Sports massage can help as part of a Jumper's knee treatment program especially if the injury has become chronic. Massage can be applied both to the quadriceps muscles and the injured tendon itself.
The following sports massage guide is intended for information purposes only. We recommend seeking professional advice before attempting any self help treatment.
IMPORTANT: Before starting any massage treatment the therapist will check for contraindications (if any apply to you, then massage is not allowed).
Sports massage routine
Massage therapy for treating patella tendinopathy should be focused on direct frictions to the tendon itself. However, other massage techniques can also be applied to the quad muscles in order to improve the flexibility and muscle condition of the quads if necessary.
Quadriceps muscles - Effleurage
Aim - light stroking to warm up the area in preparation for deeper techniques.
- With the hands stroke lightly but firmly upwards from just above the knee to the top of the thigh.
- Always stroke upwards towards the heart as this is the direction of blood flow. The other way can damage veins.
- Then lightly bring the hands down the outside of the leg keeping them in contact but do not apply pressure.
- Repeat the whole movement using slow stroking techniques, trying to cover as much of the leg as possible.
- Repeat this technique for about 5 to 10 minutes, gradually applying deeper pressure on the up strokes.
Quadriceps muscles - Petrissage
Aim - kneading movements to manipulate and loosen the muscle fibres further.
- With the hands apply a firm, kneading technique. Try to pull half the muscle towards you with the fingers of one hand whilst pushing half the muscle away with the thumb of the other hand.
- Then reverse to manipulate the muscle in the other direction.
- Work your way up and down the muscle, trying to cover as much of the surface as possible.
- Apply this technique for around 5 minutes, alternating with light stroking (above) occasionally.
Quadriceps muscles - Stripping the muscle and Circular frictions.
Aim - to apply sustained pressure to the muscle, ironing out any lumps, bumps and knots.
- With the thumb of the right hand (for the left leg), apply deep sustained pressure along the full length of the muscle.
- This technique should be slow and deliberate to 'feel' the muscle underneath.
- Repeat this 3 to 5 times in a row, alternating with petrissage for 5 to 10 minutes.
- If the therapist comes across and tight, tender knots in the muscle (usually at the point of strain or rupture), these can be worked out with deep circular frictions to the sore spots.
- Massage should be deep but not so deep that the athlete tightens up with pain.
Quadriceps muscles - Trigger points
- If the therapist finds any lumps and bumps or particularly sensitive spots then apply deep, sustained pressure to these points using the thumbs.
- Increase the pressure on the spot until it ranks 7/10 on the pain scale (10 being painful). Hold this pressure until it eases off to 4/10 on the pain scale (usually about 5 seconds).
- Without easing off with the pressure, increase again until it reaches 7/10 on the pain scale once more. Hold until it eases, repeat once more.
- This technique is very hard on the thumbs. It is important to keep the thumb slightly bent (flexed) when applying pressure to avoid damaging the joints.
Cross frictions to the Patella tendon
- Massage techniques performed directly on the tendon can help to speed up the repair process.
- Place the thumb on the tendon and massage backwards and forwards across the tendon, moving up and down to cover the whole length of the tendon.
- In the early stages massage should be very light and for duration of a minute or two. As rehabilitation progresses treatment duration and intensities can be increased.
- Apply ice to the tendon following treatment.
- If cross frictions cause a great deal of swelling or inflammation or even make the knee worse the next day then discontinue massage therapy to the tendon.
- The process may be a little uncomfortable at times but should not cause excessive pain.
- The therapist can finish off with more petrissage techniques and then finally effleurage again. The whole process should not last more than half an hour.
- Massage therapy can be applied every day if it is performed lightly however deeper techniques may result in a days recovery period to allow tissues to 'recover'.
- For rehabilitation of muscle strains, sports massage is very important in softening / preventing scar tissue forming at the site of injury and re-aligning the new healing fibres in the direction of the muscle fibres. This will help prevent re-injury.