The Patellar tendon joins the lower end of the knee cap to the top of the shin bone. Acute inflammation of this tendon is known as patellar tendonitis. If this is managed appropriately, symptoms should improve within 6 weeks. Assessment by a chartered physiotherapist to address the reason for the acute inflammation e.g. muscle imbalance, biomechanical problem, training error etc is advisable so that the injury does not become more chronic (lasting more than 6 weeks). When pain below the knee cap persists beyond 6 weeks, one possible cause is patellar tendinopathy. Tendinopathy (or tendonosis) means that inflammation in the tendon is no longer present but the tendon shows signs of microscopic degeneration. Many factors can contribute to patellar tendinopathy e.g. overuse, strength imbalance between various muscles, postural mal-alignment of the lower limb, biomechanical foot type, reduced ankle movement and lack of muscle strength or flexibility. At Iona Physiotherapy, we will first take a detailed history e.g. how long the pain has been present, your training regime etc before undertaking a comprehensive biomechanical and physical assessment with regard to the above possible causes. Treatment will include addressing any of the factors that are causing excessive load on the tendon and a progressive strengthening programme. There is a specific type of exercise that has been shown in research to rehabilitate tendinopathy (reversing degenerative changes) and help you return to your sport/activity, which is known as eccentric training
