What is Patellar Teninopathy?
Patellar tendinopathy is one of the less common tendinopathies we see in a clinic. This time, involving the part of our body just below the knee cap. As touched on in previous blogs, the tendon is typically seen as a bridge point between the muscle and bone where all the force of the muscle is channeled through in order to move the limbs. Over time, through repetitive stress, this tissue can weaken over time until it eventually starts causing pain – thus you now have a tendinopathy. The patellar tendon is a special case because it bridges the gap between the patella (knee cap) and the tibia (shine bone). Through attaching to the knee cap, it feeds into the greater quadriceps tendon. So think of it as a load bearer for our powerful quads (thigh muscle).
How does it present?
Like most tendinopathies, it usually begins gradually over time, often starting initially as just a mild pain below the front of the knee, typically on cool down after activity. Over time the pain often gets worse, where you might start feeling it during sport. Most of the time, patellar tendinopathy occurs in jumping sports, such as volleyball or basketball as these put the most
load on the patellar tendon. In the clinic, we usually find the tendon itself is very painful to touch, and can usually be provoked by activities like jumping and hopping.
How do we fix it?
When we think tendon, we think load. The first goal is to ensure we stop this cycle of overloading the tendon that is driving the tendinopathy. This may take the form of reducing the volume of sport we play, or cross training, such as avoiding the jumping part of training. In some cases, total rest, though it is important to stress that total rest in isolation rarely fixes a tendinopathy.
This brings us to the next most important element – strength. In order to reverse the weakness in the tendon we need to build up the strength. The primary way we do this is through targeting the quadriceps. Tendons are typically slow to build strength and require many weeks of training, where over time we go heavier and heavier challenging it via progressive exercise, until one day we find we have built up to playing everything we used to do. A great initial exercise is a wall sit, where you lean against the wall and slide down till your knees are at or above 90 degrees. You then hold this position for 30-60 seconds, repeated up to 5 times with rests in between.
The last main element involves fixing bad habits. Often people that develop patellar tendinopathy have developed some bad habits typically around jumping. For example, they may land with a “stiff” knee, where they land heavily and loudly without allowing the knee to gently absorb the impact. This is where an assessment is really critical.
If you think this applies to you, please arrange an appointment and book online with one of the physios below!
Having worked as a physio for many years, Simone has had a wide variety of experience in both public and private physiotherapy settings, working the last 7 years in private practice. Simone has developed a special interest in treating foot and ankle injuries, running injuries, jaw pain (TMJ) and posture- related back and neck pain.
Simone has vast experience working with elite sporting teams and athletes including Premier League football, rugby, track and field, Australian baseball, and swimming.
Simone is passionate about helping people move well and stay active. She has a plenty of experience in running video analysis, and hands on manual therapy as well as dry needling / acupuncture, and helping develop and retrain ideal movement.
When not in the clinic, you will find her out running, at the beach or spending time with family and friends.
He believes in taking a holistic approach to injury management and uses hands-on therapy, advice and exercise as medicine, including Physio Pilates.
Darren has extensive experience in treating all types of musculoskeletal problems and sports injury rehabilitation and performance improvement. He is also trained in dry needling (Western acupuncture).
On the weekend you will find Darren out playing on the soccer field, spending time with his beautiful wife and three active kids, at church, or trying to catch that perfect wave.
Book Now – Asquith
Jackie trained as a physiotherapist in Birmingham, UK qualifying in 1987. She worked in London before immigrating to Australia in 1995. After working for another private practice for 7 years Jackie decided to start Berowra Physiotherapy in 2003. This was also the year she took the exam to become a credentialed McKenzie therapist.
Jackie has also completed level 2 sports course and regularly attends post graduate seminars and courses. Jackie takes a very functional approach to treatment seeing it as a partnership between therapist and patient and keeping exercises simple and manageable.
Book Now – Berowra
Jane is a physiotherapist who is dedicated to providing high quality, individualised assessment and treatment of patients presenting with pain and movement dysfunction. This requires a thorough initial assessment which provides a reliable diagnosis. Appropriate treatment strategies can then be applied and reassessed at subsequent visits.
