PTS Blog: 3 ways to manage knee pain

3 Ways to Manage Jumper’s Knee

Patellar Tendon Pain Jumpers Knee

Patellar tendon pain (often called “jumper’s knee”) is a common injury affecting an estimated 40% of athletes in sports which require frequent jumping and landing.1 Many people are tempted to try to manage the pain on their own, but there are several reasons why working with a therapist can facilitate better results and avoid  a frustrating cycle of recurrence.

Here are a few tips to help you through this process (and a glimpse of why getting professional help is strongly advised):

1) Throw out the RICE.

There are three stages of patellar tendon pathologies and each responds differently to management strategies.2 Despite this, all tendon injuries require stress to allow for appropriate repair. The classic model of rest, ice, compression, and elevation (R.I.C.E.) following acute injuries has fallen out of favor. While protecting injured tissue is important, prolonged rest can be harmful and produce adverse changes within the tendon structure.3 To reflect this knowledge, R.I.C.E has been updated to P.O.L.I.C.E. (protection, optimal loading, ice, compression, elevation).4

2) The dosage makes the poison

Providing enough stress to stimulate desired change,  without irritating the sensitive tissue, is difficult and requires strong knowledge of how various activities affect the tendon. Finding optimal load is not as simple as changing the weight during your exercises. There are many factors which influence the ultimate stress experienced by the tendon, and this stress significantly impacts  long term pain and functionality.5 A therapist can guide you through this process and help you to get the dosage right.

3) Don’t change your tires without checking the alignment.

You cannot forget to examine the rest of your body. Recent evidence suggests that strength and range of motion limitations at joints above and below the knee may contribute to the risk of developing tendon injuries.6,7 Prior injuries and imbalanced training programs may influence your ankle and hip movement patterns during activities in subtle yet important ways. If these factors remain unaddressed, the patellar tendon is still susceptible to injury. A comprehensive evaluation can help eliminate perpetuating variables and limit the likelihood of future issues.

 

ABOUT THE AUTHOR

Jason Eure, PT, DPT

Jason Eure, PT, DPT obtained his Bachelor’s Degree in Human Nutrition, Food, and Exercise from Virginia Tech in 2011. Upon completion, Jason earned his Doctor of Physical Therapy degree in 2013 from the University of St. Augustine where he graduated with high honors and was awarded the Stanley Paris and Catherine Patla Award for Excellence in Manual Therapy.

Jason practices full time as a clinician in outpatient orthopaedics and acts as an instructor for the Evidence Informed Practice I course through the University of St. Augustine. Jason prides himself on his ability to stay up to date with current evidence and his ability to translate these concepts into the clinical environment.

Jason has an extensive background working with athletes in both rehabilitative and performance roles, as Jason formerly worked with the strength and conditioning staffs at both the University of Richmond and Virginia Tech. By combining best evidence in each respective field, Jason specializes in late-stage rehabilitation and return to sport for athletes.

 


ARTICLE RESOURCES

  1. Rutland M, O’Connell D, Brismée J-M, Sizer P, Apte G, O’Connell J. Evidence-supported rehabilitation of patellar tendinopathy. North American Journal of Sports Physical Therapy : NAJSPT. 2010;5(3):166-178.
  2. Cook J, Rio E, Purdam C, Docking S. Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research?. Br J Sports Med. 2016;50(19):1187-1191. doi:10.1136/bjsports-2015-095422.
  3. Frizziero A, Salamanna F, Della Bella E et al. The Role of Detraining in Tendon Mechanobiology. Front Aging Neurosci. 2016;8. doi:10.3389/fnagi.2016.00043.
  4. Bleakley C, Glasgow P, MacAuley D. PRICE needs updating, should we call the POLICE?. Br J Sports Med. 2011;46(4):220-221. doi:10.1136/bjsports-2011-090297.
  5. Glasgow P, Phillips N, Bleakley C Optimal loading: key variables and mechanisms Br J Sports Med Published Online First: 06 January 2015. doi: 10.1136/bjsports-2014-094443
  6. Backman L, Danielson P. Low Range of Ankle Dorsiflexion Predisposes for Patellar Tendinopathy in Junior Elite Basketball Players. Am J Sports Med. 2011;39(12):2626-2633. doi:10.1177/0363546511420552.
  7. Silva R, Ferreira A, Nakagawa T, Santos J, Serrão F. Rehabilitation of Patellar Tendinopathy Using Hip Extensor Strengthening and Landing-Strategy Modification: Case Report With 6-Month Follow-up. Journal of Orthopaedic & Sports Physical Therapy. 2015;45(11):899-909. doi:10.2519/jospt.2015.6242.