Patellar Tendinopathy

An overuse injury of the tendon found below the knee cap found commonly in jumping sports or even in sports that involve a lot of changes in direction. It is characterised by pain at the front of the knee during jumping, decelerating or changing direction. There may be some thickening of the tendon.

Treatment involves manual therapy and rehabilitation, modification of activities and injection therapy.

Current evidence for the use of shockwave therapy is limited and very inconsistent for the treatment of patellar tendinopathy.

Wang et al 2007 concluded that shockwave therapy is safer and more effective when compared to other conservative treatments for the treatment of patellar tendinopathy.

A literature review performed in 2009 concluded that shockwave therapy was a safe and promising treatment for patellar tendinopathy but also stated that there were no recommendations for a specific treatment protocol.

Zwerver et al (2011) found that use of shockwave therapy in jumping athletes found no differences compared to a placebo group in the management of the condition through a competitive season.

A systematic review of the use of shockwave therapy in lower limb tendinopathies performed in 2015 also recommended the use of shockwave therapy for Patellar tendinopathy especially if other treatment options have failed.

A more recent double-blinded study (Thijs et al 2017) found that shockwave therapy was no better at reducing symptoms than eccentric exercise but they expressed caution due to the small sample size.

Shockwave therapy may provide some benefit for the improvements in patellar tendinopathy especially if other conservative treatment options have failed but results are inconsistent and may provide no benefit.

References

  • Mani-Babu S, Waugh C, Barton C et al. the effectiveness of extracorporeal shock wave therapy in lower limb tendinopathy: a systematic review. Brit J Sports Med. 2015;48(2).
  • Wang, C. J. et al. Extracorporeal shockwave for chronic patellar tendinopathy. Am J Sports Med. 2007;35(6):972-8.
  • Zwerver, J. et al. No effect of extracorporeal shockwave therapy on patellar tendinopathy in jumping athletes during the competitive season: a randomized clinical trial. Am J Sports Med. 2011;39(6):1191-1199.
  • Thijs KM, Zwerver J, Backx FJ et al. Effectiveness of shockwave treatment combined with eccentric training for patellar tendinopathy: a double-blinded randomized study. Clin J Sport Med. 2017;27(2):89-96.
  • Van Leeuwen, Zwerver J, van den AKker-Scheek I. Extracorporeal shockwave therapy for patellar tendinopathy: A review of the literature. Br J Sports Med. 2009;43(3):163-8.