John D. MacGillivray, M.D.: TreatmentPrint: Patellar Tendonitis
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Injuries and Conditions: Patellar Tendonitis : Patellar Tendonitis : Treatment Options
 

Overview
The pain and discomfort associated with patellar tendonitis can vary widely from patient to patient and depends upon the severity of the condition. Some patients may experience minor soreness while others may experience very severe and debilitating pain. In each case, treatment is essentially the same, although the length of time required for recovery will vary according to the severity of the tendonitis.
  • Tendonitis does not require surgery; treatment is typically limited to the use of R.I.C.E. (Rest, Ice, Compression, Elevation) and occasional physical therapy.
  • Patients who seek treatment and follow therapy instructions can expect a full recovery, sometimes in less than three weeks.
  • Patients in which the bursae are also inflamed may require an aspiration of one or more of the involved bursae, a process in which some of the fluid is drained from the sac.
  • Identifying the activities that irritate the tendon, followed by modifying or eliminating these injury producing activities is the most critical step in treating the patient.

    Treatment options:

    Conservative Treatment of Patellar Tendonitis Overview

  • After the activity or behavior that has caused the tendonitis is identified, modification or elimination of the injurious activity is required.
  • A period of rest is required to allow the tendon to heal and irritation to subside. This may vary from one to two days or as long as several weeks.
  • If the patient has a tendency for over-pronation of the feet, orthotics, or corrective inserts for shoes, may be recommended.
  • For severe injuries, a knee immobilizer and crutches may be recommended for use during initial treatment.
  • Ice packs around the knee are used to help reduce pain and swelling, usually for 20-30 minutes 4-6 times daily until the swelling subsides.
  • The use of a compression sleeve helps reduce and prevent further swelling.
  • Anti-inflammatory medication is sometimes administered to treat the pain associated with the inflammation.
  • More severe cases, where the bursae are very swollen, may be treated by aspirating the bursa to reduce pain caused by the accumulation of fluid.

    Medication and Medical Products
    Knee: Compression SleevesKnee compression sleeves give added support, increasing stability and helping to reduce swelling in an injured knee. Patients that have light sprains may be directed to use a compression sleeve during the early stages of rehabilitation. Other patients that have ongoing knee problems or chronic conditions may be recommended to use a sleeve on a daily basis. These sleeves are less restricting than most other knee supports and can be worn under loose fitting clothing.

    Knee compression sleeves can be used to treat:

  • Light swelling.
  • Light knee strains.
  • Chronic inflammation.
  • Degenerative joint disease.


  • Knee: Support A knee support is a sleeve-like support that fits firmly around the knee. The support is used to reinforce the joint during motion and provide compression to aid healing and reduce pain and swelling. Patients suffering from knee strains or inflammation will usually be directed to use a support during daily activities.

    The thin and flexible construction of the support allows for normal movement of the knee and also allows the support to be worn under loose fitting clothing. To prevent harmful pressure to certain structures, the support applies differing compression around the knee. The sides of the joint receive intermittent pressure to help stimulate blood flow while the rear of the support fits relatively loose to prevent constriction of circulation. The kneecap is aided in positioning, but remains free of compression to allow its natural movement.

    Knee supports can be used to treat:

  • Strains
  • Sprains
  • Inflammation
  • Chondromalacia patella

  • Hot/Cold Pack The use of hot and cold packs to relieve pain and inflammation is a common method of treatment for many conditions. When the soft tissue groups become strained or irritated the rotating application of hot and cold can be beneficial. Cold therapy numbs the nerves to reduce pain and combats swelling by constricting blood vessels and by slowing blood flow to the site of injury. The application of heat to an injury after a few days of cold therapy and after swelling and redness has been reduced promotes the healing process. Heat therapy speeds up healing by increasing the flow of blood to the site of injury. Heat will also restore flexibility, relieve muscle cramping, and arthritic symptoms.


    Long-Term Expectations for Recovery

  • Patients can expect a full recovery after treatment.
  • With moderate exercise to recondition the surrounding muscles and reduce stiffness after the injury, a patient may participate in athletic activities at their pre-injury level.
  • If the bursitis is a result of a common athletic activity, the patient may need to discontinue or modify the activity to prevent re-injury.

    Possible Complications and Risks

  • The tendonitis may recur if the patient returns to the injury producing habit or activity.
  • If the bursa is aspirated, the procedure may have to be repeated if fluid re-accumulates.

    Surgical Hardware Considerations

    This condition does not require surgical hardware.


    Factors in Transplant Source
    This condition does not require the transplanting of tissue.