Therapy for inflammation of the patellar tendon


How is patellar tendon inflammation treated?

Treatment must be given immediately after confirmation of the medical diagnosis. In acute inflammation of the patellar tendon, treatment must begin with immobilization.

Medicines for inflammation of the patellar tendon

Using nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Brufen), helps reduce pain and swelling. However, a doctor should always be consulted before taking any medicine.
You can smear a cream with an anti-inflammatory effect, such as Diclofenac (Voltaren), directly onto the tendon, but because it is not supplied with blood, the active ingredients cannot penetrate the tendon and this measure is therefore unsuitable.

If the inflammation persists despite therapy, medication containing cortisone can be injected.
A direct cortisone injection , guided by ultrasound, can significantly reduce the pain. However, these drugs weaken the tendons, making them susceptible to tendon rupture.
Recently, attempts have been made to treat some patients with chronic patellar tendinitis by injecting platelet-rich plasma.
Research is ongoing, but it is hoped that the injections will encourage new tissue growth and help heal tendon damage.

Natural remedies for patellar tendon inflammation

The first and most important step is to avoid the activities that cause pain. You have to learn to manage your body as best you can, to understand when an activity
creates pain and then stop it immediately.
Usually, the inflamed tendon does not cause knee swelling, so applying clay is not advisable, but you can rub the knee with arnica ointment, which has a natural anti-inflammatory effect.

Kinesio taping for kneecap tendon inflammation

Effect: stabilizing and supporting for the kneecap. Shape: two strips, one ”Y” shaped, one ”I” shaped. Length: ”Y” stripe = 25 cm, ”I” stripe = 15 cm. Start the Y-stem 5-6 cm above the kneecap, the Y-branches point down. Bend the knee about 110° and attach the two Y-branches to the side of the kneecap without tension. Then, bring the knee to a flexed position of 80-90°, placing the center of the “I” strip horizontally at the lower portion of the kneecap. Using moderate tension (50% of maximum), pull the tape up to the femoral condyles on both sides, forming a “smiley face”.

In addition, the use of a knee belt (knee brace) below the kneecap, a knee bandage or wearing custom-made shoe inserts is conceivable. The benefit of these treatments is not well known, but some patients experience great relief from using these products. In any case, they seem to have a positive effect in discharging forces away from the tendon, thereby relieving it significantly.

Swimming is helpful for staying fit, but you must avoid straining your legs, so avoid breaststroke.
A good trainer can prevent tendonitis by creating an intense but not too strenuous exercise program.

Treat with heat or cold?

I am often asked by my patients whether they should treat their tendinitis with ice or heat.
In the acute phase, ice packs can be applied; these serve primarily to relieve pain, they do not have a healing effect. After the first painful 24-48 hours, cold is no longer necessary, now the application of heat helps to promote cell activity.

Physiotherapy for inflammation of the patellar tendon

Laser and ultrasound therapy  are very effective in stimulating and accelerating the healing process of the tendon.

Tecar therapy can help reduce inflammation because it involves delivering a drug through the skin using a low-dose, low-voltage electrical shock; alone is unable to heal the tendon.

Rehabilitation Exercise
Regular and consistent stretching can reduce muscle spasm and stretch the musculoskeletal system. When resuming physical activity, stretching the quadriceps, hamstrings, and calf muscles before exercise is very important. Doing the stretches even after the symptoms have disappeared will help prevent recurrence.

Weak hamstrings contribute to increased tension in the patellar tendon. Eccentric exercises (where the muscle is contracted while stretching) are particularly useful in treating tendonitis and are commonly used in patellar tendon syndrome. According to the National Academy of Sports Medicine, these exercises stimulate muscle growth and focus more on muscle tension. A doctor should be consulted before beginning any of these exercises.


Eccentric Squat
The eccentric squat is often used in the treatment of jumper’s knee. It is best practiced on a hard surface. Increase the contact surface by placing your feet shoulder-width apart. Slowly bend your knees and hips as if to sit down. Continue lowering until your thighs are parallel to the floor. Hold this position for about 10 seconds. If this exercise causes pain, shift the weight more onto the sound leg.
Slowly return to the starting position with the help of your arms. Do 3 sets of 10 repetitions each; There is a 60-second break between rounds. When lowering, make sure that your knees do not protrude beyond the tips of your toes, as this would overload the kneecap tendon.

leg press

The leg press is a piece of fitness equipment used in gyms and rehabilitation to strengthen the quadriceps in a closed kinetic chain, meaning the foot presses firmly against the tread.
The leg press stabilizes the knees and strengthens the surrounding muscles.
For this exercise to be eccentric in character, bend the knees slowly while resisting the force of the press.
Sit on the machine with your back straight and pressed against the backrest. Place your feet shoulder-width apart on the footboard.
With your knees slightly bent, unlock the machine and slowly bring your knees to your chest while slowing down the footboard. Return to the starting position and repeat the exercise. Perform three sets of 10 reps; rest 1 minute between sets.

One leg squat (only in the final phase of rehabilitation)
This is a very difficult exercise done with only one leg; you need a lot of strength and balance. It serves to increase muscle strength and must be performed slowly and evenly, without jumping or jumping back. It must be possible to stop at any point in the movement. The exercise begins while standing, the weight is on the leg affected by tendonitis, the other leg is bent. When squatting, the knee of the sound leg should touch the ground first. When standing up, the movement must not be done with momentum. If you don’t have enough strength to stand up on just one leg, you can use the other leg to help. The position of the knee is important in this exercise. The knee must not sag or protrude too far, it must remain behind the toes.

Surgical intervention

Surgical treatment is extremely rarely carried out for patella tip syndrome. However, if the pain persists despite all the treatment methods described above, in some cases surgical intervention can be considered. This is usually the case when there is tendon degeneration diagnosed by magnetic resonance imaging.
During the operation, the damaged tendon is incised and cleaned.

How long are the healing times?

Acute tendinitis will heal on its own, but you need to take it easy for at least a month or two.
Chronic tendonitis takes a long time to heal, requiring months of rest and treatment.
Physiotherapy accelerates the healing considerably, in the acute phase two weeks could already be sufficient.

Read more