Do you have the same knee injury as Rafa Nadal?

If you have pain at the front of the knee just below the patella (knee cap) you may have patellar tendinopathy. Rafa has fought long battles with his knees and patella tendinopathy throughout his career. It is no wonder when you look at the stress tennis puts on Rafa’s knees with his “never stop” attitude to move on court. Patellar tendinopathy is common in athletes who perform a lot of repetitive jumping, change of direction and deceleration movements such as tennis and other sports including basketball and volleyball. The patella tendon becomes subject to forceful repetitive

contraction from the large quads muscle group in the front of the thigh. When this force is more than that of the tendon capacity the tendon starts to break down and cause pain.

Assessment by a physiotherapist is recommended as early as pain starts because if left untreated this condition can become persistent and a challenge to treat. The assessment involves taking a thorough history of your normal activity and loading patterns. Often muscle weakness, poor biomechanics, past injuries, and changes in activity levels can be risk factors for developing the condition and need to be addressed appropriately.

Treatment initially is focused around decreasing pain by modifying activity and sporting loads to settle down the tendon pain. Isometric quadricep exercises have been shown to help with pain relief such as the Spanish squat, wall sit or sustained leg press. (Ask your physio about these). These are recommended to be used frequently like "taking a Panadol" when you are feeling sore.

Treatment remains exercise based throughout the rehabilitation period which can be up to 6 months in bad or persistent cases. An individualized progressive exercise program is advised at least 3x per week to build strength and increase the load capacity of the injured patellar tendon. Exercises are progressed over time to include sports specific drills such as jumping and change of direction to improve muscle control, power and prevent reoccurrence.

Your physio may recommend referral for other treatment options such as injections and possibly surgery however these are reserved only if exercise based treatment fails. Most athletes make a full recovery back to sport with exercise based treatment and avoid a lengthy post-surgical rehabilitation.

At PhysioLogix our tennis physiotherapists are specialists in tendinopathy rehabilitation. If you or you know someone with pain at the front of the knee and are wondering if it might be patellar tendinopathy call our friendly reception staff to make an appointment. Call PhysioLogix, The Gap on (07) 35111112.