How to prevent and treat patellar tendinitis, an affliction that happens just below the kneecap
Pain just below the kneecap and at the top of the shinbone (tibia). The pain sharpens during leg exertion, but if the tendinitis progresses enough, any knee movement will hurt.
What’s Going On In There?
The patellar tendon connects your kneecap to your tibia. It’s one of the key structures involved in extending your lower leg, whether it’s to kick in the pool or jump for a plyometric exercise.
Patellar tendinitis is a classic overuse injury—usually caused by violating the “too” rule: too much, too fast. Repeated stress on the tendon causes irritation that the body can’t repair fast enough, and pain results. You can also irritate the patellar tendon if you increase your training load too quickly or suddenly fire up the intensity.
Ignoring the pain is a bad idea. Overusing an already overused and irritated tendon can cause tendinosis, a buildup of fluid in the tendon. Eventually, it could tear. Start treatment as soon as you feel the pain, and you’ll shorten both your suffering and your recovery time.
Employ dynamic rest. Lay off hard exertion of the knee, especially jumping. Swimming is possible if you can do it pain-free. Otherwise, do intense upper-body and core workouts to maintain fitness.
Ice it. Apply ice for 15 minutes several times a day to help relieve pain.
Try a strap. A patellar tendon strap that goes around your leg just under the knee can support the tendon and relieve pain.
Massage it. Rubbing the area may help lessen the pain and promote healing.
Rehab with the strategies suggested below.
Stretch your quads and hammies. Inflexible quadriceps and hamstrings can put extra stress on the patellar tendon. Basic, disciplined stretches of both muscles can help prevent tendinitis and help heal it.
Try eccentric training. Do leg extensions — however, lower the weight slowly after lifting it at normal speed. If you’re rehabbing the tendon, you can first do this old-school by having a partner apply resistance to your lower leg and then move to a leg extension machine as your rehab progresses. Lowering the weight slowly challenges the tendon and the muscles around it, making them all stronger. This helps prevent future cases.
Note: Normally I’m not a fan of leg extensions as a regular training exercise — they don’t mimic any real-world movement and put excessive torque on the knee — but in cases of rehabbing patellar tendinitis, used as described, they can be effective.
When To Call A Doctor
Basic conservative measures and time are usually enough to cure patellar tendinitis, depending on the severity. However, if these treatments don’t help, see your doctor. He or she will examine and diagnose you and, if warranted, prescribe anti-inflammatories and physical therapy.
The use of platelet-rich plasma (PRP) is one potential new treatment. The patient’s own platelets are injected into the area to speed healing. This is effective in parts of the body that have poor blood flow and therefore heal slowly. It can be expensive and is not always covered by insurance. But for some cases, it’s worth investigating, especially if tendonosis has developed.
New York City sports medicine specialist Jordan D. Metzl, M.D. is a 29-time marathon finisher and 10-time Ironman. His book, The Athlete’s Book of Home Remedies, has more than 1,000 tips to fix all types of injuries and medical conditions.
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