Patellar Tendonitis

Overview

What is the patellar tendon?

The patellar tendon connects the bottom of the kneecap (patella) to the top of the shinbone (tibia). Despite its name, the patellar tendon is actually a ligament. Tendons connect a muscle to a bone. Ligaments connect two muscles.

The patellar tendon provides stability, holding bones together. It also works in tandem with the quadriceps (thigh) muscle and other connective tissues to help you move. You couldn’t straighten your knee or jump without it.

What is patellar tendonitis?

Patellar tendonitis happens when the patellar tendon tissue becomes inflamed (swollen) or irritated. Overuse usually causes this knee injury. It typically affects athletes at the height of their game.

Patellar tendonitis may cause minor to severe knee pain. Pain tends to worsen over time. Left untreated, pain and soreness may become debilitating. Patellar tendonitis pain may affect your athletic performance. In severe cases, it may stop you from participating in an activity altogether.

What is jumper’s knee?

Jumper’s knee is another name for patellar tendonitis. This injury commonly affects professional basketball and volleyball athletes. Repeated jumping motions slowly strain the patellar tendon over time.

Symptoms and Causes

What causes patellar tendonitis?

Patellar tendonitis happens when someone pushes knee tendon tissues too far, or too fast, over and over again. Repeated jumping and sprinting motions stress and strain the bands of patellar tendon tissues. Over time, lots of minor strains and tiny tears make the tendon tissues weak and sore.

This injury happens slowly over a long time. Medical experts still have unanswered questions about how or why patellar tendonitis occurs. Healthcare providers believe two main types of activities damage tendon tissues:

  • Sudden, sizeable increase in activity (how much you’re jumping).
  • Returning to play at full strength after a break instead of slowly getting back into your regular routine.

Can patellar tendonitis lead to a tendon tear?

Yes. Patellar tendon tears (or ruptures) are acute injuries that happen suddenly. In some cases, repeated overuse over a long time can cause the patellar tendon tissue to abruptly tear.

Patellar tendon tears often happen when you land from a jump or suddenly change direction while running. A rip may go partway or all the way through tendon tissue.

Who gets tendonitis?

Anyone can get tendonitis. Tendonitis can affect tendons in many areas of the body, such as the elbow, shoulder or hip.

Who is more likely to have patellar tendonitis?

Certain factors can affect your likelihood of developing patellar tendonitis:

  • Age: Because patellar tendonitis happens gradually over a long time, people over 40 have a greater risk than adolescents or young adults.
  • Level of athletic participation: Athletes participating at a competitive or elite (professional) level train harder and more often than recreational athletes. More intense training puts more stress on muscles and tendons.
  • Type of physical activity: You may have an increased chance of developing patellar tendonitis if you participate in activities that require a lot of jumping, sprinting or abrupt movements at fast speeds.

What activities are more likely to lead to patellar tendonitis?

Any activity that puts a lot of stress on your knee (such as from repeated jumping) could increase your risk of developing patellar tendonitis. These activities include:

  • Basketball.
  • Dance.
  • Figure skating.
  • Football.
  • Gymnastics.
  • Running.
  • Track, such as long jump and high jump.
  • Volleyball.

What are the symptoms of patellar tendonitis?

Symptoms of patellar tendinitis include:

  • Pain or dull ache at the top of the shinbone, right under the kneecap.
  • Stiffness, which may make it hard to extend the knee.
  • Worsening pain with certain movements, such as when you squat or walk down stairs.

What does patellar tendonitis feel like?

Patellar tendonitis symptoms usually get worse, slowly. At first, you may feel only minor knee pains. Discomfort may happen rarely, and only after physical activity. Over time, pain may get sharper and more severe. You may start to feel pain during physical activity.

If left untreated, patellar tendonitis can sometimes become debilitating. Symptoms may make routine tasks (such as climbing stairs or standing up) painful. Even sitting may cause discomfort.

Diagnosis and Tests

How is patellar tendonitis diagnosed?

To diagnose patellar tendonitis, your healthcare provider will first take a thorough medical history. That may include asking you about your activity level and symptoms. Be sure to tell your provider if your symptoms have changed over time.

Your provider will perform a physical exam to evaluate your symptoms. They may press all along your patellar tendon knee to gauge where it hurts. Gently moving your knee in different directions can help your provider evaluate your range of motion.

What tests might I have for patellar tendonitis?

Imaging tests don’t always capture clear details of subtle overuse injuries to tendon tissues. However, your provider may order an X-ray to rule out other potential causes of your pain around your kneecap. In advanced or prolonged cases of patellar tendonitis, both ultrasound and MRI can observe structural damage to the patellar tendon.

