Therapy of patellar tip syndrome

How is patellar tip syndrome treated?

The Patellar tip syndrome (jumper knees, Jumpers knee) is mainly treated conservatively.

Since the full picture of a patellar tip syndrome is often difficult and lengthy to treat, prophylactic measures to avoid a patellar tip syndrome are of particular importance. This includes a good one Muscle stretching, Warm up before exercising and slowly increasing the intensity of exercise. A soft sole and relieving tape bandages / orthotics for the patellar tendon can be used as prophylactic treatment measures.

Conservative therapy

The most important primary measure in the case of a patellar tip syndrome is consistent sports leave (Sports break), which should not be chosen too short. The duration depends on the complaints. We consider a period between 6 weeks and 3 months to be sensible. Then you should carefully approach your limit. Without sports leave, it will not be possible to achieve freedom from symptoms even with the therapy measures listed below!

Physical and physiotherapeutic therapeutic measures are indicated as immediate measures in acute patellar tip syndrome. These include the therapeutic use of:

  • Cold / heat
  • Electricity (electro stimulation)
  • Ultrasonic
  • Massage (friction massage)
  • physiotherapy
  • Shock wave therapy

The various therapeutic measures can be used in combination.

The temporary use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, diclofenac (Voltaren®) is also promising.

The infiltration (Encapsulation) of the tendon sliding tissue with a cortisone preparation is a study-controlled, successful therapy method for a patellar tip syndrome.
It is essential to avoid cortisone infiltration into the tendon tissue itself, as otherwise tendon death (necrosis) and the kneecap tendon can tear.

Although patellar tip syndrome (Jumpers knee), as already mentioned, is not histologically an inflammatory disease, the anti-inflammatory therapy with NSAIDs and cortisone helps.

Also read: Taping patellar tip syndrome

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The knee joint is one of the joints with the greatest stress.

Therefore, the treatment of the knee joint (e.g. meniscus tear, cartilage damage, cruciate ligament damage, runner's knee, etc.) requires a lot of experience.
I treat a wide variety of knee diseases in a conservative way.
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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Exercises / stretching

Therapeutically meaningful exercises are an essential component in the treatment of the patellar tip syndrome.
The various exercises extend from the focus of the Strength training about general Coordination- and Running exercises, such as stretching.

Above all, however, the stretching exercises should be carried out before the occurrence of a patellar tip syndrome in order to avoid this clinical picture or to reduce the risk.
Therefore, performing the stretching exercises is particularly suitable for predisposing sports as part of the warm-up program. Particular attention should be paid to the stretching of the thigh muscle, since its tendons over the patella into the Ligamentum patellae irradiate and thus there is a functional and anatomical connection between the two structures.
The prophylactic, i.e. preventive stretching exercises serve to reduce the pressure load on the patella and to lower the internal muscle tension of the thigh muscle.

Optimally, a Patellar tip syndrome thus be prevented by various stretching exercises. Otherwise, certain exercises also serve as a therapeutic measure after the surgical treatment of the injury in the event of a manifest patellar tip syndrome.
Alternatively, the exercises can also be used as an independent conservative therapy, so that an operation is not necessary at all, as the severity of the patellar tip syndrome is not that high.
In both cases, the aim of the exercises is primarily to strengthen and stabilize the muscles of the knee joint and the patellar region.

A well-developed muscular system on the thigh and good stability not only reduce the risk of patellar tip syndrome, but also accelerate the healing process.
A special exercise for that Strengthening of the thigh muscles is for example the "Wall seating“.
You stand about a step away from the wall with your feet hip-width apart. Then you lean against the wall and take a crouching position with your knees bent at 90 °.
You sit against the wall as if you were sitting on a chair. In order to achieve a training effect, the position should be maintained for at least 30 seconds.

This static exercise trains the thigh muscles particularly well and has the advantage of being very easy to perform. It is best to have a physiotherapist or fitness trainer show you more exercises to build muscle, so that correct implementation can be checked and the success of the therapy can be foreseen.

Operative therapy

In some of the patients with a Patellar tip syndrome freedom from symptoms cannot be achieved even with strong conservative therapeutic efforts. In these cases, surgical therapy measures can be considered. Before a surgical intervention, a conservative attempt at treatment of the patellar tip syndrome should be carried out for at least 6 months.

The surgical therapeutic measures listed below are used in the treatment of patellar tip syndrome. They can be used individually or in combination:

  • Removal of the sliding tendon tissue.
  • Denervation of the tendon area.
  • Tendon loosening at the tip of the kneecap.
  • Removal of the degenerative area (also possible arthroscopically)
  • Tendon incisions in the longitudinal fiber direction

For more information, see: Patellar tip syndrome surgery