Russ Paine is a well-known physical therapist with the Roger Clemens Institute at Memorial Hospital. After getting his degree in physical therapy from Texas Women's University, he trained for several years under David Drez, MD, a renowned surgeon and sports medicine specialist. He has been a rehab consultant for the Houston Rockets, Houston Astros and NASA. He has given hundreds of presentations in his career in the US and abroad, and has published many chapters in text books and papers in peer review journals.
RUSS PAINE: Today, we're going talking about patellar tendinitis which is pain just below the kneecap. And the patellar tendon connects your kneecap to your lower leg and it's part of your extensor mechanism. So if we look on the screen here, you can see this is your quadriceps tendon here. It connects to the kneecap. Here is you kneecap, and then the patellar tendon connects the kneecap to the tibia and it helps you extend your knee. And this is called jumper's knee, so jumping type of activities will create this. If you're someone who is doing a jumping activity, you're not used to it and your quadriceps muscles are not strong enough, again, the quadriceps muscle shares the load and shock absorber of your knee. So if your quad is weak and you decide to do a pick-up game in basketball, you may create some patellar tendinitis because all the load gets shifted to that patellar tendon. So again, the patellar tendon is here and we'll show in our model now exactly where that pain is located. So if you straighten your knee out-- and here's a little trick that we do to relax your quadriceps. If you push the patella down like this, you can see that it kind of bolts up. And the site or location of pain with patellar tendinitis is right here just at the apex of the patella. Typically, it doesn't hurt in the middle. But if you have pain down here where the patellar tendon inserts, that's a different kind of problem. It's called Osgood-Schlatter's which is something that happen with kids that are having a growth spurt. Patellar tendinitis is really located right at the base of the patella. And treatment for this, again, obviously is to stop the jumping activity that's causing the problem, strengthening your quadriceps and doing some quadriceps stretching, which we'll show in just a second. Ultrasound is really helpful for this. Friction massage sometimes can be helpful and iontophoresis application, which is an electrical stimulator that delivers a real low-dose of cortisone through your skin, is very helpful for this condition. Typically it's not injected because that can cause a little bit of a problem. Roll over on your stomach. So quadriceps stretch is performed, again, you just kind of reach back and grab your ankle here or your foot and pull your heel towards your buttocks, hold that stretch for about 10 to 20 seconds and do 10 of those stretches. So again, these are some of the things for patellar tendinitis. One other thing is that's really helpful is to do an ice-cup massage to that patellar tendon, obviously, not in this position, but with your knees straight, flipped over on the other side. You can use Styrofoam coffee cup, put it in the freezer full of water, and that will help alleviate patellar tendinitis.
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