Condition, prevention and treatment for knee pain
A regular complaint among athletes is knee pain. If you live an active lifestyle or play sports where high impact running, and jumping is necessary you may have experienced one of the most common knee injuries – patellar tendonitis. Patellar tendonitis develops gradually, so it’s not always easy to recognize, but over time will begin to impact day-to-day activities. So what symptoms should you be aware of? How can you manage the pain? Do you need to see an orthopedic specialist? Below we share a short guide to the condition, prevention and treatment so you know the proper steps to take if you or a loved one is suffering from knee pain.
- What does the patella tendon do?
- The patella tendon attaches the thigh muscle (quadriceps) to the shin bone (tibia). Embedded in the tendon is the kneecap (patella). When the quadricep muscles are contracted it shortens the tendon allowing the knee to extend.
- What activities require more action from the tendon?
- We use our patella tendon every day while walking, running/jogging, going up/downstairs and squatting. Anytime we are extending the knee, however more load is applied to a tendon during an eccentric (elongated) load. Think about slowly sitting into a chair, the quadriceps and patella are working in an elongated state to control our trunk from “plopping” onto the chair.
- What causes patellar tendonitis?
- Patellar tendonitis is a result of repetitive stress/overuse of the knee. This causes small tears in the tendon that can lead to inflammation and pain at the tendon. Some contributing factors include, but are not limited to:
- Muscle weakness or imbalance
- Muscle tightness
- Foot structure / improper shoe wear
- What are common symptoms that patients experience with patellar tendonitis?
- Initial symptoms patients will complain about is pain at the tendon just below the knee cap. Most commonly noted during loading of the quadricep muscles, i.e. going up and down stairs
- What are a few crucial exercises that will improve the pain?
- First and foremost, all exercise should be performed without progressively increasing the individual’s symptoms. Lower extremity flexibility must be emphasized. Proper quadriceps, hamstrings, gastroc-soleus and Iliotibial band mobility is essential. All lower extremity exercises should be held between 30-45 seconds repeated 3-4 reps. Also, eccentric strengthening exercise for the quadriceps should be addressed through leg extension, leg press and mini squats raising over a second span, holding two seconds and lowering over a four second span at a 2/2/4 second tempo with weight that does not cause pain and able to perform 3 sets of 12-15 repetitions.
- Do knee braces help remedy pain?
- Initially, some patients can receive relief from the use of a Pro Patella brace or various types of taping. The most common are McConnell taping or KT Tape. If an assistive device (bracing/taping) gives a patient enough relief to the inflamed/painful tendon allowing a patient to perform activities of daily living, then they will most likely benefit from the assistive device during rehabilitation exercise. Taping is simple, and patients can be instructed how to do this at home, making a very cost-effective adjunct to their rehabilitation.
- How can you prevent further patella injuries?
- Once symptoms improve, an individual can start weaning out of the tape or brace first for less strenuous ADL’s and using them only during their individual physical activity. Keeping up with a daily flexibility program is beneficial incorporating lower extremity and core strengthening 3-4 times a week. If someone is having any symptoms addressing them early on is much easier to take care of then allowing it to be chronic. Feel free to reach out to your medical provider as soon as you start to have symptoms. This can also be your Athletic Trainer, Physical Therapist or MD.
Try these exercises to prevent future injuries.
This is not intended to be medical advice, if you are experiencing please consult your MD.
Jon A Ramos PTA, ATC/L