How Should Patients With Jumpers Knee Be Managed
First line treatment rest, anti-inflammatories, physical therapy, brace
Patients should refrain from activities that cause pain in order to rest the tendon and allow the inflammation to subside. Anti-inflammatories should be recommended if there are no contraindications.
Physical therapy should be prescribed to include eccentric training exercises, quadriceps strengthening, and hamstring stretching. Modalities such as massage, ultrasound, and iontophoresis with steroid creams may also be useful. Initial duration of therapy should be 6 weeks.
Patients may be advised to purchase a patellar tendon unloading brace that can be purchased at most pharmacies.
Second line treatment steroid injection
For patients who do not experience pain relief with first line treatments, a steroid injection can be considered. However, there is a risk that the steroids can weaken the tendon, and promote rupture. Steroid injections for jumpers knee should be used sparingly.
Last line treatment surgery
For patients who have failed at least 6 months of non-operative treatment, surgery can be considered. There are several techniques described, but all involve debridement of the pathologic tendon with reattachment of the normal tendon back to the bone.
Controversial treatment platelet-rich plasma
There is mounting evidence that shock-wave therapy may be a useful modality. However, it is currently not readily available at most centers for this indication.
What Is The Evidence
Filardo, G, Kon, E, Della Villa, S, Vincentelli, F, Fornasari, PM, Marcacci, M. Use of platelet-rich plasma for the treatment of refractory jumper’s knee. Int Orthop.. vol. 34. 2010 Aug. pp. 909-15.
Jonsson, P, Alfredson, H. Superior results with eccentric compared to concentric quadriceps training in patients with jumper’s knee: a prospective randomised study. Br J Sports Med.. vol. 39. 2005 Nov. pp. 847-50.
Peers, KH, Lysens, RJ. Patellar tendinopathy in athletes: current diagnostic and therapeutic recommendations. Sports Med.. vol. 35. 2005. pp. 71-87.
Panni, AS, Tartarone, M, Maffulli, N. Patellar tendinopathy in athletes: outcome of nonoperative and operative management. Am J Sports Med.. vol. 28. 2000. pp. 392-7.
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First A Little Anatomy
The medical name for jumpers knee is patellar tendonitis, and it occurs when the tendon connecting your shin bone to your kneecap becomes inflamed. What causes the inflammation? Its almost always due to repetitive impact specifically, jumping or repeatedly making contact with the ground. Thats why athletes who participate in sports with lots of jumping are more prone to jumpers knee. But patellar tendonitis also occurs in cyclists, runners, and even soccer players. Youre more likely to get jumpers knee if youre older, youre overweight or have a heavier body weight overall, or you have weak leg muscles. Poor training and athletic technique can also play a role. If you overtrain, fail to warm up, or play a lot on a hard surface, youre more likely to injure your tendons, too.
So how can you tell if your pain is patellar tendonitis? First, by looking at your symptoms. Because jumpers knee involves your patellar tendon, pain and tenderness tend to occur in the kneecap area or more specifically, just below your kneecap. You may also have:
- A swollen knee
- Taking medicine to reduce swelling and pain
- Using stretching and strengthening exercises
- Injections to relieve inflammation
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Patellofemoral Pain Vs Patellar Tendonitis
Often, it can be difficult to know whether the pain is related to the patellar tendon or the kneecap joint.
Generally, patellofemoral or kneecap pain is often not as focal as patellar tendonitis pain. Also, pain usually occurs with walking, cycling, and sitting unlike patellar tendonitis. Sometimes, taping the kneecap can improve pain and point to the patellofemoral joint as the cause of knee pain.
Concluding Thoughts How To Fix Jumpers Knee Fast
With the advice of personal trainers and my athletic trainers at the various places I have played, I have now developed a system that I feel very comfortable in using with myself, and that has reduced my tendinitis to the point that I now feel comfortable enough to play basketball without any type of knee assisting strap or protective sports brace.
All the exercises mentioned here are what I would consider being general recommendations, and should not be a substitute for medical advice from your doctor.
A professional medical doctor will be able to understand the condition of your knee and help recommend the exercise program that will be suitable for the condition of your knee.
If you desire to work on your knee tendonitis by yourself, these exercises are very good examples of what can help you reduce overall pain and improve overall ability! For more tips on how to protect your knees, check out Apollo MD.
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Cause #: Bad Leg Alignment
As you can see, were trying to avoid internal rotation and adduction. For this reason, weve trained gluteal muscles that create external rotation and abduction, the opposite movements.
Unfortunately, many people start and end in this position when they run, jump, or squat. This is problematic, as it puts undue load on your patellar tendon and on other passive stabilizing structures of your knee, such as the ACL.
