JUMPING KNEE
What is a jumping knee?
Various medical terms for jumping knee are, for example, patellar tendon dinosaur, patellar tendon dininopathy or apiciitis. On the front thigh is the large muscle group quadriceps. The tendons from its four muscles come together in a strong tendon, in which the patella is baked in the middle. The tendon then attaches high up on the lower leg, tibia. Jumping knee is an overload injury in this tendon, the patellar tendon. Small stretch marks occur, usually in the transition between the patella and the tendon at the lower edge of the patella. This can also occur at the upper edge of the kneecap, but is far from as common.
Why do you get a jumping knee?
It is common to get this in sports that include a lot of jumping, start-stops and sudden changes of direction, such as basketball, volleyball, football. Can also occur in people who start with running training too intensively. However, it is most common that it affects people who play sports at a high level. Our physiotherapists look at internal and external factors that may be the cause of this injury.
Examples of internal factors are:
Foot position, a pronation (flat foot) can contribute to this problem.
Insufficient strength in the legs, especially in the front of the thigh, in relation to the activity the person performs.
The quality of the patella tendon
Examples of external factors are:
Too sharp increase in intensity or duration of an activity.
Too little rest (in this case the patellar tendon) between training sessions.
Change of surface on which the activity is performed.
Running technique with potential for improvement.
Symptoms we jump knee?
Pain locally front knee, especially at the lower edge of the patella. Some may have more pain and feel increased stiffness in the tendon in the morning or if you have sat with a bent knee for a long time. A number of different classifications have been made, to try to grade the extent of the injury in the jumping knee. Here is an example:
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Grade 1 - Pain after activity.
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Grade 2 - Pain comes at the beginning of an activity and, ceases when you get warm in the knee, but returns after the end of training.
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Grade 3a - The pain is now there when warming up, during the activity and afterwards. At this level, one can continue practicing unchanged.
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Grade 3b - The same symptoms as in grade 3, but now you can no longer continue exercising at the same level as before the onset of pain. Here you often have rest pains in the area.
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Grade 4 - The tendon goes off, ruptures.
Ultrasound diagnostics gives us a clear picture of how affected the tendon is, which gives the physiotherapist valuable information about how tough he / she can be initially in the rehabilitation training.
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How are jumping knees treated?
During part of the rehabilitation, the patient should refrain from the activity that was the basis for the injury. The purpose of the rehabilitation is to bring about a healing in the tendon and gradually increase the load in the training to increase the load tolerance in the patellar tendon. We at Alta Vita physiotherapy often treat this diagnosis with a combination of shock wave therapy and eccentric training. The shock wave treatment to speed up the healing of the tendon.
Eccentric training means that the focus is on the braking phase of a loaded movement, ie the part of the movement when the muscle works during extension. In this phase of the movement, we have about 40% more power compared to when the muscle works during extension, concentric phase . Rehabilitation training starts at a level that does not trigger increased pain in the tendon and gradually increases to become a real strain on the tendon, in order for it to withstand the activity the patient wishes to perform.
If the injury is extensive and the patient intends to return to late-loading activity, such as high jump, long jump, volleyball, surgery may in some cases be necessary.
