Tendinopathy is an injury to the tendon. It can cause pain, swelling, and limit movement. The injuries can include:
Tendinopathy is generally caused by overuse of a muscle-tendon unit. Over time, the strain on the tendon causes structural changes within the tendon itself.
Patellar tendinopathy occurs from overuse of the knee tendon. Overuse may be caused by any activity that requires:
Patellar tendinopathy is most common in the following sports:
Factors that increase your chance of patellar tendonopathy include:
Symptoms include:
The doctor will ask about your symptoms, physical activity, and how the injury occurred. The doctor will also examine your knee, and may ask you to perform certain movements.
In some cases your doctor may order:
Treatment includes:
Apply ice or a cold pack to the knee for 15-20 minutes, every four hours, for 2-3 days. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin.
Avoid the activity that caused the pain. Reduce shock or vibrations to the knee.
First talk to your doctor if you have any questions about using medications. Over-the-counter drugs that are commonly used to reduce pain include:
This strap (also called a counterforce brace) can help support the tendon and reduce pain. It is worn as a band just below the knee.
Physical therapy will help:
If the treatments above do not reduce inflammation, some doctors may recommend that you consider a cortisone injection. (This should be used only for chronic tendonitis that has not responded to other treatments that have been used for at least two months.) Check with your doctor to find out what is best for you. Avoid repeated cortisone injections.
Return to high-impact physical activity gradually. Healing has occurred when:
You may need surgery if there is:
RESOURCES:
American Academy of Orthopaedic Surgeons
http://www.aaos.org/
The American Orthopaedic Society for Sports Medicine
http://www.aossm.org/
National Institute of Arthritis and Musculoskeletal and Skin Diseases
http://www.niams.nih.gov/
CANADIAN RESOURCES:
Canadian Orthopaedic Association
http://www.coa-aco.org/
Canadian Orthopaedic Foundation
http://www.canorth.org/
References:
Aronen JG, Garrick JG. Sports-induced inflammation in the lower extremities. Hosp Pract . 1999;34:51.
Bursitis and tendinitis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Bursitis/default.asp#3_3 . Updated April 2007. Accessed June 13, 2008.
O'Connor FG, Howard TM, Fieseler CM, Nirschl RP. Managing overuse injuries: a systematic approach. Phys Sportsmed . 1997 May;25(5).
Orthopedics Hyperguide tutorial. Orthopedics Hyperguide website. Available at: http://www.ortho.hyperguides.com/faq.asp . Accessed October 11, 2005.
Post WR. Patellofemoral pain: let the physical exam define treatment. Phys Sportsmed .1998;26(1).
Last reviewed November 2008 by John C. Keel, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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