A 17-year-old basketball player has been referred to physical therapy by his family physician for evaluation and treatment of anterior knee pain. His pain had been intermittent over the past summer. However, since the start of the fall high school sport season, his pain has increased in severity and become constant. Pain is now limiting his ability to practice and play, as well as his ability to ascend and descend stairs, and stand after long periods of sitting. His coach told him that he has "jumper's knee" and that he should "get a knee strap and he should be fine." Plain film images revealed no bony abnormalities, though his tibial and femoral epiphyseal plates are almost completely ossified. Otherwise the patient's medical history is unremarkable. Signs and symptoms are consistent with patellar tendinopathy. The patient hopes to finish his season and be ready to compete in an all-star game in the spring.
Based on the patient's symptoms and history, what are the most appropriate examination tests to help confirm the diagnosis of patellar tendinopathy?
What are the most appropriate physical therapy interventions?
What is his rehabilitation prognosis?
APOPTOSIS: Programmed cell death in response to specific stimuli
ECCENTRIC CONTRACTION: Controlled lengthening of a muscle as it responds to an external force greater than the contractile force it is exerting
MUCOID DEGENERATION: Deterioration of collagen fibers into a nonfunctional gelatinous or mucus-like substance
NEOVASCULARIZATION: Formation of functional new microvascular networks in tissue that does not normally contain blood vessels, or blood vessels of a different type within a tissue
PROTEOGLYCANS: Mucopolysaccharides bound to protein chains in the extracellular matrix of connective tissue
TENDINITIS: Acute inflammation of a tendon, typically affecting its insertion; a type of tendinopathy1
TENDINOPATHY: Clinical term that encompasses all overuse conditions that affect a tendon (proximally, distally, or midsubstance) in the presence or absence of an inflammatory response; includes tendinosis2
TENDINOSIS: Chronic degeneration and a failed healing response within a tendon, but without the presence of characteristic inflammatory markers; a type of tendinopathy3
Explain the distinctions between tendinitis, tendinosis, and tendinopathy.
Describe the pathophysiology that contributes to the development of patellar tendinosis.
Describe the differential diagnoses for patellar tendinopathy.
Prescribe the most appropriate strengthening interventions for patellar tendinopathy based on examination findings.
Describe additional treatment options for patients with patellar tendinopathy that have failed conservative management.
PT considerations during management of the individual with a diagnosis of patellar tendinopathy:
- General physical therapy plan of care/goals: Decrease pain and increase function; increase lower extremity strength; prevent or minimize loss of aerobic fitness capacity
- Physical therapy interventions: Patient education regarding functional anatomy and pathophysiology; modalities and manual therapy to decrease pain; ...
Log In to View More
If you don't have a subscription, please view our individual subscription options below to find out how you can gain access to this content.
Want remote access to your institution's subscription?
Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.
If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.
AccessPhysiotherapy Full Site: One-Year Subscription
Connect to the full suite of AccessPhysiotherapy content and resources including interactive NPTE review, more than 500 videos, Anatomy & Physiology Revealed, 20+ leading textbooks, and more.
Pay Per View: Timed Access to all of AccessPhysiotherapy
24 Hour Subscription $34.95
48 Hour Subscription $54.95
Pop-up div Successfully Displayed
This div only appears when the trigger link is hovered over.
Otherwise it is hidden from view.