The patella tendon is an important connective tissue in the front of your knee. Technically, the patella tendon is a ligament (connecting bone to bone) rather than a true tendon (attaching a muscle to a bone). The patella tendon attaches the bottom our your patella (kneecap) to your tibia (shin bone). The patella tendon is commonly injured in those who run, or jump as part of their sport or weekly activities. In some textbooks and amongst the general public, patella tendon pain is sometimes referred to as ‘Jumper’s Knee’.

What is the patella tendon?

The patella tendon attaches the inferior pole of the patella, to the tibial tuberosity, which is a boney prominence at the top of your tibia. The patella tendon plays an important role in absorbing force during jumping and landing. It is thought that patella tendon pain is usually as a result of a large spike in loading of the knee, beyond what it can handle. It is quite common when someone either begins a new sport, or returns to their sport/activity after an extended period away from exercising. Activities that may irritate an inflamed patella tendon include:

• Walking long distances

• Walking downstairs or downhill

• Running

• Squatting

• Lunging

• Jumping

• Landing

Should I rest my knee?

Have you ever heard a health professional say ‘just rest for a month and come back if it doesn’t get better’. This is a commonly used phrase in healthcare, which belongs in the 20th century. We know now with injuries like patellar tendinopathy, that an element of reducing aggravating activity is probably appropriate, but only coupled with targeted rehab. Although someone with this injury wouldn’t be expected to run a marathin, their weekly activity can be deconstructed by their physio, who can form a rehab plan, with a modified version of their sport/training. This ‘deload’ respects the injury and allows a reduction in pain and inflammation, but also aims to strengthen the areas of the body taht may have contributed to the injury in the first place.

Rehab Options 

If you’re suffering from patella tendon pain, there’s a few things that you can start doing immediately to try and manage your symptoms.

Icing:

Painkillers are often overprescribed to people with patella tendon pain. A more effective and appropriate form of pain relief may be 5-10 minutes of ice application both before and after rehab and training sessions. In this way we get quick, localised, effective pain relief, without relying on pharmaceuticals.

Strengthening:

It’s a rather general term to ‘strengthen’ your legs, but a focus point to begin with is to increase your knee extensor strength. This involves loading your quad muscles in the front of your thigh and begin to feel that ‘burn’ and pump in the front of your leg. The aim here is to protect the patella tendon by improving the quads ability to absorb and produce force, rather than the tendon alone. Exercises include leg extensions, single leg squats, and stepdowns.

Running Modification:

There is biomechanical evidence that running uphill creates a larger demand on your hip extensors rather than your knee extensors. This means that by running slower, but at an incline, we can continue running with less force going through the knee. This is especially important in the early phases of rehab.

Reducing jumping:

An immediate change that will be beneficial would be to reduce your jumping. With the help of your physio, you can maintain a level of jumping and plyometrics in your training, without aggravating your knee.

If you have any questions on whether physio is the best option for you, or you have any questions about MVMNT in general, feel free to contact via email.

- Jay Towolawi, Specialist Sports Physiotherapist and MVMNT Founder.