Patellar Tendinopathy

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Patellar Tendinopathy

• Brad McIntosh  
• Doctor of Physiotherapy

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osis itis opathy

• Who cares?
• Presentation

Tendinosis Tendinitis
Insidious Acute
No incident Attributable
Common Rare
Slow to heal Rapid response
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Tendinosis

• Explaining the basics to your client
• Failed healing
• Breakdown exceeds repair
• Disorganised fibres
• Microtears (not associated with ruptures!)
• Increased blood vessels and nerve fibres

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Diagnosis

• Diagnosed on history
• anterior pain
• jumping or running sport
• coming back from a
• period of time off training
• ramped up rapidly
• warms up
• Pain on palpation at
• Blazinas point
• Localised swelling/thickening

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Tendinopathic changes

• Ultrasound features
• thickened
• hypoechoic/anechoic
• heterogeneous/disorganised

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Management

• Injections
• aprotinin
• cortisone
• autologous blood
• platelet rich plasma
• skin-derived stem cells
• sclerosing agents (polidocanol)

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Management

• Eccentrics
• Sets repetitions
• Characteristics of the regime
• pain
• consistency
• high load

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Management

• Other stuff
• Bracing taping
• Controlled loading
• Biomechanics