Patellar Tendinopathy

wall sit

Patellar Tendinopathy

What is patellar tendinopathy?

Patellar tendinopathy is when the tendon that connects your knee-cap to your shin bone becomes inflamed as a result of repetitive and increased stress to the tendon over time. When a tendon becomes stressed due to repetitive movement and a sudden increase in load, the tendon has difficulty recovering due to a poor ratio of activity to rest.

Patellar Tendinopathy diagram

Source: InjuryMap

What happens to the tendon?

Overtime a stressed tendon will develop micro-tears because of repetitive movement and an increase in load over time without proper rest between training sessions. The tendon structure becomes disrupted and repair of the tendon becomes disorganised. There 3 distinct stages regarding tendon pathology changes, these include:

  1. Reactive tendinopathy

  • Short term adaptation that thickens the tendon
  1. Tendon disrepair

  • The attempted healing following stage 1 but with greater break down of collagen and other structures involved
  1. Degenerative tendinopathy

  • Larger areas of cell death within the tendon

All these stages are load dependent (the amount of activity being performed), which is the primary factor that drives tendon health.


Patellofemoral Pain Syndrome, Patella Tracking

What symptoms are associated with patellar tendinopathy?

Typically, you will feel localised pain at the site of the tendon which seems to be worse in the morning due to stiffness. Other symptoms include:

  • Load-related pain that increases with the demand of the knee extensors (quadriceps)
  • Prolonged sitting
  • Repetitive squatting
  • Walking up/downstairs


What can I do to make my patellar tendinopathy feel better?

The pain may improve with repeated loading (exercise). An important feature of tendinopathies is that they are dose-dependent, pain increases as the magnitude or rate of application of the load on the tendon increases. Therefore, a guided exercise program by your health professional is crucial to monitor and increase load as tolerated by the tendon. Some great exercise to gradually increase load in the tendon include:

  • Wall sits
  • Lateral step downs
  • Side lying clams
  • Heel elevated squats

wall sit exercise

Alternative options to settle the pain down?

There are a couple of ways to manage it medically, these include:

  • non-steroidal anti-inflammatory drugs (NSAID’s) – ask your pharmacist
  • Cortisone injections
  • Shockwave therapy (ask your physio)

Please consult your health professional and doctor for further information regarding medical management options.


How can a Physiotherapist help?

A Physiotherapist can help by going through a thorough examination by assessing your biomechanics and any other factors that may be contributing to your patellar tendinopathy. We can help identify what stretches and exercises are needed, and to create a long-term management program for injury recovery and reoccurrence prevention.


Post by: Physiotherapist  Ray Palencia