- Anatomy of The Knee and How It Happens
- What Are the Signs & Symptoms of Jumper's Knee?
- What Causes Jumper's Knee?
- How Is Jumper's Knee Diagnosed?
- How Is Jumper's Knee Treated?
- Pain Reduction and Offloading
- Strengthening Exercising And Eccentric Loading
- Functional Activity And Back to Sport Physiotherapy
- Surgical Treatment
- Advanced Treatment
- FAQ Section
Clear from the name, it is a condition of the knee that occurs with jumping. Medically it is called Patellar tendonitis and it occurs because of activities that involve jumping or landing on the ground with force. The pathology behind the jumper’s knee is the micro-tears of the patellar tendon due to overuse or acceleration-deceleration-type activities. The patellar tendon is a band that connects your patella or kneecap with the shin bone. Sports that require jumping, running, sprinting, and landing movements cause pain in the knee due to continuous forceful impact and weight bearing on the knee joint. It is categorized as an overuse injury or sport.
Anatomy of The Knee and How It Happens
Anatomically, your knee joint is formed by the union of the thigh bone (femur) and shin bone (tibia) along with the kneecap (patella) placed above forming a joint with the femur. The muscles in front of your thigh, the quadriceps, form into a thick tendinous band distally just above the knee that runs over the patella and is attached to the shin bone. It is called the patellar tendon which is about 1 inch wide and 2 inches long band that connects the kneecap with the shin bone. The flexion and extension of the knee are controlled by the quadricep contraction.
When the muscle contracts to shorten, it straightens the leg, and when it contracts while lengthening, it flexes the knee in a controlled manner.
During jumping, the quadriceps first contract pushing the ground to bring the person to the air. During landing the quadricep contracts eccentrically (lengthens) in a controlled manner slightly filing the knee joint for shock absorption while landing and then contracts again to straighten the leg for standing.
Repetitive contraction of the muscle during jumping, cycling, or weight lifting pulls on the tendon leading to overuse injury and small tears in the tendon which makes it more of a tendinosis (rupture) rather than a tendonitis (inflammation) but it has got this name because of the repetitive mechanism of injury and the signs and symptoms.
What Are the Signs & Symptoms of Jumper's Knee?
Jumper's knee, also known as patellar tendonitis, is characterized by various signs and symptoms. The most common indication is pain in the front of the knee, specifically below the kneecap, which tends to worsen during activities such as running, jumping, or climbing stairs. Individuals with patellar tendonitis may also experience swelling and tenderness around the patellar tendon area. A few characteristics features of patellar tendonitis are,
- A localized pain just on the inferior part of the patella
- Tenderness on palpation on the patellar tendon attachment point on the patella with a completely straight leg that disappears when the knee is bent.
- Sudden pain with contraction of the quadricep muscles and resting the quads can immediately relieve the pain.
These jumper’s knee symptoms distinguish the condition from other knee pathologies, however, many of the patellar tendonitis symptoms overlap with signs and symptoms of other knee conditions.
- Pain during flexion and extension of the knee due to loading of the patellar tendon
- Prolonged sitting worsens the symptoms
- Swelling over the patellar tendon
What Causes Jumper's Knee?
Jumper's knee, or patellar tendonitis, is caused by repetitive stress on the quadriceps muscle, leading to strain on the patellar tendon. Activities that worsen the condition include high-impact sports like basketball or volleyball, which involve frequent jumping, as well as activities that strain the knee joint such as running or squatting. Identifying and modifying these activities is crucial for managing and preventing further deterioration of jumper's knee. Some activities that make the condition worse include,
- Sudden acceleration and deceleration activities like football
- Sports involving jumping, landing, and sprinting like football, basketball, high jumps, long jumps, skiing, and volleyball.
- When the quadriceps muscle contracts eccentrically with speed it leads to microtrauma in the tendon.
Some of the risk factors for patellar tendonitis are,
- Male gender
- Age between 15 to 30 years
- General health status like weak or tight muscles, degenerative diseases, and other conditions affecting your bones and muscles.
- Sports participation and frequency of practices.
- Any malalignment in the foot, ankle, or hip joint that put stress on the patellar tendon
How Is Jumper's Knee Diagnosed?
Diagnosis and medical evaluation play a crucial role in the management of various health conditions, including musculoskeletal issues like jumper's knee. Proper diagnosis enables healthcare professionals to accurately identify the underlying cause of the symptoms and formulate an appropriate treatment plan. To fix the jumper’s knee, early diagnosis of the condition is crucial that is mostly based on the jumper’s knee signs and symptoms. The diagnosis involves observation, physical exam, and radiographic study.
