Patellar tendinitis

Jumper’s knee is a clinical syndrome with tendonitis, degeneration and sometimes partial rupture of the patellar tendon. The symptoms generally appear after kicking and jumping and is more common in goalkeepers. Usually the injury is located at apex patella but a localization near the tuberositas tibiae or above patella(quadriceps tendonitis) is not uncommon.

Symptoms and diagnosis

The symptoms are anterior knee pain and distinctly located tenderness over the affected part of the tendon. The pain is aggravated by contraction of the quadriceps.

Treatment

Treatment consists of adequate warm-up and ice massage after activity, anti-inflammatory medication, ultrasound, stretching of the quadriceps and hamstrings muscles, and activity modification to avoid jumping and other movements that trigger the pain. Local steroid injections are not recommended. Surgery is indicated in chronic cases and consists of incision of the tendon and removal of the degenerative areas.

Resection of drilling of the inferior pole of the patella is sometimes recommended. It is also important to consider the patellar alignment and sometimes a lateral release, a vastus medialis advancement, or an excision of osteophytes or calcified fragments are needed.

The rehabilitation period after surgery is long, usually 4-6 months before the player can return to football. Since the patellar tendon has a poor blood supply, it is important that the post-operative rehabilitation is slow, usually an immobilization period of 4-6 weeks is recommended.

“Handbook of Sports Medicine and Science - Football(Soccer)”, Björn Eklbom