Expert Interview Jumpers Knee Treatment

Premiership physiotherapist Neal Reynolds talks about initial treatment of Jumpers knee.

Initial treatment of jumpers knee

Patella tendonitis is very similar to shin splints in that you don't tend to get one incident which causes the pain. It is not like a hamstring strain where you think yes I know when I did that or a medial ligament injury, yes I did that when I tried a block tackle.

When it comes to patella tendons it tends to be a build up of activity which causes a gradual build up of pain. The biggest question I always gets asked is "why has it suddenly happened now?". This is usually because it has built and built and built then one small change in activity, or footwear or training etc has just tipped it over the edge. But often these problems have gone on for weeks, months or maybe even years.

In professional football we are able to scan injuries with MRI and although they may only just have had pain we will be able to see that there has been a long term injury there that they were not aware of. In the past I have looked at a player for a routine medical and I have found this and yet they have never had any problems with it.

Once pain starts it needs to be treated the same was as all these type of injuries. You need to get the injury to calm down, reduce the inflammation and pain and get the injury in and out of the acute stage as quickly as possible.

The first aim is to get into and out of the inflammation stage as soon as possible. This can be done with ice, used for 20 minutes at a time and really regularly for the first couple of days to get the tendon to calm down.

There is a debate about whether the injury is patella tendonitis or patella tendinosis. For medical people what that means is, is it inflammation or is it a chronic reaction that is happening. Nowadays we are moving away from inflammation which happens in the first couple of days or weeks of an injury.

Electrotherapy such as ultrasound and laser can be used. The tendon will quite often be swollen so we will need to get that swelling down.

After the initial week of ice and electrotherapy treatment the tendon will begin to look normal again to the naked eye. This is when you can start to put some load through the tendon so that it gets used to it and dveleops tensile strength to withstand the activities required of it.

Cross training such as cycling and swimming can be used to reduce the load but maintain fitness. Over a period of time the aim is then to gradually increase the load through the tendon, using stepper, cross trainers, then running then finally twisting and jumping, explosive movements. Neal thinks it is the landing which actually puts the most stress on the tendon and causes the injury so this is important to consider and work on this in rehabilitation.

Throughout the rehab programme then you are looking for pain and swelling. If either of these are present then you need to go back to the treatment room and start again.