A day in my life, rearing it's old head. OUCH

Patellar tendinitis or "jumper's knee" is a condition resulting from overuse of the knee. The patellar tendon is a structure that attaches the quadriceps muscle group to the tibia (shin bone). The patella (knee cap) is a sesamoid (floating bone) incorporated into the patellar tendon. The patellar tendon is also referred to as the patellar ligament; some anatomists believe that since this structure connects the patella to tibia it should be classified as a ligament. Ligaments connect bone to bone while tendons connect muscles to bone.

Tendinitis is simply the inflammation of a tendon. This can be due to numerous factors. Some of the more common factors associated with this condition are:

a rapid increase in the frequency of training,
sudden increase in the intensity of training,
transition from one training method to another,
repeated training on a rigid surface,
improper mechanics during training,
genetic abnormalities of the knee joint, and/or
poor base strength of the quad muscles.
Any or all of these factors can lead to the development of patellar tendinitis.

Basketball players are the most common athletes to experience this problem. Many athletes will make a transition from football to basketball during the school year. These two sports place entirely different stresses on the knee joint. The transition itself may be the only factor contributing to the condition. Other factors in these athletes may include: a change in training surface, increased amounts of continuous running and/or jumping, and the pounding associated with football.

The signs and symptoms of patellar tendinitis are fairly easy to detect. The athlete will complain of:
pain in the area of the tendon,
the knee will often feel "tight,"
pain will be experienced early in the workout and after the workout is completed,
there may be some subtle swelling of the tendon, and
the athlete may feel that the tendon is "squeaking."
Treatment of this condition begins with continuation of a general fitness and flexibility program. The best treatment is prevention! The multi-sport athlete should utilize proper conditioning techniques to ease the transition from one sport to another. Proper conditioning should include aerobic fitness, lower body strength training, and lower body flexibility training. Flexibility is very important in preventing overuse injuries such as patellar tendinitis.

Once the condition is present, there are several treatment options. The athlete is strongly encouraged to remain active in practice as well as rehabilitation so that he/she will not detrain, fail to keep up on the offensive and defensive schemes of the game, and most importantly loose the mental drive to compete. The rehabilitation should be designed to decrease the symptoms, strengthen the muscles of the quad region and improve hamstring and quad flexibility.

Also, factors that may pre-dispose the athlete to this injury should be isolated and corrected. This could be as simple as improving the conditioning of the athlete (e.g. non-pounding conditioning such as interval training on a bicycle rather than running). If the tendinitis is due to a strength imbalance in the quadriceps and hamstrings, the athlete should begin exercises to target the weak muscles of the quads or hamstrings.

A General Rehabilitation Program Should Include
Non-impact aerobic conditioning,
Flexibility training for quadriceps and hamstring muscle groups,
Decrease in predisposing factors,
Use of physician prescribed non-steroidal anti-inflammatory medications,
Use of theraputic modalities, such as: Ultrasound, Electric Muscle Stimulation, or Iontophoresis*,
Cryotherapy (ice massage or ice packs),
Strengthening exercises, such as: leg press, side step-ups, and mini squats, and
Return to full competition as symptoms allow.
* These treatments must be prescribed by a physician and performed by the licensed health care professionals such as Athletic Trainers.

Treating this condition begins with prevention through a structured off-season, in-season, and transition season. Once the tendinitis occurs one must first recognize the predisposing factors, whether it is the repeated pounding of running on a poor floor, rapid increase in jumping, or a strength imbalance. If this condition goes unchecked, the tendon may form scar tissue in the irritated area, resulting in a career of fighting off the tendinitis whenever there is an increase in volume or intensity of the training sessions.