The patellar tendon bridges the patella and tibial tuberosity, completing the extensor mechanism. Patellar tendinopathy (jumper's knee) affects the proximal tendon at the inferior pole insertion — the highest stress zone during eccentric loading. It is the most common overuse injury in jumping sports. MRI shows hypoechoic signal on ultrasound and T2 signal increase at the inferior pole.
Transmits quadriceps force from the patella to the tibial tuberosity for knee extension; the lever arm changes through the range of motion with peak mechanical advantage at 60 degrees of flexion
Patellar tendinopathy is managed with eccentric loading (decline squat — 25-degree decline board increases patellar tendon load while reducing quadriceps-patellar contact force). Heavy slow resistance training is now equally supported by evidence. Intratendinous injection of corticosteroid is not recommended due to rupture risk. PRP injection provides moderate benefit. ESWT (shockwave therapy) achieves 60-70% good results.
Inferior patellar pole tendon degeneration from jumping overload managed with eccentric decline squat loading and heavy slow resistance training.
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