Pain under the kneecap while walking, climbing stairs or cycling may indicate an injury to the patellar tendon. This tendon connects the thigh muscle (quadriceps) to the lower leg via the kneecap.
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Pain under the kneecap
Overload is often the cause. We mainly see the complaint in football players, volleyball players and korfball players - sports that involve a lot of jumping (hence the name jumper's knee) or that require a lot of acceleration and deceleration.
Why the patellar tendon causes complaints
The combination of an accumulation of small micro-injuries and an inadequate healing response has a net negative effect on the tendon structure. The tendon may swell slightly and the fibers become of poorer quality. In short: the tendon becomes weaker and people suffer from this. An abnormality of the tendon can often be seen on ultrasound or MRI.
Treatment with prolotherapy
Many of our patients have already visited the sports carer or the physiotherapist at the sports club, without convincing results after long rehabilitation processes. These patients are eligible for treatment with prolotherapy.
With prolotherapy we inject a mild inflammation-inducing agent (glucose) into the attachment of the patellar tendon to the kneecap, where the injury is often located. In this way we provoke the local healing response that failed to occur after the original injury. After all, it is the inadequate healing response to the original injury or micro-injuries that has caused the tendon to become weaker and ultimately cause complaints.
It is important to treat this tendon. If the degeneration process continues, it can lead to a (partial) rupture of the tendon — a scenario that we want to avoid as much as possible.
Platelet rich plasma (PRP)
Recently, scientific research has paid attention to the use of Platelet Rich Plasma for this condition. PRP is a concentrated form of proliferation therapy; research for this condition shows mixed results.
We draw your blood, centrifuge it and isolate the repair cells (platelets) and growth factors from it. We inject this concentrated mix of strong stimuli for the healing response into and around the affected tendon. Although this treatment is generally safe, traditional prolotherapy with glucose is sufficient in most cases.
Recognizable symptoms
- Pain under the kneecap when walking
- Pain under the kneecap when climbing stairs or cycling
- Complaints when jumping, accelerating and braking
- A slightly swollen knee tendon
Scientific references (3)
- Charousset C, Zaoui A, Bellaiche L, Bouyer B. Are multiple platelet-rich plasma injections useful for treatment of chronic patellar tendinopathy in athletes? a prospective study. Am J Sports Med. 2014 Apr;42(4):906-11.
- Gosens T, Den Oudsten BL, Fievez E, van 't Spijker P, Fievez A. Pain and activity levels before and after platelet-rich plasma injection treatment of patellar tendinopathy: a prospective cohort study and the influence of previous treatments. Int Orthop. 2012 Sep;36(9):1941-6.
- Vetrano M, Castorina A, Vulpiani MC, Baldini R, Pavan A, Ferretti A. Platelet-rich plasma versus focused shock waves in the treatment of jumper’s knee in athletes. Am J Sports Med. 2013 Apr;41(4):795-803.
