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Tendonitis

Overview

Sports that involve a lot of running, jumping, and kicking can lead to pain in the front of the knee.

Adolescents often develop this pain during or after growth spurts. Bone growth occurs faster than soft tissue growth, resulting in tightness in the tendon across the front of the knee joint. This tightness combined with repetitive movements can result in tendonitis.

The tendon in the front of your knee is called the patellar tendon. This tendon connects the quadriceps muscle to the shin bone (tibia). This tendon can be divided into two areas: the quadriceps tendon and the patellar tendon. The quadriceps tendon is above the knee cap (patella) and the patellar tendon is below the knee cap. When the quadriceps muscle tightens, it pulls on the tendon and the knee straightens. This muscle is used during many activities including: squatting, stair climbing, kicking, running and jumping.

Tendonitis

Osgood Schlatter

Osgood Schlatter disease occurs in the lower part of the tendon where it attaches to the shin bone. Contraction of the quadriceps muscle pulls on the tendon and the bone where the tendon inserts. Repetitive stress through this area can cause a bump to form on the front of the shin bone.

Sinding Larson Johansson

Sinding Larson Johansson disease is similar to Osgood Schlatter disease, but occurs in a different location. Sinding Larson Johansson disease occurs just below the knee cap (patella). A bump can sometimes be felt just below the knee cap.

Patellar tendonitis

Patellar tendonitis is when the tendon gets irritated. It is different from the above conditions because it does not happen near the insertion of the tendon into the bone.

The above conditions result in similar symptoms such as:

  • Pain in the front of the knee with running, jumping, kneeling, squatting, or climbing stairs
  • Pain during full flexion (bending) of the knee
  • Pain in both knees
  • May be able to feel a bump in the area that is tender/painful
  • Initial pain at beginning of activity and return of pain after stopping activity

An evaluation by Dr. Shelbourne or Dr. Benner can help isolate the specific cause of your symptoms.

Treatment

Rehabilitation to improve flexibility in the muscles around your knee often helps alleviate symptoms. Sometimes surgery is needed to remove the damaged part of the tendon. Rehabilitation is necessary to allow for a return to normal activities following surgery. Rehabilitation focuses on restoring full, symmetric range of motion and strength.