{"id":2004,"date":"2023-11-05T09:27:59","date_gmt":"2023-11-05T09:27:59","guid":{"rendered":"https:\/\/michiro.co.za\/css\/?page_id=2004"},"modified":"2023-11-17T17:12:29","modified_gmt":"2023-11-17T17:12:29","slug":"patellar-tendinopathy-jumpers-knee","status":"publish","type":"page","link":"https:\/\/michiro.co.za\/index.php\/patellar-tendinopathy-jumpers-knee\/","title":{"rendered":"Patellar Tendinopathy"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"2004\" class=\"elementor elementor-2004\">\n\t\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5af6850 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5af6850\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-4f9db03\" data-id=\"4f9db03\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5f21d1c elementor-widget elementor-widget-image\" data-id=\"5f21d1c\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.15.0 - 20-08-2023 *\/\n.elementor-widget-image{text-align:center}.elementor-widget-image a{display:inline-block}.elementor-widget-image a img[src$=\".svg\"]{width:48px}.elementor-widget-image img{vertical-align:middle;display:inline-block}<\/style>\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"341\" src=\"https:\/\/michiro.co.za\/css\/wp-content\/uploads\/2023\/11\/PatellarTendinopathy-1024x341.png\" class=\"attachment-large size-large wp-image-2580\" alt=\"\" srcset=\"https:\/\/michiro.co.za\/css\/wp-content\/uploads\/2023\/11\/PatellarTendinopathy-1024x341.png 1024w, https:\/\/michiro.co.za\/css\/wp-content\/uploads\/2023\/11\/PatellarTendinopathy-300x100.png 300w, https:\/\/michiro.co.za\/css\/wp-content\/uploads\/2023\/11\/PatellarTendinopathy-768x256.png 768w, https:\/\/michiro.co.za\/css\/wp-content\/uploads\/2023\/11\/PatellarTendinopathy-260x87.png 260w, https:\/\/michiro.co.za\/css\/wp-content\/uploads\/2023\/11\/PatellarTendinopathy-50x17.png 50w, https:\/\/michiro.co.za\/css\/wp-content\/uploads\/2023\/11\/PatellarTendinopathy-150x50.png 150w, https:\/\/michiro.co.za\/css\/wp-content\/uploads\/2023\/11\/PatellarTendinopathy-600x200.png 600w, https:\/\/michiro.co.za\/css\/wp-content\/uploads\/2023\/11\/PatellarTendinopathy.png 1500w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-a61d855 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"a61d855\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-b65dfe8\" data-id=\"b65dfe8\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9549ec6 elementor-widget elementor-widget-text-editor\" data-id=\"9549ec6\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.15.0 - 20-08-2023 *\/\n.elementor-widget-text-editor.elementor-drop-cap-view-stacked .elementor-drop-cap{background-color:#69727d;color:#fff}.elementor-widget-text-editor.elementor-drop-cap-view-framed .elementor-drop-cap{color:#69727d;border:3px solid;background-color:transparent}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap{margin-top:8px}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap-letter{width:1em;height:1em}.elementor-widget-text-editor .elementor-drop-cap{float:left;text-align:center;line-height:1;font-size:50px}.elementor-widget-text-editor .elementor-drop-cap-letter{display:inline-block}<\/style>\t\t\t\t<h3><strong>Definition:<\/strong><\/h3><p>Tendinopathy of quadriceps tendon or the attachments of the infrapatellar tendon; the term \u2018jumper\u2019s knee\u2019 implies functional stress overload due to jumping or increase in activity.<\/p><h3><strong>Pathophysiology: <\/strong><\/h3><p>Forces through one leg on landing from a jump can be up to <strong>12 times body weight<\/strong>; for a 75 kg person = 900 kg of weight transmitted through the leg at peak force! Repetitive jumping (eccentric to concentric loading) eventually results in infrapatellar tendon microtears as damage exceeds body\u2019s ability to repair itself \u2192 pain &amp; loss of tensile strength \u2192 macroscopic tendon thickening \u2192 collagen degeneration \u2192 tendon rupture (severe cases).<\/p><h3>Demographics<\/h3><p><em>Incidence: <\/em>estimated ~20% of jumping athletes <em>Age: <\/em>any age (more common 12-35 yrs)<\/p><p><em>Gender: <\/em>bilateral female = male<\/p><p>unilateral: male &gt; female (2:1) <em>Genetics: <\/em>one study noted a longer lower patellar pole associated with chronic patellar tendinopathy (Hyman, 2008) <em>Risk factors: <\/em>over training.<\/p><ul><li>Poor jumping &amp; landing technique\/ biomechanics<\/li><li>Jumping sports (volleyball, basketball)<\/li><li>Inflexibility &amp; weakness of hamstrings or quadriceps (also look at hip flexors)<\/li><li>Rapid increase in activity or intensity (<strong><em>10% rule = don\u2019t increase training distance, intensity, or time more than 10% per week<\/em><\/strong>)<\/li><li>Court surface hardness or slope<\/li><li>Increased body weight &amp; height<\/li><li>Over pronation &amp;\/or worn out foot wear may play a role<\/li><\/ul><h4>History<\/h4><ul><li>Anterior knee pain (achy or itching quality) below the patella (rarely may be above)<\/li><li>Pain is worse with excessive activity<\/li><li>Increased pain after prolonged sitting, relieved by straightening leg<\/li><li>History of positive risk factors (jumping activities) There are 4 main stages<ol><li>Pain only after activity, without functional<\/li><li>Pain during and post activity, although satisfactory performance level in their sports or activity.