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Patellar Tendinitis

Patellar tendinitis is usually an injury which affects the tendon linking your kneecap (patella) to your shinbone. The patellar tendon performs a crucial function in the way you use your legs. It helps your muscles extend your lower leg to be able to kick a ball, push the pedals on your bicycle and jump up in the air.

Patellar tendinitis is most common in active people whose sports involve regular leaping, for example, basketball, soccer and volleyball players. For this reason, patellar tendinitis is commonly known as jumper's knee. However, anybody can experience patellar tendinitis, regardless of whether a repeated jumper or not.

For most people, treating patellar tendinitis begins with conventional approaches.

Symptoms

Discomfort is the first characteristic of patellar tendinitis. The pain commonly is located in the portion of your patellar tendon between your kneecap (patella) and the area where the tendon attaches to your shinbone (tibia). During physical exercise, the pain may feel sharp ? particularly when running or jumping. After a exercise or practice, the pain may persist as a dull ache.

The pain in your knee may:

Initially be present only as you begin work out or just after a rigorous workout

Increase while you raise the intensity of your exercise

Progress to be present prior to, during and soon after physical exercise

Make going up and down stairs very painful

Turned into a constant ache that can make it hard to rest at night

Causes

Patellar tendinitis is a type of excessive use injury. It happens when you place repetitive stress on your patellar tendon. The strain results in tiny tears in the tendon, which your body tries to fix. But as the tears in the tendon become more numerous, your body can't keep up, causing the swelling in your tendon to worsen.

A mix of factors may contribute to the development of patellar tendinitis, as well as:

Intensity and frequency of physical activity. Repeated jumping is mostly associated with patellar tendinitis. Abrupt increases in the concentration of training or increases in regularity of exercise also put extra pressure on the tendon.

Being obese. Moreover, being overweight or obese increases the stress on the patellar tendon, and some studies suggest that having a greater waist circumference or higher body mass index may increase the risk of patellar tendinitis.

Tiny leg muscles. Reduced flexibility in your thigh muscles (quadriceps) and your hamstrings, which run up the back of your thighs, could raise the tension on your patellar tendon.

Malalignment of your leg bones. The way your leg bones line up could be off a bit, adding stress on your tendon.

Raised kneecap (patella alta). Your kneecap may be placed higher up on your knee joint, leading to increased strain on the patellar tendon.

Muscular imbalance. If some muscles in your legs are much stronger than others, the more powerful muscles could pull harder on your patellar tendon. This uneven pull could cause tendinitis.

Patellar tendinitis is commonly known as jumper's knee. However, due to the fact any person can experience patellar tendinitis, regardless of whether a frequent jumper or not, this term may be misleading. Terms that doctors occasionally use to describe recurring patellar tendinitis that causes further degeneration of the patellar tendon include patComplellar tendinopathy and patellar tendinosis.

Complications

By trying to work through your suffering, overlooking the warning signs your body is sending you, you could trigger more tendon damage and other complications, like:

Weak leg muscles. As your leg compensates for the discomfort in your knee, your thigh muscles (quadriceps) and calf muscles can weaken.

Ripped tendon. The body cannot keep up with the continuing wear and tear on your tendon, leading to larger and larger tears in the patellar tendon.

Severe knee pain. Knee pain can go on if the factors contributing to patellar tendinitis are not resolved.

When you should see a doctor

If you feel knee pain, consider self-care methods first, like icing the affected region and temporarily reducing or avoiding routines that induce your symptoms.

Call your physician if your pain:

Carries on or worsens

Interferes with your skill to execute routine activities

Is associated with inflammation or redness about the joint

Preparing for your appointment

If you have knee pain while in or after physical activity, and it does not improve with ice or rest, schedulae an appoitment with your doctor. Right after an initial assessment, your doctor may recommend you to a athletics treatments specialist or to a doctor with superior training in the treatment of joint disorders (rheumatologist).

Here is some information to help you get all set for your visit, and what to expect from your doctor.

What you can do

List any discomforts you have been having, and for how long.

Write down your important medical information, including other conditions with which you have been diagnosed and all medications and remedies you're taking.

Record your typical daily activity, including the length and intensity of athletics exercise or other exercise. Your physician will also be interested to know if you've recently modified the regularity, intensity or method of your workouts.

Please note any kind of recent injuries that may have damaged your knee joint.

Make a note of things to ask your doctor. Creating your list of questions ahead of time can help you maximize your time with your doctor.

