Patellar Tendonitis Rehab

Your patellar tendon attaches your quadriceps muscles at the front of your thigh to your shin bone, or tibia, in your lower leg. The tendon begins just below the kneecap, or patella, and inserts at the tibia tuberosity, a large bump at the top of your shin bone.

Tendons are made of tough fibrous tissue that is continuous with the muscle, attaching it securely to bone. As the muscle shortens, it pulls on the bone to which it is attached, producing movement. The job of the patellar tendon is to straighten the knee by pulling on the tibia.

Patellar Tendonitis is a common athletic overuse injury, although it can occur in non-athletic populations. During physical activity, the patellar tendon is subjected to great force loads as it straightens the knee during walking, running and jumping. Patellar tendon dysfunction is sometimes called jumper’s knee due to its prevalence in sports that involve jumping.

Tendinitis refers to inflammation of the tendon, but the term tendinosis offers a more accurate description of jumper’s knee, because tendon injuries tend to be degenerative rather than inflammatory.

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Patellar Tendonitis Causes

Tendinosis occurs when excessive forces cause disruption of the tendon cells, called tenocytes, making them weaker and less able to cope with repetitive load. If not given time to heal, painful degeneration of the entire tendon may occur.

Causes of patellar tendinosis (tendonitis) include:

  • Sports like basketball that require repetitive jumping and landing
  • Running
  • Poor flexibility in the quadriceps and/or hamstrings
  • An elevated kneecap (patella alta)
  • Inadequate recovery time between activity sessions

Patellar Tendonitis Symptoms

  • Sharp pain along the tendon after running or jumping
  • Persistent pain or aching at the front of the knee
  • Tenderness to touch
  • Stiffness and pain in the tendon first thing in the morning

Patellar Tendonitis Diagnosis

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Diagnosis is based on symptoms and a physical exam. At NYDNR, we confirm our diagnosis with high resolution diagnostic ultrasound, to rule out other possible causes of knee pain.

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Please explore more advanced diagnostic option unavailable anywhere else:

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Patellar Tendonosis Treatment

Treatment for patellar tendonosis is geared to managing symptoms while the knee recovers and heals. Discontinuing activities that cause pain, applying ice and taking NSAIDs may help. Stretching the muscles of the upper leg can reduce load on the patellar tendon.

At NYDNRehab, we take an active approach to treating patellar tendinosis. Some of our treatment methods include:
  • Patellar tendinosis physical therapy
  • C.A.R.E.N, our computer assisted rehabilitation environment
  • Kineo intelligent load system
  • DD Robotech Neurocognitive training
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Regenerative Therapies are Game
Changers for Knee OA

The human body has its own innate healing mechanisms, but it sometimes needs a nudge to accelerate the healing process. Regenerative technologies help to jump-start healing by stimulating tissue repair at the cellular level. Our outpatient regenerative therapies expedite recovery with minimal discomfort for the patient.

Focused Extracorporeal Shock Wave Therapy (ESWT)

Focused ESWT is used as a regenerative treatment for damaged tendon, muscle and bone tissue. This technology produces high frequency sound waves to stimulate the body’s own reparative mechanisms. It is especially effective for chronic degenerative tendon disorders and myofascial pain syndrome.


Extracorporeal Magnetic Transduction Therapy (EMTT)

EMTT is a fairly new technology that transmits high energy magnetic pulses to targeted tissues. The magnetic waves synchronize with the body’s own magnetic fields, causing a disturbance that triggers a regenerative response. EMTT waves can penetrate deep tissues up to 18 cm beneath the skin’s surface, to target difficult-to-reach tendons, muscles, bones and nerves.

Extracorporeal Pulse Activation Technology (EPAT)

Extracorporeal Pulse Activation Technology (EPAT)

Extracorporeal Pulse Activation Technology (EPAT)

EPAT, also known as defocused shock wave therapy, uses acoustic pressure waves to enhance blood circulation to targeted tissues. This speeds up the delivery of oxygen and nutrients to damaged tissues and stimulates cellular metabolism, to accelerate the healing process.


High Energy Inductive Therapy (HEIT)

HEIT uses electromagnetic fields to penetrate cells, tissues, organs and bones, to reactivate the electrochemical function of cells and cell membranes. HEIT generates a magnetic field 600 times stronger than the field of a normal magnet, to stimulate healing of nerves, muscles and blood vessels.

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Ultrasound Guided Injection
Therapies

Injection therapies use natural/neutral solutions that stimulate cellular repair by either nourishing or irritating the targeted cells. Guidance by ultrasound ensures that the injected substances hit their mark, for maximum effectiveness.

Focused Shockwave Therapy

Platelet Rich Plasma (PRP)

PRP therapy uses a sample of the patient’s own whole blood, which is spun in a centrifuge to extract a high concentration of platelets. When injected into damaged tissues, PRP initiates tissue repair by releasing biologically active factors such as growth factors, cytokines, lysosomes and adhesion proteins. The injected solution stimulates the synthesis of new connective tissues and blood vessels. PRP can help to jump-start healing in chronic injuries and accelerate repair in acute injuries.


Proliferation Therapy, aka Prolotherapy

Prolotherapy uses a biologically neutral solution, often containing dextrose, saline or lidocaine. The solution irritates the affected connective tissue, stimulating the body’s own natural healing mechanisms to encourage growth of new normal ligament or tendon fibers.

Electromagnetic Transduction Therapy (EMTT)
Ultrasound Guided Dry Needling

Ultrasound Guided Dry Needling

Myofascial trigger points often contribute to pain syndromes and motor dysfunction. Dry needling is an outpatient procedure that inserts non-medicated needles into the trigger point to evoke a twitch response, releasing the trigger point and immediately relieving pain. Ultrasound guidance eliminates the need for multiple insertions, reducing pain and discomfort for the patient.

Our Rewards

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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

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Complete tear of rectus femoris
with large hematoma (blood)

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Separation of muscle ends due to tear elicited
on dynamic sonography examination

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