PATELLAR TENDINOPATHY (JUMPER’S KNEE) What is patellar tendinopathy? Tendions ae strong bands of connective tse that attach muscle to Bone: When m tenn ie scutely injured is called strain, Tendonitis is when a ten- dons inflamed. When there are mictears ina t= ‘dan rom repeated injury it scaled tendinoss. The term tendinopathy refers bath inflammation and Patella tendinopathy ls called jmpor's knee, te lnlamimation inte band of tase (C4 patella te don) that connects the kneecap (patel to the hin bone (bi), How does it occur? ‘The most common activity causing ptellar tendinopathy is too much jumping. Other repeated activites suchas runing, walking ee Biyeling may Jead to patellar tendinopathy ll ofthese activities ppt repeated stress on the patella tad, causing it foe inflamed Patella tendinopathy canals hagpen to people wo have problems withthe way tet hips, legs, Kees o feet are aligned, This alignment problem ‘can result from having wide hips, beng knock-kneed, ‘or having fet with arches that collapse when you ‘walk or un, a condition called over pronation, The patellar tendon may sometimes ear complet Jy-or rupture, during strenuous actvty. What are the symptoms? Symptoms may include: ‘prin and toners around the pala tendon « swelling in your knee joint or sweling where the patella tendo attaches tothe shinsone «+ pain with jumping, ning, or walking, especially Alownhill or downstairs «pal with bending or straightening the leg, ‘ tendemess behind the kneecap your patellar tendon is raptuted, wally you will have sudden sovere pain and you wil be unable To straighten your logo walk How is it diagnosed? Your heatheate provider will examine your knee ta see you have tendemese at the pater tendon. He ‘or she will also have You ran, jump, er sa to see if this causes pain. Your fet wil examined fo sew f you have a problem with over-pronaton, Your provider may order Xerays or an MRL you knee How is it treated? “Teatment inches the following ‘Place an ice pack on your knee for 20 to 30 minutes ‘every 34 hours forthe fret 2to 3 days or until the pain goes away. «+ levate your knee by placing a pillow underneath {your lg when your knee hts Take ant-nflammatory pain medicine, suchas ‘ibuprofen, as prescribed by your healthcare provider (adults aged 65 years and older should ot take non-steroidal sn-nflammatory medicine for more than 7 days without thei healtheare provider's approval), PATELLAR TENDINOPATHY (JUMPER’S KNEE) ia = we Sli =Doth eerie ecmtmended by your ealthane provider or pial therapi ‘Your halthare provider my recommend that you ‘+ wen shoe ines (led etl) er ove pron thn (jou can buy orthotics pharmacy oF athe ieshoe store o hey ean be easton) ‘use a infapatallr aap strap paced beneath the noacap ver the palo tendon ‘weara neoprene knee seve which supports your ee and patel ‘ile you ae mecoveng frm your injury, you wl ‘net change your sport or actly to one at oe ‘ot make your condition worse Fr exami, you ‘hay ned to Bjleo wi stead aca tf severepaelfemorl pan syodrome,surgecy may betcommended Your esthenre provider wil chow you eecie 1o help decree te pain Sind your nce When can I return to my sport or activity? “The goal of rehabilitation to tar you to your porto etiviy as soon a safely posable yu ‘tua too soon you may worsen your inary, hich ‘oul ead to permanent damage Everyone ecovers ‘tom injury at a frente. Het to your sport oF ‘tity wl be determined By how sun your Kee ‘eoves ot by how many day or week thas Been fine your ry occur In eral, he lenge you have sympioms before you start testment the longer wil kee get beter “You may safely retum your sport or actity when stating foe Be tp ofthe is ed progres ing tothe end ach ofthe lowing ib rue + Yur ined