Patellar tendonitis is an injury to the tendon that connects your kneecap (patella) to your tibia. It is often known as a jumper’s knee. It is a painful and potentially debilitating condition affecting athletes and active individuals of all ages.

Physical therapy has emerged as a key factor in managing and preventing this injury. Through targeted exercises, manual therapy, and other techniques, physical therapy can help improve strength and flexibility in the affected knee, reduce pain and inflammation, and ultimately restore function and performance.

In this article, we will explore various patellar tendonitis treatment exercises.

Initial Assessment of Patellar Tendonitis

The primary symptom of patellar tendonitis is pain, which worsens with activity, and there may also be stiffness and tenderness in the affected area. The initial assessment of patellar tendonitis includes the following:

• Evaluation of Pain and Range of Motion

The primary symptom of patellar tendonitis is pain, usually located at the bottom of the kneecap, and worsens with activity. In addition to pain, there may also be stiffness and tenderness in the affected area. A range of motion assessment can be conducted to determine the extent of the injury.

• Identification of Contributing Factors

The common contributing factors to patellar tendonitis are repetitive knee joint stress due to sports or physical activities and muscle imbalances or weakness in the lower extremities. Other factors include a sudden increase in training intensity, inadequate warm-up or stretching, and poor biomechanics or foot alignment. Identifying and addressing these contributing factors is important to prevent the development or recurrence of patellar tendonitis.

Treatment Plan For Patellar Tendonitis

Physical therapy for patellar tendonitis typically includes a combination of exercises and stretches. Exercises such as quad sets, straight leg raise, and heel slides can help to strengthen the muscles around the knee, including the quadriceps and hamstrings.

Strengthening and stretching muscles can help to support the knee and reduce stress on the patellar tendons. It’s important to note that every patient’s treatment will be unique and tailored to their needs.

Strengthening exercises

Strengthening exercises are an important component of physical therapy for patellar tendonitis. These exercises help improve muscle strength, reducing stress on the patellar tendon and promoting healing. Various strengthening exercises are listed below:

• Quadriceps strengthening exercises:

Terminal knee extensions: Sit with your back against a wall and a rolled-up towel under your injured knee. Straighten your knee and hold for five seconds before lowering it back down.
Step-up: Step onto a platform or step with one foot, then bring the other foot up to meet it. Repeat with the second leg as you take a step backward.
Leg press: Sit on a weight machine and press the weight away from your body, extending your knees and contracting your quadriceps.

• Hamstring strengthening exercises:

Hamstring curls: Use a resistance band or a weight machine to perform hamstring curls, lifting your heels towards your buttocks while lying face down on a bench or machine.
Swiss ball hamstring curls: Lie on your back with your heels on a Swiss ball, then lift your hips off the ground and roll the ball towards your buttocks with your feet.
Romanian deadlifts: Use a barbell or dumbbell to perform Romanian deadlifts, bending at the hips and keeping your knees bent.

• Calf strengthening exercises:

Calf raises: Stand on the edge of a step or platform with your heels hanging off, then raise your heels as high as possible before lowering back down.
Seated calf raises: Sit on a weight machine and lift a weight with your feet, contracting your calf muscles.
Jump rope: Jumping rope can help to strengthen the calves and improve overall lower leg stability.

Stretching exercises

Stretching is an important component of patellar tendonitis physical therapy exercises. These exercises help improve flexibility and mobility, reducing stress on the patellar tendon and promoting healing. Several stretching exercises are listed below:

• Quadriceps stretching exercises:

Standing quad stretch: Stand on one leg and grab your ankle with your hand, pulling your heel towards your buttocks.
Lunge stretch: Step forward with one foot and bend your front knee, keeping your back leg straight and your heel on the ground.
Quad foam rolling: Lie face down with a foam roller under your thigh, then roll back and forth along the length of your quad muscle.

• Hamstring stretching exercises:

Standing hamstring stretch: Stand with your feet hip-width apart and hinge forward at the hips, reaching towards your toes.
Supine hamstring stretch: Lie on your back with one leg straight up in the air, using a towel or strap to pull your foot towards your head gently.
Hamstring foam rolling: Sit on a foam roller with your legs extended in front of you, rolling back and forth along the length of your hamstring muscles.

• Calf stretching exercises:

Standing calf stretch: Stand with your hands on a wall and one foot back, keeping your heel on the ground and bending your front knee.
Downward dog stretch: Start in a plank position, then lift your hips up and back into a downward dog position, pressing your heels towards the ground.
Calf foam rolling: Sit on the ground with a foam roller under your calf, then roll back and forth along the length of your calf muscle.

Other Interventions

In addition to strengthening and stretching exercises, other interventions may help treat patellar tendonitis:

• Massage therapy:

Soft tissue massage can help to reduce tension and inflammation in the quadriceps and patellar tendon. Deep tissue massage, trigger point therapy, and myofascial release techniques can reduce pain and improve mobility.

• Electrical stimulation:

Electrical stimulation, or transcutaneous electrical nerve stimulation (TENS), involves using a small device that delivers electrical impulses to the affected area. This can help to reduce pain and promote healing by increasing blood flow and stimulating the release of natural pain-relieving chemicals in the body.

• Ice and heat therapy:

Applying ice or heat to the affected area can help to reduce pain and inflammation. Ice therapy is typically used in the acute phase of injury, while heat therapy is used in the subacute phase to improve blood flow and promote healing. Heat therapy can be applied using warm compresses, hot packs, or baths.

Progression of Treatment

Treatment progression for patellar tendonitis involves advancing the exercises and stretches as the patient’s pain and range of motion improve. Here are some factors that may be considered in the treatment progression:

• Advancement of exercises and stretches:

Physical therapy can be started with gentle stretches to reduce pain and inflammation. As the patient’s pain subsides, the physical therapist will gradually introduce more challenging exercises and stretches, such as weight-bearing and dynamic stretches. The goal is to improve strength, flexibility, and overall patellar tendonitis pain relief while avoiding exacerbating symptoms.

• Monitoring of pain and range of motion:

The physical therapist will monitor the patient’s pain levels and range of motion throughout treatment. This may involve using pain scales, range of motion measurements, and other assessment tools.

Conclusion

Patellar tendonitis can be challenging to manage but can be effectively treated with the right approach. Physical therapy reduces pain, improves strength and mobility, and prevents future injuries. Working closely with your healthcare provider and following through with your prescribed treatment plan is important.

Additionally, taking proper care of your body, including rest, nutrition, and maintaining proper posture during exercise, can help prevent the recurrence of the condition. Prioritize your health and well-being, and don’t hesitate to seek professional help.