Do you find yourself wincing at knee discomfort during activities that once felt effortless? Is unease keeping you from enjoying sports or even daily tasks? You might be experiencing Patellar Tendonitis or Quadriceps Tendonitis. Don’t worry—you’re not alone, and there’s a clear path to healing. Let’s explore what these conditions are and how you can regain your active lifestyle.

What Are Patellar Tendonitis and Quadriceps Tendonitis?

Patellar Tendonitis

Commonly known as “jumper’s knee”

Patellar Tendonitis is an overuse injury causing inflammation of the patellar tendon. This crucial tendon connects your kneecap (patella) to your shinbone (tibia) and helps you straighten your knee. Repetitive stress from activities like jumping and running can cause tiny tears in the tendon fibers, leading to discomfort and weakness.

Quadriceps Tendonitis

Quadriceps Tendonitis affects the quadriceps tendon, which attaches the powerful thigh muscles to the kneecap. This tendon is essential for straightening your leg from a bent position. Overuse or sudden increases in activity can lead to inflammation and micro-tears, resulting in discomfort and reduced function.

Who Is Affected?

Understanding who is at risk can help in early detection and prevention.

• Age Group: Adolescents to middle-aged adults (16-40 years old) are more susceptible due to high levels of physical activity.
• Gender: Both males and females are affected, though it’s slightly more prevalent in males, possibly due to higher participation in high-impact sports.
• Active Individuals: Athletes and fitness enthusiasts involved in sports like basketball, volleyball, soccer, and running are at increased risk due to repetitive jumping and rapid movements.

How Do These Injuries Occur?

Overuse and Repetitive Stress

• Continuous Strain: Engaging in activities that put constant stress on knee tendons without enough rest leads to micro-tears and inflammation.
• Sudden Increase in Activity: Rapidly intensifying workouts or starting new high-impact sports can overwhelm tendons not accustomed to the stress.

Poor Biomechanics

• Misalignment: Flat feet, high arches, or improper gait increase stress on knee tendons.
• Improper Technique: Incorrect form during exercises like squats and jumps contributes to tendon strain.

Muscle Imbalances

• Tight Muscles: Tight quadriceps or hamstrings pull excessively on tendons.
• Weak Muscles: Weak hip or core muscles alter knee mechanics, increasing tendon load.

Inadequate Equipment

• Worn-Out Footwear: Lack of proper support fails to absorb impact, transferring stress to knees.
• Hard Surfaces: Training on concrete or hard surfaces increases impact forces.

Symptoms to Watch For

Recognizing the symptoms is essential for timely intervention.

• Discomfort:
  • Location: Front of the knee—below the kneecap (Patellar Tendonitis) or above it (Quadriceps Tendonitis).
  • Nature: Starts as mild unease during activity, progressing to a persistent ache.
• Tenderness: Sensitivity to touch or pressure in the affected area.
• Swelling: Mild swelling due to fluid accumulation from inflammation.
• Stiffness: Difficulty bending or straightening the leg, especially after inactivity.
• Weakness: Feeling of the knee “giving way,” affecting balance and movement confidence.

What Should You Do If You Suspect Tendonitis?

Take Prompt Action

1. Rest Your Knee: Avoid activities that cause discomfort to prevent further tendon damage.
2. Apply Ice: Reduce inflammation by applying ice packs for 15-20 minutes every 2-3 hours.
3. Use Compression: Support your knee with a brace or strap to reduce strain and provide stability.
4. Elevate Your Leg: Decrease swelling by keeping your leg raised above heart level when resting.
5. Over-the-Counter Medications: Anti-inflammatory drugs can help manage discomfort and inflammation.
6. Seek Medical Attention: Schedule an appointment with a healthcare provider for accurate assessment.

Diagnosis: What Will the Doctor Do?

Medical History

• Symptom Discussion: Share how your symptoms started, their severity, and how they affect your daily activities.
• Activity Level: Discuss your physical activities, sports involvement, and any repetitive knee movements.
• Previous Injuries: Inform about any past knee injuries or surgeries.

Physical Examination

• Visual Inspection: Checking for swelling, redness, or deformities.
• Palpation: Identifying tender areas by gently pressing on the tendon.
• Range of Motion Tests: Assessing flexibility and joint function.
• Stability Tests: Evaluating the strength and stability of your knee joint.

Imaging Tests

• X-rays: To rule out bone issues like spurs or fractures.
• Magnetic Resonance Imaging (MRI): Provides detailed images of soft tissues, revealing inflammation or tears in the tendon.
• Ultrasound: Shows tendon movement and blood flow in real-time.

