CARING FOR ATHLETES
Jumper’s Knee
It is not uncommon for athletes who participate in basketball, long and high jump, and triple jump to complain of a condition involving pain localized to the front of their knee. This condition is frequently referred to as “jumper’s knee” and is usually more common at the very beginning or the very end of the basketball or track seasons. Most commonly, the athlete complains of localized pain and tenderness in the area directly above the top portion or directly below the bottom portion of the kneecap. It is at these vulnerable areas the major thigh muscle attaches to the kneecap and lower leg. Sports medicine specialists diagnose this condition to be patellar tendonitis or quadriceps tendonitis.
Jumper’s knee is believed to be the result of repetitive trauma to the tendinous attachments to the kneecap. When an athlete is out of condition and begins a new basketball or track season, he or she may develop painful symptoms. Also, due to longer playing seasons and increased intensity in daily participation, the tendon may become inflamed from overuse during the latter part of the season. Microtrauma and microtearing of tendinous tissue about the kneecap occurs with excessive jumping, where one’s body weight creates tremendous forces. Other predisposing athletic endeavors include performing squatting exercises, such as catching in baseball or squatting during weight lifting. Malalignment of the knee cap due to excessive foot pronation or congenital leg bone malalignment may also be causative factors, whereby creating undue stress on the kneecap’s tendinous tissue.
The process of microtrauma to the kneecap’s tendons may be progressive in nature if the athlete continues to play. However, should the athlete decrease the intensity level or amount of time of participation, the symptoms should decrease.
The athlete with jumper’s knee will always experience pain but may or may not experience swelling. Occasionally the athlete will experience weakness in the quadriceps, accompanied by a catching or giving away sensation about the knee. X-ray examination usually reveals little information regarding diagnosing this condition.
Treatment of jumper’s knee is conservative. When possible, the athlete should decrease the level and intensity of participation. Simply stated, any activity that increases the painful symptoms should be eliminated. Conservative physical therapeutic measures, to include whirlpool, ultrasound, electrical stimulation, followed by ice message provide symptomatic relief. Physical therapy ultrasound and electrical stimulation may be applied with topographical hydrocortisone in a safe noninvasive matter in an effort to decrease localized inflammation.
Most importantly the athlete should be biomechanically evaluated in an effort to identify any predisposing anatomical cause of jumper’s knee. Frequently the athlete is found to have a malpositioned kneecap resulting from excessive foot pronation or poor leg bone alignment. These malalignment conditions are successfully treated with; the donning of in-shoe orthotic inserts with complementary stretching and strengthening exercises. Frequently a neoprene knee support specifically designed to stabilize the kneecap and remove patellar tendon stress may be prescribed.