ee ca be fll sighted and ent thot pain PATELLAR TENDINOPATHY (UMPER' KNEE ntinue) + Your knoe and eg have nai noemal strength ompate othe oni se an eg + Your nee snot swollen + You ae able to jog steaight head witout limping ‘You ae able to spin stright bead witout imping “You ae abet do 4. depre cus 1 You ae able to do 9 deg cuts, 1 You are abet do 20-yard igure oight ns 1 You ae abet do 10a igureoaight uns You are abe to jump on both Leys withou pan and mp on te njred leg who pal How long will the effects it last? The eects of patel tendinopay vary A tendon atts ony sadly amd! and has ut tre fo ‘hurt may nprove within few wks A endo hat Sssigifeany nfl and hasbeen pina for 2 Teng ane may ok up toa few rome t prove ‘ounce t stp deg the activities tat sie pin ‘nfl your tendon as hele yo continue ding tite tt cause pai, your symptoms wil mare tnd it wil ake longer to moter How can | prevent patellar tendinopathy? Patella tennopathy eval cause by ovense using actin nach jmp runing o ik Ing uphl can best be prevents by having son {igh mck, ‘The following may also help prevent jy ‘When you cree, wea hoes that it properly sl ace righ forthe activ. ‘Cena sate belo and ter exeriingPATELLAR TENDINOPATHY (JUMPER’S KNEE) REHABILITATION EXERCISES ‘You can do the hamstring stretch ight away. When the pan in your knee has decreased you can de the 1. STANDING HAMSTRING SIRETCH: Place the hel of your lag on a stoo| about 18 inches high. Keop your knoe straight. Lean for- Ward, bending atthe hips until you fee! ‘2 mid svtch nthe back of your high, Make sure you do at rol your shoulders and bend al the walt ‘when doing this or you wil stretch Your lower back instead. Hox the Stretch fr 15 to 30 soconds. Repeat 3 times foreach og ou eres eee YY) soins peter , iceman ca erate seinen eaten ‘ouecies seconds, Repeat 3 times on each sda 3. SIDELYING 1&6 LUFT: Lyng on you edo, tion the ‘ront thigh muscles on your top log and it that leg 8 to 1Oinches aay 2 from the otner is, Koop the eg svaight. Do 3 sets of 10. 4. STRAIGHT LEG RAISE: Le on your back with you logs: ‘taight out in font of you. Bend one knee ard place ‘ho foot fat onthe floor Tightan up the top of your thigh muscle onthe opposite leg anit thatlog ‘bout B inches off the ‘oor keeping the thigh masele ight ‘throughout. Slowly lower your lag back ‘downto the oor Do ‘Deets of 10 on each side, 20 ‘stengtnning the thigh muceloe wing the rest of tho exooie, 5. suPUP: Stand with the oot of ‘one lag on a support ike a block ‘oF weod) 8 to § inches high “Fa0% Sif your weight onto the leg on the support and svaighton ‘he kee as the othe og ‘comes off the flor Lower ‘your 69 back tothe floor ‘Slouly.De 3 sets of 10 Teale rename ers Sepa mee, iro esp ai 7. NE STABILIZATION: Wrap a peo of elastic tubing ‘aroun the ane of one lag. Te @ Knot ine other ‘end ofthe tubing and close it in a door. [A Stang facing the door onthe leg vthout tubing and bend your knee sighty, keeping your thigh muscles tight. While maitaiing ths positon, move the leg with the tubing straight back behind ‘yu 09 3 sets of 10, 8. Tur 90° so the leg without tubing is clase fo the door Move the leg with tubing away from your body. Do gots of 70.PPATELLAR TENDINOPATHY (JUMPER'S KNEE] REHABILITATION EXERCISES coninue) (C.Turm 0° again so your back is ‘athe door Move the fg wlth tubing straight out in ont of you. Bo 3 sets oF 10 ste sTHBL2ATION 10. Turn your body 80° again so tho log with tubing is closest othe door. Move the lag with tubing across your body. Do 3 sets of 10. Hold onto a chairif you need help balancing, Tis ‘xercse can be made even more challenging by stancing on a pilow wile you move the log with tubing RESISTED TERMINAL KNEE EXTENSION: Make @ oop “rom apiece