Jumper’s knee, also known as patellar tendinopathy, is an overuse injury caused by repetitive stress on the patellar tendon which connects the kneecap (patella) to the shin (tibia). (Draw a line from the bottom of your kneecap to the bump on the top of your shin and this is where the patellar tendon is).
Tendinopathy results from degeneration of the tendon. When we exercise, our muscles and tendons experience micro-tears which our bodies quickly repair. However, in some cases, repetitive exercise may cause micro-trauma, which our body is unable to repair fast enough leading to pain, swelling and discomfort.¹
More specifically to patellar tendinopathy, the pain, discomfort and swelling is along the patellar tendon. Generally, symptoms are correlated to activities that repeatedly stress the tendon such as jumping, running or a significant increase in activity in the past 2-3 months. According to a study by Ian et al, 22% of elite athletes experience patellar tendon pain during their career.²
Most individuals will experience a combination of stiffness, swelling, and pain below the kneecap. Often, the pain will be aggravated with running, jumping, climbing stairs, and prolonged sitting or standing.
Conservative management generally resolves symptoms in most athletes. Initially, it is important to reduce the volume and frequency of training, particularly the activities that increase symptoms and discomfort. However, we want to modify our activities, not rest altogether. Research shows that rest leads to muscular and tendon atrophy and will likely result in patellar tendinopathy again when an athlete returns to their sport.³
For physical therapy, the gold standard for patellar tendinopathy is eccentric exercise, particularly on a decline squat board.² ⁴ However, there is increasing research supporting heavy, slow resistance training programs for treatment of tendinopathy.⁴ For those that have too much pain or discomfort with these approaches, they may benefit from isometric exercises first. Eventually, it is important to slowly reintegrate plyometric training and get our athletes back to what they love!
If these symptoms resonate with you, come see us at Unbroken Rehab and Athletics and get back to your sport pain-free!
References:
- Rees JD, Maffulli N, Cook J. Management of tendinopathy. Am J Sports Med. 2009;37:1855-1867.
- Ian OB, Engebretsen L, Bahr R. Prevalence of jumper’s knee among elite athletes from different sports: a cross-sectional study. Am J Sport Med 2005;33:561–7.
- Reinking MF. CURRENT CONCEPTS IN THE TREATMENT OF PATELLAR TENDINOPATHY. Int J Sports Phys Ther. 2016 Dec;11(6):854-866. PMID: 27904789; PMCID: PMC5095939.
- Challoumas D, Pedret C, Biddle M, Ng NYB, Kirwan P, Cooper B, Nicholas P, Wilson S, Clifford C, Millar NL. Management of patellar tendinopathy: a systematic review and network meta-analysis of randomised studies. BMJ Open Sport Exerc Med. 2021 Nov 29;7(4):e001110. doi: 10.1136/bmjsem-2021-001110. PMID: 34900334; PMCID: PMC8634001.
