Andrew Miller’s first go around on the disabled list for his patellar tendonitis seemed to do the trick until a large drop off in the velocity of his fastball surfaced on Monday night. In terms of knee injuries, this is the best-case scenario for Miller as the team has not made any mention of damage to ligaments or cartilage in the knee. The team needs to take their time and get Miller ready to go for the postseason. Provided t
Patellar tendonitis is often times referred to as “jumper’s knee” and manifests itself as pain just below the kneecap, along the patellar tendon. Patellar tendonitis should not be confused with a condition called Osgood Schlatter’s disease, which results in similar knee pain during childhood.Secondary to increased levels of pain, deficits in strength, range of motion and overall functional level can also be present. This condition is something that develops over time as a result of repetitive stress on the knee joint, patella and patellar tendon.The patellar tendon is located immediately below the patella (kneecap); its purpose is to connect the patella to the tibia (shin bone) and assist the quad (thigh) muscle to straighten the knee. The suffix -itis refers to inflammation, so the term “tendonitis” indicates tendon inflammation.
More often than not, conservative management of patellar tendonitis goes a long way.The key piece with any type of tendonitis is a temporary shutdown from the activity which aggravates the patient’s symptoms.
If the individual continues to be subject to the aggravating activity which causes their symptoms/pain, then the body will have a difficult time progressing through the healing process.
Physical therapy intervention for patellar tendonitis will incorporate a period of pain control early on via rest and ice among other things. A licensed rehabilitation professional will examine the patient’s strength and range of motion of their legs and identify any deficits which may be contributing to the problem. From here an effort to improve strength through the hips and quadriceps muscle will be made in order to provide better stability for the knee.
The most important part of rehab for patellar tendonitis is something referred to as eccentric strengthening. The primary two types of muscle contraction utilized during exercise are concentric contractions and eccentric contractions. Concentric contractions refer to the shortening of a muscle and its muscle fibers and eccentric contractions refer to the lengthening of a muscle and its muscle fibers. If we consider a bicep curl, for example, the concentric phase of the contraction occurs when an individual bends the elbow and dumbbell up towards the shoulder. Subsequently, the eccentric portion of the contraction occurs when the elbow extends and the individual lowers the dumbbell back down to the starting position. Concentric strengthening of the quadriceps muscle occurs with knee straightening and eccentric strengthening occurs with controlled knee bending with the foot on the ground. Eccentric strengthening assists in developing better control of a muscle and the joint it helps support.
Once the individual is able to demonstrate pain free strength and range of motion of the leg/knee a progression to dynamic functional activities will be initiated. The individual will be allowed to continue to progress through rehab so long as they do not encounter any setbacks along the way. Return to baseball specific activities is the last phase of rehab and can begin once the player has cleared all previous physical therapy and functional goals.
He is an avid Cleveland sports fan and has experience rehabbing athletes of all levels and from a variety of sports.Follow Brandon on Twitter for more Cleveland Indians injury insight and analysis:@blbowers12