Understanding Blazina’s Classification for Patellar Tendonitis

Blazina’s Classification describes the severity of Patellar Tendonitis to guide treatment:

• Stage 1: Discomfort After Activity
  • Description: Mild discomfort only after intense physical activity; subsides with rest.
  • Implication: Early sign; tendon shows initial stress.
• Stage 2: Discomfort During and After Activity
  • Description: Unease during activity that lingers after; doesn’t severely limit performance.
  • Implication: Progressing tendon damage; needs intervention to prevent worsening.
• Stage 3: Prolonged Discomfort and Performance Impairment
  • Description: Persistent discomfort during and after activity; affects ability to perform.
  • Implication: Significant tendon damage; increased risk of rupture; requires aggressive treatment.

Treatment Options

1. Rest and Physiotherapy

Conservative Management focuses on reducing stress on the knee and correcting alignment issues through non-invasive methods.

• Activity Modification: Limit activities that worsen symptoms to allow healing.
• Physical Therapy:
  • Stretching Exercises: Improve flexibility in quadriceps and hamstrings.
  • Strengthening Exercises: Build muscle strength around the knee.
  • Eccentric Training: Focus on controlled lengthening of the muscle-tendon unit.
• Additional Therapies:
  • Ultrasound Therapy: Promotes blood flow and healing.
  • Massage Therapy: Reduces muscle tension.

Recovery Period: Several weeks to months.

Recurrence Rates: Symptoms may reappear, especially if the underlying alignment issue isn’t corrected.

2. Platelet-Rich Plasma (PRP) Injections

What is PRP Therapy?

PRP therapy involves injecting a concentration of your own platelets into the injured tendon. Platelets release growth factors that stimulate tissue healing and reduce inflammation.

Procedure:

1. Blood Draw: A small amount of your blood is drawn.
2. Centrifugation: Blood is spun to separate platelets from other components.
3. Injection: Concentrated platelets are injected into the tendon under ultrasound guidance.

Benefits:

• Minimally Invasive: Non-surgical option with minimal downtime.
• Natural Healing: Utilizes your body’s healing mechanisms.

Considerations:

• Variable Outcomes: Results can vary; not all patients may experience significant improvement.
• Multiple Sessions: Some cases may require more than one injection.

3. Surgical Intervention

If conservative measures fail, surgical treatment may be considered.

Topaz Radiofrequency Ablation

• Procedure: Small probes deliver radiofrequency energy to stimulate healing.
• Benefits: Reduced recovery time and positive outcomes in chronic cases.

Excision and Repair

• Procedure: Removal of damaged tissue and reinforcement of healthy tendon.
• Benefits: Addresses the root cause and restores tendon strength.

Recovery Period:

• Topaz Procedure: 2-3 months.
• Excision and Repair: 3-6 months.

Rehabilitation:

• Essential physical therapy for regaining strength.
• Gradual return to activities.

Recovery and Recurrence Rates

Conservative Management

• Recovery Time: May provide temporary relief but often requires ongoing effort.
• Recurrence Risk: Higher chance of symptoms returning without structural correction.

Surgical Treatment

• Recovery Time: Involves comprehensive rehabilitation but leads to lasting improvement.
• Recurrence Risk: Significantly reduced when anatomical issues are corrected through surgery.

The Importance of Surgical Treatment

While physiotherapy and conservative methods can help manage symptoms, surgical treatment may be necessary to correct the underlying cause.

• Long-Term Relief: Restores normal knee mechanics, reducing discomfort and improving function.
• Improved Quality of Life: Enhances mobility and allows you to return to activities without discomfort.
• Prevention of Further Damage: Addresses the root cause, lowering the risk of chronic knee problems.

For active individuals eager to return to their routines, surgery can be a highly effective option.

Take the First Step Toward Healing. Imagine a Life Without Knee Discomfort.

• Wake up energized and ready to embrace each day.
• Return to the sports and activities you love.
• Walk confidently without unease holding you back.

Dr. Sean Leo is here to guide you every step of the way, offering personalized treatment plans tailored to your unique needs—including the latest options like PRP therapy and advanced surgical techniques.

Don’t let knee discomfort dictate your life any longer. Book Your Consultation Today.

Take control of your health and happiness. Reach out to Dr. Sean Leo now, and embark on your journey to a discomfort-free future.

References

1. Zandi, H., Shadmehr, A., & Mozafari, M. (2019). Minimally Invasive Surgical Excision of Patellar Tendon Ossification With Topaz Radiofrequency Ablation. Arthroscopy Techniques, 8(8), e883-e887.
2. Filardo, G., et al. (2018). Platelet-rich plasma injections for the treatment of refractory Achilles tendinopathy: results at 4 years. Blood Transfusion, 16(4), 362–364.
3. Dragoo, J. L., et al. (2014). Platelet-rich plasma as a treatment for patellar tendinopathy: a double-blind, randomized controlled trial. The American Journal of Sports Medicine, 42(3), 610–618.
4. Marcos Henrique Frauendorf Cenni, et al. (2015). Patellar tendinopathy: late-stage results from surgical treatment. Rev Bras Ortop, 50(5), 550–555.