Patellar tendinopathy is usually associated with insidious onset of localised pain on the patellar tendon just below the knee cap.
Repetitive trauma causes degeneration and micro- tearing of the tendon.
It is suggested that there are four stages to tendinopathy:
- Early inflammatory reaction- usually first 24- 72hours. The body’s normal mechanism which sends cells to the area to try and heal the injury
- Angiofibroblastic degeneration- there is an increase in fibroblastic cells, vascularity and neuronal ingrowth of the tendon which causes malalignment of tendon structure
- Structural failure- at this stage the tendon ruptures (varies in size)
- Fibrosis or calcification- formation of fibrous tissue or calcification within the tendon
Pain is usually made worse with jumping, changing directions and decelerating.
There may also be a thickening of the tendon.
Patients recover well with Physiotherapy treatment and should expect to be able to return to normal sports/ activities.
Injuries to the medial collateral ligament that is lower down usually takes longer to rehabilitate than a tear that is higher.
- Relative rest and modifying aggravating activities is essential to successful treatment
- Physiotherapy treatment aims to reduce pain and improve functional strength as well as identify and treat overcompensating structures