A blog by runners. For runners.

Anyone Can Develop "Jumper's Knee"

Dr. Nace is our running injuries guest blogger. He blogs twice a month on common running injuries, and also takes questions from readers. This month his injury spotlight is on “jumper's knee.” If you have a question you'd like to ask Dr. Nace, or an injury you'd like to suggest he cover, click “Ask the Doctor” at the bottom of the page.


As a follow up to my post on “runner's knee” last month, I thought I'd touch on “jumper's knee” because they have seemingly similar symptoms. “Jumper's knee” is not limited to people who play basketball or volleyball, it can happen to anyone, but those who frequently jump are more prone to this condition.

Symptoms of Patellar Tendonitis, otherwise known as “Jumper's Knee”

  • Pain at the bottom of the kneecap
  • Difficulty straightening the knee
  • Unstable feeling when standing for prolonged periods of time

The patellar tendon attaches your shin to your kneecap and this allows your leg to straighten and bend. Patellar Tendinitis or “jumper's knee” occurs when there is pain in the inferior patellar region, below the kneecap instead of behind it like in “runner's knee.” Fibers of the tendons can become inflamed and over time they can become damaged. This damage to the fibers is called tendonitis and if left untreated, it can result in micro-tearing, which can ultimately lead to Tendinopathy. Tendinopathy is caused by long-term overuse that results in deterioration of the tendon without any associated inflammation.

Causes:

Much like “runner's knee” the primary causes for “jumper's knee” are overuse and muscular imbalance.

Generally, individuals who do 'too much too soon' when they begin new workout regimens or dramatically increase the intensity or amount of activity tend to experience symptoms related to this condition. Doing 'too much too soon' dramatically elevates your chances for injury. I have seen this occur more frequently with patients that take up plyometrics or some cross-fit workouts that involve jumping to supplement their normal running routines.

Again, like “runner's knee,” muscular imbalance can compromise overall muscular stability and a system of compensatory movements allow weaker muscles to piggyback onto the stronger groups. For example, if your hamstrings are weaker than your quads, your body will find a way to temporarily adjust to maintain fluid movements and this might result in injury.

Treatment Options:

  • Stretch, stretch, and stretch… An emphasis on stretching quadriceps is important for protecting yourself from “jumper's knee.” DO NOT BOUNCE when stretching, it will exacerbate the injury.
  • Do not train or play through the pain. Rest when needed and get ahead of the pain by taking Tylenol or other OTC pain relievers as needed if medically able.
  • Adjust training regimens and strengthen muscle groups equally.
  • Look into getting a patella strap. It increases the mechanics of the knee and promotes controlled movements. It also encourages people to be more aware of their knee issues.
    Note: This is not intended for use in treatment of “runner's knee.”

  • Iontophoresis  a technique used by physical therapists whereby electronic stimulation is used to drive ions and anti-inflammatory medicine directly into the tendon.

In the past, patients have asked about Cortico Steroid Injections but I always advise against it because it can weaken the tendon.

Pain that persists for more than two weeks after attempting the options included above means it is time to visit your physician. If you can extend your knee but experience pain than you might have “jumper's knee.” If you cannot extend your knee due to the level of pain, you may have a more serious problem like a torn tendon. Not a lot of imaging can be done but Ultrasounds or MRIs are the best options available and typically surgery is not needed.

Running Injuries

Dr. James Nace, MD

James Nace, MD is an orthopedic surgeon-joint replacement and doctor of general orthopedics specializing in hip, knee and shoulder joint preservation and reconstruction. He practices out of the Rubin Institute for Advanced Orthopedics at Sinai Hospital of Baltimore, Maryland. Throughout his career as a physical therapist and orthopedic surgeon, Nace has gained the most satisfaction from treating runners and all types of athletes for their injuries and helping get them back to training and competing.

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