How in the world did the term "jumpers knee" evolve?
Hmmm... lets see now. Because you jump a lot?
You are indeed a genius!
But that's not the only cause of this very common chronic overuse injury/condition.
We are in the final weeks of the winter sports season and some of the kids, particularly in the sport of basketball, have been battling volleyball drills knee for a few weeks while others have been battling it for a few years!
Years?
Absolutely! I see more chronic patella tendinitis (which is a more medically correct term for jumpers knee) in today's athletes than ever. As a matter of fact I don't remember anyone having this condition back in the day. I'm sure some kids had a bout or two with this but very few and not to the extend I see in today's athletes.
So what does jumping have to do with it?
Well, if you look at the very powerful quadriceps muscle group you'll notice that they insert into the proximal or top part of the patella or knee cap. At the distal or bottom part of the patella is where the true patella tendon begins. This patella tendon travels distally and inserts into the tibial tuberosity, that boney bump at the top and front of your tibia or shin bone. If you've ever had Osgood Schlatters disease as a kid you know exactly where this boney landmark is.
When the quadriceps forcefully contract they generate a considerable amount of force that runs down through the patella, patella tendon, and to volleyball drills insertion on the proximal tibia to extend the lower leg and allow jumping to occur.
Obviously in the "court sports", basketball and volleyball in particular, the amount of jumping is never ending. These activities also require considerable lateral movement which requires a constant stance of knees flexed and butt down. This ongoing "good stance" further places significant stress on these jumping components.
Another common cause of this condition that I frequently see is in weight training kids that do a lot of deep squats, power cleans, and clean and jerk lifts. Jumpers knee isn't just for jumpers anymore. The overload power lifting often seen in off season football weight training has it's fair share of cases also.
So does the whole patella tendon hurt?
I suppose it can. But far and away the largest site of jumpers knee pain is at the top of the patella tendon, at it's origin into the distal apex of the patella. And it is painful, debilitating, and very difficult to resolve through conservative treatments. I'm especially referring to kids that have chronic, long term symptoms for 1-3 years and have tried seemingly everything to get rid of it. And nothing seems to work.
So what kind of treatment does "everything" consist of?
First of all, giving advise on any injury or condition, you always have to start by seeing your local physician or physician of your choice first (if your insurance allows!). But please be advised that some of these physicians don't understand jumpers knee/patella tendinitis from a bad case of hemorrhoids and care about as much. They're simply going to give you prescription of drugs and hopefully, a prescription to a reputable Physical Therapist or Athletic Trainer. Do your homework on the therapist part prior to seeing the physician so you can assist in recommending the prescription.
Modify your activity level! This has to happen if you ever expect to get over anything! This doesn't necessarily mean completely stopping what you're doing but you must identify the specific activities that are causing you the pain and eliminate them from your daily routine. Competitors hate this but you're beating a dead horse otherwise.
Ice massage- 2, 3, 4, 5...... times per day 10-12 minutes each time. Get yourself some 7 oz. paper cups, fill them about full of water, and slap them in your freezer. Take one out of the freezer, peel the paper away from the top of the cup exposing a nice round piece of ice, and massage it the length of the patellar tendon. Very simple!
Cross Fiber Massage- this can be beneficial for reducing the amount of scar tissue forming at this stress site but will probably have limited benefits if your condition becomes overly chronic and long term.
NSAID's (Non-Steroidal Anti-Inflammatory Drugs)- Over the counter Ibuprofen or Aleve. Your physician can prescribe stronger ones. I'm of the opinion that these medications, prescribed or OTC, should be used sparingly and primarily in a recovery process. Taking these substances just to get through another practice or workout is absolutely the wrong approach. You need to reassess your course of treatment if that's the case. I use certain prescribed anti-inflammatory medications for kids in need for what I call "spot duty" which is to help them perform as best they can toward the end of long and grinding seasons. But this is short term use, not long term. Always consult your physician regarding NSAID usage.
Ultrasound and/or Iontophoresis Treatments- These modalities can be of assistance but limited in my opinion particularly when this condition becomes long term chronic. It's safe to say that not a whole lot helps once you reach that level of inflammation with never ending physical activity.
Patella Tendon Straps- They seem to help some individuals and are simply fashion statements for others. Again, it's difficult to effectively overcome chronic inflammation without rest.
How About Surgery?
I believe surgery is a viable option for individuals that have battled this condition over a period of 2-3 years (or less) and have faithfully tried every conservative treatment to the best of their abilities. But I would caution you to find an orthopedist that has a proven track record of performing this procedure with positive results for the majority of his/her patients. No one bats a thousand but their record needs to show overwhelmingly positive results. It's not at all a complicated or largely invasive procedure but I've seen a few surgeries on some kids with chronic jumpers knee that shouldn't have been done. A least not the way they were done by orthopedists that clearly were "practicing". So again, do your homework!
So what is the best way to prevent jumpers knee?
Again, you must modify your activity level first and foremost to a comfortable level if you're going to overcome any overuse chronic inflammation problem but especially so with jumpers knee. Many of the kids I see with this condition have abused it for so long they have reached a point where conservative treatments simply have little if any positive results so they are often faced with the prospect of surgical intervention in hopes of attaining any meaningful results. Young kids in a growth spurt are going to be highly susceptible to overuse problems so exercise progressions and modifications are critical prevention components.
Proper pre-participation warm-up is crucial. The body needs to MOVE for 12-15 minutes to increase the core temperature and begin an efficient blood flow to the working muscles prior to any exercise regime but this is often neglected. Yes, a good 15 minute stretching program needs to take place after the warmup and at the end of vigorous activity during cooldown. There seems to be a growing opinion by some athletic individuals that stretching is a waist of time. I find this theory to be more prevalent in individuals and coaches that are too lazy to either warmup or cooldown. Overall flexibility in many of our nations youth is horrendous! So obviously I don't subscribe to the no stretch hypothesis.
Lastly, simply don't let chronic jumpers knee become chronic, especially in young teenage kids that are growing. The body does a great job of taking care of itself if you decide to take care of it. And do it earlier not later.
Help a kids' jumpers knee today! It's a Win! Win!
Ike
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