This injury is usually caused by excessive angular traction. Mechanical misalignment may include internal malleolar torsion or excessive subtalar joint pronation. The symptoms are characterized by patellar pain at the insertion of the tendon on the inferior patella pole during uphill riding or high-mileage rides.
Dry needling acupuncture therapy is very effective in treating this condition and should include both homeostatic and symptomatic acu-reflex points of the lower limb and the core system.
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