Category Archives: Patellar Tendonitis (jumpers knee)

Patellar Tendonitis (jumpers knee)

Tendonitis: Why Won’t It Go Away?

Because it could be tendinosis.  Often, chronic tendonitis (also spelled tendinitis), lasting more than 6 weeks is really tendinosis (also spelled tendonosis).  The difference is that acute, short-term tendinitis is thought to be caused by mostly by inflammation, which is an active immune response of the body to a perceived threat.  The acute, inflammatory tendonitis usually resolves within several weeks by icing the area 3 to 4 times daily for 20-30 minutes, resting, and taking over-the-counter or prescription strength anti-inflammatory medication, such as ibuprofen.  It is important to consult your physician for advice on your particular situation.

Chronic tendonitis is often defined by the tendon pain lasting more than 6 weeks, and the condition is referred to as tendinosis.  Tendinosis is thought to be mainly caused by degeneration of the tendon.  In order to effectively treat and resolve tendinosis, you must stimulate regeneration of the affected tendon.  There are very few approaches that do this.  Astym treatment is regenerative soft tissue therapy which successfully resolves many difficult conditions.  To see how Astym therapy works on different diagnosis of tendinitis/tendinosis, take a look at this Outcomes Data from thousands of Astym therapy patients.  If you would like to find a certified Astym therapy provider to see if Astym therapy would be right for you, use this Find a Provider directory.

What is Astym treatment?

Astym treatment is a physical therapy treatment that regenerates healthy soft tissues (muscles, tendons, etc.), and eliminates or reduces unwanted scar tissue that may be causing pain or movement restrictions.

Astym treatment is highly effective for restoring movement and reducing pain from soft tissue injury/dysfunction, and Astym even works when other approaches routinely fail.  One of the main reasons for this is that Astym was designed to target the underlying cause of many soft tissue problems, rather than just trying to relieve symptoms.  Here are some of the diagnoses where patients have demonstrated excellent clinical results when treated with Astym:

• Lateral epicondylosis, chronic lateral epicondylitis
• Carpal tunnel syndrome
• DeQuervain’s tenosynovitis
• Wrist sprain
• Plantar fasciopathy/heel pain/chronic plantar fasciitis
• Achilles tendinosis and chronic achilles tendinitis
• Shin splints
• Patellar tendinosis, chronic patellar tendinitis/tendonitis (jumper’s knee)
• IT band syndrome
• Chronic hamstring strain
• Joint contractures
• Overuse injuries
• Pain or loss of motion & function following surgery, trauma or overuse injury

Here is a full listing of diagnoses that have been monitored and the outcomes (treatment results) tracked.

Astym treatment is non-invasive, which means there are no injections or incisions.  Instruments are applied topically (on top of the skin) to locate dysfunctional (unhealthy) tissue, and to transfer mild to moderate pressure to the underlying soft tissue structures.   Astym treatment stimulates tissue turnover, scar tissue resorption, and the regeneration of tendons, muscles and other soft tissue structures.

Astym treatment  is typically provided twice weekly for four to five weeks (about 9 total treatment sessions) and is done in conjunction with eccentric loading, stretching, and functional exercises. Unlike other treatments, Astym encourages patients to active, workers to stay on the job, and athletes to stay in their sport during treatment. The Astym process actually makes the tissues of the body stronger, and allows a patient’s body to become adapted to greater stress without injury.  Patients are very satisfied  and enthused with the results they see from Astym

Astym is used in settings ranging from therapy clinics to hospitals to industrial rehabilitation to elite/professional athletics. This highly-effective, proven treatment helps countless patients every day. Astym is scientifically based and supported by clinical research and extensive outcomes.

What is Astym treatment?: Astym Definition, Part II

Astym treatment is effective in resolving many soft tissue problems, including chronic tendinopathies, tendon pain, tendon injury, stiffness, restricted movement, limited function and other conditions associated with adhesions or scar tissue that can occur after trauma or surgical intervention. It is also quite effective on sprains, strains, and other acute and sub-acute soft tissue injuries.  Continue reading What is Astym treatment?: Astym Definition, Part II

What is Astym treatment?: Astym Definition, Part III

Scientific studies have shown an increase in fibroblast recruitment and fibroblast activation with Astym treatment, which reveal the body’s underlying physiological response to Astym.  These studies highlight the regenerative mechanism of Astym treatment and help us understand how Astym treatment results in the regeneration of soft tissues. There also appears to be a neurological component to the Astym treatment process as evidenced by immediate changes in pain perception (often pain is immediately reduced) and strength measures (strength often immediately increases) following treatment.

At its core, Astym treatment was developed from basic science research to stimulate a regenerative response at a cellular level.  Following that, there were a number of case studies published and then a randomized clinical trial on patellar tendinopathy.  A large randomized clinical trial on lateral epicondylosis was then awarded a platform presentation at the American Society for Surgery of the Hand’s national meeting.

