What are the risk factors for patellar (kneecap) tendonitis?

From the Guidelines

Patellar tendonitis risk factors primarily include repetitive loading of the patellar tendon, particularly in jumping athletes, as well as activity-related anterior knee pain exacerbated by navigating stairs and prolonged sitting. According to 1, patellar tendinopathy causes activity-related anterior knee pain and occurs in athletes and nonathletes alike, with repetitive loading of the patellar tendon placing jumping athletes at greatest risk. Some key risk factors for patellar tendonitis include:

• Overuse from repetitive jumping or running activities
• Sudden increases in training intensity
• Muscle imbalances, such as weak quadriceps or hamstrings
• Poor flexibility
• Improper technique during sports
• Structural issues like flat feet or high arches
• Age, with the condition more common in young active individuals and those over 40 due to tendon degeneration
• Being overweight, which places additional stress on the patellar tendon, increasing risk
• Previous knee injuries or surgeries, which can create biomechanical changes that predispose to tendonitis
• Training on hard surfaces and wearing inadequate footwear without proper shock absorption Understanding these risk factors, as outlined in 1, allows for preventive measures including gradual training progression, proper warm-up routines, strength training for supporting muscles, maintaining healthy weight, and using appropriate footwear for your activity and foot type.

From the Research

Patellar Tendonitis Risk Factors

The risk factors for patellar tendonitis can be categorized into intrinsic and extrinsic factors.

• Intrinsic risk factors include:
  • Muscle flexibility and strength 2
  • Body weight, body mass index, waist-to-hip ratio, leg-length difference, arch height of the foot 3
• Extrinsic risk factors include:
  • Acquisition and level of skills 2
  • Playing conditions, the kind of sport, playing level and personal characteristics 4

Prevention and Treatment

Prevention is essential to reduce the risk of patellar tendonitis, especially in athletes who participate in jumping sports.

• Screening is an essential tool to assess patellar tendonitis 4
• Treatment options include eccentric exercises, cryotherapy, platelet-rich plasma (PRP) injections, and anti-inflammatory strategies 5, 4, 6
• Rehabilitation intervention or direct modification of the equipment or environment can help reduce the load on the patellar tendon and improve pain and function 2