Patellar Tendonitis (patella=knee cap, tendonitis=inflammation of the tendon) is generally an overuse injury where the tendon, and muscles attaching to it get very tight, causing discomfort.
This injury is often a running injury, runs from the front of the hip, where it starts attached to the pelvis. It runs down the front of the leg (muscle name- rectus femoris), crossing the knee (patellar tendon) and attaching on the tibia (patellar ligament). It's much like a long road that changes names at major landmarks or intersections. :) It's all still the same structure, so if you have a high level of tension in the quad muscles, particularly the rectus femoris, it will transfer pressure through the tendon and ligament, compressing the knee cap(patella) to the bony structures below. Not pleasant.
As with many muscular and tendon issues, the discomfort from patellar tendonitis will usually improve by reducing the tension in the muscle, which will reduce the pressure on the surrounding structures. So, massage (can be done with a foam roller or tennis ball), stretching, and icing is usually how we do that.
The massage approach techniques for patellar tendonitis will
address surrounding muscles, beyond the quad. Working with the other
hip flexors, the hamstrings, glutes and the lower leg muscles will allow
for greater movement and release of tension throughout the leg. We
have worked with several individuals with chronic knee pain, which was
alleviated by this approach as well...since it takes the pressure from
the connecting muscles off the joint.
The stretches we use address all these muscle groups as well. It is incredibly rare that one single muscle is strained without those surrounding it having some kind of pathological issue as well...so, just addressing the point of pain will rarely bring lasting relief. This is an important concept that we talk with our clients about often. In our bodies, we have a number of muscles engaging to move our bodies through different planes of movement. Although one muscle may do the majority of the work in one particular direction, rotating a limb at a joint just slightly, will engage different supporting muscles. When there is an injury, unless it was a significant pin pointed trauma, there has often been a build up of pressure and tension over time that finally reaches a tipping point.
Ice works to reduce inflammation, so if you are experiencing patellar tendonitis, ice can help to reduce the localized inflammation. When we apply ice for an injury like this, we are sure to just keep it on the area for 15-20 minutes, taking an hour break before reapplying the ice. When using a contrast treatment, alternating warm and cold, we will use each for 10-15 minutes at a time. However, if using ice in a localized area, the muscles (further up from the point of pain in the tendon) are likely still be exerting pressure in the form of muscle tension on the tendon, and the inflammation often will not go away without addressing the full issue.
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