tendon is a structure that attaches the quadriceps muscle group
to the tibia. Patellar
tendonitis, also known as jumper's knee, is the condition that arises
when the patellar tendon and the tissues that surround it, become
inflamed and irritated. This is usually due to overuse, especially
from jumping activities. It is a common affliction of volleyball,
basketball, soccer players, and runners. Rapid acceleration, deceleration,
jumping, and landing concentrate a large amount of stress on the
extensor mechanism of the knee.
Patellar tendonitis can be classified by the following techniques:
Stage 0 - No Pain
Stage 1 - Pain only after intense sports activity; no undue
Stage 2 - Pain at the beginning and after sports activity; still able to perform at a satisfactory level
Stage 3 - Pain during sports activity; increasing difficulty in performing at a satisfactory level
Stage 4 - Pain during sports activity; unable to participate in sport at a satisfactory level
Stage 5 - Pain during daily activity; unable to participate in sport at any level (14)
In mostly stages 1-4, this condition can be treated by a conservative approach. The therapy includes strengthening the muscles around the knee and continuation of non-contact aerobic exercise. The athlete is encouraged to continue exercising and working out despite the tendonitis. In addition to this, the knee should be frequently iced.
In severe cases of tendonitis, approximately 10% of cases in athletes, surgery must be performed to alleviate the pain of tendonitis. Six weeks after the surgery in most cases, the athlete could begin their physical therapy to begin playing their respective sport again. Most cases for these surgeries are Stage 5, but many times, especially in professional athletes, surgery is requested because the patient doesn't want to deal with the non-operative therapies and the pain of tendonitis. (14)
Often times, athletes, especially toward the end of their careers present with forms of arthritis. Sometimes, it is confused with a ligament injury. If the athlete has chronic pain as a result of arthritis, there are a couple therapies which they can pursue.
First, and most commonly, they can undergo a conservative therapy known as RICE:
R - rest
I - ice
C - compression
E - elevation
This therapy is common in most sports for general soreness. For these athletes that have arthritis, it will ease the pain, swelling, and make it much easier to play on. Often times, they must take time away from their sport to allow it get a little better.
For those athletes whose arthritis is too bad, often times a high tibial osteotomy will alleviate their pain. These patients often present with symptoms similar to ACL injury, the way to distinguish the two are that the arthritic athletes may have an altered gait, including decreased external knee flexion moments, high external adduction moments, increased external knee extension moments, and increased knee hyperextension during stance phase. (26)
This procedure corrects the alignment of the knee of the patient, which relieves pressure on the arthritic part of the knee. This new alignment shifts the weight of the body onto a portion of the knee that has more cartilage. This procedure is great for young arthritic athletes because it can delay knee replacement for around ten years. (27)