Causes of Patellar Tendonitis
Patellar tendonitis is a condition that affects the patellar tendon that connects the patella to the shinbone. The tendon, along with the muscles in the area, allow the body to run, jump, and kick. The injury is also called “jumper’s knee”, and it is a common injury for athletes. For example, people who regularly participate in sports like basketball and volleyball are more likely to develop a tendonitis knee.1 Additionally, soccer, American football, tennis, gymnastics, and skiing are a few other activities that contribute to damaging the patellar tendon. Unfortunately, patellar tendonitis can affect anybody. Advancing age can cause degeneration, and the degeneration is often a result of repetitive micro-damage. In other cases, a different injury that healed improperly can lead to patellar tendonitis. Inadequate healing is the least common cause of tendonitis, and repetitive stress and overuse are the most common causes of the condition.2
Patellar Tendonitis Symptoms
There are a number of symptoms associated with patellar tendonitis. Pain in back of knee is the primary symptom. Furthermore, the pain may worsen when the patient runs, jumps, lands, or sits for a prolonged amount of time. Usually, the pain gradually increases. Patients who continue to engage in the activity that caused the injury will notice worsening symptoms over time. The area around the patella may be tender and stiff. Visually, the damaged tendon might look thicker than an uninjured tendon.3 A doctor may diagnose the injury with questions about the patient’s physical activities, symptoms, and with a physical examination. Patients should try to keep track of when their symptoms started and what at-home remedies they have tried. A doctor might also use imaging tests, such as X-ray, MRI, or ultrasound, to see any damage to the tendon, bone, or soft tissue. After diagnosis, treatment can begin.4
Usually, a traditional doctor will recommend medications such as Advil, Aleve, or Tylenol for short-term reduction of pain and inflammation. For severe pain, a doctor might suggest a corticosteroid injection for relief. Unfortunately, the injection could potentially weaken the tendon. The primary treatment method for patellar tendonitis is physical therapy. A typical physical therapy session might include warm-ups, massage, stretches, and strengthening exercises. Further, ultrasound is not just for diagnosis. Ultrasound and electrical stimulation might provide pain relief. A physical therapist may also suggest using a knee brace or taping during therapy to reduce pain. Patients should follow the exercise program created by the physical therapist, as the exercises should not further damage the tendon. Still, in some cases, the patient might need surgery to repair the tendon. Surgery recovery time and limitations vary depending on the type of surgery and the patient.5
A chiropractor will diagnose jumper’s knee similarly to a doctor. However, chiropractors try not to recommend medications or invasive treatment unless they are absolutely necessary. The most effective chiropractic treatment for jumper’s knee is the Active Release Technique, or ART. Of course, not every chiropractor is trained in ART. In addition to in-office adjustments and treatment, the chiropractor will suggest exercises and stretches for the patient to try at home. The chiropractor will also tell the patient about activities to avoid during recovery, such as squatting or sitting with knees bent. Furthermore, patients can try RICE: rest, ice, compression, and elevation of the damaged knee. Chiropractors often work with physical therapists to develop treatment and exercise plans for the patient. Additionally, chiropractors also often work with massage therapists. In many cases, massage therapists and chiropractors share the same office. The patient can visit both alternative care practitioners.6
Massage Therapy for Tendonitis
Massage therapy is another form of treatment that can help ease the pain of patellar tendonitis. Sports massage is a treatment used by many athletes because of how effective it can be as part of recovery. Massage works in multiple ways. It promotes circulation, which helps the body naturally heal itself. Massage therapy can also decrease tightness and increase flexibility and strength. A massage therapist can also properly address trigger points. Different styles of massage therapy are used over the course of recovery, including ice massage. Fortunately, the patient may even try self-massage at home to relieve pain and promote relaxation. Balancing rest and physical activity is a very important part of the recovery process. Furthermore, patients can try any combination of healthcare providers to find the treatment plan that works for them. Some patients might only need a chiropractor and a physical therapist.7
Other Causes of Back of Knee Pain
Unfortunately, there are many causes of back of knee pain. For example, the patient might be experiencing leg cramps. Anything including exercise, pregnancy, dehydration, infection, and nerve problems can cause leg cramps. Another form of tendonitis, biceps femoris tendonitis, may develop as a result of hamstring muscle strain. A fluid-filled sac behind the knee may be a Baker’s cyst, which is caused by arthritis or a knee injury. The patient might tear the meniscus, and athletes are prone to meniscus tears. There are other forms of ligament injuries and tendonitis that can cause pain behind the knee. Further, there are several forms of arthritis that can affect the knees. Osteoarthritis, rheumatoid arthritis, lupus, and psoriatic arthritis can all cause back of knee pain. When a deep vein inside the leg develops a blood clot, it is known as deep vein thrombosis.8
When Is It Time to See a Doctor?
Not every cause of knee pain is too serious. For example, patellar tendonitis might respond well to at-home treatment alone. However, there are symptoms that indicate that it is time for a medical professional to intervene. Patients who experience swelling and redness in the leg, a lot of pain, fever, and trouble breathing should seek medical attention. Patients should also talk to a doctor if they already have a history of blood clots. Other dangerous symptoms include changes in the appearance of the knee joint and a leg that is unable to hold weight. Patients will need to tell their doctor about all of the symptoms, as some symptoms can indicate a dangerous condition.9
2, 3 https://physioworks.com.au/injuries-conditions-1/patella-tendonitis-tendinopathy
4, 5 https://www.healthline.com/health/patellar-tendonitis#diagnosis
Find out more about other conditions that affect the knee.