Do you find it difficult to run, jump, or do day to day activities because of pain at the front of your knee? You may have patella tendinopathy, aka jumper’s knee. Read on to find out what this means, and what you can do to help yourself!
What is patella tendinopathy?
The knee is made up of many structures, including bones, ligaments, tendons, and muscles. The femur (thigh bone) moves with the tibia (shin bone) and the patella (kneecap) to form the knee joint.
The quadriceps muscle, which helps to straighten the knee, attaches its tendon into the top of the tibia, with the patella sitting in the middle of the tendon. Although technically a ligament, the patella tendon is a common area for tendinopathy to occur.
Originally called tendonitis due to the belief that the tendon was inflamed, it is now referred to as tendinopathy or tendinosis, which is an overuse injury. This occurs as a result of repeated overuse and overstressing of the patella tendon, which is common in jumping sports such as volleyball and basketball – hence the nickname “Jumper’s knee”
How does Jumper’s knee feel?
- Pain in the front of the knee, generally below the kneecap
- Localised pain when pushing right over the tendon
- Pain increases with jumping, landing, or running activities
- Can have pain with prolonged sitting
- Most commonly an achy pain
- Pain tends to come on gradually and can persist after activity
- Commonly related to an increase in a sports activity
- Can feel stiff first thing in the morning
- Image reference from:
What causes it?
When we load our tendons through exercise, a mild form of strain or “microdamage” occurs, which our body responds to by making more collagen fibres to strengthen the tendon and promote healing – this is a normal and healthy physiological response.
However, when the amount of tissue damage occurring begins to outdo the healing ability of the body, the connective tissue in the tendons becomes disorganised. This is what we consider a tendinopathy.
Tendons are really strong when they are being pulled longways, but they don’t cope as well when being squashed sideways. When we over bend our knees, the tendon wraps around the front of the knee and pressure ends up being pushed into the side of the tendon and it gets a bit compressed in this position. Overworking the tendon in this position such as jumping and running can contribute to the development of tendinopathy.
- Some risk factors involved in developing Jumper’s knee include:
- Increased BMI
- Increased cholesterol levels
- Reduced health of the tissues (may be associated with smoking, diabetes)
- Poor jumping/running/landing techniques
- Activity on hard or sloped surfaces
- Increase in frequency or intensity of exercise levels
- Lack of adequate rest for tissue healing to occur
What can I do?
Tendons respond best to load and being worked, so the best way to rehab it and get a healing change is to actually work the tendon. In the same breath, tendinopathies are an overuse injury, so they also need time to heal and recover. Essentially, there needs to be a balance between loading (damage) and resting (healing).
Tendons actually take a bit longer to heal than muscles do, so after you have worked your patella tendon with loading exercises, you really need about 2-3 days before fully loading it again in order for it to reach its peak level of healing. We still want you to remain active and healthy, but you do need to pencil in recovery days!
This might mean that you need to adjust the amount of exercise that you are doing; e.g reducing the distance that you are running from day to day, or leaving a day or two between leg workouts to allow for that peak healing to occur.
It’s also important to eat well, drink plenty of water, and regularly get good sleep! Although these are basic lifestyle factors, they are important factors in our body’s ability to heal.
If you think you might have Jumper’s knee and would like to consult with one of our osteopaths for personalised advice, you can book online here: https://www.bodywellhealthcare.com.au/book-online/
Disclaimer: This blog is for educational purposes and not for diagnosis. If you do suffer from knee pain, please visit your primary healthcare provider for a proper evaluation, diagnosis, and personalised management.