The Great Patella Debate

Knee injuries happen to athletes all of the time – whether minor, major, or so catastrophic that it’s only been recorded 15 times. Ever. Such was the unfortunate case for Houston Texans offensive lineman Derek Newton during Monday Night Football. While blocking, Newton’s foot seemingly got caught under him as he toppled over backwards, tearing BOTH patella tendons simultaneously. It was a disheartening sight to see this mountain of a man restrained by vacuum splints on both of his legs. Helpless. That is, what I assume, the only way to describe that feeling. This was a similar injury suffered by New York Giants wide receiver Victor Cruz, but Cruz saw the more common fate of rupturing the tendon in only one knee. Many speculated if Cruz would ever walk the same again, but after two long years of recovery he seems to be doing very well. Let’s take a closer look at what both of these catastrophic injuries circle around: the patella tendon.

The patella tendon is up for debate before it is even injured. Is it a tendon or a ligament? The answer is about as straightforward as any political question we’ve seen this election cycle. Some consider it an extension of the quadriceps tendon, which attaches your quad muscles to your knee cap, continuing over the knee cap and ending on the top of the shin (attaching muscle to bone). Others believe it is a ligament, insinuating that it originates on the bottom of the knee cap, attaching it to the shin bone (attaching bone to bone). The former can argue that the patella is a sesamoid bone, and that sesamoid bones typically develop within a tendon. The latter can rebuttal that it is its own structure. I’m sure that by now you’ve had enough of debates, so we’ll just refer to it as its common name: the “patella tendon”.From mal-tracking to instability, the patella (kneecap) can be injured in many ways. In essence it is just floating around, if not for the patella tendon, anyway. The combination of the patella and its tendon are the most common source of knee injury. Injuries to the knee joint that we often see include:

Jumper’s Knee (Tendinitis)
Chondromalacia Patella (Runner’s Knee)
Bursitis
Subluxation
Dislocation
Fracture
Arthritis

Notice what’s not on the list: patella tendon rupture. The patella tendon is extremely strong, and it takes a tremendous amount of force for its fibers to tear. For the common injuries listed above, there are a multitude of non-surgical treatments from patella tendon bands and braces to injections and PRP therapy. Most, however respond best to, or can be prevented by a strong knee stability exercise program. Our physical therapists and athletic trainers orchestrate the most effective exercise programs for their patients based on what their bodies need. However, patella tendon rupture does require surgery in addition to extensive physical therapy. We work diligently with all of our athletes and patients alike to prevent these injuries and treat them when they do happen. Please remember that you should always consult a physician on medical matters. Nothing that you learn on the internet can replace a medical degree. With that, we wish Derek Newton a speedy recovery! Stay Well.

-VS