The main symptom of Jumper's Knee is pain at the very bottom of the kneecap at the front of the knee. It can range from being a mild niggle which is often ignored toknee pain which makes it almost impossible to walk.
Symptoms usually come on gradually over a period of weeks. The bottom of the patella (known as the lower pole) will be very tender when pressing in. The athlete is likely to experience aching and stiffness after exercise and pain when contracting the quadriceps muscles in acute cases.
How bad is my Jumper's Knee?
Patella tendon injuries are grade 1 to 4 depending on severity:
- Grade 1: Pain only after training.
- Grade 2: Pain before and after training but pain eases once warmed-up.
- Grade 3: Pain during training which limits your performance
- Grade 4: Pain during every day activities
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 jumper's knee at your peril! If left to become chronic it can be very difficult to treat and may require surgery.
Other signs will include a thickening of the affected tendon which may also have redness over the area. It is likely that an athlete with patella tendonitis will have a weak vastus medialis oblique (VMO) muscle on the inside of the thigh as well as significant weakness in the calf muscles. VMO is important in keeping the kneecap tracking correctly which in turn effects the direction of the forces through the patella tendon.
Jumper's knee assessment
Assessment and diagnosis of jumper's knee or patella tendonitis. These techniques can be used to help determine if jumper's knee is the cause of the pain.
When assessing a suspected case of jumper's knee, the therapist will usually begin with questions concerning not only the current injury, such as how and when it started and what the symptoms are, but also about your general health and previous injuries. Following this, an objective, or physical examination will be used, to help determine the possibility of this injury and to rule out others.
Palpation and observation - The therapist will look at the knee and the leg in general, looking for signs of injury such as swelling and bruising, as well as possible contributors to the injury, such as fallen arches. They will then feel the area for warmth, tension and tender areas.
Range of motion - The therapist will often look at the range of motion of the surrounding joints which can help to rule out joint injuries, as well as indicate which muscles or structures may be tight. With jumper's knee, it is common for the quadriceps muscles to be tight and so bending the knee may be limited and may cause pain in the patella tendon.
Resisted muscle tests - The therapist may get the patient to contract the quad muscles,looking for both pain and weakness compared to the other side as these are both indicators of jumper's knee. Contracting the muscles with the leg straight is more likely to elicit a painful response than a bent knee against resistance especially in longer term chronic cases. Functional tests using body weight are more likely reproduce pain.
Functional tests - If none of these tests produce a positive result, the therapist may ask the patient to perform some movements which cause pain, such as squats or lunges. This will help to determine which movements causes pain, when and where.Squats are usually painful in cases of jumper's knee.