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Patella Tendinopathy Cheat Sheet (DRAFT) by

Presentation , management etc

This is a draft cheat sheet. It is a work in progress and is not finished yet.

Risk Factors

- Micro-­tea­rin­g/d­ege­ner­ation of the proximal attachment of the patella tendon (inferior pole on proximal, poster­iom­edial fibres of the tendon)
- Jumpers knee - excessive loading of knee extensor mechanism
- However, landing causes more forces on the tendon
- Rapid accele­ration and decele­ration
- Athletes that jump, basket­ball, volleyball
- Excessive foot invers­ion­/allow deeper angles of knee flexio­n/foot supination
- Unilateral but can be bilateral


- Chronic without identi­fiable onset
- Can relapse and remit
- Painful during arising from seated position, squatting, jumping, stair climbing, running (downh­ill­/do­wns­tairs)
- May have pain over tibial tuberosity (consider osgood sclatters if swelli­ng/pain over TT on skeletally immature pt)
- Pain over inferior pole of patella
- Pain/d­isc­omfort on PROM knee flex & RROM ext
- Squat test
- Pain decreases on knee flexion (passive knee extension flexion sign + standing active quads sign)
- Assess for quadriceps and hamstring hypert­onicity and weak quads
- Allows excessive knee flexion due to inadequate decele­ration


- Not usually required unless: Hx of trauma, surgery, joint swelling, OA


- F#
- Infection
- Neoplasm
- Articular cartilage injury
- Chondr­oma­lacia Patella
- Osgood Schlatter Disease
- Osteoc­hon­dritis Dissecans
- OA
- Plica
- Bursitits
- Quad tendonitis
- Sindin­g-L­arsen Johansson syndrome
- Bipartite Patella
- Referred pain from Lx/Hip


- Transverse friction massage
- Eccentric Exercise
- US
- Ice/Ice massage
- Shockwave therapy
- Avoid complete rest
- Stretching and myofascial release of hamstring, quads, gastro­soleus, ITB, pirifo­rmis, anterior hip capsule, psoas
- EMT of ankle, knee, hip, LS
- Streng­thening of Quads ( five 45 second isometric quad contra­ctions at 75% strength)
- Eccentric training + static stretching (unila­teral squats on 25 degree decline board - return to standing using unaffected leg and should not squat >60 degrees , can progress to weights 10 reps twice a day for 12 weeks
- Moderate effort with low reps - change in night pain
- Address weakness in gluts, quads, hamstring
- Arch supports
- Treadmill walkin­g/r­unning (less stress on quads)
- Surgical consult if : >50% tear, reoccu­rring