What is Patellar Tendon Tear

Patellar tendon tear, also called a patellar tendon rupture, is a tear in the thick band of tissue that connects the kneecap (patella) to the shin bone (tibia). The condition can make it hard or impossible to straighten the leg.

What are the causes?

This condition can be caused by:

• A hard, direct hit (blow) to the front of the knee.
• Falling on your knee.
• A deep cut under the patella
• Landing on your foot with your knee bent after a high jump or fall.
• Activity-related wear and tear that weakens the tendon.

What increases the risk?

This condition is more likely to develop in:

• Athletes who plays contact sports.
• Athletes who participate in sports that involve jumping or have a high risk of falls, such as downhill skiing.
• People who are younger than age 40.
• People who have a weakened tendon from:
  • Long-lasting jumper’s knee (patellar tendinitis).
  • Medical conditions like diabetes or rheumatoid arthritis.
  • Repeated corticosteroid use.

What are the signs or symptoms?

The main symptom of this condition is severe pain. Other symptoms include:

• A popping sound.
• Swelling.
• Weakness in your knee.
• Difficulty straightening your knee or the inability to straighten your knee.
• A feeling that your knee is giving way (instability).
• Bruising.
• A patella that slides up toward the thigh.

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms.
• Your medical history.
• A physical exam.
• Imaging tests, such as:
  • X-rays to check if your patella has moved up and out of place.
  • MRI to check for a tear or disruption of the patellar tendon.

During the physical exam, your health care provider will check the position of your patella and see if you can extend your knee.

How is this treated?

This condition may be treated by:

• Resting your knee and keeping it from bending.
• Wearing a knee brace for several weeks to keep your knee straight.
• Using crutches or a walker to keep weight off your knee.
• Taking medicine to reduce pain and swelling.
• Doing exercises (physical therapy) to restore full movement and strength to your knee.

If these treatments do not help, you may need to have surgery to reattach the tendon or to repair the tear.

Follow these instructions at home:

If you have a brace:

• Wear it as told by your health care provider. Remove it only as told by your health care provider.
• Loosen the brace if your toes tingle, become numb, or turn cold and blue.
• If your brace is not waterproof:
  • Do not let it get wet.
  • Cover it with a watertight covering when you take a bath or shower.
• Keep the brace clean.

Managing pain, stiffness, and swelling

• If directed, apply ice to your knee.
  • Put ice in a plastic bag.
  • Place a towel between your skin or brace and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Move your toes often to avoid stiffness and to lessen swelling.
• Raise (elevate) your knee to the level of your heart or above that level while you are sitting or lying down.
• Take over-the-counter and prescription medicines only as told by your health care provider.

Driving

• Do not drive or operate heavy machinery while taking prescription pain medicine.
• Ask your health care provider when it is safe for you to drive.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do exercises as told by your health care provider.

General instructions

• Do not use your knee to support your body weight until your health care provider says that you can. Use crutches or a walker as told by your health care provider.
• Do not use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. Tobacco can delay healing. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?

• Give your body time to rest between periods of activity.
• Make sure to use equipment that fits you.
• Be safe and responsible while being active to avoid falls.
• Maintain physical fitness, including:
  • Strength.
  • Flexibility.

Contact a health care provider if:

• Your symptoms do not get better with home care.
• Your symptoms get worse with home care.

Patellar Tendon Tear Rehab

Ask your health care provider which exercises are safe for you. Do exercises exactly as told by your health care provider and adjust them as directed. It is normal to feel mild stretching, pulling, tightness, or discomfort as you do these exercises, but you should stop right away if you feel sudden pain or your pain gets worse. Do not begin these exercises until told by your health care provider.

Stretching and range of motion exercises

These exercises warm up your muscles and joints and improve the movement and flexibility of your knee. These exercises also help to relieve pain and stiffness.

Exercise A: Knee flexion, active

1. Lie on your back with both knees straight. If this causes back discomfort, bend your healthy knee so your foot is flat on the floor.
2. Slowly slide your left / right heel back toward your buttocks until you feel a gentle stretch in the front of your knee or thigh, or until your knee is at a __________ degree angle.
3. Hold this position for __________ seconds.
4. Slowly slide your left / right heel back to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Strengthening exercises

These exercises build strength and endurance in your knee. Endurance is the ability to use your muscles for a long time, even after they get tired.

Exercise B: Quadriceps, isometric

1. Lie on your back with your left / right leg extended and your other knee bent.
2. Slowly tense the muscles in the front of your left / right thigh. When you do this, you should see your kneecap slide up toward your hip or see increased dimpling just above the knee. This motion will push the back of the knee down toward the surface that is under it.
3. For __________ seconds, keep the muscle as tight as you can without increasing your pain.
4. Relax the muscles slowly and completely.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise C: Straight leg raises (quadriceps)

1. Lie on your back with your left / right leg extended and your other knee bent.
2. Tense the muscles in the front of your left / right thigh. When you do this, you should see your kneecap slide up or see increased dimpling just above your knee.
3. Keep these muscles tight as you raise your leg 4–6 inches (10–15 cm) off the floor. Do not let your knee bend.
4. Hold this position for __________ seconds.
5. Keep these muscles tense as you lower your leg.
6. Relax your muscles slowly and completely.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise D: Straight leg raises (hip abductors)

1. Lie on your side with your left / right leg in the top position. Lie so your head, shoulder, knee, and hip line up. Bend your bottom knee to help you keep your balance.
2. Lift your top leg 4–6 inches (10–15 cm) while keeping your toes pointed straight ahead.
3. Hold this position for __________ seconds.
4. Slowly lower your leg to the starting position.
5. Allow your muscles to relax completely.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise E: Straight leg raises (hip extensors)

1. Lie on your abdomen on a firm surface.
2. Tense the muscles in your buttocks and lift your left / right leg about 4 inches (10 cm). Keep your knee straight as you lift your leg. If you cannot lift your leg that high without arching your back, place a pillow under your hips.
3. Hold this position for __________ seconds.
4. Slowly lower your leg to the starting position.
5. Allow your muscles to relax completely.

Repeat __________ times. Complete this exercise __________ times a day.