of elastic tubing by tyng a knot in Both ‘ends. and closing both knots ina coer Step int the ioop se the tubing around the back of one fag. Lif the ‘other foot off the ground. Hold onto a chai for bal ‘nce, i needed, Bend the kee on the eg wih tubing about 45 degrees. Slowly straghton your log, keoping your thigh muscie tight as You do this. Do this 10 tes, 09 sets. An easier way to o this sto perform this ‘exercise while standing on both legs. {8 DECLINE ECCENTRIC SQUAT: Stand with both fost on an angled platform oF with Your hoo on a 3 inch high board. Put | alyour eight on one log and squat ‘down to-a 45 degree angle. Use your )) other eg to help you return from the ‘squat. When this exercise becomes {_2259; hold weights in your hands to ‘maka the exercise more ficult. Dod seis of 10. conc SQUat ape 0 20a Cop n/t. A gh na Pn yr per ite wasps THE SPORTS MEDICINE PATIENT ADWSOR OF rts aPATELLOFEMORAL PAIN SYNDROME (RUNNER’S KNEE) What is patellofemoral pain syndrome? Patllofemoral pain syndrome i poin behind the scocap. thas been given many names, chiding patelofemoral disorder patellar malligament, her's Knee, and chondromalacia How does it occur? Patllofemoral pain syndsome can occ from over: ‘use of the knoe in sports and activites such a= rat ring walking, jumping, or bicycling ‘The kneecap (patella is attaches to the large group of msl in the thigh called the quadriceps. It also attached to the shin bone by thepatllat tendon. The [kneecap fits into grooves inthe en of the thigh bone (Gemma) called the femoral condyle, With repented bending and straightening afte ke, You can ir tate the inside surface ofthe knocap and case pain Patellofemoral pain syndrome alo nay result from the way yout hips, legs ees or fet ate aligned. This alignment problem canbe caused by your having wide hips or underfeveloped thigh -usles, being knock-kneed, oF ving feet With arches that callapse when walking or Funing a cone dition called over-pronation). ‘What are the symptoms? ‘The main symptom is pain bchied the kneecap. You may have pain when you walk un, ost fora long lime. The pai is generally worse when walking dlownhill or down stairs, Your kage may swell at Himes. You may fel oe hese shopping Popping, oF arinding inthe knee How is it diagnosed? ‘Your healthcare provider will review your symptoms, cevamine your knee and may order knee Xr0)s How is it treated? “Treatment includes the following + Place an ice pack on your kre for 20 to 30 minutes ‘every 3 tod hours forthe ist to 3 days or ul the pain goes away *Blevate your knee by placing 2 pillow underneath your log witen your knee hurts « Thke antiinflammatory pain medicine sch as Ibuprofen, as prescribed by your healthcare provider (adults aged 65 yearsand older should ot take noresteroidalant-nghammatory medicine for more than 7 days without their healthcare provider's approval) + Do the exercises recommended by your healthcare provider a phiysieal therapist, ‘Wu ealtheare provider may recornmend that you: + Wear shoe inserts (called orthotics) for overprona- tion. You can buy orthotics ata pharmacy orale Je shoe store or they can be custom-made ‘+ Use an infapatella tap, astap paced beneat. ‘he kneecap over the paella tendon. ‘Wear a neoprene knee sleeve, which wil give sup port to your knee and patel, “While you ae recovering from your injury, you will ‘eed to change your spot o activity to one that does ‘rot make your condition worse. For example, you, spay need to bicycle or svi instead of run ie eases ‘severe patellofemoral pain syndrome, sugery may evecommended. Your healthare provider will shove PATELLOFEMORAL PAIN SYNDROME (RUNNER'S KNEE) ie (oeers) ent ‘apo Somes recto ea tere 22 THE SPORTS MEDICINE PATIENT ADVISOR