“Jumper’s Knee”, also known as patellar tendinopathy, is a painful condition characterized by stress to the patellar tendon most commonly caused by an overuse injury. The term Jumper’s Knee was first used in 1973 to describe an insertional tendinopathy, which is a tendon injury that occurs where the tendon attaches to bone. In Jumper’s Knee, this occurs at the attachment of the kneecap tendon to the lower kneecap (inferior pole of the patella). Jumper’s Knee refers to functional stress overload due to jumping.
This often painful condition is usually activity-related, occurring in sports requiring strenuous jumping, and is caused by small tears in the patellar tendon which result in a localized patellar tendon tenderness. As the name implies, the condition is common in athletes from jumping sports where there is a high demand for the speed and power of the leg extensors‒the quadriceps (Lian OB, Engebretsen, et al). These sports, such as volleyball, track (long and high jump) basketball, long-distance running, and skiing often lead to high eccentric quadriceps loadings.
Patellar tendinopathy can be debilitating and result in the prolonged absence and potential retirement from sports.
Common Symptoms of Jumper’s Knee:
- Exquisite pain beneath your kneecap when moving
- Bruising or redness
- Stiffness of the knee while jumping, kneeling or squatting
- Pain while bending the knee
- Your patellar tendon may appear larger or thicker than your other knee
- Localzied swelling
How Bad is my Jumper’s Knee?
Jumper’s Knee injuries are graded from 1 to 4 depending on the severity of pain.
GRADE:
- 1. Pain only after training
- 2. Pain at the beginning of sports activity disappears with warm up and sometimes reappears with fatigue
- 3. Pain at rest and during activity along with the deterioration of performance.
- 4. Pain during everyday activities
Risk Factors:
Risk factors include gender, greater body weight, being bow legged or knock-kneed, having an increased angle (Q-angle) of the knee, having an abnormally high knee cap (patella alta) or abnormally low kneecap (patella baja), and limb length inequality. Impairment to Jumper’s Knee includes poor quadriceps and hamstring flexibility. Vertical jump ability, as well as jumping and landing technique are believed to influence tendon loading.
Diagnosis and Treatment:
Evaluation by a skilled physical therapist is imperative to prevent the progression of symptoms and damage to the patellar tendon and a safe return to activity. The clinical assessment will include a thorough history of the injury and a detailed physical examination, If thought necessary, the physical therapist will refer to a sports medicine physician for x-rays and/or ultrasound of the involved area.
Once a thorough evaluation by the physical therapist is completed, and appropriate treatment specific to the injury will be implemented. Treatment of the injured area may include all of the following:
- Relative rest (avoid or activity modification of aggravating factors) including jumping activities and sports
- Cryotherapy (localized ice cup massage in for pain modulation)
- Manual Therapy including friction massage to the patellar tendon
- Targeted stretching and strengthening of the involved and surrounding areas
- Range of motionfunctional mobility exercises for your hip, knee and ankle
- Taping techniques for biomechanical correction and appropriate muscle firing
- Gradual progressive loading of the tendon
- Modalities for the reduction of inflammation
Conclusion:
Patellar Tendinopathy, aka “Jumper’s Knee”, can frequently be difficult to manage and frustrating for the patient with a goal of returning to sporting activity. It is imperative that the athlete receive a proper diagnosis and an appropriate rehabilitation program specific to their needs for a safe and effective return to sport.
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About the author:
Leo Quinn, PT, has extensive experience in orthopedic and sports injury rehab. He’s been practiving physical therapy since 2001 and completed his board certification as an Orthopedic Clinical Specialist in 2012. Leo is also an ASTYM™ certified provider.
He has been instrumental in co-developing Rose City Physical Therapy’s ACL prevention and rehab programs. He enjoys working with patients contending with general orthopedic conditions and post-surgical rehabilitation, as well as those with sports-related injuries. He has a special interest in helping the active individual striving to return to outdoor recreation and sport.