Patellar tendinopathy: Physical therapy and injection treatments

Patellar tendinopathy, commonly known as jumper’s knee, is an overuse injury of the patellar tendon. It is a frequent injury, particularly in jumping athletes such as volleyball and basketball players. Jumper’s knee is often a long-lasting injury and can have a major impact on sports and even work participation. The development of jumper’s knee and the best treatment for it are still unclear. The general aim of this thesis was to investigate the development and management of patellar tendinopathy. This thesis showed that patellar tendon structure did not change in healthy adolescent volleyball players during heavy loading of the tendon. Furthermore, two new exercise-based physical therapy programs for athletes with patellar tendinopathy performed in-season were found to decrease pain, while athletes kept on playing without load reduction. Interestingly, these 4-week programs did not immediately affect tendon structure and dimensions. A systematic review of the literature on injection treatments for patellar tendinopathy showed that corticosteroid injections are detrimental, while all other injections studied showed positive results. The positive outcomes may also be the result of the post-injection rehabilitation program. Since these programs are poorly described in current literature, a post-injection exercise-based physical therapy program for patients with jumper’s knee was developed. This program was found to be feasible; first results showed that a platelet-rich plasma injection in combination with this program were mostly positive. This thesis contributes to knowledge on the development of jumper’s knee and shows that exercise-based physical therapy has an important role in its management.