Patellar Tendonitis
Patellar tendonitis is a knee injury characterized by inflammation of the patellar tendon and overuse.
The patella is the kneecap. The patellar tendon is located at the front of the knee between the kneecap (patella) and shinbone (tibia) and allows your child to straighten their knee so they can run or jump. When this tendon becomes inflamed, it is called patellar tendonitis. You might also hear it referred to as “jumper’s knee.”
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Causes
There are a number of reasons why patellar tendonitis may occur. Some common ones include:
Improper warm up and cool down
Inadequate stretching program
Training too hard or too much in a particular sport, especially those that involve jumping, like basketball
Exercising or playing on concrete or another hard surface
Symptoms
Common symptoms related to patellar tendonitis are:
Pain, usually felt between the kneecap and where the tendon attaches to the shinbone
Dull ache
Swelling
Tenderness
Diagnosis
To determine if your child has patellar tendonitis, our specialists will perform a physical exam that may include flexibility tests, stress tests, muscle tests and gait analysis. These tests will help our specialized team better understand your child’s condition, assess range of motion and identify abnormalities that might occur in bone alignment or muscle function.
After a physical exam, our specialists may also order imaging tests such as an X-ray, MRI or ultrasound.
Treatment
Possible non-surgical treatments your doctor may offer or recommend to treat your child’s patellar tendonitis include:
Physical therapy or home exercise programs
Activity modification or rest
Over the counter nonsteroidal anti-inflammatory drug (NSAIDs)
Bracing
Rarely injections
At-Home Care
Common at-home treatment options for patellar tendonitis include:
Icing the Area:
Put ice packs wrapped in a towel or thin cloth on your child’s knee for 20–30 minutes every 3-4 hours for the first 2-3 days. If pain does not go away, contact your healthcare provider.
Elevating the Injured Limb:
Elevate your child’s lower leg by placing it on a pillow when your child is lying down. Elevating it above the heart level can help reduce swelling and pain.
Taking Non-Prescription Medication:
Take a non-steroidal, anti-inflammatory drug (NSAID), such as ibuprofen as recommended by your healthcare provider.
Exercising:
Your doctor may recommend doing exercises at home. These are designed to stretch the affected knee, maintain range of motion in the joint and strengthen your child’s knee.
Bracing:
Have you child wear a chopat or runner’s strap when practicing, playing, or doing other physical activities
Rehabilitation Exercises
Below are common exercises a doctor may recommend to help your child recover after patellar tendonitis. Always check with your doctor to find out which exercises are right for your child.
Stretching
Hamstring Stretch
Lie on back and bring the affected leg towards the chest.
Grab the back of the thigh and try to extend the leg.
Your child may also try this with a towel around the foot if it is more comfortable.
Hold for 30-60 seconds. Repeat 3 times.
Quadriceps Stretch
Stand sideways to a wall, about an arm’s length away from the wall, with your injured leg towards the outside.
Facing straight ahead, keep the hand nearest the wall against the wall for support.
With your other hand, grasp the ankle of your injured leg and pull your heel up toward your buttocks. Do not arch or twist your back.
Hold this position for 30 seconds.
Repeat three times.
Note: This may also be done while lying on the opposite side and grasping the ankle of the affected leg. Do not arch or twist your back. Hold this position for 30 seconds. Repeat three times.
Range of Motion
Patellar Mobility
Sit with injured leg outstretched and the muscles on top of thigh relaxed.
Take index finger and thumb, and gently press kneecap down toward foot.
Hold for 10 seconds, then return to the starting position.
Pull kneecap up toward waist and hold for 10 seconds, then return to the starting position.
Push kneecap inward toward other leg gently, and hold it for 10 seconds.
Repeat these steps for approximately 5 minutes.
Strengthening
Quadriceps Set
Sit on floor with injured leg outstretched.
Tighten muscles at the top of thigh by pushing the back of knee down into the floor.
Concentrate on contracting the inside part of the thigh.
Hold for 5 seconds.
Repeat 3 times. Do 3 sets of 10
Straight Leg Raise
Sit on the floor with the injured leg straight and the other leg bent, foot on the floor.
Pull the toes of the injured leg in as far as possible, while pressing the back of the knee down and tightening the muscles on the top of the thigh.
Raise the leg six to eight inches off the floor and hold for 5 seconds.
Slowly lower back to the floor.
Complete 3 sets of 10.
Weight Lifting (Leg Extension)
This exercise requires a weight lifting bench with a leg extension attachment.
Sit on bench with the weight attachment in front of lower legs.
Extend knees by straightening legs, taking care straighten legs completely.
Use enough weight to cause fatigue, but not pain.
Do 3 sets of 10.
When Will My Child Return to Play?
After your child has had an injury like patellar tendonitis, it’s normal to want to know how long the injury will take to heal and what you can expect.
Every child is unique, every injury is different and your doctor will be able to give you general guidelines as to when your child may be able to return to play. Patients need to be symptom-free with daily activities before they can return to higher level sports, and this may take a few days to weeks depending on the severity of their injury.
The best thing you can do for your child is to make sure you consistently follow your doctor’s instructions, including doing at-home exercises regularly. When it is okay to do so, our doctors and staff will let you know when your child can return to play at a controlled level.
How to Prevent Patellar Tendonitis
Perform warm up and cool down stretches, especially the thigh muscles
Do exercises to strengthen thigh muscles
Avoid playing or practicing on hard surfaces, like concrete
Avoid single sport specialization
Avoid playing on multiple teams in one season
Do not participate in sports more hours per week than your child’s age
Take on season off each ear for fun free play