Patella Tendonopathy / Tendinosis

This condition is often referred to as jumper’s knee as it is frequently exacerbated in sports requiring an explosive knee extension (straightening) which puts an enormous force across the front of the knee joint. The quadriceps muscle of the thigh is the second largest in the body whose combined contractile force pulls across the knee cap (patella) and into the patella tendon (ligament) which attaches onto the front of the tibia (shin) bone. For reasons unexplained this structure can fail to repair itself causing an aching pain in the front of the knee known as a patella tendonopathy or a tendinosis. Typically this will develop over a number of weeks causing increasing discomfort which does not resolve even after long periods of rest.

When examined under a microscope the tendon has lost it’s normal healthy structure of long collagen bundles neatly packed together and instead is full of shorter, poorer quality collagen fibres arranged haphazardly. The cells responsible for maintaining the tendon are called tenocytes and have been known to start acting as if they were bone cells instead putting down calcium creating a very painful calcific tendinitis.

In the early stages it may be sufficient to ease off of training to allow the tendon time to recover. If this fails then a specific exercise called an eccentric loading program is prescribed and in combination with extracorporeal shockwave therapy can return the tendon to it’s healthy state again. Biomechanical gait analysis may also be required to prevent a recurrence of the problem.

Click here for a video of the management of patella tendonopathy with extracorporeal shockwave therapy