Pain, pain, go away, come again another day, I want to jump again, pain, pain, go away!
So you used to be able to jump higher and further. Now there is an annoying pain at the front of your knee which doesn’t seem to go away?
Feeling troubled about the pain at the front of your knee? Here are some ways to figure out what it could be and how Physiotherapy can help!
Pain in the front of knee?
To start off, let’s look at some key structures around the knee that are involved when jumping. As seen from the picture, the patellar tendon is a structure which joins your kneecap (known as the patella) to your shin bone. It stores energy and helps transmit forces and loads from muscle to bone.
During activities such as jumping or changing direction, the patellar tendon is repeatedly subjected to high impact loads.
This can cause overloading at your tendon, leading to pain experienced at the front of your knee. An increase in training load or volume, or how much your knee is bent during weight-bearing activities could also potentially overload the structures in your knee.
How do I know if the pain is coming from my tendon?
Patellar tendon problems can be associated with pain experienced at the front of the knee with explosive type activities (i.e. jumping and downhill running).
There are three main determining factors for patellar tendon pain — also known as ‘Patellar Tendinopathy’ or ‘jumper’s knee’:
- Your knee pain occurs at the start of your activity, settles after warm-up, and returns after activity;
- You have tenderness (that’s a big word for pain) just at the bottom of your kneecap;
- And the pain remains concentrated (usually at the bottom of your kneecap) at rest and during loading.
Your Physiotherapists will perform a battery of tests to determine whether the pain is coming from your patellar tendon or the structures surrounding the patella, or any other potential contributing factors to your pain. Of course, this will take place after obtaining a detailed history about what you might have done right; or in this case, wrong.
What are some exercises to improve patella tendon pain?
Inappropriate landing, running or jumping techniques can result in unequal and excessive loads on your patellar tendon. Biomechanical deficits such as instability and lack of foot and ankle range of motion, or weakness in your hips, may also contribute to the pain you are experiencing.
Your Physiotherapists can help to address the above factors to help improve loading at your knee, as well as the other factors that may be contributing to your patella tendon pain.
Your Physiotherapist will also provide you with a treatment plan for patellar tendinopathy. Exercises will target mainly your lower extremity muscles — crucial in reducing forces on the patellar tendon during impact and landing!
Here is an overview of what your rehabilitation process may look like:
Stage 1
You will begin with isometric exercises (i.e. muscle contraction without joint movement). This helps to allow your pain to settle while still continuing to load your tendon at a lower load.
Wall Sits
Isometric Knee Extension
Stage 2
Once your pain has improved, your Physiotherapist will introduce strengthening exercises aimed at progressively increasing the load on your tendon. This will include isotonic exercises (i.e. muscle contraction with joint movement).
Isotonic Knee Extension
Weighted Split Squats
Stage 3
With adequate muscle strength, you can then progress on to energy storage exercises. These exercises will place high loads on your tendon, thus you should begin at a low level and progress gradually, depending on your functional goals.
Box Jump
Split Squats Jump
Book now or give us a call to schedule an appointment to see our Physiotherapist who will be able to partner you to recovery as we address your patella tendon pain.
DISCLAIMER: These advise and exercises should not replace the need for a consultation with a Physiotherapist especially if your condition doesn’t improve. Therapeutic exercise should be carefully selected to suit your condition.
Ref:
Brukner, P. (2017). Clinical Sports Medicine: Injuries. McGraw-Hill Education (Australia) Pty Limited.
Filed under: Knee
