Patellar Tendinitis (Jumper’s Knee) & Chondromalacia Patellae (CMP)
Anatomy: The Patella or kneecap and patellar tendon below it (as well as the quadriceps tendon above it) form a chain that is used when getting up from a chair, for stairs and for other vertical motion activities.
Injury: Pain in the front (and often back) of the knee from inflammation of these structures is the most common cause of knee pain that I see as a knee specialist.
Diagnosis: Both problems cause pain in front of the knee. Patellar tendinitis is characterized by tenderness at the bottom tip of the kneecap. CMP however is characterized by audible grinding in front of the knee. When severe it becomes PR arthritis.
- PRP-Stem Cell Treatment: This is the most common application of this treatment in my practice. PRP is almost always sufficient without need for using stem cells. Athletes are often affected. This is also among our highest success treatments with over 90% of patients gaining substantial relief and avoiding surgery. With thousands of injections performed we are one of the most experienced Orthopaedic Centers in the world in its use. Usually only one or two injections are needed.
- Activity Modification/Exercise: Contrary to what is often written dedicated quadriceps strengthening generally aggravates the problem. We therefore place patients on custom exercise programs that maintain leg strength but provide relief to the patella. The hallmark of this program is a special workout using the elliptical, please see video, but with a different technique emphasizing leaning forward to shift the center of mass in front of the knee. This provides a balanced quads workout but provides greater hamstring and gluteal toning. There should be a low resistance setting with a high rate to provide a high heart rate useful oxygen debt workout but with low tendon strain and patellar compression in a fifteen minute timespan. Even our marathoners say this is a “killer workout” (in a “good way”) that also allows the knee to heal. Squatting and kneeling should be avoided and stairs and ladders minimized.
- Physical Therapy: Hip and core strengthening is carried out by our expert therapists and is quite helpful.
- “NO PILLS NO PAIN” Our philosophy is to avoid drugs, especially NSAIDs such as motrin, advil and aleve, that interefere with healing, mask symptoms, and are very toxic (GI bleeds, kidney failure and heart attacks among other problems). You should also avoid liniments, creams, patches, braces and ice – all of which mask pain thus allowing the problem to worsen while doing nothing (despite clever advertising) to help it
- Nutritional Supplements: We have performed extensive research in this area and will guide you to safe, beneficial products