Jumpers Knee Patellar Tendinopathy Information

Jumpers Knee Patellar Tendinopathy Information

Patellar tendinopathy, also known as jumper's knee, patellar tendinitis, and Sinding-Larsen-Johansson disease, is a common cause of knee pain in athletes. It’s commonly referred to as jumper’s knee because of all tendinopathies affecting physically mature jumping athletes, patellar tendinopathy accounts for around 20%. However, this is an injury common to an array of sports that don’t involve jumping - from bowling or golf to skateboarding or snowboarding. Furthermore, it can also occur in everyday activities that stress the patella tendon.

 

 

 

Jumpers Knee - Patellar Tendinopathy

 

Anatomy As It Relates To Patellar Tendinopathy

The knee is a hinge joint that allows for flexion and extension of the leg. The tibio-femoral joint is formed where the femur (thigh bone) and tibia bone (shin) connect with each other. The knee joint that is formed by the articulation of the patella (kneecap) and the femur is called the patello-femoral joint. The patella is a small bone in front of the knee that glides back and forth on a grove in the femur bone as the knee is flexed and extended. It helps provide stability as that quadriceps pull the patellar tendon to straighten the knee. The quadriceps start at the hip and extend down the front of the thigh, where they eventually insert into the patellar tendon just under the patella on the tibia bone. The patellar tendon is a thick rope-like band of fibers that extends from the bottom of the patella to the tibia. The above anatomy is essential for jumping motions and landing stability, pedaling motions, and kicking motions.

* Note - there is often confusion from calling the patellar tendon a “tendon.” This is because structures that connect bone to bone, as the patellar tendon does by connecting the patella to the tibia, are usually anatomically classified as ligaments. Tendons usually connect muscle to bone. So, while anatomy books reference the structure connecting the patella to the tibia as the patellar tendon, some may alternatively reference the structure as the patellar ligament.

What Is Patellar Tendinopathy/ Jumper‘s Knee?

Patellar tendinopathy is used to describe two tendon injuries that most often occur together:

1. Tendonitis - inflammation of the tendon.
2. Tendinosis - micro-tears and progressive degradation of the tendon tissues at a cellular level.

Tendonitis and tendinosis may occur together or chronic tendonitis may cause tendinosis. Complete rupture of the patellar tendon may occur if the patellar tendinopathy continues.

What Causes Patellar Tendinopathy/ Jumper’s Knee?

Sports that involve repetitive jumping place a tremendous strain of the patellar tendon. Sports that require sudden changes in direction and any activity that involves repetitive stress or overuse of the knee joint also place a great deal of stress on the patellar tendon. This stress causes inflammation, collagen degeneration, and micro-tears to the tendon tissue.

There are certain factors that often contribute to the development of patellar tendinopathy:

* being overweight
* suddenly increasing the duration or intensity of physical activity
* muscular imbalances in the leg can cause the stronger muscles to pull harder on the patellar tendon
* tightened leg muscles place a greater strain on the patellar tendon
* misalignment of the leg bones (knock-knees or bow-legs) or kneecap (patella alta and balta) can also place undo strain on the patellar tendon

What Are The Symptoms Of Jumper's Knee/ Patellar Tendinopathy?

As a general rule, the symptoms of jumper’s knee in athletics are divided into four progressive stages:

Stage 1: A dull ache or pain between the kneecap and the shinbone that occurs after activity. There usually isn’t any functional impairment of the knee.
Stage 2: Localized pain occurs at the beginning of the activity, subsides during the activity, and then returns at the end of the activity. Function of the knee remains intact.
Stage 3: Localized pain appears at the beginning of the activity and persists long after the activity is completed. Function is limited.
Stage 4: Intense pain is present from the patellar tendon rupturing. The knee is unable to function properly and will be extremely weakened.

 

Strengthening Exercises

These Jumpers Knee - Patellar Tendinopathy Exercises are ideal to build strength and flexibility.

Massage Treatment

These Jumpers Knee - Patellar Tendinopathy Massage Techniques are of great value in pain relief; circulation stimulation; dispersing blood and fluid accumulations; swelling reduction; and relaxing muscle spasms, especially when used alongside the Sinew Therapeutics liniments and soaks.

 

ACUTE STAGE SYMPTOMS AND TREATMENT

 

This stage is characterized by swelling, redness, pain, and possibly a local sensation of heat, indicating inflammation. If coolness makes your pain feel better, then the Acute Stage Treatment is recommended.

 

ACUTE STAGE SYMPTOMS:

 

The acute stage starts the moment an injury occurs and lasts until the swelling and inflammation are gone. The swelling is the result of the blockage of blood, tissue fluids and circulation in the knee because their normal movement has been disrupted by the force of the injury. Just like cars back up behind a traffic jam, causing congestion, exhaust and overheating; blood and fluids back up behind the injured knee, causing pain, inflammation, lumps and swelling.

The sensation of heat is due to the warming action of the blood and fluids overheating in the injured knee as they back up and accumulate. Stiffness and decreased mobility are due to spasms in tendons and ligaments that have contracted reflexively beyond their normal range from the impact of the injury.