The aim Jane’s treatment is to provide patients with effective self-management strategies based on education and personalised exercises and/or management advise. This facilitates optimum results and prevention of further injuries. Year of experience and commitment to continuing education enables Jane to provide reliable and accurate assessments and effective treatment strategies.
Extensive experience in neurological rehabilitation at Royal Prince Albert Hospital and Prince of Wales Hospital has given Jane a holistic approach to movement disorders. One of her special interests is chronic pain. She has completed her post-graudate education through the University of Sydney (Graduate Certificate in Pain Medicine) and have attended David Butler’s Explain Pain course. This training has enabled me to give chronic pain sufferers evidenced based and up to date assessment and treatment. Jane is also quiet passionate about minimising the risk of transition from acute pain to a chronic pain. Early assessment of people who have soft tissue injuries can help identify those at risk of developing a chronic pain problem (neck and low back being the most common). Education, management advise and appropriate exercise can help prevent pain becoming chronic.
Restoring normal movement requires a keen, experienced eye and ear to detect the source of the problem or the link. Pain and movement dysfunction can often have abnormal contribution from the central nervous system. Jane’s background in neurology and pain medicine give her the edge on being able to include neuromuscular facilitation with exercise and functional movement programmes.Book Now – Wahroonga
Jennie has managed the Physiotherapy Department for Nepean and Hornsby Hospitals for 12 years, has been a member and chairperson for the OH&S; Committees of Nepean and Hornsby Hospitals and has been a member of the APA council. She is delighted to be working at Berowra Physiotherapy on Monday, Wednesday and Thursday afternoons.
Book Now – Berowra
Matthew prides himself on delivering up to date physiotherapy practice. He has postgraduate training in manual therapies and dry needling and pairs these skills with a focus on exercise therapies. Matthew believes exercise is often the key ingredient that will guide you towards recovery, and will work with you to find a program that can allow you to excel.
Matthew’s special interests include back pain and lower limb injuries, but welcomes everything and anything!
Betty’s passion to become a physiotherapist began in her early teens when she visited the physio tent at netball for advice after having injured herself skateboarding. Now her passion has evolved into helping people find ways to move better and stay active.
Having graduated from the University of Sydney with a Bachelor of Exercise and Sport Science and Masters of Physiotherapy, Betty has developed a great understanding of how the body moves and how to use exercise to help others improve their health and wellbeing. Betty’s passion for exercise and sports injury rehabilitation is reflected in her experiences working as a physiotherapist with National Premier League football teams, as well as AFL and rugby teams. Betty enjoys working with people of all ages and abilities to find the right treatments to help them achieve their healthiest selves.
In her spare time, Betty likes going to the gym and lives and breathes all things netball. She also enjoys a challenge, so she has recently started playing football. During the holidays, you may find Betty going camping or hitting the beach with friends and family.
Rob became interested in anatomy, exercise, and the human body when he began going to the gym in high school. He began researching and managing his own injuries with exercise and from that point, physiotherapy stood out as a career for him.
Rob developed his skills and gained experience in private practice, musculoskeletal, sports physiotherapy and post-surgical rehabilitation at the Australian Catholic University where he completed his Bachelor of Physiotherapy. Rob believes in managing patients with a combination of hands-on techniques and exercise. He aims to involve the patient in the decision-making process to optimise results such as reducing pain and increasing function in work, sport, or day-to-day living.
Outside of physiotherapy, Rob enjoys living an active life including cycling and regularly going to the gym and outdoors with friends and family.
Denise has been practising for more than 20 years, since graduating from her Physiotherapy degree at Sydney University, in both hospital and private practice settings. She has developed a special interest in treating postural neck and back pain, shoulder injuries and foot and ankle pain, as well as rehabilitation following hip and knee surgery.
Denise experienced first-hand the benefits of improving core muscle strength and stability after having her first child, and this led to her undertaking Clinical Pilates courses.. She has since applied this knowledge widely in the clinic for the treatment and prevention of pain and poor posture, utilising the principles learned from from 15 years of practising and teaching physiotherapy- based Pilates. Denise has vast experience as an educator, teaching everything from Get Fit to Ski classes, to Physio Pilates and Prenatal Education classes. She feels great satisfaction in seeing her clients learn more about their bodies and how they can move better.