Jumper’s Knee or Patellar Tendinitis
What Happens:
- Inflammation of the patellar tendon, most commonly occurring at the tenoperiosteal junction inferior to the patella.
- The patellar tend0n is the tendon of the four quadriceps muscles ( rectus femoris, vastus lateralis, vastus intermedius, and vastus medialis) and is very strong.
- Quadriceps tendon usually refers to the portion proximal to the patella and crossing the patella
- Patellar ligament /tendon is usually used to refer to the portion inferior to the patella to its insertion at the tibial tuberosity
- The patella helps extend the leg.
Patellar Tendonitis/ Jumper’s Knee Massage:
CAUSES:
- Overuse injuries: particularly in running or jumping on hard surfaces ( ie. Basketball and volleyball)
- Improper warm up causing tight quadriceps muscles which puts a strain on the tendon
- Structural misalignment at the hip, knee, or ankle
- Cumulative microtrauma ( repetitive strain)
- A rapid increase in the frequency and or intensity of training
- Poor base strength of the quad muscles or imbalance in the quads
- Raised knee cap:” patella alta” ( higher on the knee): creates more strain on the tendon
Patellar Tendonitis/ Jumper’s Knee Massage:
SIGNS AND SYMPTOMS:
- Insidious onset of pain, aching and tenderness, usually just below the patella
- Pain increases with activity and decreases with rest
- Pain on climbing stairs or hills, and with kneeling
- Pain may be sharp and infrequent at first but develop into a dull constant ache (difficulty sleeping)
- Pain with arising from a chair or squatting position
- Possible sweating
- Patient may walk with a limp or toe walk ( antalgic gait)
Patellar Tendonitis/ Jumper’s Knee Massage:
OBSERVATION, PALPATION AND TESTS:
- Pain on palpation
- Pain on stretching ( prone: heel to buttocks quad stretch)
- Pain on resisted action : patient seated with knee flexed, patient straightens against therapists resistance
- Pain with squatting
- Try testing immediately after the activity that causes pain
- Full AF ROM or slight reduction at the end range
- Full PR ROM or slight reduction at the end range
3 tools to use to confirm a tendonitis:
- Resistance: reproduces pain
- Extreme stretch: reproduces pain
- Palpation: reproduces pain
Patellar Tendonitis/ Jumper’s Knee Massage:
MASSAGE THERAPY TREATMENT:
- Massage helps in the healing process by increasing circulation, decreasing tightness in adjacent muscles and increasing flexibility and strength.
- Massage the patellar tendon with XFF ( only in chronic), quadriceps, gastrocs, TFL, ITB, hamstrings, glutes
- Treat trigger points in the quads, gastrocs, TFL, ITB, hamstrings and gluteal muscles
- Note: During the acute stage, be sure to treat only proximally; no onsite or distal. May put ice on patellar tendon.
Patellar Tendonitis/ Jumper’s Knee Massage:
SELF CARE:
- Rest from the painful activities
- Stretch quadriceps, hamstrings, and calves prior to activity
- Ice massage
- Strapping ( tensor bandages) or taping
- Adjust body mechanics ( learn proper take off and landing techniques)
