Jumpers Knee

Jumpers kneeJumpers knee or patellar tendonitis is an overuse injury that results in pain at the front of the knee, localised at a point towards the bottom of the kneecap. Repetitive strain from too much running or jumping causes inflammation or degeneration of the patella tendon.

Patellar tendonitis can be a tricky condition to treat and requires a substantial period of rest and a thorough treatment and rehabilitation program. In the most severe or persistent cases, surgery may be required.

Jumpers knee symptoms

Symptoms of jumpers knee consist of pain at the bottom front of the kneecap over what is called the lower pole of the patella.

The bottom of the patella will be very tender when pressing in and may appear larger or thicker than the unaffected side. The athlete is likely to experience aching and stiffness after exercise and pain when contracting the quadriceps muscles in acute cases. In particular jumping activities are likely to cause most pain or discomfort. Jumpers knee is graded 1 to 4 depending on how bad the injury is with grade one being only mild pain after training and a grade four resulting in constant pain.

The VISA pain questionnaire is excellent for monitoring symptoms which can often be difficult to describe or measure with a long term chronic condition.

Warning!! - This injury may seem like a niggling injury that is not that bad. Many athletes continue to train and compete on it as it may not be a debilitating injury and recovers after a short period of rest. However, neglect jumpers knee at your peril! If left to become chronic it can be very difficult to treat and may require surgery.

Read more on symptoms and diagnosis.

What is Jumpers Knee?

Jumpers knee painThe patella tendon, also known as the patella ligament joins the kneecap or patella to the shin bone or tibia. The large quadriceps muscles at the front of the thigh pull on the kneecap producing huge forces through the patella tendon, especially when jumping.

Jumpers knee is an overuse injury. With repeated strain, micro-tears as well as collagen degeneration may occur in the tendon. This is known as patellar tendinopathy or Jumpers Knee. It should be distinguished from patella tendonitis (tendinitis) as this condition indicates an acute inflammation of the tendon whereas tendinopathy is more about degeneration of the tendon. In practice the majority of chronic cases are more likely to be degeneration of the tendon rather than acute inflammation which should settle down after a few days rest.

Although it is an overuse injury there are a number of factors which may make it more likely to suffer from this injury including poor foot biomechanics, weak quadriceps muscles and incorrect training practices.

Read more on causes and prevention.

Treatment

Jumpers knee strap

Treatment for patella tendonitis consists of reducing the initial pain and inflammation through rest and ice followed by a rehabilitation program which will include eccentric strengthening exercises.

Apply the PRICE principes of protection, rest, ice compression and elevation. Apply cold therapy on a regular basis, especially during the first 24 to 48 hours and after any form of exercise. A cold therapy wrap or gel ice pack is ideal. If the tendon is painful then ice can be applied for 10 minutes every hour reducing frequency as symptoms improve.

Wear a knee support, or jumpers knee strap to reduce pain and ease the strain on the tendon. A jumpers knee strap wraps around the tendon just below the knee changing the angle of the tendon against the patella which changes the part of the tendon the forces are transmitted. A simple patella taping technique can also relieve the strain on the tendon in the same way.

Play patella taping video.

Ultrasound applied to the knee

A doctor may prescribe anti-inflammatory medication e.g. ibuprofen. Do not take ibuprofen if you have asthma and check with a doctor before taking any medication. It is thought that anti-inflammatory medication may help in the short term with acute inflammation and pain but may even hinder healing later on.

A professional therapist may use electrotherapy in the form of ultrasound or laser treatment to reduce pain and inflammation and aid the healing process. Cross friction massage to the tendon may also be beneficial, particularly for more chronic cases. They can also advise on a full rehabilitation program consisting of eccentric strengthening exercises.

Aprotinin injections may help tendinopathies by restoring enzyme balance in the tendon. If the knee does not respond to conservative treatment, surgery may be required.

Read more on treatment and rehabilitation.

Exercises

Quadriceps stretchStretching exercises for the quadriceps muscles at the front of the thigh should be done regularly. This will lengthen then muscles and place less stress on the tendon. Hold stretches for 10 seconds in the acute stage and up to 30 seconds later in the rehabilitation program. Testing the flexibility of the thigh muscles is a good idea.

Read more on stretching exercises for jumpers knee.

Eccentric strengthening exercises which are done by performing the downwards phase of a squat exercise are though to be most important and stimulate healing. This is done by dropping down slowly and then up more quickly using the good leg to help on the up phase.

Read more about strengthening exercises for jumpers knee.