Patellar tendinopathy, another name for “jumper’s knee,” is a painful knee ailment mostly associated with exercises that lead to micro tears in the patellar tendon. It primarily affects athletes involved in sports requiring intense jumping. localized patellar tendon tenderness is generally the first sign. The patellar or quadriceps tendon’s buildup of stress is usually what causes the tears. As the name suggests, players from jumping sports—where leg extensor speed and power are highly valued—are prone to this condition. Sports like volleyball, track (long and high jump), basketball, long-distance running, and skiing lead to significant eccentric quadriceps loadings1. An overuse injury of the knee extensor mechanism, jumper’s knee is caused by repeated mechanical stress from sports involving motions including leaping, landing, accelerating, decelerating, and cutting2. When these motions are repeatedly performed in a single session or if there is not enough recovery time in between sessions, the knee extensor tendons may microtear. The patellar tendon inserts on the inferior pole of the patella, which is the part of the knee extensor mechanism most prone to be impacted. This condition is predisposed to by several intrinsic knee characteristics. These include excessive force production on the knee, aberrant patellar height, excessive Q-angle of the knee, ligamentous laxity, and tightness in the quadriceps and hamstrings. Athletes’ performance level, the hardness of the ground where the sport is played, and an excessive volume and frequency of training are some other variables that might cause jumper’s knee3. Body weight, body mass index, waist-to-hip ratio, leg-length difference, foot arch height, quadriceps strength, and vertical jump performance are other potential risk factors. The patellar tendon may experience higher strain as a result of several circumstances4. At some time in their careers, up to 14% of recreational jumpers and 45% of elite jumpers will have symptoms similar to jumper’s knee1.
A thorough evaluation is the first step a physical therapist will take to learn about the patient’s symptoms, health history, and degree of activity. This usually entails a thorough explanation of the type and timing of the pain as well as any particular motions or activities that make it worse.
If you are suffering from jumper’s knee you may experience;
- Pain at inferior side of patella.
- Discomfort associated with overload worsens when the knee extensors are under stress especially during activities that cause the patellar tendon to store and release energy5. The first step in physical therapy treatment for Jumper's Knee is to customize a plan that will lessen discomfort, encourage healing, and return function. The first emphasis is on using techniques like cold treatment to reduce inflammation and pain. According to bleakley et al; following an acute soft tissue injury, cryotherapy can impact important inflammatory processes at the cellular and physiological levels. After the discomfort is managed, specific exercises are added to the therapy plan. According to bahr et al; Results from eccentric strength training of lower limb muscles have been demonstrated to be just as effective as those from surgery. Before recommending surgery, eccentric training should be done for a period of twelve weeks. Rodriguez-Merchan states that eccentric exercise seems to be the recommended course of action for those with patellar tendinopathy8. For recovery, eccentric loading has been the most popular strategy. Research indicates that all loading regimens help people feel less pain and regain function. To ensure a safe return to the patient's sport or everyday routine, the therapist will add functional exercises as strength and mobility improve. These exercises will replicate the patient's regular activities. The ultimate objective of the treatment plan is to enable complete recovery and avoid recurrence by regularly modifying it in response to the patient's progress. To control further dry needling can also be in therapeutic plan. According to styoychev et al; during the research, there was a statistically significant reduction in the symptoms as indicated by the patient9. In summary, physical treatment for Jumper's Knee involves a focused and well-thought-out strategy. People can effectively reduce pain, strengthen the knee, and restore mobility with focused exercises, pain management strategies, and a gradual return to activities.
Physical Therapy for Trapezius Myalgia is not about treating symptoms, it’s about embracing a holistic approach to health. Reach out to your nearest Advance Physical Therapy clinic to experience customized treatment protocol tailored to you. Your journey to pain free life is within reach!
References:
1. Lian, Ø. B., Engebretsen, L., & Bahr, R. (2005). Prevalence of jumper’s knee among elite athletes from different sports: a cross-sectional study. The American journal of sports medicine, 33(4), 561-567.
2. Fredberg, U., & Bolvig, L. (1999). Jumper’s knee: review of the literature. Scandinavian journal of medicine & science in sports, 9(2), 66-73.
3. Tibesku, C. O., & Pässler, H. H. (2005). Jumper’s knee–a review. Sportverletzung Sportschaden: Organ der Gesellschaft fur Orthopadisch-Traumatologische Sportmedizin, 19(2), 63-71.
4. Van der Worp, H., Van Ark, M., Roerink, S., Pepping, G. J., Van Den Akker-Scheek, I., & Zwerver, J. (2011). Risk factors for patellar tendinopathy: a systematic review of the literature. British journal of sports medicine, 45(5), 446-452.
5. Kountouris, A., & Cook, J. (2007). Rehabilitation of Achilles and patellar tendinopathies. Best practice & research clinical rheumatology, 21(2), 295-316.
6. Bleakley, C. M., & Davison, G. W. (2010). Cryotherapy and inflammation: evidence beyond the cardinal signs. Physical therapy reviews, 15(6), 430-435.
7. Bahr, R., Fossan, B., Løken, S., & Engebretsen, L. (2006). Surgical treatment compared with eccentric training for patellar tendinopathy (jumper’s knee): a randomized, controlled trial. JBJS, 88(8), 1689-1698.
8. Rodriguez-Merchan, E. C. (2013). The treatment of patellar tendinopathy. Journal of Orthopaedics and Traumatology, 14, 77-81.
9. Stoychev, V., Finestone, A. S., & Kalichman, L. (2020). Dry needling as a treatment modality for tendinopathy: a narrative review. Current reviews in musculoskeletal medicine, 13(1), 133-140.
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