Patellar tendinopathy is a common condition amongst footballers, both at the elite and non-professional level.
Symptoms can linger for long periods of time and will often come back even if treated the first time.
It can have a big impact on someone’s ability to participate and at the level they want to, so it is important that we understand a bit more about the condition and what to look out for.
What is Patellar Tendinopathy?
Patellar Tendinopathy is a relatively common cause of pain at the front of the knee, usually localised to where the pointy bit of the kneecap lies. The quadriceps muscles at the front of the thigh connects to the shin bone via the patella tendon, and when this tendon is overused or overloaded, it can lead to what we call tendinopathy. This simply means that the tendon struggles to cope with the demands of the load placed on it, leading to micro tears and consequently, pain.
What Causes Patellar Tendinopathy?
It is an overuse injury that occurs due to repetitive stress from activities requiring movements like jumping, landing, acceleration, deceleration and cutting movements - all of which are characteristic of the demands of football. These movements require the tendon to store and load energy, which is one of the most stressful actions on the tendon itself.
Sudden increases in load can often lead to symptoms. For example, going back to pre-season training after a period of time off or an increased number of matches/training sessions in any given week may be enough to cause symptoms.
What symptoms to look out for?
The two most notable features of patellar tendinopathy are:
Pain localised to the bottom pointy part of the kneecap
Pain over the front of the knee that increases with actions such as jumping and landing
Pain from patellar tendinopathy will rarely be present at rest. It will occur instantly with loading and as soon as the load is removed, it will stop - sometimes the pain may even be made better by repetitive loading when the tendon warms up. Coming down the stairs is a classic example of a movement that may aggravate a knee with patellar tendinopathy. There may also be weakness and stiffness associated with the affected knee.
How do we manage Patella Tendinopathy?
Load management and pain relief
Reducing the load on the tendon and modifying your activities are the most important factors for helping with pain in the early stages. However, we do not want to stop activities altogether. This may include reducing the frequency, intensity or duration of training sessions or finding an alternative whilst symptoms settle. Isometric (holding a position) exercises have been shown to be very beneficial for pain relief! Examples could be holding your position on a leg extension machine or doing a wall sit exercise.
Once pain allows, strengthening can start. The exercises performed should focus on strengthening the whole lower limb and specifically the quads. Tendons usually respond well to heavy loads so heavy weights on the machines at the gym are ideal but at-home alternatives are also viable. These exercises should gradually progressed according to symptoms.
Back to full football
Football-specific training should be completed before going back into full training and matches and actions such as sprinting, bounding and jumping are included. These movements should be pain free during and afterwards to ensure that the tendon is ready for the demands of the game
Here at SV Sports Therapy, we can help footballers and athletes to deal with tendon-related injuries by assessing their individual needs, using a variety of treatment methods and providing bespoke rehabilitation and management plans to get them safely back onto the pitch pain-free.
Did you know that alongside SV Sports Therapy, Emily works alongside the academy at Watford Football Club, providing pitch-side first aid, injury assessment and injury rehabilitation to players aged 9-16? She knows her stuff!
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