Many athletes experiencing aching and tenderness where the patellar tendon inserts at the patella (kneecap) have a condition called “jumper’s knee” or patellar tendinitis. Symptoms can occur above or below the patella. Landing from jumps is the most painful.
In this review article, doctors specializing in orthopedic sports describe this condition and its causes. They discuss the nonoperative management of jumper’s knee. When to consider surgery is also presented.
Patellar tendinitis is classified or graded from Stage I to Stage IV. Stage I is pain only after sports activity. Stage II is pain at the start and end of sports activity. Stage III is constant pain. Stage IV is complete rupture of the tendon.
Microtears of the tendon occur with repeated loads. If the body doesn’t have time to heal between training sessions, then chronic tendinitis and even can rupture occur. Risk factors for this condition include the patient’s anatomy, tight muscles, or leg length difference. Other factors include the hardness of the playing surface and number of training sessions. Direct trauma to the patella or tendon can also cause chronic tendinitis.
Early stages of patellar tendinitis (Stages I and II) are treated conservatively. Rest, strengthening, and medications are used first. The athlete is told to avoid motions that will reinjure the tendon. Sports training should be restricted to every second day. Slow return to full activities is allowed when the athlete is completely without pain when jumping. Reducing tendon load this way allows time for better healing. The player is also advised to use ice after activities to control swelling and inflammation.
When conservative care fails, surgery may be needed. Nonoperative care must be tried consistently for six to 12 months first. Surgery is reserved for more advanced disease that does not respond to all other measures. After surgery, the patient is protected in a splint and started on a rehab program. It may be six months before the athlete can return to full sports play.