Patellar Tendonitis/ Jumper’s Knee Massage

jumpers-knee-massageJumper’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:

  1. Resistance: reproduces pain
  2. Extreme stretch: reproduces pain
  3. 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)
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