Patellar tendinopathy, commonly known as “jumper’s knee,” is a condition characterized by pain and dysfunction in the patellar tendon.  This condition is most common among athletes involved in sports involving frequent jumping, such as basketball and volleyball, but it can also affect individuals outside of sports due to repetitive stress on the knee.

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Symptoms of Patellar Tendinopathy

The hallmark symptom of patellar tendinopathy is pain localized at the front of the knee, just below the kneecap. This pain typically develops gradually and may worsen with activity.

Key symptoms include:

1. Anterior Knee Pain: Discomfort or aching at the base of the kneecap, especially during or after physical activity.

2. Tenderness : Sensitivity to touch over the patellar tendon.

3. Stiffness : Morning stiffness or discomfort after periods of inactivity.

4. Swelling : Mild swelling around the knee joint.

5. Reduced Performance : Decreased ability to jump, run, or perform activities that stress the knee.

If left untreated, the condition can progress, leading to increased pain and potential tendon degeneration.

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Causes of Patellar Tendinopathy

Patellar tendinopathy mainly occurs due to an overuse injury resulting from repetitive stress on the patellar tendon. This repetitive strain leads to microtears in the tendon fibers, and without adequate rest and recovery, these microtears can accumulate, causing pain and functional impairment.

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Common contributing factors include

1. Repetitive Activities: Engaging in activities that involve frequent jumping, running, or abrupt directional changes can overload the tendon.

2. Muscle Imbalances: Weakness or tightness in the quadriceps, hamstrings, or calf muscles can alter knee mechanics, increasing stress on the patellar tendon.

3. Improper Training Techniques: Sudden increases in training intensity or volume without proper conditioning can predispose individuals to tendon injuries.

4. Biomechanical Issues: Poor foot mechanics, such as flat feet or overpronation, can affect knee alignment and increase tendon strain.

5. Age and Degeneration: As individuals age, tendons lose elasticity and are more susceptible to injury.

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Physiotherapy Treatment for Patellar Tendinopathy

Physiotherapy is a cornerstone in the management of patellar tendinopathy, focusing on pain reduction, restoring function, and preventing recurrence.

1. Pain Management

• Rest and Activity Modification : Reducing or modifying activities that exacerbate symptoms allows the tendon to heal.

• Ice Therapy :  It helps in  reducing inflammation and alleviate pain.

• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) : Under medical guidance, NSAIDs can be used to manage pain and inflammation.

• Accelerated Healing Therapy – It is the most advanced electrotherapy and it helps in accelerating the healing process of the tissues .

2. Stretching Exercises

Improving flexibility in the lower limb muscles can reduce strain on the patellar tendon.

• Quadriceps Stretch : Standing on one leg, bend the opposite knee and pull the heel toward the buttocks, holding the stretch for 30 seconds.

• Hamstring Stretch : Sitting with one leg extended, reach toward the toes, holding for 30 seconds.

• Calf Stretch: Standing facing a wall, place one foot behind the other and lean forward, keeping the back heel on the ground, holding for 30 seconds.

3. Strengthening Exercises

Building strength in the quadriceps and surrounding muscles supports the knee joint and reduces tendon stress.

• Isometric Quadriceps Contractions : Tighten the thigh muscles without moving the knee, holding for 5-10 seconds.

• Straight Leg Raises : Lying on your back, lift one leg straight up, holding for a few seconds before lowering.

• Wall Sits : With your back against a wall, slide down into a sitting position and hold for 30 seconds.

• Step-Ups : Stepping onto a raised platform and back down, focusing on controlled movements.

4. Eccentric Training

Eccentric exercises involve lengthening the muscle-tendon unit under load and are particularly effective for tendon rehabilitation.

• Decline Squats: Standing on a decline board, perform slow squats, focusing on the downward movement.

• Single-Leg Eccentric Squats : Standing on one leg, slowly lower into a squat position, then use both legs to return to standing.

5. Neuromuscular Training

Enhancing proprioception and neuromuscular control can improve knee stability.

• Balance Exercises : Standing on one leg or using balance boards to challenge stability.

• Agility Drills : Incorporating ladder drills or cone drills to improve coordination and control.

6. Gradual Return to Activity

A structured return-to-activity program ensures the tendon adapts to increased loads.

• Progressive Loading : Gradually increasing the intensity and duration of activities.

• Sport-Specific Drills: Incorporating movements and skills specific to the individual’s sport or activity.

7. Supportive Devices

Using supportive devices can alleviate stress on the patellar tendon during rehabilitation.

• Patellar Tendon Straps : These straps apply pressure to the tendon, distributing force and reducing strain.

• Knee Braces : Providing stability and support to the knee joint during activity.

8. BFRT :

It helps in regaining muscle strength in minimal efforts by doing low intensity exercises and gaining the same benefits of high intensity training. It helps in accelerating the recovery of the involved tissues.