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Wimbledon Clinics
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May 12, 2017

Jumper's Knee

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Sports that involve a lot of impact, jumping turning, changes of direction and impact such as running, football, and skiing, carry a particularly high risk of knee injuries. One of the most common, but misunderstood by patients knee injuries is jumper’s knee.

What is jumper’s knee?

Jumper’s knee is a term used to describe patella tendinopathy.

This is a common chronic injury, usually seen in athletes and caused by repetitive strain from running or jumping.

What causes Jumper’s knee?

The knee and in particular the patella tendon experiences the greatest level of stress with jumping and landing activities. 

In order to jump, the quadriceps muscles quickly contract, which straightens the knee and pushes you into the air. Vice versa when landing, the quadriceps muscle contracts to absorb the landing forces.

 

Often initial damage may be relatively minor and not cause any problem. However, with insufficient rest and recovery, lesions (small tears) may occur in the tendon and with further excessive exercise the damage can exceed the rate of repair. This causes the lesions to become progressively worse, often inflicting pain and dysfunction. Without rest and treatment, the result is a serious tendon injury or patella tendinopathy).

There are 3 key factors which can cause patella tendinopathy:

  1. A sudden increase in training intensity and volume
  2. Poor lower limb flexibility
  3. Poor lower limb biomechanics

Tendon injuries occur in three key areas.

  • Where the tendon joins the muscle (musculotendinous junction),
  • In the middle of the tendon or mid-tendon (non-insertional tendinopathy), or
  • Where the tendon connects with the bone (tendon insertion).

Patella tendinopathy, should be specifically distinguished from patella tendonitis (tendinitis) as this condition indicates an acute inflammation of the tendon as opposed to actual tendon damage caused by the degeneration of the tendon.

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 The symptoms of jumper’s knee

Jumper’s knee may start as just a niggling injury and many athletes continue to train and compete on it as it doesn’t seem debilitating. However, not paying attention to your knees could result in servere damage.

Patients will often feel pain especially in the front part of the knee and at the bottom part of the kneecap. Stiffness, and loss of strength in the knee joint.

 

The pain usually occurs after exercising, especially when you try to contract the quadriceps muscles. You may have more pain and stiffness during the night or when you get up in the morning. In some instances the front of your knee may be tender, red, warm, or inflammed, and some patients can hear a crunchy sound or clicking feeling when when bending thier leg.

 

Jumper’s Knee is normally assessed against 4 tendinopathy phases.

Stage I: Reactive Tendinopathy - Pain may occur after sports activity but this is normal tissue adaptation and improves joint strength if enough recovery is allowed.

Stage II: Tendon Disrepair - The tendon tissue is attempting to heal. The patient has pain both during and after activity but is still able to participate in the sport satisfactorily. The pain may be severe enough to interfere with sleep.

Stage III: Degenerative Tendinopathy  - The tendon cells are dying. The patient's pain is sustained, and sport’s performance is affected.

Stage IV:  Tendon Tear or Rupture – Acute  pain and complete loss of knee function and often surgery is the only option.

More about preventing jumper’s knee and knee injury prevention in general can be found on this site http://www.wimbledonclinics.co.uk/injury-prevention-screening-programme

 

What are the treatment options for jumper’s knee?

Basic treatment approach (Stage I & II)

The treatment of jumper's knee is specific to the degree of the injury.

The early stages are often treated as any injury, using the PRICE method: Protect, Rest, Ice, Compress, Elevate, with the addition of various eccentric strengthening exercises for rehabilitating the knee. 

At stage III, the above treatment should be continued, along with ceasing all activity that puts any starin in the knee. Rest should be considered for an extended period, such as 3 to 6 weeks. Additonally, it may be advisably to wear a knee support

 

Injections (Stage III)

Jumper’s knee can be managed through injectable treatments.

PRP – is blood plasma, enriched with a higher concentration of platelets and used to relieve pain and kick start the healing process. Click here to find out more about PRP http://www.wimbledonclinics.co.uk/blog/prp-magic-or-myth-can-it-really-help-your-knee

Sclerosing Injections - Sclerosis, the act of injecting a chemical irritant (e.g. polidocanol) into the tendon, it is thought inhibit nerves, thus reducing pain significantly.

Aprotinin Injections - Aprotinin is a protein which inhibits the enzyme ‘metalloprotease’ that breaks down protein which makes up tendon tissue and helps the tendon recover faster.

 

Physiotherapy: Rehabilitation can help most cases but the treatment may take months.

 

Surgical approach? (Stage IV)

A surgical approach is needed for severe cases (Stage IV) of jumper’s knee.

The need for surgery and the type of surgery to be performed vary depending on the case of the patient. Usually, surgery is only performed if all conservative treatment options fail.

Surgical methods for treating jumper’s knee have a success rate of approximately 80%. Those who undergone surgery and continue with physiotherapy can return to their sports at their previous performance level. However, giving ample time for the injured knee to recover is critical, often a delay of 6 to 12 months before returning to sports activity should be expected.

 

Consult a knee specialist

If you think you may have a knee injury and need advice and specialist treatment, then contact us today and we’ll put together a clear strategy for treatment and recovery, so you can be back to your best as soon as possible.

Call us on: 0208 944 0665 or email us at: info@wimbledonclinics.co.uk

 

For more information about knee injury and the benefits of consulting a knee specialist, click here http://www.wimbledonclinics.co.uk/knee-clinic/

 

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