- Swelling over the patellar tendon
- Slight redness or change of color if a tendon rupture is present
- Tenderness on palpation
- Tenderness on the inferior edge of the patella, when the knee is extended, reduces when the knee is flexed to 90 degree
Ultrasound and MRI are the best diagnostic tools used for Patellar tendonitis. These imaging procedures not only identify the pathology but also checks for the severity of the injury which helps clinicians to predict patellar tendon recovery time.
How Is Patellar Tendonitis Treated?
How to fix a Jumper’s Knee condition is a three-stage process
Pain Reduction and Offloading
Icing is recommended for pain reduction in the acute stage as it leads to capillarization of the region that speeds up the healing process. In the subacute and chronic stages, heat therapy is provided to reduce pain and promote healing.
Rest is preferred over complete immobilization because it provides the needed time for healing without the risk of muscle atrophy. A jumpers knee strap or a knee brace can modifiy the angle of pull of the tendon on the patella and reduces the strain on the patellar tendon. KT tape for patellar tendonitis also serves the same function without restricting functional movements.
Strengthening Exercising And Eccentric Loading
Surgery should be considered as a last resort for treating patellar tendinopathy, typically recommended only when conservative treatments have failed to improve the condition within a period of six months. It's important to note that the majority of individuals with patellar tendinopathy experience successful recovery without the need for surgical intervention, emphasizing the importance of exploring non-invasive treatment options before considering surgery. Kt tape for patellar tendonitis can be a valuable part of these non-invasive treatments, providing support and relief to the affected area while allowing individuals to continue their daily activities and rehabilitation exercises.
Functional Activity And Back to Sport Physiotherapy
If there is enough recovery in the first two stages, then back-to-sport training begins which includes advanced strength training exercises like squats, lunges, and weight training under the supervision of a qualified health professional or physiotherapist.
Surgery should be considered as a last resort for treating patellar tendinopathy, typically recommended only when conservative treatments have failed to improve the condition within a period of six months. It's important to note that the majority of individuals with patellar tendinopathy experience successful recovery without the need for surgical intervention, emphasizing the importance of exploring non-invasive treatment options before considering surgery.
Platelet-Rich Plasma Therapy: Platelet-Rich Plasma (PRP) works in patellar tendinopathy by promoting the regrowth of the damaged tendons. The plasma contains growth factors and biochemicals that support the growth of tendon and muscle cells by enhancing vascularization and matrix formation. Thus it regrows the injured tissue much stronger and healthier than the previous one.
Extracorporeal Shock Wave Therapy: ESWT is a painless, low-risk, conservative treatment modality for tendinopathies. It works by sending acoustic waves to the painful areas of tissue damage and promotes the regeneration of tendons, muscles, or bone tissues. It is effective for patellar tendonitis as it increases the circulation and stems cell activity in the region to reduce pain and speed up healing.
Patellar tendonitis or jumper’s knee comes with pain and tenderness on the inferior tip of the kneecap that increases with sports activities involving repetitive straining of the patellar tendon. Patellar tendonitis symptoms respond well to conservative management including eccentric training, advanced treatment methods, and protective measures, but if it fails to heal in any case, then surgical intervention is carried out. Return to sport becomes easy with early diagnosis of the condition followed by patellar tendon exercises under the supervision of an expert trainer or physiotherapist.
Frequently Asked Questions
What causes Jumper’s Knee?
Jumpers Knee is often caused by repetitive stress or overuse of the patellar tendon. Activities such as jumping, running, and sudden changes in direction put excessive strain on the tendon, leading to microscopic tears and subsequent inflammation.
What are the symptoms of Patellar Tenonditis?
The common symptoms of Jumpers Knee include pain and tenderness around the patellar tendon, especially just below the kneecap. The pain may worsen with activities that involve bending or straightening the knee, such as jumping or squatting. Swelling and stiffness may also be present.
Can Jumpers Knee be prevented?
While it may not be entirely preventable, there are measures you can take to reduce the risk of developing Jumper’s Knee. This includes incorporating proper warm-up and cool-down routines, wearing appropriate footwear, gradually increasing the intensity and duration of activities, and cross-training with low-impact exercises to avoid overloading the patellar tendon.
Can I continue participating in sports with Jumpers Knee?
It depends on the severity of your condition. In mild cases, modifying activities and taking adequate rest may allow you to continue participating in sports. However, in more severe cases, it may be necessary to take a break from high-impact activities until the tendon heals. Consult with a healthcare professional for guidance tailored to your specific situation.
How long does it take to recover from Jumpers Knee?
The recovery time for Jumpers Knee varies depending on the severity of the condition and individual factors. In general, with proper treatment and adherence to rehabilitation protocols, most individuals can expect to recover within a few weeks to several months. However, it's important to note that each person's recovery timeline may differ.