Management and Treatment

How is patellar tendonitis treated?

Patellar tendonitis treatments mostly focus on managing your symptoms and strengthening the soft tissues in your knee. At first, your provider may ask you to try conservative therapies, such as rest. In minor cases, these measures may be enough to relieve your pain.

If the condition doesn’t go away, your provider may recommend you:

  • Take it easy: Avoid the activities or movements that trigger your symptoms. Pushing through pain may cause more damage to tendon tissues.
  • Rest: Stay off your feet as much as you can. Rest gives your body time to heal.
  • Apply ice: If you have swelling around your knee, placing an ice pack on the area for 15 minutes at a time, a few times a day, may reduce inflammation.
  • Take pain relievers: Taking over-the-counter anti-inflammatory medicines as needed may be enough to relieve minor aches or knee pains.
  • Support your knee: Your provider may recommend you wear a support device over the knee, such as a knee brace. Support devices may relieve the pain.
  • Try physical therapy: A trained professional will guide you in doing special exercises and stretches. These motions slowly increase the strength and flexibility of injured tendon tissues. Physical therapy may also relieve some of your discomfort.
  • Have surgery: Surgery to treat patellar tendonitis is rare. However, if imaging tests show a tendon tear, your provider may recommend surgery to repair the damaged tissues.

Prevention

How can I prevent patellar tendonitis?

To reduce your risk of a sports injury, take these steps before you start any physical activity:

  • Ensure a proper fit: Make sure all athletic gear (such as shoes, clothes or support devices) fit your body type.
  • Stretch it out: Give yourself at least five minutes before an activity to stretch major muscle groups. Regular stretching makes muscles and tendons more elastic. More elastic tissue is less likely to tear.
  • Don’t rush the warmup: Don’t push your body to the max right away. A solid warmup gives your muscles time to wake up, which makes an injury less likely.

Outlook / Prognosis

How long does it take for patellar tendonitis to heal?

Healing takes time. The details of your recovery (such as what it looks like and how long it takes) will depend on many factors that are specific to you.

You may start feeling better after a few weeks of taking it easy. Yet someone with more severe patellar tendonitis may find it challenging to stay on top of chronic pain.

Try not to rush your body through recovery. Pushing your body before it’s fully healed can damage tendon tissues more, which may set your recovery back.

Living With

When should I call the doctor?

Reach out to your provider for an evaluation if you experience:

  • Dull ache around the knee that lasts long after you stop activity.
  • Sharp, severe knee pains after a sudden movement.
  • Worsening knee pain during physical activity.

What should I ask my healthcare provider?

If you have patellar tendonitis, you may want to ask your provider:

  • Do I need any tests?
  • What treatment should I try first?
  • Will my symptoms get worse?
  • What can I do to help my body heal?
  • When can I resume athletic pursuits?
  • What are the risks of pushing through pain?

A note from Cleveland Clinic

Recovering from a sports injury such as patellar tendonitis can be frustrating. You may feel tempted to cut your recovery short. But pushing your body too fast, too soon, has the potential to further damage already weakened tendon tissues. Instead, consider sitting down with a provider you trust to talk openly about your expectations. Work with your provider to develop a treatment and rehabilitation plan that fits your goals and prioritizes your long-term health.

Last reviewed by a Cleveland Clinic medical professional on 04/19/2021.

References

  • National Institute of Arthritis and Musculoskeletal Diseases. . Accessed 4/26/2021.Knee Problems (https://www.niams.nih.gov/health-topics/knee-problems/advanced)
  • National Institute of Arthritis and Musculoskeletal Diseases. . Accessed 4/26/2021.Types of Knee Problems (https://www.niams.nih.gov/health-topics/knee-problems/advanced#tab-types)
  • Merck Manuals. . Accessed 4/26/2021.Infrapatellar Tendinitis (https://www.merckmanuals.com/home/children-s-health-issues/connective-tissue-disorders-in-children/infrapatellar-tendinitis?query=Infrapatellar%20Tendinitis)
  • Rudavsky A, Cook J. Journal of Physiotherapy. 2014;60:122-9. Accessed 4/26/2021.Physiotherapy management of patellar tendinopathy (jumper's knee). (https://www.sciencedirect.com/science/article/pii/S1836955314000915)
  • Santana JA, Sherman AI. [Updated 2019 Nov 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan. Accessed 4/26/2021.Jumper’s Knee. (https://www.ncbi.nlm.nih.gov/books/NBK532969/)

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