Today Chris and I will touch base with last year’s Grumpy Knee Series as we dive deep into the Patellar Tendon and why / how it gets compressed and painful.
The concept we are looking at for six weeks (last week’s example was the Elbow in case you missed it) is how tendons become painful around bony prominences (in other words like a piece of tough rubber tubing pulled tight, then bent around a metal pole and pulled back and forth). The underside of the tendon may suffer the most but of course the whole thing just hurts!
This is the classic "jumpers knee". The spot of maximum tenderness is usually the tendon as it attaches onto the distal pole of the patella. When the knee flexes (bends) the change in angle of the tendon to the patella causes the pointy inferior pole to push into the uppermost portion on the patella tendon. Again, this compression area corresponds very closely to the site of pathology.
This may explain why some people knees hurt under the Patella when sitting for a long period of time - also called “Movie-Goer’s Knee”! The bone is pushing into the tendon from behind for the whole time because of the knee bend.
Also why kneeling really stings for some knees and not others!
The Patella digs into the under-surface
of the upper patellar tendon
Rehab Training ideas:
Can you think WHY the following three interventions would very likely help bring relief for this type of knee pain? What biomechanical effect do they all have in common….
1. Deep tissue myofascial release and passive stretching of the Quadricep?
2. A strong rope bound around the knee at the level of the Patella Tendon (like the Jumper’s Knee Brace)?
3. Isometric Quadriceps contractions on a leg extension machine 10 secs for a few repetitions also might make it feel amazing for a little while….
Hehehe - the answer is coming next week ;)
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