Patellar Tendonitis Treatment

Patella is the medical term for kneecap.  The patellar tendon is the connective tissue that attaches the patella (a bone) to the tibia (shinbone); so the more accurate term would be ligament.  But it does not sound as fetching as “tendonitis,” hence the rather inaccurate term.  Tendons connect muscle to bone, not bone to bone.

The patellar ligament allows the lower legs muscles to move, so upright walkers can jump, pedal or kick.  Landing on the knee without proper cushion may damage the patellar ligament.  Sudden changes in leg movement can also bring about twitching pain.  The people who are most commonly afflicted with ligament damage are those who had to do these movements regularly – basketball pros, cyclists, and football and volleyball players.  Fitness fanatics who just had to run five miles a day may likewise suffer without endurance preparation.

Patellar tendonitis is the inflammation of this ligament.  Inflammation may just be a symptom of degeneration or rupture of this ligament resulting from overuse.  When the body can no longer keep up with minor repairs in the ligament because it is not given enough time to recover, inflammation may ensue.

Pain just below the kneecap is the body’s way of saying that it is not yet ready to go back to action.  Pain is aggravated by kneeling or jumping (hence, the condition is also known as jumper’s knee).  The damage does not usually occur all at once, but compounded by over-exertion over time.  So a twinge just below the kneecap may be the start of jumper’s knee.  A twinge is something most athletes work through, with little forethought that it might progress to something more serious.

The primary treatment of patellar tendonitis is P.R.I.C.E.  As with all other soft tissue injuries, the concerned area should be:

  • Protected.  Not only should gear be worn over the area. Tears usually arise when ligaments are subjected to sudden use.  Proper warm up goes a long way in preparing the body for a strenuous activity ahead so injury can be minimized;
  • Rested.  The pain is indication that the area be immediately immobilized.  This is to allow the ligament to recover.  Rest also prevents further injury to the area;
  • Iced.  Apply packs of ice or frozen peas to reduce swelling and pain in the short-term.  To prevent “ice burn” or frost bite,   wrap the area with damp towel.  Never apply ice for more than 20 minutes at a time.    Give the injured area enough time to re-warm. An ice pack every two hours for the first 48 hours is just about right;
  • Compressed.  To restrict blood flow and consequently, swelling, a snug-fitting bandage around the injured part may provide temporary relief from throbbing pain. However, while temporarily beneficial, compression may delay healing;
  • Elevated.  The concerned area will benefit from elevation above heart level to restrict blood flow to it and therefore reduce swelling.  The patient can lie on his back with his injured legs propped up in a pillow.

If conservative measures have been taken and the condition has not improved, autologous blood injection or injection of platelet-rich plasma may be recommended.

Autologous blood injection means that the same blood drawn from the patient is reinjected into the injured area to promote stem cell growth.  Injection of platelet-rich plasma requires the patient’s blood to be centrifuged so that the platelet content is four times more concentrated than the blood in circulation.  Platelets promote healing by producing collagen (scar tissue).

In extreme cases, surgery may be necessary to remove the damaged ligament.

Either way, the ligament will have to be stretched and strengthened through gentle massage.  The patient will risk more serious damage if he will work the muscle through before full recovery.