Patellar tendinopathy

Patellar tendinopathy

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  PRATIGYA DEUJA PATELLAR TENDINOPATHY
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  DEFINITION  Jumper’s kneeor patellar tendinopathy ,A/K/A patellar tendonitis is a condition characterized by inflammation of patellar tendon. This connects patella to shin bone.  It is a chronic overuse injury of the patellar tendon resulting from excessive stress on the knee extensor mechanism.  Seen in sports requiring repetitive jumping, running and kicking. Example: Volleyball, basketball, tennis ,track
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  Patellar Tendinopathy
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  DEFINITION  Acceleration, deceleration,take off and landing generate eccentric forces that can be 3 times greater than conventional concentric and static forces.  These eccentric forces may exceed the inherent strength of the patellar tendon, resulting in micro tears anywhere along the bone tendon interface. CAUSES  Extrinsic causes:- Error in training  Intrinsic causes:- Biomechanical flaws (such as tight hamstring and excess femoral anteversion and jumping mechanics)
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  CLINICALFEATURES 1) Dull, achinganterior knee pain after a strenous exercise session. 2) Onset:- Insidious 3) Localized 4) Stiffness or pain after prolonged sitting or climbing stairs 5) Swelling
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  FOURPHASES Phase 1 :-Pain is after activity only and is not associated with functional impairment. Phase 2 :- Pain is present during and after activity but does not limit performance and resolves with rest. Phase 3 :- Pain is present continually and is associated with progressively impaired performance. Phase 4 :- Compete tendon rupture
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  EXAMINATION& LIMITATION PHYSICAL EXAMINATION FUNCTIONAL LIMITATION 1) Tenderness:- Positive at inferior pole of patella 2) Crepitus and pain with compression of the patellofrmoral joint 3) In advance disease, quadriceps atrophy 1) Inhibition of knee extension impairs atheletic performance 2) Walking difficulty 3) Difficulties with ascending or descending stairs
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  INVESTIGATION&TREATMENT INVESTIGATION TREATMENT  X-RAY Ultrasound  MRI  Conservative :- Ultrasound, iontophoresis, NSAID, Corticosteriod  Surgical :- Resection of tendon with resuturing of tendon
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  TREATMENT  Stretching exercises Strengthening exercises; Focus on eccentric strengthening  Knee brace , cap, counterforce straps  Sports – specific drills and training  Eccentric squats  Leg presses  Slant board exercise
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  Decline squat andStep squat
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  Split Squat
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  Refrences  https://thenakedphysio.com/2014/09/22/the-challenge-of-knee-pain/  Mayoung et al. Eccentric decline squat protocol offers superior results at 12 months compared with traditional eccentric protocol for patellar tendinopathy in volleyball players  Clinical sports and medicine – Peter Brunker and Karim Khan  Physical Medicine and Rehab – Walter R. Frontera