The typical patient experiencing inferior knee pain has changed as the number of females participating in sports increases. MayoClinic.com reports that one type of inferior knee pain, Osgood-Schlatters, that used to be primarily found in boys is now being seen almost as often in girls.
Anatomy
The knee is extended by contraction of the quadriceps muscle in the front of the thigh. The force is transmitted through the patella or kneecap. The patellar tendon connects the kneecap to the shin-bone also known as the tibia. Forceful knee extension is required for jumping, kicking and cycling. Injury to the patella tendon can make it difficult to stand and walk, because the extensor muscles are active even while standing.
Jumper's Knee
Patellar tendonitis is an inflammation of the tendon. Jumper's knee is another term for patellar tendonitis, since it typically occurs in basketball players, volleyball players, and soccer players. It usually develops after activity is suddenly increased. Having tight hamstring muscles, being knock-kneed or bow-legged increases the chance of developing patellar tendonitis, according to MayoClinic.com.
Pain from patellar tendonitis usually is a dull pain in the tendon that happens before and after activity. As the tendonitis worsens, it becomes a sharp pain with jumping or stair climbing. It can worsen to the point it interferes with activities.
The treatments include avoiding activity that irritates the patellar tendon and icing the knee. A therapist may use iontophoresis on the tendon. A strap worn over the tendon may help alleviate the pain.
Patella Tendon Tears
The patella tendon produces a sharp pain if it tears. The tear can be partial or complete. Weakness of the leg and bruising is seen. When the tear is complete, the kneecap may move slightly above the knee. The American Academy of Orthopaedic Surgeons reports the location where the patella tendon tear occurs reflects the patient's condition. Tears in the middle of the tendon happen with chronic conditions or medications that weaken the tendon. The AAOS lists rheumatoid arthritis, diabetes, renal failure, systemic erythematosus lupus, infection and use of corticosteroids or anabolic steroids as causes of patellar tendon weakness. Sudden forces including jumping or landing from a jump create a patellar tendon tear near the patella. A piece of the patella may break off. The AAOS treatment recommendations depend on the severity of the tear. Complete tears usually require surgical fixation.
Osgood-Schlatters
MayoClinic.com cites studies showing that one in five teenage athletes has pain due to Osgood-Schlatters. During the growth spurt of puberty, the bone at the insertion of the patella tendon changes from a rapidly growing area in children bone to adult bone. Running, jumping and doing sports that require sudden changes of direction can make this area irritated. New bone forms at the point where the tendon pulls on the bone creating a bony lump. Treatment is the same as patellar tendonitis in adults.
Other Causes
The AAOS lists other causes of inferior knee pain as bursitis, infection or fracture. Bursitis presents as a gradual swelling over the inferior knee. Medical treatment should be promptly sought if redness, sudden swelling and fever are present as they are signs of an infection.
References
- MayoClinic: Patellar-Tendonitis
- American Academy of Orthopaedic Surgeons: Your Orthopaedic Connection: Patellar Tendon Tear
- Womens's Sports Foundation: Go Out and Play: Youth Sports in America
- American Academy of Orthopaedic Surgeons; Comprehensive Orthopaedic Review: Lieberman, J, ed.; 2009