Knees collapsing to the midline of the body are the main cause behind ACL-tears, especially among women. However, this faulty movement pattern will also overload your patellar tendon.
How Bad Leg Alignment Causes Jumpers Knee
If your knee collapses inward when you move, the force transmitted through the patellar tendon will be off-axis and not parallel with the collagen fibers inside the tendon. Its much like opening and closing a zipper by pulling it off to the side, instead of straight up and down.
It will slowly break down the zipper and you need to expend more energy to get it done because its less effective.
In your knee, the force pulling off-axis will slowly overload your collagen fibers. This overuse eventually results in jumpers knee. Oh, and youre wasting energy when you move that way, which means that if you learned to move properly, youd be able to jump higher and run faster with the same amount of energy expended.
Alignment When Walking
The next time you walk, look at your feet and their alignment. Are they pointing to the outside?
More Severe Patellar Tendinitis Symptoms Can Include Some Of The Following:
- Pain when kneeling or standing up, as well as during activities like walking, running, jumping, squatting or lifting heavy objects with your legs
- Swelling and tenderness of the patellar tendon
- Soreness or aches behind the lower part of the kneecap
- Difficulty straightening the legs without pain
- Continued stiffness, pain, and soreness even after a period without physical activity
Avoiding jumpers knee treatment is not recommended. The symptoms can increasingly make simple movements or activities that people take for granted, extremely painful and difficult.
For professional athletes, untreated patellar tendonitis can even be career ending.
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How Is Jumper’s Knee Treated
Treatment for jumper’s knee includes:
- rest and taking a break from sports
- taping or wearing a knee support or strap just under the patella
- sitting with the leg raised
- ibuprofen to help with pain and swelling
- massage therapy
- strengthening and stretching muscles through physical therapy or an at-home exercise program
If someone with jumper’s knee does not rest the knee, the tendon can become more damaged. Although it is not common, surgery may be needed if:
- the pain does not go away
- the patellar tendon is more damaged than is typical with jumper’s knee
What Are The Main Symptoms Of Jumpers Knee
It is possible you might not recognize jumpers knee condition immediately as it might start off with mild pain. The main symptoms of jumpers knee are pain and tenderness, swelling and pain while doing some exercises or bending the leg. If you are experiencing some discomfort or tenderness behind the kneecap or stiffness while kneeling, jumping or sitting, these might be another warning signs.
Jumpers knee is divided into 4 stages that describe the level of injury stage 1 being the mildest and requiring just home remedies while stage 4 being the worst-case scenario:
- Stage 1 You will feel pain or discomfort only after exercising or being active, but you wont feel much different.
- Stage 2 The knee will cause pain during and after activity, but youll function normally in your daily life.
- Stage 3 The pain will start to disturb your normal life and it will be harder to perform sports or other activities.
- Stage 4 The tendon will be completely torn and you will need surgical help.
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When To Call A Doctor
If these treatments dont help your patella injury, see your doctor. He or she will examine and diagnose you and, if warranted, prescribe anti-inflammatories and physical therapy.
New York City sports medicine specialist Jordan D. Metzl, M.D. is a 33-time marathon finisher and 13-time Ironman. His book, The Athletes Book of Home Remedies, has more than 1,000 tips to fix all types of injuries and medical conditions.
Patellar Tendonitis/jumpers Knee Exercises
Jumpers knee or Patellar tendonitis exercises are an important part of our full step-by-step rehabilitation program.
Our full, step-by-step Jumpers knee rehab program has been created by elite level sports physio Paul Tanner and comprises four phases. At each phase exercises become progressively more advanced:
- Phase 1: Acute
- Phase 3: Heavy slow resistance
- Phase 4: Eccentric loading
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Cause #: Low Gluteal Strength
Your glutes are the big strong muscles on your hip. These muscles are used when running, jumping, landing from a jump, and many other athletic movements.
The gluteal muscles also help you control the alignment of your knee during these movements. Therefore, if you have weak gluteal muscles, your legs are more likely to end up in a position in which you place excess load on your knees. Research has also uncovered low gluteal strength as a risk factor for patellar tendonitis , so lets look into how you can make sure those muscles are strong.
How to improve gluteal strength
For a healthy patellar tendon, the three important movements your gluteals need to be strong in are hip abduction, hip external rotation, and hip extension. If you are strong in these movements, it will be easy for you to maintain good leg alignment in your sport. We will train these movements with the following three exercises.
