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What is the patellar tendon?

It is the tendon that contains the patella bone and attaches to the tibia at the front, just below the knee. When the quadriceps muscle contracts, the patellar tendon pulls the tibia to allow the knee to extend.

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Note that technically, there can be two different irritated tendons. We can have the quadriceps tendon or the patellar tendon. The quadriceps tendon is just above the patella, while the patellar tendon is the one that passes through the patella and attaches below it.

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However, it is not necessary to distinguish between the two, as the management is very similar. We will therefore refer to patellar tendinopathy as the term.

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What are the causes of patellar tendinopathy?

This can be caused by:

• Too rapid an overload on the knee muscles
• Poorly managed repetitive movements with weight-bearing and the knee bent, such as squats, jumps, and running.

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Here are some classic examples of the development of this pathology:

• Resuming running after the winter without proper pacing (especially if you do a lot of downhill slopes)
• Going for a mountain hike without being used to it.
• Starting a new workout with squats and lunges without allowing the body to adapt.

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What are the symptoms of patellar tendinopathy?

The most common symptoms are:

• Pain in the front of the knee, just below the kneecap.
• The pain may be increased by:
  
  • Doing a squat
  • Going up or down stairs
  • Running
  • Walking
  • Jumping

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How is patellar tendinopathy diagnosed?

Diagnosis is possible based on a review of your symptoms and a clinical examination. X-rays cannot detect tendinopathy.

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When to consult a physiotherapist for patellar tendinopathy?

You should consult a physiotherapist if you have symptoms as described above or if your doctor has already ruled out any other cause that may be responsible for your pain.

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You do not need to see a doctor before consulting a physiotherapist. If your condition requires you to see a doctor, your physiotherapist will be able to tell you.

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What are the physiotherapy treatments for patellar tendinopathy?

Your physiotherapist will perform an assessment to determine the cause of your tendinopathy and will evaluate the following elements:

• Your joint mobility
• The gliding of your nerves
• The quality of your movements
• Your strength and stability

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Based on the assessment results, your physiotherapist will:

• Mobilize your knee to reduce pain and improve your movement
• Give you specific exercises to retrain the control of your knee movements.
• Give you exercises to regain mobility, reduce pain and regain your muscle strength.
• Teach you how to properly manage your daily activities and hobbies to optimize healing
• Give you advice for your posture and movements.

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What to do at home for patellar tendinopathy?

Temporarily stop doing movements that cause too much pain, and then gradually start doing them again.

Here are some tips that may help:

• Do isometric quadriceps contraction exercises.
• Avoid painful workouts that include deep squats, high running speed, or downhill running.
• Practice transfer activities that reduce stress on the area, such as swimming.
• Do strengthening exercises for your glutes.

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If you don't see any improvement after 10 days, you should consult a physiotherapist.

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If you are a runner, please refer to the blog article on running (link to come) for concrete tips for running.

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To learn more...

You can listen to the podcast PARLE-MOI DE SANTÉ created by one of our physiotherapists, Alexis Gougeon.

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Episode #1 discusses the prevention and treatment of running injuries.

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Find the episode on YouTube:

Click below to listen to episodes on podcast platforms:

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Sources

• Dubois, B. (2019). La clinique du coureur, la santé par la course à pied. Mons Eds.

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