Fitness & Exercise

Jumper's Knee

TREATMENT continued...

The treatment of jumper's knee is often specific to the degree of involvement. Stage I, which is characterized by pain only after activity and no undue functional impairment, is often treated with cryotherapy. The patient should use ice packs or ice massage after terminating the activity that exacerbates the pain and later again that evening. If aching persists, a course of regularly prescribed anti-inflammatory medications should be administered for 10 to14 days.

Stage II

In stage II, the patient has pain both during and after activity but is still able to participate in the sport satisfactorily. The pain may interfere with sleep. At this point, activities that cause increased loading of the patellar tendon (for example, running or jumping) should be avoided.

A comprehensive physical therapy program, as discussed above, should be implemented. For pain relief, the knee should be protected by avoiding high loads to the patellar tendon, and cryotherapy should continue. The athlete should be instructed in alternative conditioning to avoid injury to the affected area.

Once the pain improves, therapy should focus on knee, ankle, and hip joint range of motion, flexibility, and strengthening. 

If the pain becomes increasingly intense and if the athlete becomes more concerned about his or her performance, a local corticosteroid injection may be considered. The doctor will explain the pros and cons of these injections.

Stage III

In stage III, the patient's pain is sustained, and performance and sport participation are adversely affected. Though discomfort increases, therapeutic measures similar to those described above should be continued along with not participating in activities that may worsen or prevent recovery from the injury. Relative rest for an extended period (for instance 3 to 6 weeks) may be necessary in stage III. Often, the athlete will be encouraged to continue an alternative cardiovascular and strength-training program.

If the condition does not improve with treatment, surgery may be considered.  Some athletes will not be able to continue to participate in activities that worsen or prevent recovery from the problem.

Stage IV

Tendon rupture requires surgical repair.

Medical Issues and Complications

Knee immobilization is not recommended because it results in stiffness and may lead to other muscle or joint problems, further prolonging an athlete's return to activity.

Consultations

Consultation with a physical medicine and rehabilitation specialist or an orthopedic specialist is recommended, particularly for Stage I cases that do not respond to conservative treatment and more severe cases (Stages II, III, and IV)

Recovery Phase

Physical Therapy

An in-depth, stage-specific description of a conservative therapy program is described above. In brief, in the recovery phase, the athlete and therapist should work to restore pain-free joint range of motion and muscle flexibility, symmetric strength in the lower extremities, and joint sensation. Sport-specific training, including high-level sport specific exercises, should then be initiated.