Patellar tendinitis

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Treatments and drugs

By Mayo Clinic staff

Patellar tendinitis treatment is a long process, no matter what type of treatment you've chosen. Recovery may take a few weeks or months if the injury isn't too severe, or as long as a year or more for people who undergo surgery.

Most people with patellar tendinitis find pain relief and improvement using conservative treatment — meaning treatments other than surgery. If you have persistent signs and symptoms for six months or more, you may want to discuss the potential benefits and risks of patellar tendon surgery with your doctor.

Conservative treatment
The conservative approach to treating patellar tendinitis aims to reduce the strain on your tendon and then gradually build up the tendon's strength. Your doctor may suggest several techniques to accomplish this, including:

  • Rest. Rest doesn't mean giving up all physical activity, but avoid running and jumping. Your doctor can suggest other ways of staying active without stressing your damaged patellar tendon. It's especially important to avoid any activity that gives you pain.
  • Adjusting your body mechanics. A physical therapist can help you learn to better distribute the force you exert during physical activity. For instance, an athlete who jumps frequently might learn proper takeoff and landing techniques.
  • Stretching your muscles. Inflexible muscles, especially inflexible thigh muscles (quadriceps), contribute to the strain on your patellar tendon.
  • Strengthening your tendon. A physical therapist may recommend specific exercises to strengthen your patellar tendon and the muscles around it. Exercises can also help strengthen your quadriceps. A specific type of exercise for strengthening the quadriceps called eccentric strengthening has been shown in some studies to help treat and prevent patellar tendinitis. This strengthening exercise involves lowering weight slowly after raising it, such as a seated knee extension exercise.
  • Patellar tendon strap. A strap that applies pressure to your patellar tendon can help to distribute force away from the tendon itself and direct it through the strap instead. This may help relieve pain.
  • Massage. Massaging the patellar tendon may help encourage tendon healing.

If you've recently developed patellar tendinitis, you can expect at least several weeks or months of conservative therapy before you'll be able to fully resume physical activity, including jumping. If you've re-injured your patellar tendon, the time for healing may be even longer.

Surgery
You and your doctor may consider surgery for your patellar tendinitis if more conservative approaches aren't working, usually after about six months or more. There is little research into the best surgical techniques for patellar tendinitis, so the procedure you undergo often depends largely on your injury, as well as your surgeon's preferred method. Surgery may include repairing any tears in your tendon or removing any badly damaged parts of your tendon.

Expect six to 12 months of recovery after surgery. As many as a quarter of people who undergo surgery still experience pain, and some people aren't able to return to their sport of choice after surgery.

Other approaches
Other types of therapy may provide relief from pain associated with patellar tendinitis. Though these methods haven't been thoroughly researched, your doctor might consider trying:

  • Medications. It isn't clear whether nonsteroidal anti-inflammatory drugs (NSAIDs) offer any relief from pain associated with patellar tendinitis. NSAIDS are usually used to relieve pain associated with inflammation, but chronic patellar tendinitis doesn't involve inflammation. Corticosteroids may be used for pain relief, though there's a concern that they could also weaken the patellar tendon.
  • Extracorporeal shock wave therapy. This form of therapy uses sound waves to promote healing of the tendon. Some research suggests this type of therapy may be effective in relieving the symptoms of patellar tendinitis.
  • Other physical therapy treatments. This category includes treatments using ultrasound, laser and electrical stimulation. These can help to provide pain relief, though it's not known if these treatments can help heal the tendon.

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Jan. 8, 2008

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