Question

I play football and I have been told I have patellar tendonitis. Rest does not seem to help much. A cortisone injection made it feel better, but I have no strength or stability, especially when I stand on one leg. What else can I do?

Answer

Patellar tendonitis is an overuse or overload syndrome, the hallmark symptom being pain in front of the knee. Usually there is a distinct localized tender spot. Patients also describe night pain, pain with sitting, squatting, or kneeling. Climbing stairs can also be painful.

There may be puffiness around the front of the knee; usually the patient has pain when the knee is bent (flexed) extremely, as well as sometimes with full straightening (extension).

If the condition has been present for some time, the quadriceps muscle (front of the thigh) may be smaller than on the other leg.

Treatment involves primarily rest, but also the use of non-steroidal anti-inflammatory medicines (NSAIDs), such as ibuprophen, acetaminophen, or diclofenac. Cortisone injections should not be injected directly into the tendon, as this may increase the risk of rupture of the tendon.

After the inflammation has been relieved, the patient should have physical therapy to restore strength and pain-free range of motion. A knee sleeve with an opening for the patella can be helpful.