Gluteal Exercise 1: Hip Abductions
To do hip abductions, lie down on your side with your body in a straight line. Put some padding under your hip if youre on a hard surface. Now, lift the upper leg up, merely using the muscles of your hip. You should feel the contraction on the outside of your hip.
Keep your feet parallel to the ground, so dont let them rotate outwards. If you let them rotate outwards , other muscles of the leg will take over, and the exercise will be less effective, so pay attention to your technique.
Gluteal Exercise 2: Clamshells
What Is The Recovery Time From Patellar Tendonitis
The timeline varies from person to person, but Harrington cautions that the process can take longer than most expect. You cant rush it, he says. The key is to be consistent, patient and willing to modify activities.
Pushing too hard, too fast can lead to a setback. If you do an activity and feel knee pain afterward, its a sign to dial down the intensity level of your workout.
Its easy to get frustrated, says Harrington, but slow and steady is the idea here.
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Phase 3 Jumpers Knee Exercises
This is the heavy slow resistance phase.
The aim of phase 3 is to further increase the load through your knee.
In addition to treatment methods phase 3 consists of 21 exercises, which become more dynamic and challenging then earlier phases.
End Jumpers Knee Once And For All
Back when I suffered from patellar tendonitis, I was so frustrated with my lack of healing progress that I often considered quitting my sports, basketball and volleyball, altogether. Stretching, warming up thoroughly, quad strengthening exercises, knee sleeves, no matter what I tried, the pain always kept coming back.
Today, my knees are stronger than ever. I can do extremely demanding leg exercises, such as deep single-leg squats, without any problems. I can play my favorite sports without having to worry about aching knees and I know how I can train my legs to become even stronger without risking a return of the injury.
It took me years of research into knee health and a lot of self-experimentation until I finally discovered the reasons for my jumpers knee. Up to that point, I had completely ignored these hidden factors, but once I addressed them, my pain slowly disappeared.
In this article, I will show you the three most important secrets to successfully treating patellar tendonitis. Ive called this the jumpers knee treatment triangle, because if you ignore one of its parts, the whole thing collapses. Youll also learn an exercise with which you can heal your patellar tendons.
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Patellar Tendinitis Causes Prevention And Risk Factors Plus Rehabilitation Exercises And Stretches
Patellar Tendinitis, commonly known as Jumpers knee, is an extremely painful and frustrating injury that puts a big strain on the front of the knee joint, just below the patella .
Patellar tendinitis is common among running related sports. However, it doesnt normally occur in an instant, like an ankle sprain or hamstring strain, but starts off as a dull ache, and progresses quickly to a sharp, debilitating knee pain.
Note: The term patellar tendinitis and patellar tendonitis are interchangeable and mean the same thing.
How Is Jumpers Knee Treated
Jumpers knee is an injury to the tendon usually caused by overuse and repetitive actions that stress the tendon. We review the variety of conservative and surgical options available to treat this injury.
Athletes can make high demands on their knees through intense running and jumping in sports like soccer, basketball, and volleyball. These actions can cause repeated stress on the patellar tendon in the kneecap, making athletes particularly vulnerable to jumpers knee. We review the treatments used to address this painful condition.
The best way to handle jumpers knee is to recognize the symptomskneecap pain and tenderness during activityin the early stages and stop activity to allow your patellar tendon to heal and recover. Never try to play through pain. There are steps you can take at home to care for this injury. Self-treatment includes rest, ice, and elevation for up to two days, followed by an exercise rehabilitation program designed to stretch and strengthen the muscles and tendon.
If kneecap pain continues and increases, its time to consult a sports medicine physician at Summit Orthopedics for an evaluation and diagnosis. If jumpers knee is the problem, your physician may talk with you about a number of treatment options, including the following:
Appropriate care provided by the Summit Orthopedics sports medicine team can put you safely on the road to recovery, and get you back to the sports you enjoy.
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Stretches To Help Patellar Tendonitis
The goal is to develop load tolerance to handle the demands on the knee, what is typically thought of as building strength around the joint, says Harrington. Its also helpful to work on flexibility.
This gives the tendon a break and resolves issues that can cause increased or abnormal strain on the tendon, notes Harrington.
Tight muscles in your hamstrings, hips or calves can contribute to a flare-up of patellar tendonitis by putting added stress on your knee. Stretches and exercises that target your lower body can prevent or ease the problem.
Suggested stretches and exercises include:
What this helps: The stretch can increase flexibility and loosen up your hamstrings and hips, allowing better range of motion in your knee and pelvis.
What this helps: The stretch addresses tightness in the calf, which can lead to knee and foot pain.
Kneeling hip flexor stretch
What this helps: The stretch targets muscles across your hip and knee joints.
Resting And Supporting The Knee
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