Patellar Tendinopathy
Treatment
- Relative Rest
- Exercise - Eccentric Strengthening Exercises - Young et al. recommend the use of a decline squat protocol however conflicting views on the use of eccentric training protocols have been found in the literature
- Massage/Frictions
- Pharmacotherapy - Iontophoresis or phonophoresis using a corticosteroid
- Icing
- “Surgery is an effective treatment that should be reserved for patients who have failed conservative therapy.”2
Prevention
In general, patients presenting with a patellar tendinopathy have recently experienced a change in their training regimen. For this reason it is important that care be taken when changing a training regimen. Rutland et al. recommends that changes should be less than a 10% per week increase in physical load, repetitions, intensity, frequency, and duration of activities.
Education
"Fatigue, poor technique, and training errors may play a role in this disorder."4 Because of this, it is important to educate the patient on proper technique and the elimination of training errors. It is also important to educate them on the importance of adequate rest when they have become fatigued to avoid placing stress on the patellar tendon. Education on a home exercise program designed specifically to meet impairments discovered during examination and treatment will also be beneficial.
References
1. Khan KM, Maffulli N, Coleman BD, Cook JL, Taunton JE. Patellar tendinopathy: some aspects of basic science and clinical management. Br J Sports Med. 1998;32(4):346-355.
2. Jensen K, Di Fabio RP. Evaluation of eccentric exercise in treatment of patellar tendinitis. Phys Ther. 1989;69(3):211-216.
3. Wilson JJ, Best TM. Common overuse tendon problems: A review and recommendations for treatment. Am Fam Physician. 2005;72(5):811-818.
4. Cook JL, Khan KM. What is the most appropriate treatment for patellar tendinopathy? Br J Sports Med. 2001;35(5):291-294.
5. Woodley BL, Newsham-West RJ, Baxter GD. Chronic tendinopathy: effectiveness of eccentric exercise. Br J Sports Med. 2007;41(4):188-198; discussion 199. Epub 2006 Oct 2024.
6. Rutland M, O'Connell D, Brismee JM, Sizer P, Apte G, O'Connell J. Tre. N Am J Sports Phys Ther. 2010;5(3):166-178.
7. Young MA, Cook JL, Purdam CR, Kiss ZS, Alfredson H. Eccentric decline squat protocol offers superior results at 12 months compared with traditional eccentric protocol for patellar tendinopathy in volleyball players. Br J Sports Med. 2005;39(2):102-105.
2. Jensen K, Di Fabio RP. Evaluation of eccentric exercise in treatment of patellar tendinitis. Phys Ther. 1989;69(3):211-216.
3. Wilson JJ, Best TM. Common overuse tendon problems: A review and recommendations for treatment. Am Fam Physician. 2005;72(5):811-818.
4. Cook JL, Khan KM. What is the most appropriate treatment for patellar tendinopathy? Br J Sports Med. 2001;35(5):291-294.
5. Woodley BL, Newsham-West RJ, Baxter GD. Chronic tendinopathy: effectiveness of eccentric exercise. Br J Sports Med. 2007;41(4):188-198; discussion 199. Epub 2006 Oct 2024.
6. Rutland M, O'Connell D, Brismee JM, Sizer P, Apte G, O'Connell J. Tre. N Am J Sports Phys Ther. 2010;5(3):166-178.
7. Young MA, Cook JL, Purdam CR, Kiss ZS, Alfredson H. Eccentric decline squat protocol offers superior results at 12 months compared with traditional eccentric protocol for patellar tendinopathy in volleyball players. Br J Sports Med. 2005;39(2):102-105.