Jumper’s knee

General information

Patellar tendonitis, also known as “jumper’s knee,” is a condition characterized by an inflammatory process at the point where the patellar tendon attaches to the lower edge of the patella. This tendon is characterized by great strength and allows the quadriceps muscle group to straighten the tibia. Therefore, it fulfills a vital role in walking, running, jumping, and other leg activities. Knee pain is the first sign that you need to see a doctor.

The most common traumatic injury in acyclic, high-speed, high-strength sports is patellar ligament tendinitis, or, as it is known, “jumper’s knee.” The specific inflammation associated with overloading when landing after a jump requires a comprehensive approach to treatment and step-by-step physical rehabilitation.

Causes of jumper’s knee

This occupational disease occurs to a greater or lesser extent in 40-50% of athletes involved in track and field, volleyball, basketball, long jump, and high jump. It is associated with extreme, significantly exceeding the body weight load transferred to the patella ligament when landing on a hard surface. The onset of the disease provokes the occurrence of tendinopathy: excessively intense training, often repeated microtraumatization of the patella, lack of appropriate warm-up before sharp exercise, a sudden increase in the volume of loads of traumatic injuries, congenital and acquired pathologies of the knee joint. Insufficient flexibility of the Achilles tendons and quadriceps muscles can also play a role in improper loading on the patellar tendon and the formation of patellar tendinopathy, as well as displacements (knee joint deformity or flat feet).

Symptoms of patellar ligament tendonitis

The most characteristic symptom of “jumper’s knee” is pain. It can be localized in the upper or lower pole of the patella or the area of the tibial tuberosity. When bending the knee, pain sensations increase, and there is an unpleasant feeling of stiffness and tension. In the case of the development of reactive inflammation, the area of the injury becomes red and swollen. At first, the soreness appears only after sports. As the condition worsens, the “starting” pain bothers patientsduring training, when descending or ascending stairs, and after prolonged sitting. Without timely treatment, the symptoms acquire a wavy course that can last for many months and even years. 

Patients suffering from jumper’s knee syndrome. have the following complaints:

• The area of pain and soreness is pinpointed to the injured part of the ligament.
• Localized pain on the anterior and posterior sides of the patella on pressing or palpation.
• Pain and stiffness after exertion.
• Pain on contact with the quadriceps muscles.
• Staying in one static position (sitting or standing) for long periods of time can cause rapid movements.

Stages of Development Tendinitis of the patella ligament develops in 3 stages: 

I – mild; does not affect motor function.

II – moderate; pain during and after physical activity.

III – severe; restricted mobility due to persistent pain.

Diagnosis of jumper’s knee

Consultation with a medical professional (doctor or physical therapist) yields the following results: The injured part of the tendon may have a reduced thickness compared to the unaffected side. Sometimes, a small swelling forms around the area of pain, and sometimes, the medial broad oblique muscle of the thigh is decreased in function. 

Vigorous exercises such as squats and lunges, and especially straightening the knee with force from the maximally flexed position of the injured tibia, can provoke pain.

The disease is diagnosed based on the data of instrumental techniques: 2-projection radiography, ultrasound, and MRI.Magnetic resonance imaging is recognized as a highly effective method of choice, allowing visualization of cartilage and connective tissue of the knee joint. This painless and safe technology assesses the condition and boundaries of the patellar ligament lesion as accurately as possible and reveals dysplastic processes that are not visible on X-ray and ultrasound.

Treatment for jumper’s knee

Two treatment models are recommended: conservative (nonsurgical) and surgical.

Conservative therapy is initially applied after the diagnosis of patellar tendinopathy. The main objective is to avoid overloading. Treatment depends on the degree of injury.

Pathologies of the musculoskeletal system, accompanied by aseptic inflammation of tendons, are in the competence of an orthopedist-traumatologist. In the early stages of the disease, conservative treatment of the jumper’s knee is prescribed. The complex therapeutic measures include medication to relieve inflammation and pain relief, cryotherapy, extracorporeal shockwave therapy, drug electrophoresis, and wearing and orthotics of the knee joint. 

Surgical treatment

Under normal circumstances, it is a last resort. To date, little convincing evidence has been collected to support surgical techniques in the conservative treatment of patellar tendinopathy. Chronic tendinitis accompanied by complete rupture of the patellar ligament requires surgical removal of the altered tissue. Surgery involves excision of the injured area of the tendon or lateral excision, in which small incisions are made on the side of the tendon that takes the load of the middle third. After surgery, an intensive rehabilitation program is usually recommended. In particular, eccentric strengthening exercises can help stimulate recovery.

All these treatment options are available in more than 800 hospitals worldwide (https://doctor.global/results/diseases/jumpers-knee). For example, Arthroscopic jumper’s knee surgery can be performed in these countries for following approximate prices:

Turkey $3.1 K in 26 clinics

Germany $9.0 K in 43 clinics

China $9.7 K in 8 clinics

Israel $11.3 K in 16 clinics

United States $14.1 K in 17 clinics.

Rehabilitation

A physical rehabilitation program is prescribed for maximum recovery and accelerated resumption of training: therapeutic exercises, physiotherapeutic procedures (magnetic, laser therapy), taping, and therapeutic massage. Active sports training is strictly contraindicated until the rehabilitation period is over. 

Consequences and prevention

Lack of full-fledged treatment and failure to comply with the doctor’s recommendations can lead to several serious complications: chronization of the pathological process, rupture of the patella’s ligament, muscle weakness, and inabilityto engage in sports. To avoid the development of jumper’s knee syndrome, it is recommended to gradually increase physical activity, not allow forced overloads, follow the training regimen, making systematic breaks for rest.