Team Canada Volleyball physiotherapist Hilary Mallinger breaks down the facts and best ways to treat this common condition affecting many young athletes.
Patellar tendinopathy, or Jumper’s Knee, is pain and inflammation in the patellar tendon, which lies just below the patella, or knee cap. The patellar tendon’s function is to transfer force from the quadriceps muscles to the tibia, causing the knee to extend. Patellar tendinopathy a condition primarily found in young (15-30 years of age) athletes whose sport involves significant jumping. Common sports in which athletes present with this condition include volleyball, basketball, athletics (predominantly jumping events), tennis and football. The demands of these sports involve high loads and a lot of repetitive loading on the patellar tendon, particularly in jumping and landing, but also in quick changes of movement and deceleration. Elite volleyball athletes have an extremely high percentage of Jumper’s Knee; as many as 40-50% will experience this condition.
What causes patellar tendinopathy?
There are several anthropometric (measurements of the human body) factors that contribute to patellar tendinopathy. These factors can include: weight, body mass index, leg length difference, structure of the arch of the foot, strength and range of motion of the quadriceps and hamstrings, as well as vertical jump performance. However, the most common factor that contributes to jumper’s knee is chronic repetitive tendon overload, or poor load management. (For more information on load management, refer to previous articles published on Momentum Volleyball by this author)!
Source: Chrissy Benz, @cb_sportphotography
How can you tell if you have patellar tendinopathy?
If you, your athlete or your child has patellar tendinopathy, signs and symptoms that may be described include:
Pain localized just below patella, or knee cap
Pain in patellar tendon with load-related activities including:
Jumping and landing
Coming down stairs
Squatting and lunging (especially on decline)
Pain in patellar tendon that occurs instantly with loading and usually stops immediately when the load is removed
Pain may improved with repeated loading
How can you manage patellar tendinopathy?
Ensure you or your child works with a physiotherapist who understands the sport and active management of tendinopathies, and have a strength plan from your physiotherapist or strength coach in place. Patellar tendinopathy is best treated used a graduated exercise program, and NOT just with rest! Most importantly, loads need to be increased gradually and managed over the course of a season(s) so as to reduce likelihood or severity of onset of jumper’s knee.
Hilary Mallinger is the team physiotherapist for Volleyball Canada Senior Women’s Indoor National Team. Hilary is the co-owner of Cadence Physiotherapy in Scarborough, Ontario and specializes in sports rehabilitation, particularly overhead, jumping and running sports.
Sources:
Hymann, Garett. “Jumper’s Knee in Volleyball Athlete’s: Advancements in Diagnosis and Treatment.” Current Sports Medicine Reports, vol. 7, iss. 5, 2008, pp. 296-302., https://doi.org/ 10.1249/JSR.0b013e31818709a5
Schwartz, Aaron, et al. “Patellar Tendinopathy.” Sports Health: A Multidisciplinary Approach, vol. 7, no. 5, 2015, pp. 415–420., https://doi.org/10.1177/1941738114568775.
Rees, Johnathon, et al. “Management of Tendinopathy.” The American Journal of Sports Medicine, vol. 37, no. 9, 2009, pp. 1855-1867., https://doi.org/10.1177/0363546508324283