Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Patella tendonitisJumper’s kneeInfrapatellar tendinitis ++ 726.64 Patellar tendinitis ++ M76.50 Patellar tendinitis, unspecified knee ++ 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated With Localized Inflammation +++ Description ++ Fibers in the middle portion of the tendon breakdown, degenerate, swell, and thicken.Pain common in inferior patella regionOverload of eccentric quadriceps contractionTypically lacks the presence of inflammatory cellsTerms “tendonitis” or “tendinitis” incorrectTypically associated with tissue degenerationTwo TypesLipoid: fatty tissue deposited in the tendonMucoid: conversion of tendon in softer material with gray or brown appearanceThickening of tendonNeovascularizationIncreased presence of varicose nerve fibersMost likely source of pain +++ Essentials of Diagnosis ++ Insidious onsetImproves initially with movementDiagnosis made by patient history and clinical examinationUltrasound or MRI +++ General Considerations ++ Must address training errors and biomechanics deficits to prevent recurrenceIs it truly a tendon? It runs from the patella (bone) to the tibia (bone), which would be labeled as a ligament. +++ Demographics ++ People participating in athletic activity (though, it also occurs in sedentary individuals)RunnersJumping sportsOnset more common during training verse competitive event +++ Signs and Symptoms ++ Pain with palpation of tendonPain in anterior kneeTenderness changes position with tendon movement during extensionIncreased swelling throughout the dayThickening of the tendonDecreased flexion ROMDecreased extension strength +++ Functional Implications ++ Inability to climb stairs or ladderInability to push-off during ambulationDecreased stride length during ambulationDecreased squat depth +++ Possible Contributing Causes ++ Intrinsic risk factorsDecreased knee flexion ROMDecreased quadriceps strengthGreater pronation/calcaneal varus and faster rate of maximum pronationObesityPatella altaMuscle imbalanceHyperlipidemiaHypertensionIncreased Q angleExtrinsic risk factorsTraining errorsSudden increase in mileage or intensity or inclineIncreasing in jumpingReturn too fast from inactivityEnvironmental factorsHigh incidence with training in cold weatherFaulty equipment Surface too hardShoes not supportive +++ Differential Diagnosis ++ Tendon ruptureTendon partial tearBone spurChondromalaciaBursitisMeniscal tearACL instabilityL4 radiculopathyOsgood-Schlatter Sinding-Larsen Johansson diseaseOsteoarthritis +++ Imaging ++ UltrasonographyMRIX-ray ++ Hypertrophic tendonHyperechoic mass at midtendonIrregular tendon structure +++ Medication ++ NSAIDsProlotherapy: sclerotic injection (most common dextrose) +++ Medical Procedures ++ Tendon debridementExtracorpeal shock wave therapy (ESWT) ++ For imaging, radiologistFor injection, orthopeadist ++ Pain with movement after prolonged immobility with the knee flexed (i.e. after sitting at a desk, driving, movies) ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.