In addition to ongoing clinical and scientific research, the Astym program also emphasizes the collection of practical information.  Astym treatment has put major effort into developing a reliable national outcomes collection system and database, where clinicians from all across the country independently enter data to create a national bank of dependable outcomes data.  These outcomes (treatment results) show the percentage of people with each condition that resolve (get better).  Not only does this provide a good real-world evidence base for Astym treatment, it also allows patients and health care providers to know how many treatments it should take to resolve a certain condition, and what percentage of those cases should resolve.  For instance, for a patient with plantar fasciitis, you can predict that in 10 therapy visits, 91.8% of patients will be improved or much improved.  To see a full listing of diagnoses and outcomes, click here:  http://www.astym.com/Content/documents/ASTYM%20Outcome%20Report.pdf

Jumper’s Knee Treatment

Meet today’s guest blogger:

Noel Tenoso

Noel Tenoso, PT, DPT, OCS practices in the Portland, Oregon area and owns 2 clinics, Advance Sports & Spine Therapy. He has certifications in manual therapy and Mechanical Diagnostic Therapy with the McKenzie Institute. Both clinics have met the criteria of being certified McKenzie Clinics. He has been certified with Astym since 2005.

Pain in the front of the knee is very common in many types of sports that are associated with quick stops, starts, changes in directions, and jumping. “Jumper’s knee” or patellar tendinitis/tendinopathy is a condition that usually persists for more than 4-6 weeks after symptoms appear. Pain is generally intermittent and associated with activity.

 

Clinicians practicing Astym will find a nodule of tissue (scar tissue) just below the kneecap that correlates with the patient’s symptoms. This scar tissue may represent the dysfunctional healing of the tendon that can be addressed effectively with Astym treatment and exercises.

 

Clinically, a physical therapist can assist with management of jumper’s knee by stimulating the lower extremity with Astym treatment to assist with resorption of the dysfunctional tissue, and to stimulate production of new collagen tissue. In conjunction with treatment, the patient needs to participate by doing stretching exercises and increasing activity that will help guide the healing of this new tissue. Another important aspect of rehabilitation is making sure future recurrence is prevented by addressing the poor biomechanics that may have put too much pressure on the knees. A physical therapist can help to evaluate and educate the patient on how to reduce the stress to the knees through incorporation of the hips and proper trunk posture with quick stop/starts, changes of direction, and jumping.

 

Stretches that address improving flexibility of the muscles of the hips, quadriceps, hamstrings, and calf muscles in conjunction with Astym are helpful. Also “eccentric” exercises1 have been shown to help by doing lengthening exercises of the quadriceps with resistance to discomfort while squatting on a decline board.

 

1Jonsson P, Alfredson H. Superior results with eccentric compared to concentric quadriceps training in patients with jumper’s knee: a prospective randomized study. BJSM, 2005; 39: 847-850

Research on Astym: Summary of Astym Treatment’s Evidence Base

At its core, Astym treatment was developed from solid basic science research to stimulate regeneration at a cellular level.  Following that, there were a number of case studies published and then a randomized controlled clinical trial on patellar tendinopathy.  A large randomized controlled clinical trial on lateral epicondylosis was awarded a platform presentation at the American Society for Surgery of the Hand’s national meeting, and is now being submitted for publication(for more information on this study, click here: http://blog.astym.com/blog/astym/0/0/effective-treatment-for-tennis-elbow-presented-at-hand-surgeons-meeting).

Several other studies have also been completed and are being prepared for publication or submitted for publication. To see a full listing of research on Astym treatment, please visit the research page by clicking here: http://astym.com/professionals/research.asp

One of the main reasons for the effectiveness of Astym treatment is its sound evidence base.  Astym treatment was scientifically developed to target the true underlying cause of many soft tissue problems:  degeneration and inappropriate scarring/fibrosis that interferes movement and causes pain.  One of the factors that guided the scientific research and development of Astym treatment was medical science’s recent discovery that tendinopathy is degenerative (worn or broken down) in nature and only rarely has a component of inflammation (the body’s immune system actively responding to an injury or threat).  Generally, most treatments of tendinopathy focus on reducing inflammation, and those treatments have not been very successful.  In light of the recent evidence indicating that degeneration is the underlying cause of tendinopathy, Astym treatment was developed with a focus on stimulating the regeneration of healthy tissue, rather than on reducing inflammation, and that is one reason why Astym is so effective at resolving tendinopathies.

In addition to ongoing clinical and scientific research, the Astym program also emphasizes the collection of practical, clinically useful information.  Astym treatment has put major effort into developing a reliable national outcomes collection system and database, where clinicians from all across the country independently enter data to create a national bank of dependable outcomes data.  These outcomes (treatment results) show the percentage of people with each condition that resolve (get better).  Not only does this provide a good real-world evidence base for Astym treatment, it also allows patients and health care providers to know how many treatments it should take to resolve a certain condition, and what percentage of those cases should resolve.  For instance, for a patient with plantar fasciitis, you can predict that in 10 therapy visits, 91.8% of patients will be improved or much improved.  To see a full listing of diagnoses and outcomes, click here:  http://www.astym.com/upload/pdf/Astym%20Outcome%20Reports.pdf