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Patellar Tendinitis: Signs, Symptoms, Treatment, Prevention

This is an excerpt from Sport First Aid-6th Edition by Robb S Rehberg.

Patellar tendinitis is inflammation of the patellar tendon, which attaches the kneecap to the lower leg bone (tibia). It is caused by forceful contraction of the quadriceps muscles, or weak quadriceps muscles and inflexible quadriceps, hamstrings, and calf muscles (see figure 13.12).

Figure 13.12 Patellar tendinitis is inflammation of the tendon that attaches the kneecap to the tibia.
Figure 13.12 Patellar tendinitis is inflammation of the tendon that attaches the kneecap to the tibia.

Signs and Symptoms

Mild

  • Mild pain from the bottom of the patella to the top of the tibia
  • Slight point tenderness between the patella and the upper tibia
  • Mild pain with running and jumping activities
  • Mild pain when forcefully straightening the knee

Moderate to Severe

  • Moderate to severe pain from the bottom of the patella to the top of the tibia
  • Moderate to severe point tenderness between the patella and the upper tibia
  • Decreased ability or inability to forcefully straighten the knee, especially when jumping, lifting weights, and running
  • Moderate to severe pain with running and jumping activities
  • Moderate to severe pain when forcefully straightening the knee
  • Thickening of the patellar tendon
  • Localized swelling
  • Limping

FIRST AID

Mild

  1. Rest the athlete from painful activities.
  2. Apply ice to the injury for 15 minutes.
  3. Refer the athlete to the appropriate health care provider if symptoms and signs worsen (or occur more often, especially with daily activities) or do not subside within a few days.

Moderate to Severe

  1. Rest the athlete from all activities.
  2. Monitor the athlete, treat them for shock if needed, and send for emergency medical assistance if shock occurs.
  3. Prevent the athlete from walking on the injured leg.
  4. Apply ice to the injury for 15 minutes, and send the athlete to the appropriate health care provider (if shock does not occur).

Playing Status

  • For mild patellar tendinitis, the athlete can return to activity if signs and symptoms subside; the knee is free of pain; they have full knee range of motion and quadriceps strength; and they have full quadriceps, hamstring, and calf flexibility. If the athlete is sent to a health care provider, they cannot return to activity until examined and released by the health care provider. When returning to activity, the athlete may benefit from wearing a neoprene (rubberized) knee sleeve (to keep the tendon warm during activity) and from stretching the hamstring, quadriceps, and calf muscles daily.
  • For moderate to severe patellar tendinitis, the athlete cannot return to activity until examined and released by a health care provider; the knee is free of pain; they have full knee range of motion and quadriceps strength; and they have full quadriceps, hamstring, and calf flexibility. When returning to activity, the athlete may benefit from wearing a neoprene (rubberized) knee sleeve (to keep the tendon warm during activity) and from stretching the hamstring, quadriceps, and calf muscles daily.

PREVENTION

  • Preseason exercises to strengthen the core, gluteal, and quadriceps muscles and stretch the quadriceps, hamstring, and calf muscles
  • Adequate aerobic warm-up before activity
More Excerpts From Sport First Aid-6th Edition

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