Patellar tendon ruptures can occur during athletic competition and as a result of accidents around the home. These injuries may arise from sudden, traumatic incidents or from chronic overuse. Unfortunately, many individuals experience weakness and knee instability as a result of a patellar tendon rupture. However, with effective treatment, it’s possible to restore range of motion and strengthen the surrounding tissues to support the joint. At Sports Medicine Oregon, we offer a wide range of conservative care treatments for less severe patellar tendon injuries, as well as surgical options when appropriate, to help athletes and active individuals achieve their activity and knee stability goals. In this post, we will answer many of the most common questions regarding patellar tendon tears, including “what does a partial patellar tendon tear feel like?” and “what are my treatment options?” Let’s take a look...
Before we dive into patellar tendon tear treatment, a little anatomy lesson is in order. Above the knee, the quadriceps muscle connects the femur to the kneecap (known as the patella) via the quadriceps tendon. Below the knee, the patellar tendon connects the patella to the tibia, also known as the shin bone, the larger of the two bones that make of the lower leg. During movement, these muscles and tendons work together to allow us the ability to extend the lower leg, straightening the limb. The patellar tendon also keeps the patella in place during activity, protecting the joint from injury.
Patellar tendon ruptures are common sports injuries, but they can also occur during all manner of accidents. There are many patellar tendon tear causes, most of them involving a sudden, blunt blow to the front of the knee. For example, a fall onto the knee from a significant height will subject the tendon to tremendous force, potentially leading to a partial patellar tendon tear or a complete rupture. Car accidents can also impart this kind of sudden, direct trauma. In addition, some chronic injuries (namely patellar tendinosis) may weaken the tendon over time, increasing the risk of a patellar tendon rupture.
Athletes participating in certain sports are more likely to suffer a complete or partial patellar tendon tear. Football, basketball, volleyball, and other sports that involve large amounts of jumping are the most likely to lead to overuse injuries, weakening the tendon over time. Volleyball players are especially susceptible to patellar tendonitis, a condition colloquially known as “jumper’s knee.” In fact, a recent study estimated the prevalence of jumper’s knee among elite volleyball athletes to be as high as 50 percent. Once the tendon has been weakened in this way, a patellar tendon rupture or partial tear is most likely to happen at the beginning of a jump or during the landing, as the movement tightens the tendon.
Individuals suffering from chronic tendonitis in the knee may treat their symptoms with corticosteroid injections. Unfortunately, corticosteroids injections in the knee can cause further damage to the patellar tendon over time, increasing the risk of a patellar tendon rupture. With this in mind, prevention is key. Preventing patellar tendonitis will also minimize the future danger of acute patellar tendon injuries such as ruptures. The RICE method — an acronym for Rest, Ice, Compression, and Elevation — is an effective at-home preventive treatment to utilize after intense workouts or minor injuries that could add up over time.
To learn more about the RICE method and effective treatment, read our blog post on hot and cold therapy.
After suffering a rupture or partial tear, there are several patellar tendon tear symptoms a person may experience. At the time of injury, many people report feeling a sudden tear or pop in the knee. At times, this “pop” felt during a patellar tendon rupture may also be audible to observers. As noted previously, the patellar tendon attaches the kneecap to the shin, and a patellar tendon rupture severs this connection. As a result, the kneecap is no longer held in its typical position in front of the knee. Oftentimes, the kneecap may be positioned much higher than normal after a complete patellar tendon tear, due to the quadriceps tendon pulling the kneecap upward toward the thigh. General swelling, bruising, and soreness around the patellar tendon and knee joint are also typical patellar tendon tear symptoms. Walking after a patellar tendon tear is possible, however, many patients will notice significant knee instability as well as severe pain. Your doctor will first need to properly diagnose the injury before suggesting appropriate patellar tendon rupture treatment.
To rule out other conditions or injuries, your doctor will first physically examine the joint. During this physical examination, the doctor will guide you through a series of movements to pinpoint the location of the pain as well as test stability, strength, and range of motion of the joint. After a full patellar tendon rupture, patients are unable to fully extend the knee, so this is one of several key factors the examination will check for. Your doctor will also inquire about athletic participation and medical history to better understand the underlying cause of the injury. Additional diagnostic imaging such as x-ray and MRI may be used to determine the severity of the injury and rule out other possibilities. For example, a fracture of the patellar itself may closely imitate patellar tendon tear symptoms. These imaging tests will help rule out this possibility.
Once the injury has been properly diagnosed, the overseeing medical professional will recommend appropriate patellar tendon tear treatment options. Over the counter medications can be used to manage pain and discomfort in the days following a less severe patellar tendon tear. Ice should be applied immediately following the injury to minimize swelling and the accumulation of fluid in the knee. Immobilization is often an effective treatment option for a small patellar tendon tear. Braces can be used to minimize the use of the knee joint and allow the tear to heal. It’s important to minimize activity during the recovery process to prevent reinjury or exacerbating the existing injury. The joint may need to be immobilized for up to six weeks, depending on the severity of the tear. Next, the doctor will recommend patellar tendon tear physical therapy when appropriate. These patellar tendon exercises will focus on increasing the strength and range of motion of the knee joint. At first, a physical therapist will guide the patient through the proper execution of these patellar tendon rehab exercises. Then, the therapist will design a personalized rehabilitation program the patient can follow independently at home during the patellar tendon recovery process. Over time, these patellar tendon exercises will strengthen the joint, increase joint stability, and minimize the risk of knee injuries moving forward. Unfortunately, even with rehabilitation exercises, there is a limit to what the knee can heal from on its own. A severe tear will require immediate medical attention and patellar tendon surgery.
A small, partial patellar tendon tear may be adequately treated with nonsurgical treatments such as immobilization, assistive braces, and physical therapy. However, a complete patellar tendon rupture will require surgery, as will a partial patellar tendon injury that has not responded adequately to nonsurgical methods. During patellar tendon surgery, the surgeon will focus on reconnecting the severed patellar tendon. This will involve locating the two severed ends of the tendon and sewing them back together with a series of sutures. In instances where the patellar tendon rupture has separated the tendon completely from the patella itself, the surgeon will need to drill a series of small holes in the patella, forming a new anchor site to suture the tendon back in place. Depending on the injury, it may be necessary to use metal screws to anchor the tendon to the kneecap.
Many patients are eager to inquire about their anticipated patellar tendon rupture recovery timeline. It’s great to set reasonable goals and be closely involved in your own recovery, but it’s important to remember that every injury is unique. Every patellar tendon rupture recovery period will pass differently, depending on the patient and the severity of the rupture. For a smaller partial patellar tendon tear, a patient should expect to use an immobilization brace for up to 6 weeks. During this time, the individual will typically need crutches to assist with mobility and prevent aggravating the injury. It may take up to 6 months before the individual can return to the playing field and regular pre-injury activity levels.
Similarly, after a complete rupture, the patellar tendon surgery recovery time will also vary. Immediately following the procedure, the knee will be immobilized, and the individual will need crutches to assist with mobility for a few weeks to prevent reinjury. It may take a full year to make a complete patellar tendon tear surgery recovery. Many patients experience weakness in the injured knee even after the patellar tendon has fully healed. Fortunately, a personalized and effective patellar tendon rehabilitation program can minimize these lingering effects and restore strength.
Individuals who need physical therapy after a patellar tendon rupture or partial patellar tendon tear can greatly benefit from comprehensive care at our state-of-the-art physical therapy facility. If you or a loved one have recently suffered a patellar tendon injury, come in for a consultation to learn more about the latest treatment options. Our team is dedicated to helping patients achieve their active lifestyle goals without limitations.
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