As ligaments and tendons stretch and tear, blood from ruptured blood vessels becomes trapped in the local tissues. As the trapped blood clots up, it sticks the tissues together creating adhesions. Adhesions cause pain, inflammation and restricted movement because the layers of tissue that used to slide smoothly across one another now adhere and snap which interferes with normal functioning. It is essential to break up clotted blood as quickly as possible to prevent adhesions and scar tissue from forming.

During the acute stage it is very important to restore normal circulation to the knee, break up clotted blood and stagnant fluids, reduce swelling, and reduce the redness and heat associated with inflammation. By restoring the flow of blood, fluids, and circulation in the knee, then pain is relieved, damaged tissues can regenerate with healthy functional tissue, and the knee can strengthen and regain it's mobility.

 

ACUTE STAGE TREATMENT:

 

1. Apply the Sinew Herbal Ice on your knee to reduce redness, swelling, and inflammation while dispersing accumulated blood and fluids to help restore normal circulation to the knee. This first-aid treatment is used in place of ice to significantly speed up the healing process. It reduces the swelling and inflammation more effectively than ice, allowing you to more quickly regain range of motion. Acute Sinew Liniment can be used in-between applications.

Ice is not recommended because it does not help repair damaged tissues and keeps everything in the injured area frozen, causing the stagnation of blood and fluids and the contraction of muscles, tendons and ligaments. In Chinese sports medicine ice is not used and is considered a culprit in injuries that donít heal well.

2. Massage your knee with Acute Sinew Liniment to relieve pain, reduce swelling and inflammation, break up clotted blood and stagnant fluids, and stimulate circulation of blood and fluids to help cells quickly repair damaged tissues. Sinew Herbal Ice can be used in-between applications.

3. The Sinew Sports Massage Oil is recommended for use before and after exercise, sports and strenuous activity. It warms and stimulates your muscles, increases circulation and relieves tightness, hence improving your performance and helping to prevent injury.

 

 

CHRONIC STAGE SYMPTOMS AND TREATMENT

 

This stage begins once the swelling and inflammation are gone, but you still feel pain, stiffness, weakness, and/or sensitivity in cold and damp weather. If heat makes your pain feel better, then the Chronic Stage Treatment is recommended.


CHRONIC STAGE SYMPTOMS:

 

The chronic stage begins once the swelling and inflammation are gone, but you still feel aching pain and stiffness. This is because there are still accumulations of stagnant blood and fluids in the knee that are blocking circulation and blood supply to damaged tissues, creating residual pain, stiffness and weakness. You may actually feel hard nodules like sand in the tissue, indicating accumulation, calcification, and adhesions, which all cause pain, stiffness, and joint instability.

Your knee may feel more sensitive to the cold and ache in cold and damp weather due to impaired circulation. When you move your knee you may hear a clicking or popping sound from the tendons and ligaments slipping very slightly in and out of their natural alignment indicating weakness and joint instability, causing chronic pain and a cycle of reinjury. These symptoms are often the result of failure to treat the injury properly from the outset and overicing.

Increasing circulation and blood supply to the damaged tissues is very important in treating chronic injuries because tendons and ligaments do not have an extensive direct supply of blood. That is why chronic injuries can be slow to heal. Increasing local circulation also prevents cold and dampness from penetrating the injured area, preventing pain and stiffness.

During the chronic stage it is very important to break up remaining accumulations of blood and fluids, and increase circulation and blood supply to the damaged tissues. By increasing circulation and blood flow in the knee, then pain and stiffness is relieved, and the tendons and ligaments can strengthen to restore stability.


CHRONIC STAGE TREATMENT:

 

1. Massage your knee with Chronic Sinew Liniment to relieve pain and stiffness, strongly stimulate circulation and blood flow to damaged tissues, and promote the healing of overstretched tendons and ligaments. Sinew Injury Poultice and/or the Sinew Warming Soak can be used in-between applications.

2. Apply the Sinew Injury Poultice on your knee to relieve residual pain and stiffness, significantly stimulate circulation and blood flow to damaged tissues, and further promote the healing of overstretched tendons and ligaments. The Sinew Injury Poultice is particularly useful if your knee is more painful in cold and damp weather. Chronic Sinew Liniment and/or the Sinew Warming Soak can be used in-between applications.

3. Soak your knee with the Sinew Warming Soak to ease joint pain, increase range of motion, and strongly increase local circulation to drive coldness and dampness out of damaged tissues. The Sinew Warming Soak is particularly useful if your knee is more painful and sensitive to cold or hurts more in cold weather. The soak can be used by saturating a towel in the liquid and applying it to your knee. Chronic Sinew Liniment and/or the Sinew Injury Poultice can be used in-between applications.

4. The Sinew Sports Massage Oil is recommended for use before and after exercise, sports and strenuous activity. It warms and stimulates your muscles, increases circulation and relieves tightness, hence improving your performance and helping to prevent injury.