Patellar Tendinopathy: A Pitfall of ACL Reconstruction Rehab

ACL reconstruction is a common surgical procedure that aims to repair a torn anterior cruciate ligament (ACL) in the knee. While the surgery is successful in restoring knee stability, it often leads to a long and challenging rehabilitation period. One of the complications that can arise during ACL reconstruction rehab is patellar tendinopathy, a condition that affects the patellar tendon, which connects the kneecap to the shinbone. In this blog post, we will discuss the causes, symptoms, and treatment options for patellar tendinopathy during ACL reconstruction rehab.

Causes:
Patellar tendinopathy can develop due to several reasons, including overuse, repetitive stress, and biomechanical imbalances. In the case of ACL reconstruction rehab, it can occur due to the following reasons:

1. Increased stress on the patellar tendon due to altered biomechanics after surgery.
2. Overuse of the patellar tendon during the rehabilitation exercises.
3. Early return to sports or physical activities before the patellar tendon has fully healed.

Symptoms:
The most common symptom of patellar tendinopathy is pain in the knee, particularly in the area just below the kneecap. The pain can be sharp or dull, and it may worsen with activities that involve bending the knee, such as squatting or jumping. Other symptoms may include:

1. Swelling and stiffness in the knee.
2. Tenderness in the area just below the kneecap.
3. Limited range of motion in the knee.

Treatment:
The primary goal of treating patellar tendinopathy during ACL reconstruction rehab is to reduce pain and inflammation while promoting healing of the tendon. Here are some treatment options that may be recommended:

1. Rest and activity modification: Resting the knee and avoiding activities that exacerbate pain can help reduce stress on the patellar tendon. Your physical therapist may recommend modifying your activity level to avoid aggravating the tendon.
2. Heavy slow resistance training: Research has shown that heavy slow resistance (HSR) training can be an effective treatment for patellar tendinopathy. HSR involves lifting weights slowly and under high tension, which can stimulate tendon healing and promote strength gains. Your physical therapist can design an HSR program tailored to your needs and goals.
3. Eccentric exercise: Eccentric exercises involve lengthening the muscle while under tension, which can help strengthen the tendon and improve its ability to absorb force. Your physical therapist may incorporate eccentric exercises into your rehabilitation program.
4. Manual therapy: Soft tissue mobilization, massage, and joint mobilization can be useful for reducing pain and improving mobility around the knee.
5. Biomechanical correction: Your physical therapist may evaluate your movement patterns and identify any biomechanical imbalances that could be contributing to your patellar tendinopathy. Correcting these imbalances with targeted exercises or modifications to your movement patterns can reduce stress on the tendon.

Patellar tendinopathy during ACL reconstruction rehab can be a challenging condition, but with the right treatment, most people can recover and return to their previous level of activity. Treatment options for patellar tendinopathy during ACL reconstruction rehab focus on reducing pain and inflammation while promoting healing of the tendon through exercise and manual therapy. If you experience any symptoms of patellar tendinopathy during ACL reconstruction rehab, it’s essential to seek the help of a qualified physical therapist to develop an appropriate treatment plan.