Jumper's Knee Phase 3

This is the heavy slow resistance phase. The aim of phase 3 is to further increase the load through the patella tendon and begin to introduce some plyometric exercises. Only move on to phase 4 when you have achieved the Exit Criteria for this phase.

Treatment

To be done daily.

Cold therapy

Apply cold therapy for 10 to 15 minutes after exercises or training to help keep any pain or inflammation under control. Do not apply ice directly to the skin but wrap it in a wet tea towel.

Note: A commercially available hot and cold wrap is more convenient and can be used to apply compression as well.

Massage

If available get a deep tissue massage up to a couple of times a week. Techniques should be applied to the Calf muscle, hamstrings, quads & plantar fascia under the foot. If not then you can use a foam roller daily instead.

Foam roller

Use a Foam roller over your quadriceps (front thigh), hamstrings, and calf muscles, Or if available a deep tissue sports massage.

This can be done daily and is a good idea to make it part of your normal training routine/warm-up.

All foam rolling exercises are 3 sets for 20 seconds each.

1) Calf

This exercise massages the calf muscles at the back of the lower leg.

The leg is rolled over the roller along the full length of the muscles from the ankle to just below the knee and back again.

More pressure is applied from the ankle upwards following the direction of blood flow in the muscles.

2) Quadriceps

This exercise performs a myofascial release and stretches on the quadriceps muscles at the front of the thigh.

The roller is applied along as full a length of the muscle as possible with more emphasis or weight from the knee upwards, following the direction of blood flow along the muscles.

3) Hamstring

This foam roller exercise massages and applies myofascial release to the hamstring muscles.

Pressure is applied from just above the knee upwards following the direction of blood flow.

Mobility & Stretching

Aim to do these exercises at least once a day.

Active ankle mobility

The advantage of this exercise is that the damaged ligaments will not be stressed by sideways movement. The calf and shin muscles maintain strength and the pumping motion helps to decrease swelling.

Teaching Points:

Pull the foot up as far as it will go (dorsiflexion)
Hold for a couple of seconds and then point it away from you (plantar flexion) and hold again
3 sets of 30 seconds

Note: Avoid sideways (lateral) movements that may stress the injured ligament.

Quadricep stretch

Teaching points:

Keep your knees together and gently pull your leg up
You should feel a stretch at the front of the leg which should not be painful
Hold onto something for balance if you need to or try holding your ear with the opposite arm
Hold the stretch for 30 seconds and repeat with a short break in between

Note: This should be comfortable, don’t force the stretch!

3 sets of 30 seconds (3 – 5 times per day).

Calf stretch (straight & bent knee)

Calf stretches should be done with your leg straight to stretch the larger gastrocnemius muscle and bent to target the deeper soleus muscle.

Straight knee:

Place your hands on the wall and step forward with the foot you are not stretching
Keep your toes pointed forward and your back heel on the ground and lean into the wall without bending your back knee
Hold the stretch for 2 sets of 30 seconds
Repeat this exercise 3 to 5 times throughout the day

Bent knee:

Place your hands on the wall and step forward with the foot you are not stretching
Keep your toes pointed forward and your back heel on the ground and lean into the wall
Bend the knee and ease in to feel a stretch lower down at the back of your leg
Hold the stretch for 2 sets of 30 seconds
Repeat this exercise 3 to 5 times throughout the day

Hamstring stretch

This is a convenient stretch if the ground is cold or wet.

Teaching point:

Stand on one leg with the other resting on a bench or similar
Tilt the hips forward to increase the stretch
Ease into the stretch and hold, as comfortable – don’t force the stretch!
Repeat 1-2 times a day
Hold the stretch for 15 seconds, relax and hold again for 15 seconds
Perform on each leg separately

Activation

Aim to do these exercises 4 times a week.

Crab walk with band

Teaching point:

Place a resistance band around your knees and walk sideways
This gets the hip muscles firing and fatiguing under bodyweight load
Make sure they are done pain-free on the knee
Perform 4 sets of 4 steps on each side with a short rest in between

Note: If it is painful then try not bending your knee so much, or wait a few days – You may need to go back to phase 1.

Dynamic ice skaters

Teaching Points:

Place a resistance band around your knees to increase the load on your lateral hip muscles
Walk forward and backwards up on your toes
Maintain a good posture by keeping your head and chest up
4 sets of 4 steps forward and backwards (each way)

Note: Focus on control of movement and being light on your toes.

Single leg bridge

Teaching point:

Lie on your back, knee bent, and push the hips upwards to work the gluteal muscles and hamstrings
Use one foot on the floor pushing up
Hold the position briefly and then lower
3 sets of 8 reps

Note: Make sure you squeeze the gluteal muscles and aim to maintain a straight line from the shoulder on the ground to the knee at the top point of the exercise.

A march linear

Teaching Points:

This is a functional exercise that helps transition to running and more explosive exercises later on
March forwards on your toes driving your knees high
4 sets of 5 metres

A march lateral

Teaching Points:

Perform marching drill sideways, aiming to be on your toes with high knees
4 sets of 5 metres each way

Strengthening

Progress through these exercises 3 times a week.

Single leg calf raise (straight)

Teaching points:

Hang off a step and lower your heel toward the floor
Rise up on your toes as far as you can keeping the movement in a comfortable range, and then lower back down
Start Bodyweight, and gradually add load with dumbbells
Perform 3 sets of 12 repetitions with a straight leg

Single leg bent knee calf raise

Teaching points:

With your knee bent hang off a step and lower your heel toward the floor
Rise up on your toes as far as you can keeping the movement in a comfortable range, and then lower back down
Start Bodyweight, and gradually add load with dumbbells
Perform 3 sets of 12 repetitions with your knee bent

Heavy leg press

Teaching points:

* This is the most important strengthening exercise in this phase *

It is best done with a leg press machine, but you can do a weighted box squat as a substitute. Add weight so it feels like 70% of your max effort.

Perform a slow controlled leg press (no more than 90 deg knee bend)
3 seconds concentric (pushing up) and 3 seconds eccentric (lowering down)
So one rep should take 6 seconds
Aim for 6-8 repetitions only and perform this exercise 3 times per week

Step down counterbalance squat front

Teaching points:

Perform 3 to 4 sets of 6 to 8 repetitions on each leg
Only drop as far as is comfortable and use a slow, controlled movement at all times

Hack squat/Back squat

Teaching points:

This exercise should be done with slow repetitions
Each rep should be 3 seconds concentric (up) and then 3 seconds eccentric (down)
Do 6-8 reps 3 times per week

Squat

DL squat to between 45-90 degrees as range allows

3 x 12

Sumo squat

3 x 12 as range allows

Movement control

2 – 4 times per week.

Forward T

Teaching Points:

Stand on one leg with your knee slightly bent
Lean forwards, open up your arms pulling the non-supporting leg backward to make the shape of a ‘T’
Maintain balance for 4 or 5 seconds and repeat
Perform 2 sets of 6 repetitions on each leg, holding the T position for 2 or 3 seconds each time