INTRODUCTION
Jumper’s knee is a condition that causes activity related ‘front of knee’ pain. It is generally more common in people involved in jumping sports such as basketball or volleyball where the pain occurs during the landing phase of the jump. However, it can also affect non-athletes who experience pain when going down stairs and with prolonged sitting.
ANATOMY
The medical terminology for jumper’s knee is patellar tendonosis. The patella tendon is a strip of soft tissue that connects the kneecap to top of the leg bone (tibia). Jumper’s knee occurs when the tendon just below the kneecap is injured.
DIAGNOSIS
People with jumper’s knee often describe an insidious onset of pain at lower tip of the kneecap which is made worse with landing after a jump or when going down stairs or with prolonged sitting. There is usually tenderness when palpating the lower tip of the kneecap.
INVESTIGATIONS
An ultrasound or MRI scan may be performed to confirm the diagnosis of Jumper’s knee.
TREATMENT
There are many treatment options for jumper’s knee ranging from pain relief to attempts at healing depending on the acuity and severity of the condition.
Pain Relief
- Ice – useful for acute pain
- Medications – Paracetamol and non-steroidal anti-inflammatory (e.g. Ibuprofen)
- Acupuncture
Exercises
Eccentric ‘knee drop’ exercises should be performed at least daily to mechanically load the tendon and provide a direction for the fibres to heal. This is often done on a shallow decline to increase the load the patellar tendon. Ask your sports medicine practitioner to show you how to perform these exercises.
Activity Modification
Patients with patellar tendonosis may have to reduce or even completely cease the aggravating activity to adequately rest the injured tendon. In the meantime, other non-impact activities such as cycling, swimming or use of the aerobic cross trainer may be undertaken to maintain cardiovascular fitness.
Biomechanics
A flat foot, high arches or feet that roll in excessively may worsen jumper’s knee. It may be worth considering a pair of insoles or orthotics to help correct any abnormal foot biomechanics.
GTN Patches
Tendon injuries have a slow recovery time because they have a poor blood supply. Recent studies have shown that low dose GTN patches (usually used in patients with coronary heart disease) can help improve jumper’s knee.
Injections
A cortisone injection may provide short to medium term pain relief. Autologous blood and PRP injections are being more frequently used in the treatment of jumper’s knee. This involves the injection of the patient’s own blood into the patellar tendon insertion.
Surgery
A small percentage of patients may require surgery for chronic and severe intractable pain.