What is Patellar Tendinopathy? (PT)
Patellar tendinopathy, henceforth PT, is a common disease among athletes performing sports which involve the expression of explosive force (basketball, volleyball, track and field, tennis, and soccer).
Clinically, PT affects the front part of the knee and is characterized by localized pain in the lower pole of the patella and by painful swelling when pressed upon.
Pain is often aggravated by a workload increase on the knee extender, especially during activities which store and release energy in the patellar tendon.
When the pain caused by the inflammation and the weakening of the tendon persists for more than a week, we can refer to it as a tendinopathy.
Risk Factors
- Weak thigh muscles (quadriceps) and an increase in tension of the patellar tendon due to hamstrings.
- Muscle imbalance. If some leg muscles happen to be stronger than the others, they can cause an irregular traction which in turn causes tendonitis.
- Additionally, chronic diseases which interrupt the normal blood work can weaken the tendon. For instance, diseases such as kidney failure, autoimmune diseases such as lupus or rheumatoid arthritis and metabolic diseases such as diabetes can all weaken the tendon and expose it to possible tendinopathies.
Rehabilitation process
First, rehabilitation entails active rest, reducing in consequence the workload and removing the gestures which increase pain, without interrupting physical activity and control of pain through physical therapies (laser therapy, shock waves, ultrasound).
What is especially important at this stage is the de-contracting massage of the quadriceps, reflexsogen of the femoral rectum and the transverse deep patellar tendon massage combined with a good performance of stretching exercises of the anterior and posterior chain to loosen tensions on the tendon itself.
In the subacute stage one can commence eccentric and elastic muscle strengthening of the quadricep and of the core muscles with devices as our Minivector. Simultaneously, it is possible to execute platelet plasma injections and even thermotherapy with fisio hyperthermia device Delta, has proven to be a valid option during the rehabilitation path.
New healing perspectives with physio hyperthermia
Anatomical structures which are usually little perfused by blood, such as articular surfaces, benefit from hyperthermy as the increase of blood perfusion increases the local cellular exchange and facilitates the removal of the inflammation. Often, the tendon pathology picture is complicated by the presence of calcifications during phlogosis, as a result of necrobiotic processes’ insufficient blood irroration.
Hyperthermy’s therapeutic action in this kind of diseases consists in maximally increasing blood flow, consequently improving tissutal exchanges and necrobiosis removal followed by cellular turn over, positively affecting the increase in the cellular metabolism induced by hyperthermy.
The last, but certainly not least positive effect of this type of therapy is, for the same mechanisms, the elimination of calcium deposits, an elimination which makes hyperthermy even more indicated in these cases.
References
“Patellar tendinopathy – Recent developments toward treatment”
“Ipertermia in terapia fisica” di E. Alicicco, G. Alessandrelli, A. Borrani
