Knee pain is one of the most common issues we see at Endeavour Rehab. Often, the diagnosis is what’s colloquially referred to as “jumper’s knee,” which is also known as patellar tendonitis—pain and inflammation in the patellar tendon. Here, we’ll discuss more about the condition and how it’s diagnosed and treated, answering questions including:
– What is jumper’s knee (patellar tendonitis)?
– Where is your patella located?
– What are the symptoms of jumper’s knee?
– How is jumper’s knee diagnosed?
-What causes jumper’s knee?
– What are the treatment options?
– What are some exercises and stretches for patellar tendonitis?
– What activities should you avoid during recovery?
– How long does it take to recover from jumper’s knee? How soon can you work out and play sports?
-How can you take care of your knees and prevent injury?
Though it’s commonly called “jumper’s knee,” the term is often used to refer generally to knee injuries, even in someone who isn’t an athlete. Jumper’s knee, also called patellar tendonitis, is pain and inflammation in the patellar tendon. Usually, this pain is felt like an achy or sore sensation in your kneecap.
Your patella—the medical term for kneecap—is at the front of your knee. The patellar tendon connects your patella to your tibia (shin bone). Your patella actually floats: it’s attached by several different layers of connective tissue on the top and bottom of your kneecap and along the sides. It has some freedom to move from side to side or up and down, depending on what you’re doing with your knee.
Like we mentioned above, jumper’s knee is pain underneath the knee that typically is felt like an achy or sore sensation. It’s also possible for it to show up as a sharp, shooting pain in your knee. Your knee might also give out due to pain, particularly when you’re landing or stepping down. However, jumper’s knee is more commonly felt as an achiness because it’s something that tends to build up for a long time and worsen without being addressed.
Often, people experience jumper’s knee with activities like running, jumping, or cutting sports. It can also create pain with simpler, basic things like walking or going up or down stairs. You also might feel pain after being immobile for a while, whether sitting for a long time or first thing in the morning after getting out of bed. Despite the name “jumper’s knee,” anyone can get it even if they’re not what you’d call a “jumper.” We see it commonly in runners or cutting sport athletes. While it’s more often seen on a single leg, it can also be experienced on both sides.
When someone comes into our clinic at Endeavour Rehab, the first thing we’ll do is ask about where the pain is. We can do a pressure test in the area to see if there is tenderness, which can indicate jumper’s knee. We’ll also have you do certain movements—like walking, jumping, squatting, going up a step—to better understand what’s going on in the area. We also might do some testing of your kneecap’s mobility, to see if pain is caused by moving in certain directions. As well, we’ll look into other differential diagnoses such as Osgood-Schlatter disease (which occurs in adolescents, involving pain and swelling below your knee joint), or a patellar tendon tear.
Once we have the diagnosis in terms of the actual local injury and where the pain is, it’s important for us to look deeper into the issue and the contributing factors to it.
One big factor is looking into what’s happening at the ankle. Things like extra stress, irritation or bad movement patterning can all impact the amount of stress on your knee. When we’re doing an assessment for jumper’s knee or knee pain, we carefully look at things like ankle range of motion, ankle strength and balance. We also look at things from the hip standpoint—range of motion, strength, coordination and patterning. Some of the nerves that come off of the hip joint go down the inner thigh towards the area underneath the knee—in particular, a nerve called the saphenous nerve, that provides innervation to the area below the knee.
In addition, we assess the other leg from where knee pain is occurring to determine if there’s anything there that might be putting more stress on the other knee. We even look at your back, because a lot of the nerves in your lower back play a big role in symptoms you might be experiencing related to your knees. Our goal is trying to understand where weaknesses may be occurring in your body or what might be causing pain, which will ultimately help us create a treatment plan.
Finally, we also explore change in activity as a possible cause for knee pain. For example, someone who has been inactive and suddenly got a lot more active, or someone who changed their mechanics by changing footwear in a significant way. We often see knee pain in people who start trying to do plyometric training, which is jumping or explosive strength training to increase upper body strength. We might see people who changed sports to something with a different set of demands.
Treatment will focus on the areas found during the assessment phase, with a goal of improving pain and reducing inflammation around the lower part of the knee.
