Patellar tendinopathy: Clinical diagnosis, load management, and advice for challenging case presentations

Peter Malliaras, Jill Cook, Craig Purdam, Ebonie Rio

Research output: Contribution to journalComment / DebateOtherpeer-review

83 Citations (Scopus)

Abstract

The hallmark features of patellar tendinopathy are (1) pain localized to the inferior pole of the patella and (2) load-related pain that increases with the demand on the knee extensors, notably in activities that store and release energy in the patellar tendon. While imaging may assist in differential diagnosis, the diagnosis of patellar tendinopathy remains clinical, as asymptomatic tendon pathology may exist in people who have pain from other anterior knee sources. A thorough examination is required to diagnose patellar tendinopathy and contributing factors. Management of patellar tendinopathy should focus on progressively developing load tolerance of the tendon, the musculoskeletal unit, and the kinetic chain, as well as addressing key biomechanical and other risk factors. Rehabilitation can be slow and sometimes frustrating. This review aims to assist clinicians with key concepts related to examination, diagnosis, and management of patellar tendinopathy. Difficult clinical presentations (eg, highly irritable tendon, systemic comorbidities) as well as common pitfalls, such as unrealistic rehabilitation time frames and overreliance on passive treatments, are also discussed.
Original languageEnglish
Pages (from-to)887-898
Number of pages12
JournalJournal of Orthopaedic and Sports Physical Therapy
Volume45
Issue number11
DOIs
Publication statusPublished - 1 Nov 2015
Externally publishedYes

Keywords

  • Anterior knee pain
  • Eccentric exercises
  • Knee
  • Tendinitis

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