- January 23, 2019
- Posted by: Daniel Ryan
- Category: Knee Injuries
Jumper’s Knee | Knee Pain Physiotherapy Fremantle
Through our previous posts, we have highlighted other causes of knee pain in Patellofemoral Joint Pain Syndrome or Runner’s Knee, and ITB Friction Syndrome. Following on from this series, we will look into Patellar Tendinopathy, or Jumper’s Knee as a source of knee pain often experienced at the bottom of the knee cap.
Distinguishing between Patellofemoral Pain and Patellar Tendinopathy can be difficult, however the following guide should make a diagnosis easier! Here we compare the two common knee pathologies:
Distinguishing Patellofemoral Knee Pain and Jumper’s Knee
|Signs||Patellofemoral Joint Pain Syndrome||Patellar Tendinopathy / Jumper’s Knee|
|Pain||Non-specific and vague.|
This pain can move towards the inner knee, outer knee or the bottom of the knee cap. And it often changes depending on the activity!
|Pain is felt at the bottom of the kneecap on the patellar tendon.|
|Onset||Occurs with running (especially downhill, climbing steps/stairs or running hills)|
Any weight bearing activity that involves the knee bending and straightening repetitively can trigger this pain, if abnormal patellofemoral mechanics exist – it is especially common in runners!
|Activities that involve jumping and changing direction typically aggravate this pain.|
Pain is often experienced in the first 1/3rd to 1/2 of a squatting movement. It is common in basketball players, netball players and sports that involve jumping, bounding or climbing.
|Tenderness||Usually tenderness is experienced on the sides of the kneecap, or at the bottom of the kneecap. However, in some cases NO tenderness can exist with this condition.||Commonly experienced at the bottom of the knee cap and can extend along the patellar tendon.|
Pain can also be experienced on the attachment of the patellar tendon to the shin bone.
It is rarely experienced in the mid portion of the tendon!
However, there may be a feeling of ‘thickening’ along the affected patellar tendon depending on how long the pain has been experienced!
|Knee Movement||Range of movement is usually normal, however in severe cases it can be limited.||Usually normal.|
|Functional Movement||Squats and stairs often aggravate pain.|
Specific taping can decrease pain considerably.
|Decline squatting movements often aggravate pain.|
Taping has a lesser effect.
Signs and Symptoms
Jumper’s Knee is so called because this condition is experienced by people who partake in sports and activities that involve repetitive jumping, bounding and changing directions. Personally, it has been the one injury that has hampered my basketball playing days, and you don’t have to look far during weekend basketball matches to see people wearing these braces:
It is a common injury!
As mentioned above, pain is typically experienced below the knee cap. This is usually directly under the knee cap (almost on the bone), and can also be experienced at the insertion of the patellar tendon onto the shinbone. It is rarely felt in the mid portion of the tendon. Onset wise. This pain comes on with prolonged jumping, bounding and changing direction. In mild to moderate cases, it is felt during the middle of a match, however as this condition worsens, it can come on increasingly earlier during activity. It also often takes time to settle following activity. Once aggravated, the knee can become highly painful when bent for long periods (e.g. sitting in a chair with the knees bent, or- in my case- driving home from basketball!). In moderate to severe cases, if you feel along the tendon- it will often feel thicker and more swollen compared to the unaffected side.
Patellar Tendinopathy / Jumper’s Knee Treatment
Treatment for this condition requires considerable time and effort! And, to the dismay of many athletes, it isn’t as simple as just requiring massage or dry needling! We need proper exercise rehabilitation.
It is best to think of it this way: If you are experiencing pain in this region, your patellar tendon isn’t currently strong enough to cope with the load you are putting through it! This could be due to a few reasons:
- Simply, your quadriceps and patellar tendon are weak and need to be strengthened.
- Your glutes and hamstrings are weak, and as such, increased load is going through your quadriceps and patellar tendon causing it to be overloaded.
- Combination of both.
In addition, compression through the patellar tendon, which occurs if your quadriceps are tight can contribute to this pain as well.
These factors can be assessed by your physiotherapists at Move Physiotherapy Fremantle.
If tightness is your main issue. Start by using your foam roller on your tight muscles for 2-minutes per muscle group, 2x/daily. We recommend foam rolling as opposed to stretching, especially for the quadriceps, as stretching can create further compression along your patellar tendon and therefore exacerbate pain.
If you require strengthening, begin training your weaknesses 3x/weekly in a controlled manner. Throughout your sport, training and rehab, you should never allow your pain to go above a 4/10 level. If this occurs, you are most likely creating further damage in your patellar tendon.
Move Physiotherapy Fremantle are your knee pain experts. If you need guidance for your rehabilitation, book in at Move Physiotherapy Fremantle and begin your rehab journey today.