Listed here are some basic questions to ask a physician who is evaluating you for possible patellar tendinitis. If any additional concerns occur to you on your visit, don't hesitate to ask.

What is the most likely cause of my signs and symptoms?

Are there any other possible triggers?

Do I need any checks to verify the diagnosis?

What treatment method method do you advise?

With therapy, do you expect I am going to eventually be able to return to my current activity?

How long will I need to avoid my current exercise?

What types of exercise workout can I safely follow while I'm healing, if any?

What other self-care steps should I be taking?

What is the likelihood that I will need operation?

How often will you observe me to monitor my progress?

Should I visit a specialist?

What to expect from your doctor

Your physician will probably ask you a variety of questions. Being prepared to respond to them may reserve time to review any points you want to talk about in depth. Your physician may ask:

What are your symptoms?

When did you initially observe these symptoms?

Have your symptoms been getting more intense?

How extreme is your pain?

Does your pain occur prior to, throughout or right after your training - or is it continuous?

Is the pain connected with any knee swelling, locking or instability?

What is your regular exercise or sports-training regimen?

Have you recently made any modifications to your training routine, such as training harder or more time, or using new techniques?

Are you still able to carry out your sport or preferred workout at a reasonable degree?

Are your symptoms affecting your ability to complete normal, daily tasks, like walking up stairs?

Have you tried any at-home treatments so far? If so, has anything helped?

Have you recently had any accidents that may have generated knee damage?

Have you been diagnosed with any other medical conditions?

What pills are you currently taking, as well as vitamins and dietary supplements?

What you can do meanwhile

In the time prior to your appointment, try self-care measures in your own home. Until your doctor sees you, stay away from your joint in ways that cause or worsen pain. Icing the affected region also may help.

Assessments and diagnosis

Your physician can probably identify you have patellar tendinitis depending on your signs and symptoms. If the diagnosis isn't as clear, he or she may conduct tests to eliminate other conditions. Tests and examinations might consist of:

Physical exam. Your doctor may apply strain to different areas of your knee to find out exactly where you're experiencing pain. Pain associated with patellar tendinitis usually concentrates on the front part of your knee, just beneath your kneecap.

X-rays. X-rays don't show the patellar tendon, however they do help to exclude other bone problems that could contribute to knee pain.

Ultrasound. This test uses sound waves to create an image of your knee, revealing the location of tears in your patellar tendon.

Magnetic resonance imaging (MRI). MRI uses a magnetic field and radio waves to create graphics that are more descriptive than ultrasound images. MRI can reveal more subtle changes in the patellar tendon.

A combination of tests may help your doctor rule out other conditions that can cause knee pain similar to patellar tendinitis, such as:

Pain behind your kneecap (patellofemoral pain syndrome)

Tears in the cartilage (meniscus) that cushions your knee joint

Breakdown of the cartilage beneath your kneecap (chondromalacia patella)

Remedy and Medicines

Patellar tendinitis treatment is a long process, regardless of what type of treatment you've chosen. Recovery usually takes a few weeks or months if the injury isn't too severe, or as long as a year or more for people who undertake surgical procedure.

Most people with patellar tendinitis find pain relief and improvement using traditional treatment ? which means treatment options aside from surgical procedure. Surgical treatment for long-term patellar tendinitis (often called patellar tendinopathy or patellar tendinosis) is seldom performed. However, for those who have persistent signs and symptoms for more than 1 year, you may want to discuss the possible benefits and risks of patellar tendon operation with your physician.

Conventional treatment

The traditional approach to treating patellar tendinitis is designed to reduce the strain on your tendon and then gradually build up the tendon's strength. Your doctor may recommend numerous techniques to achieve this, including:

Rest. Rest does not mean stopping all training, but avoid running and jumping. Your doctor can suggest other ways of staying active with out straining your injured patellar tendon. It's especially critical to avoid any activity that gives you pain.

Altering your body mechanics. A physical therapist can help you learn to better distribute the pressure you apply during work out. For instance, an athlete who jumps regularly might learn correct takeoff and landing skills.

Stretching your muscles. Rigid muscles, especially inflexible thigh muscles (quadriceps), contribute to the tension on your patellar tendon.