<\/li><li>Prolonged pain during or after activity, with increasing difficulty in performing at a satisfactory level.<\/li><li>Complete tendon tear requiring surgical repair (note patellar displacement).<\/li><\/ol><\/li><\/ul><p><strong><em>Inspection:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/em>Potentially altered gait.<\/strong><\/p><p>Swelling &amp; inflammation are rare. Affected tendon may appear thicker.<\/p><p><em>Palpation:<\/em><\/p><p>Localized <strong>point tenderness over tendon<\/strong><\/p><p>\u00a0<\/p><p><strong><em>Motion:<\/em><\/strong><\/p><p>Pain with compression of patellofemoral joint Hamstring or quadriceps tightness<\/p><p>Possible compensatory joint dysfunctions (foot, ankle, knee, hip, pelvis, low back)<\/p><p>Active range of motion weakness with squat, mild crepitus possible Possible pain with passive range of motion at end range of knee flexion stretch of infrapatellar tendon<\/p><p>Possible pain with resisted range of motion into extension or quadriceps weakness<\/p><p>Should not have ligament laxity.<\/p><p><strong>Surgery <\/strong>(rarely required)<\/p><ul><li>Indicated in stage 4 &#8211; arthroscopic repair has<\/li><\/ul><p>shown good to excellent recovery as early as 6 weeks<\/p><h4>Follow-up<\/h4><h5><strong><u>Rehabilitation Program<\/u><\/strong><\/h5><ul><li>Knee immobilization is contraindicated due to resulting stiffness &amp; may lead to muscle or joint contracture, further prolonging condition<\/li><li>Stretch hip &amp; knee flexors &amp; extensors<\/li><li>Strengthen lower extremity with closed chain eccentric exercises (slow squat on decline board) &#8211; Jonsson, 2005, found eccentric quadriceps strengthening on a decline board superior to concentric strengthening in terms of pain, treatment satisfaction &amp; return to play<\/li><li>Sport-specific proprioceptive training &amp; plyometrics<\/li><\/ul><h5><strong><u>Prevention\/ Education<\/u><\/strong><\/h5><ul><li>Proper footwear, consider orthotic use<\/li><li>If there is a co-existing patellar tracking problem consider knee brace with a patellar cut out<\/li><li>Consider change in activity type or lifestyle<\/li><li>Balance exercises (wobble board)<\/li><li>Palpable point tenderness is the best finding<\/li><li>Single leg stance or hop functional assessment<\/li><li>Excessive pelvic motion or abdominal (core) weakness affecting biomechanics<\/li><\/ul><h4>Jumper\u2019s knee is strongly suggested when chondromalacia is negative Treatment<\/h4><ul><li>Ice after activity<\/li><li>Consider short-term anti-inflammatory use for pain reduction<\/li><li>Modify activities to avoid patellofemoral pressure<\/li><li>Mobilization &amp; manipulation of the spine, pelvis, hip, knee, &amp; foot to help optimize biomechanical function<\/li><li>TENS for short-term pain reduction<\/li><li>Ultrasound or phonophoresis (infusion of medication)<\/li><li>Extracorporeal Shock Wave Therapy (may show outcome of success similar to surgery<\/li><\/ul><p>&#8211; Peers, 2003) &#8211; shock waves to treat chronic musculoskeletal conditions stimulates healing by moving injury back to an acute phase of healing. \u2013 BEST TREATMENT OPTION<\/p><h4>Prognosis<\/h4><ul><li>Within ~3 week significant improvement is usually noted with conservative treatment of stage 1 or 2<\/li><li>Stage 3 may take longer &amp; require long-term lifestyle &amp; activity modification<\/li><li>With co-existing knee pathologies (instability, chondromalacia patellae, etc.) expect healing to be long &amp; potentially lead to chronic knee issues<\/li><li>With co-existing knee pathologies (instability, chondromalacia patellae, etc.) expect healing to be long &amp; potentially lead to chronic knee<\/li><\/ul>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Definition: Tendinopathy of quadriceps tendon or the attachments of the infrapatellar tendon; the term \u2018jumper\u2019s knee\u2019 implies functional stress overload due to jumping or increase in<span class=\"excerpt-hellip\"> [\u2026]<\/span><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-2004","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v21.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Patellar Tendinopathy - MiChiro<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/michiro.co.za\/index.php\/patellar-tendinopathy-jumpers-knee\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Patellar Tendinopathy - MiChiro\" \/>\n<meta property=\"og:description\" content=\"Definition: Tendinopathy of quadriceps tendon or the attachments of the infrapatellar tendon; 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