Nov 2014 01

The patellar tendon

By: Dave Wheeler

It's funny how this job works: unusually last weekend I had 2 clients in the space of 24 hours both with knee pain caused by inflammation of the patellar tendon.

The 1st client was a 28 year old part-time instructor of a popular hard-core exercise class; the 2nd was a 36 year old who had just started exercising at the gym and was really going for it.


patellar tendon

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The patellar tendon - the tendon of the quadriceps muscle

The quadriceps (the "kicking" muscles") are responsible for the action called knee extension - the action of kicking.

There are 4 muscles of the quadriceps:

  1. Rectus femoris (shown in blue in the diagram below)
  2. Vastus medialis (shown in red)
  3. Vastus lateralis (shown in yellow)
  4. Vastus intermedialis (shown in green)


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The 4 muscles of the quadriceps join together close the knee to form the patellar tendon (have a look at the first diagram); this tendon then passes over the knee-cap, the patellar, and attaches to the lower leg (called the tibia) at a little bony prominence just below the knee called the tibial tuberosity.

Imagine the muscles contracting, pulling on the tendon which pulls on the lower leg - it causes the kicking action.


Patellar tendonitis

Tendonitis is a painful condition caused by tendons that become irritated or inflamed through over-use.

Patellar tendonitis is usually caused by repeated jumping, squats or kicking.

In the case of the 2 clients last weekend, this is exactly what they'd been doing - way too many jumps and squats.

Patellar tendonitis is usually felt just below the knee-cap especially when trying to kneel down or bend the knee.

In really severe cases, there will be swelling just below the kneep-cap and the tendon and quadriceps muscles above the knee can also be affected.


Treating patellar tendonitis

The first thing to do in the case of acute inflammation is to ice the knee:

Ice means a bag of frozen peas, wrapped in a tea-towel applied to your knee for 4 mins at a time; do this at least 4 times throughout the day for a couple of days (7 times a day would really be ideal).  Remember to bin the peas afterwards.. don’t give yourself food poisoning by trying to eat them!

After the inflammation has gone down - usually after 48 hours - a good sports & remedial massage therapist will be able to peform some stretches using a technique called soft tissue release.

Some good old fashioned deep tissue massage of the muscles of quadriceps will then help to relieve the tightness there that's built up from over-use.

As ever, if you think I can help, give me a call.