Strengthening your tendon. A physical therapist may recommend specific workout routines to improve your patellar tendon and the muscles around it. Physical exercises can also help strengthen your quadriceps. A particular type of exercise for strengthening the quadriceps called eccentric strengthening has been shown in some research to assist in treating and prevent patellar tendinitis. This strengthening exercise involves lowering weight slowly after raising it, such as a seated knee extension exercise.

Patellar tendon strap. A strap that implements force to your patellar tendon can help to spread force away from the tendon itself and direct it through the strap instead. This may help ease pain.

Phototherapy. This technique involves applying the appropriate wavelength of deep penetrating red light to speed up the body’s healing process on a cellular level.  Phototherapy  also provides effective pain relief without side effects.

Iontophoresis. This technique involves applying a topical corticosteroid treatment to the area affected by tendinitis. A compact apparatus then uses an electrical charge to deliver the medication through your skin. Your physical therapist can help you in the use of iontophoresis.

Corticosteroid treatment. An ultrasound-guided corticosteroid shot into the sheath around the patellar tendon will help relieve discomfort making it possible to complete strength activities that otherwise may be too agonizing. You will need to follow activity restrictions for around three weeks after the injection, including avoiding jumping or running routines.

Massage. Massaging the patellar tendon may assist promote tendon healing.

If you've recently developed patellar tendinitis, you can expect at least several weeks or a few months of conservative therapy prior to you'll be able to completely resume physical activity, including jumping. If you've re-injured your patellar tendon, the time for recovery can be even longer.

Operation

You and your doctor may take into account surgery treatment for your patellar tendinopathy in select cases if much more conventional solutions aren't helping after 12 months of treatment. There's minimal research into the best surgical techniques for patellar tendinitis, therefore the procedure you undergo often depends largely on your injury, as well as your surgeon's favored method. Surgical procedures can sometimes include repairing any tears in your tendon or removing any badly damaged parts of your tendon.

Most individuals who may have had patellar tendinitis surgical procedures are able to resume athletic training within about 6 months. In some cases, however, recovery may take as much as 18 months.

Alternative ways

Other types of remedy may provide relief from pain associated with patellar tendinitis. Though these procedures haven't been thoroughly reviewed, your doctor might consider trying:

Pain medicines. Nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids may provide short-term relief from pain linked to patellar tendinitis. Then again, since the benefit of these stereoare not generally suitable for long-term pain management.

At home Phototherapy. Portable at home Phototherapy has been proven to provide pain relief without the side effects or (NSAIDS). This makes phototherapy a great short and long term therapy for pain management.  In addition to pain relief, phototherapy has been proven to speed up the body’s healing process.  With a powerful at home phototherapy device, one can achieve the same results without having to pay a practitioner.

Platelet-rich plasma (PRP). In this experimental method, your own blood plasma is injected into the affected region. Although small studies have found this technique helpful in lowering the pain of patellar tendinitis, huge, managed research are essential.

Extracorporeal shock wave therapy. This type of therapy uses sound waves to promote healing of the tendon. Some research implies this type of treatment method may be effective in alleviating the symptoms of patellar tendinitis.

Other physical therapy solutions. This category consists of treatments using ultrasound and laser stimulation. These can help to provide pain alleviation, though it's not known if these treatment options will help heal the tendon.

Lifestyle and do-it-yourself solutions

If you believe you're going through patellar tendinitis, consider these methods to pain alleviation at home:

Avoid activity that causes discomfort. This could imply reducing how often you practice or temporarily switching to a lower impact sport. Don't try to work through the pain, as this can further hurt your patellar tendon.

Ice. Apply ice right after activity that causes pain. Place ice in a plastic bag and wrap the bag in a towel. Or try an ice massage. Freeze water in a plastic foam cup and secure the cup as you apply the ice directly to your skin. The cold can help to minimize your pain and lower swelling.

Prevention

To reduce your risk of developing patellar tendinitis, take these measures:

Do not play through pain. When patellar tendinitis is diagnosed in its earliest stages ? whenever pain is apparent, but doesn't limit your ability to perform ? you're more likely to be helped by traditional treatment. In case your sport is causing knee pain, rest, apply ice to the part of pain and try a different type of physical exercise until your pain is fully gone.

Strengthen your muscles. Strengthening the quadriceps muscle can help it be able to handle the load that you put on it. Eccentric strengthening workouts are especially effective in preventing and treating tendon problems.

Improve your technique. If your approach in an activity or exercise is flawed, you will be setting yourself up for problems with your tendons. Consider taking instruction or getting professional instructions when starting a new sport or using training apparatus.