Patellar tendinopathy is mainly a disease of athletes. However, non-athletes can also develop patellar tendinopathy if the knee is incorrectly loaded. The disease progresses in four stages, with movement restrictions and pain increasing as the condition progresses. However, surgery is often the last resort if other therapeutic approaches have not been successful.
Below you will find further information and selected specialists for patellar tendinopathy.
Patellar tendinopathy - also known as "jumper's knee" - causes pain at the lower end of the kneecap (patella). Those affected notice this when running and doing other sporting activities.
The knee joint is the joint in the human body that is subject to the greatest strain. Together with the thigh bone and the shin bone, the kneecap, technically known as the patella, forms the so-called bony joint body. The patellar tendon connects the tibia to the lower end of the kneecap. The main task of this patellar tendon is to transfer force from the lower leg to the thigh. It is therefore exposed to constant strain, especially during sporting activities. It regulates the pressure distribution in the knee joint. If the load is incorrect or too high when running, this leads to severe pain for those affected.
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According to a medical definition from 1978, patellar tendinopathy is divided into four different degrees of severity:
Heavy strain on the knee joint, such as running a marathon or jumping, can lead to pressure pain below the kneecap. Depending on the degree of severity, the pain is only noticeable when warming up and disappears temporarily as the load increases until it can be felt again after the training session.
In more severe cases, the discomfort can be felt throughout the entire exercise session. In particularly severe cases, the pain in the patellar tendon can be permanent (chronic). In the case of patellar tendinopathy, stretching the knee joint against resistance often causes pain.
Patellar tendinopathy is caused by overloading of the patellar tendon due to unusual, repeated or heavy tensile stress. There are both internal and external factors that can trigger so-called "jumper's knee".
These include the respective - usually sporting - activities that often trigger the symptoms. Jumping sports in particular place maximum tensile stress on the patellar tendon, which is why sports such as basketball, long jump, high jump and volleyball are particularly likely to trigger patellar tendonitis. For this reason, this syndrome is also known colloquially as "jumper's knee" .
What is important for patellar tendinopathy is how severe or unusual the strain on the knee has been. Patellar tendinopathy can also occur during
can also occur.
A high kneecap also favors the occurrence of patellar tendinopathy, as does congenital ligament weakness or reduced elasticity of the leg muscles.
The doctor, usually an orthopaedist or sports traumatologist, will first inquire about the patient's sports habits. Jumping sports, bodybuilding or jogging on hard surfaces, for example, suggest that the corresponding complaints are due to patellar tendinopathy.
The subsequent physical examination often reveals pressure pain over the tip of the kneecap. It is also characteristic if the extension movement of the lower leg against resistance leads to pain in the patient. Rather rare signs of patellar tendinitis are visible swelling or redness. Some sufferers also report pain after prolonged sitting, such as after long car journeys.
In some cases, however, the knee joint may be completely unremarkable. In this case, a suspected diagnosis can only be made on the basis of the patient's medical history.
Sonography (ultrasound) is a simple and painless procedure for the patient to diagnose a jumper's knee. The doctor will always examine the (supposedly) healthy opposite side so that possible changes can be correctly assessed by the doctor. Typical changes in a jumper's knee that can be detected by ultrasound include
X-rays do not help with jumper's knee and are only used to rule out other diseases of the knee.
With the help of magnetic resonance imaging (MRI), however, the doctor can localize the degenerated region very precisely. MRI is also helpful for differential diagnosis. For example, an MRI can often be used to rule out whether the symptoms are caused by knee osteoarthritis.
If the patient feels pain when running, it is advisable to interrupt or stop the sports session and seek medical treatment. The following procedures are available to doctors and patients for the treatment of "jumper's knee":
The tension on the kneecap can be reduced by regularly stretching the thigh muscles. A hot roller or cold applications also improve blood circulation in the tendon insertion area, which improves the nutrition of the tendon above the kneecap.
Physiotherapy treatment is still possible, particularly in the early stages. Shock wave and ultrasound therapy as well as electrotherapy or manual therapy are useful. The physiotherapist will first inquire about the patient's symptoms and select the appropriate treatment options based on the severity of the condition and then create an individual treatment plan.
Aquajogging classes are a good option if the pain symptoms are already pronounced. In the water, the heaviness of the limbs is reduced and it is often even possible to perform jumps without pain.
Commercially available painkillers can help to alleviate the pain during an acute episode. However, a doctor should always be consulted beforehand, if only to diagnose the exact cause of the pain. Furthermore, painkillers are not recommended for long-term treatment.
Surgical procedures should only ever be used as a last resort for patellar tendinopathy in order to enable the patient to lead a pain-free life or to restore their athletic performance. In such a surgical procedure, the inflamed layer of fat around the patellar tendon is removed first. The corresponding areas of the tendon are separated out and abnormal blood vessels are sclerosed. The procedure can be either open or minimally invasive and can be performed under local or general anesthesia.
The best way to prevent patellar tendinopathy is to regularly stretch the muscles after running. This reduces muscle tension in the thigh. In addition, a thorough warm-up before running and a moderate increase in training intensity during the course of training are of fundamental importance. It is also very important to allow the body sufficient time to regenerate between the various training sessions - regardless of the type of sport.
Overweight people should also consider losing weight. Lower body weight reduces the strain on the patellar tendon and knee joints, so that complaints occur less frequently - or at least to a lesser extent.
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