Patellar Tendon
Patellar tendonitis – Jumpers Knee
What is the patellar tendon?
The patellar tendon is a thick band organized tissue that connects the patella (kneecap) to the tibia (shin bone). Plays a crucial role in transmitting forces generated by muscles in front of the thigh (quadriceps) in the tibia so that the leg can be straightened and support our weight during walking or jumping. The patellar tendon with the muscle quadriceps, patella, quadriceps tendon, and surrounding tissues ("retinacula") is the extensor of the knee. The patellar tendon is composed a highly organized arrangement of collagen that run longitudinally to resist tensile forces as a string.
What Patellar tendinitis?
Patellar tendinitis is defined as inflammation of the patella tendon, and occurs most often at the root just below of the patella. The most common cause is injury due to overuse or repetitive, and has been reported among athletes in most sports. However, activities of jump provides particularly high in the tendon and the condition is more common among basketball players, players tennis players, volleyball, athletics and players football. With repetitive jumps, small, often "microscopic" Tear and tendon injuries can occur. Chronic wounds and response results healing in inflammation and localized pain. Celebrities elite athletes, including Brandon Inge of the Tigers, the Mets Oliver Perez, and tennis Rafa Nadal coped with chronic patellar tendinitis in his career. Rarely, an acute patellar tendinitis may develop in response to a single traumatic event and should raise concerns with respect to a partial or total rupture of the tendon.
What are the symptoms of patellar tendinitis in athletes?
The diagnosis of patellar tendinitis is usually straightforward. The pain is often reproduced by palpation of the area of inflammation and injury. It is further often in the lower pole of the patella, but can occur anywhere along the course of the tendon. Compared to the other extreme, normal knee, the tendon is often inflamed and often hot to the touch. Depending on the severity, the athlete may have significant pain with jumping or kneeling. Walk up and down stairs can also place heavy loads extensor and aggravate the pain.
X-rays are sometimes useful in evaluating other causes of knee pain, but are usually normal with patellar tendinitis. If the patellar tendon ruptures, the ball is moving "up" and the distance between the patella and tibia is larger normal (patella alta). Ultrasound and MRI are sensitive and specific identification and location of the patellar tendinitis tendon field "Micro-injury '.
What may increase my risk of patellar tendinitis as an athlete?
The cause of tendinitis patella in athletes is often multifactorial. However, some factors may increase the risk of this injury are:
• abuse, especially with recurring activities of the jump.
• Insufficient air conditioning or stretching – a length-tension relationship and the fulfillment of abnormal muscles in the thigh and calf may increase tension in the patellar tendon and increase the risk of injury.
• Obesity – a slight increase in weight increased dramatically up pressure on the patella and extensor mechanism. In fact, a profit of £ 1 may be manifested by more than 8 to 10 pounds of force on the knee in certain activities.
• patella alta – a "above normal" position of the ball can increase the pressure and the risk of patellar tendon injury.
The athletes may prevent patellar tendonitis?
Unfortunately, it is difficult to predict the development of patellar tendinitis. However, as with most overuse injuries, stretch before vigorous competition can help prevent injuries. Stretching the quadriceps tendons and muscles the calf will help minimize the risk of damaging the tendon eccentric loads during operation or jumping activities.
How patellar tendinitis treated in athletes?
The first line of treatment of patellar tendinitis in athletes is generally conservative. The principles basic treatment include:
Rest
It is essential that the athlete to avoid provocative activities that cause pain. Normally, this means the cessation of competition and the rest period of running and jumping activities. This will decrease stress and prevent recurring injury to the tendon.
Ice and anti-inflammatory drugs (NSAIDs)
Ice and nonsteroidal antiinflammatory drugs (NSAIDs) can certainly help ease the pain, and may be useful in increasing physical therapy and stretching exercises for healing and recovery.
Exercise and Physical Therapy
As the pain goes away after a period of rest, stretching and strengthening exercises are initiated. These exercises help to restore the relationship normal length or tension of muscles and tendons, and also play a crucial role in preventing the recurrence of patellar tendinitis. It is critical is to learn the proper techniques for jumping and landing, and strengthen the muscles around the kneecap to reduce forces in the tendon itself. eccentric exercise to strengthen the quadriceps muscles has proved particularly effective – These are exercises that involve muscle contraction, while the elongation, for example, reduce weight in a controlled manner to a long bent knee position.
Steroid injections are not recommended for treatment of patellar tendinitis. So you can certainly reduce local inflammation at the site of injury, injections should be approached with caution because steroids can weaken the tendon and increase the risk of rupture of the patellar tendon.
Is there a role for recording or reinforcement in the treatment of Patellar tendinitis?
Recording or the use of a tendon "belt" key of the patella often has provided substantial assistance to athletes, although success varies. The exact mechanism is unknown but is believed to alter the register or hold the angle and direction of stress at the site of injury in fact "Discharge" of the region and reducing pain through the distribution of forces outside the tendon. A belt is specially used to download Chopat patella tendon and patellar tendinitis for two Osgood-Schlatter disease.
What are the treatment options can be regarded as short patellar tendinitis surgery?
A number of other treatments were used with varying success in the treatment of tendinitis patella. These include:
Platelet-rich plasma (PRP) PRP injection has been used recently in the treatment of chronic tendinitis, refractory. PRP is derived from the patient's blood and concentrates many important growth factors that have proven important in the healing response of the body after injury. Preliminary results were encouraging, but long-term success remains unknown.
Extracorporeal shock wave Therapy (ECW): ECW uses sound waves to stimulate healing of tendon injury. It has been used with modest success in the treatment of tendinitis and plantar fasciitis.
Laser and electrical stimulation: Although the mechanism of action is unclear, and the stimulation of laser techniques power has been successfully reported in small series of cases.
Is there a role for surgery in the treatment of patellar tendinitis in athletes?
Surgery is indicated in severe cases of patellar tendinitis that can not be resolved by conservative measures. The operation aims to repair tendon tissue and tendon debridement viable now severely damaged, usually just below the kneecap. Many athletes, including Brandon Inge, Oliver Perez and Carlos Beltran, have undergone surgery and returned to competition of MLB success.
For more information on sports-related injuries, please visit www.sportsmd.com . SportsMD are the most reliable resources for sports health and fitness information for those involved in sport throughout the world. We have met Doctors major sports and industry experts Health – each exchange of valuable, practical tips that you can play without injury. About the Author
Dr. Asheesh Bedi is an Assistant Professor of Sports Medicine and Shoulder Surgery at the University of Michigan and MedSport Program. He is a team physician for the University of Michigan Athletic Department and specializes in both arthroscopic and open surgery for athletic injuries of the shoulder, elbow, hip, and knee.
Dr. Bedi completed his undergraduate training at Northwestern University where he graduated Summa Cum Laude. He graduated from the University of Michigan Medical School with AOA recognition, and remained in Ann Arbor to pursue residency training in Orthopaedic Surgery at the University of Michigan. After completing his training, Dr. Bedi completed a two-year fellowship in sports medicine and shoulder surgery at the Hospital for Special Surgery and Weill Cornell Medical College in New York. He has also pursued additional dedicated training with Dr. Bryan Kelly in arthroscopic hip surgery for young athletes. While in New York, he was an assistant team physician for the New Jersey Nets professional basketball and New York Mets professional baseball organizations with Dr. Riley Williams, Struan Coleman, and David Altchek. He was also an orthopaedic consultant for the U.S. Open Tennis Tournament in 2007 and 2008 with Dr. David Dines and an assistant team physician for Iona College Athletic Programs.
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