The Back Pain Doctor
A patellar tendon tear disrupts the tendon that connects the bottom of the kneecap to the top of the shinbone — part of the mechanism that straightens the knee. Tears may be partial, where some fibres remain intact, or complete, where the tendon separates from the kneecap and the knee can no longer be straightened. Complete tears are disabling and almost always need surgery. It takes a strong force to cause the injury, and the risk is higher when the tendon is already weakened.
Assessment focuses on recognising the injury early — testing whether the knee can be straightened, feeling for a gap below the kneecap, and noting a high-sitting kneecap — because a complete tear is a time-critical problem. A side-view X-ray often confirms it, and MRI is used when the extent of the tear needs to be clarified. Recognised contributors such as corticosteroid use and previous knee surgery are taken into account.
Very small partial tears are managed non-surgically with a period of bracing and a graded physiotherapy program. A suspected complete tear is referred promptly for orthopaedic surgical repair, as outcomes are better when the tendon is reattached soon after the injury. Recovery after repair is gradual, generally taking around six months of protected rehabilitation before full strength and function return.
The options below include the treatments offered at The Back Pain Doctor. Listing a treatment does not mean it is recommended for this condition. The evidence, likely benefit and role of each option are considered against the diagnosis, examination findings, imaging where appropriate, patient goals, risks, cost and alternatives.
This is the starting point for most musculoskeletal conditions.
The priority is to identify the likely pain generator, explain the condition clearly, modify aggravating load and build a realistic plan to restore strength, movement and confidence.
Evidence is condition-specific; it is not a universal pain treatment.
Shockwave is best framed as an adjunct where the diagnosis fits. It is generally more established for selected tendon and plantar heel pain presentations than for many joint or nerve conditions.
Read moreEvidence varies substantially by condition, tissue and preparation method.
PRP may be discussed in selected tendon or joint presentations. It should not be presented as a guaranteed regenerative treatment, and uncertainty, cost and alternatives should be discussed.
Read moreBest used for specific inflammatory or irritable pain generators, usually for short-term relief.
An injection may help when a joint, bursa, tendon sheath or other defined structure is driving symptoms. It is not a cure and needs to be weighed against risks, recurrence and the need for rehabilitation.
Read moreClinical evidence is still developing and guideline support is limited.
EMTT may be discussed as an adjunct in selected presentations, but should be presented with clear uncertainty and never as a replacement for diagnosis, load management or rehabilitation.
Read moreEvidence is condition-specific and generally less established than exercise-based care.
Prolotherapy may be considered in carefully selected chronic ligament, tendon or joint-related pain presentations, but it is not a first-line treatment.
Read moreMost relevant when focal myofascial pain is a clear contributor.
Trigger point treatment may reduce pain from focal muscle spasm or myofascial tenderness. It should be paired with movement restoration, strength work and recurrence prevention.
Read moreRelevant only when the history and examination support nerve irritation or entrapment.
Nerve-focused treatment may be discussed when there is a plausible peripheral nerve pain generator. Progressive weakness, major neurological deficit or red flags require a different pathway.
Read moreThis is general information only. Suitability is assessed individually. Treatments with limited or condition-dependent evidence may still be discussed, but only with clear explanation of uncertainty, expected benefit, risks, cost and alternatives. Red flags, progressive neurological symptoms or suspected serious pathology require a different pathway.
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Your assessment focuses on understanding the likely source of your pain and the most appropriate non-surgical options for your diagnosis, with the aim of reducing pain and improving function.
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