We can do that through electroacupuncture, which will help to activate nerves and muscles related to the region and make sure that they are all functioning as optimally as possible—from the ankle, to the hip, the lower back and the opposite knee. We also address jumper’s knee through manual therapy, which helps to release the area, improve the mobility of the tendon and reduce any adhesions or restrictions to the movement of the knee. As well, we look at strengthening the entire chain, especially the quadriceps (the muscles down the front of your thigh).
One thing we may also recommend is using patellar tendon straps. These are similar to a knee brace, but is a very thin brace that goes just underneath your kneecap. It can be a little bit uncomfortable, but may actually give some people relief if it’s adjusted appropriately. A patellar tendon strap is more of a short-term fix that won’t solve the problem completely, but it can help people stay active even with knee pain. There are also a variety of taping techniques that can be used to improve patellar stability or to simulate the patellar strap.
In many cases people want to stay active while they have knee pain, so we’ll make recommendations to you depending on your specific situation.
We recommend that people have a more dynamic warm-up to prepare their body for an activity they want to do. This looks like starting with lower intensity activities, like walking, light stretching or lunging, and then progressing to more intense activities before participating in your sport or activity. In many cases, warming up helps symptoms be manageable for people. It’s important also to do a proper cool-down after your activity with stretches for your quadriceps, hip flexors and ankles.
In terms of exercises for jumper’s knee, the key is to find movements that don’t aggravate knee pain. We may start you with something very basic like isometrics. This is strengthening exercises for the knee that don’t involve movement of the knee. You find a position that activates your quadriceps and hold that position for 10-30 seconds, which will help to activate the muscle, decrease pain and improve your body’s ability to heal the inflamed and irritated area of the tendon.
From here, we’ll progress to eccentric movements, which is where your knee is bending more but also loading. Slowly going into a squat is a really great way to activate the muscles of the quadriceps and put a little bit of stress on the patellar tendon without aggravating it too much. For example, you could squat down to a chair and then use support from the other leg to stand up straight. Or you can go down with both feet slowly, then offload the injured leg a bit while standing up.
The other thing we might have you do is do exercises that have your heels elevated. This will change the amount of stress on the knee, reinforce the tissue, stimulate healing, and improve the overall function of the knee.
It depends on the severity of your symptoms. For really mild symptoms, as we mentioned, a patellar tendon strap or just doing a proper warm-up and cool down may be sufficient. But in some cases, time off may be necessary, if irritation has reached a more significant level. If you’re experiencing higher levels of pain, it’s a good idea to either reduce the amount of or avoid high-impact activities. For example, switching from running to being on an elliptical or doing activities in the water vs on a court or hard surface.
It’s critical to address knee pain early rather than trying to power through, as it can prevent issues from becoming chronic and causing you to need to take time off, especially as an athlete.
Duration of recovery depends heavily on the individual and the severity of their symptoms. If you need to continue participating in your sport, recovery might last for six months or longer, though improvements can be made through things like proper warm-up and cool-down, as we’ve mentioned above. If we’re able to get to the issue really early on, recovery time can be a lot shorter, often within six to 12 weeks. Recovery time also depends on other factors such as what other areas of your body are affected and how severely.
There are a few key things you can do to create better knee health and prevent knee injuries like jumper’s knee. First, it’s important to improve the health of the joints around your knee, such as ankle and hip function, strength, range of motion and control. For example, making sure that when you squat, your knees don’t come inwards toward the midline. This will help put your knees in the best position going forward.
Another key area is challenging your knees in a variety of different ways and not limiting yourself to one type of specific movement. For instance, in volleyball, instead of only jumping with straight knees, working on getting lower into knee ranges of motion and positions that might be less familiar.
Additionally, avoiding a sudden increase or change in activity is important, which will help make sure your body is well-prepared for the activities you want to do. Finally, it’s important to make sure you address any symptoms or injuries completely to ensure you won’t have underlying factors that will contribute to future knee pain.
Looking for a physiotherapy clinic in Toronto or have more questions? Contact us at Endeavour to learn more and book your treatment.
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