Patellar tendonitis, otherwise known as Runners Knee or Jumpers Knee, is caused by overuse of the patellar tendon. Initially, the knee will only hurt after sport, as the overuse becomes worse, the pain will start at the onset of play and get better as the knee warms up. This is because overuse of the knee during certain sports leads to micro tears in the tendon. When the tendon heals, it develops scar tissue that becomes painful and may lead to the tearing of the entire tendon.
Patellar tendinitis is an overuse injury seen in athletes in all high impact sports like athletics, tennis, basket, vaulting, gymnastics, cross fit etc. In most cases, by the time the person experiences the painful symptoms, the damage is extensive and requires a long-term recovery process. This injury is the most common injury to end the careers of high-performance tennis players.
Since inadequate recovery is the biggest cause for patellar tendinosis, the aim in treatment is to stop the overload on the tendon and allow the tendon to heal itself.
Rest does not mean total immobilization but rather an adjustment of activities and no competitive sport or jumping exercises. Eccentric and low impacted exercises with attention to detail under the supervision of an experienced biokineticist or trainer will yield the best results.
Platelet-rich plasma injections have saved some high profile athlete's careers and are an option that is used successfully for many cases. Which infiltrations will be of benefit for you will be discussed with you during your consultation with Dr Morkel.
If all conservative approaches fail, resistant (grade 4) cases may benefit from surgical removal of scar tissue.
All of these methods of treatment require at least 6 months of recovery before returning to sports. For any of the above treatments to provide good results, physical adjustments and sufficient recovery time will be needed.
Since these injuries can take up to 2 years to heal, prevention is better than cure. While changing court surfaces and shoes may not help, changing from a long, heel strike, stride in the running to a shorter, midfoot strike, stride seems to promise lower tensile forces on the patella. In tennis focussing on midfoot or fore foot strike running, should lower the incidence of patellar tendinitis. Adjusting of running patterns should be done very early in any athlete's career.
It is also important that athletes follow an injury prevention program, focussing on eccentric training of quadriceps and hamstrings and strengthen the core muscles. Adequate recovery after training should be prioritised. And while adequate recovery for a high-performance aspiring athlete is a difficult challenge, measurements of sleep patterns, jump tests or beep tests are all guidelines to determine adequate recovery in individual athletes.