar tendon

Patellar Tendonitis Risk Increases With:

  • Sports that require sudden, explosive quadriceps contraction (jumping, quick starts, or kicking)
  • Running sports, especially running down hills
  • Poor physical conditioning (strength and flexibility, such as with weak quadriceps or tight hamstrings)
  • Flat feet

Patellar Tendonitis Preventive Measures

  • Appropriately warm up and stretch before practice or competition
  • Allow time for adequate rest and recovery between practices and competition
  • Maintain appropriate conditioning:
    • Cardiovascular fitness
    • Thigh and knee strength
    • Flexibility and endurance
  • To help prevent recurrence, taping, protective strapping or bracing, or an adhesive bandage may be needed for several weeks after healing is complete
  • Wear arch supports (orthotics)

Expected Outcome

  • Patellar Tendonitis is usually curable within 6 weeks if treated appropriately with conservative
    treatment and resting of the affected area.

Possible Complications

  • Prolonged healing time if not appropriately treated or if not given adequate time to heal
  • Recurrence of symptoms if activity is resumed too soon, with overuse, with a direct blow, or when using poor technique
  • Untreated, tendon rupture requiring surgery