Physical Therapy for Patellar Tendinopathy

What is Patellar Tendinopathy?

Patellar tendinopathy is an injury caused by overuse of the quadricep and patellar tendon. Pain will present into the inferior pole of the patella and increase with more difficult activities ei walking → running → jumping. It is most common in ages 15- 30 years old. The pain will gradually increase and there will not be one traumatic event causing the onset.

Prevention includes providing adequate rest between periods of activity. This pain typically is provoked by loading the tendon (i.e. jumping) and will immediately resolve after the activity is ceased.

What Increases Patellar Pain?

Activities that typically increase this type of pain are performing deep squats, increasing the load of the squat, vigorous jumping and increased training times.

Those that are at higher risk for this injury are men, those who increase training volume quickly, poor hip extensor strength, decreased hamstring and quadricep flexibility, patellar tracking issues, those that perform jumps with increased knee flexion and decrease trunk flexion or stiff landing mechanics

How to treat Patellar Tendinopathy with Physical Therapy

1. Proper diagnosis

2. Period of activity modification of those activities that provoke pain

   1. Eliminating those exercises that cause 2/10 of pain while not in therapy

3. Proper quad strengthening and patellar tendon loading

   1. Note: pain may go up to a 3/10 at PT but shoulder reduce to baseline after 24 hours and improve week by week.

   2. A Physical Therapist will know which exercises and proper dosage to give without causing increased damage and promote healing.

4. Kinetic chain strengthening throughout the hip, calves, and ankles

5. Adjusted squatting and jumping mechanics

How long for the pain to disappear?

For this injury, the recovery time is about 8-12 weeks with proper rehabilitation. One can expect to be back to sport around 6 months with little to no symptoms. That is not to say that the pain will not come back. One must take the proper precautions going forward to prevent a recurrence. It must be noted that pain and injury do not always correlate.

When we get hurt the area gets hyper sensitive; meaning that some exercises might hurt, but with the proper dosage there with be no damage caused. A good rule of thumb for increasing activity difficulty is that once an activity that was once painful is now non-painful you can start to increase the difficulty