Updated: Apr 10
Knee pain is one of the most common complaints in athletes. Jumper’s knee being one of the most common diagnoses; also known as patellofemoral pain syndrome, anterior knee pain, mal-tracking patella, patellar tendonitis, and the list goes on. Most of the time, this type of knee pain is on the front of the knee, just below the kneecap and it got its name from pain that comes when jumping. However, it doesn't have to come from jumping. Basically any activity that can put stress on the knee can lead to patellar tendonitis including stairs, squatting, running/sprinting, cutting, and many more. Typically, inflammation occurs at the tendon that connects the quad muscle to the front of the shin after passing across the kneecap.
Does this sound familiar; have you or your child experienced this type of pain? Let’s take a deeper look at where jumper’s knee comes from and how to treat it.
The Great Quad/VMO Strengthening Debacle
I have treated many athletes with knee pain, specifically the jumper’s knee type of pain. The most common request from physicians is to work on quad strengthening and VMO activation for these athletes; however, when I test their quad strength it appears very strong and equal to their opposite side. What I tend to see more often is that they don’t know how to turn on their glutes/buttock muscles and lack strength here vs the quad. When the glutes don’t fire, we transfer the strain to the knee and over time create inflammation at the patellar tendon. This is commonly seen with jumping because it is a repetitive motion in a lot of sports.
When an athlete comes to me and shows deficits in their quad strength and the ability to contract this muscle, it tends to be either after surgery or after suffering with this pain for a prolonged period and the quad muscle has shut down making it hard for them to recruit it and this causes strain to the patellar tendon and inflammation.
No matter which one is the cause of the pain, the treatment is the same: take away the strain to the patellar tendon and increase the activation and strength of the glutes and then teach the athlete how to turn these muscles on when jumping, etc.
Creating a Stable Base
Moving and jumping from a stable base of support is important for many reasons:
It creates a solid foot to plant and move off of,
It allows for proper activation of the glutes and quads, and
We can generate the most power to move quickly and efficiently.
Learning how to create a stable base isn’t the hard part though, it is learning how to turn the muscles on when we need them that is the hardest part. But, you have to start somewhere, and learning how to create a stable base is the first part.
Practice standing on one leg. In this position you may notice your foot wiggling around a lot or your body swaying from side to side and you may use your arms to counterbalance this motion. To increase the stability in this single leg position try to contract your buttock muscles on the same side as well as press your big toe down into the floor while keeping your foot flat on the ground. It sounds like a lot, and it is, but once you nail this position down, you can start to incorporate it into activity/exercises and then sport-specific movements that you can put into practice in your off-season. Once your season rolls around, you will be so used to turning these muscles on, that you won’t have to think about it during your games and your knees will thank you for it.
Not Sure Where to Go From Here?
Let me tell you a story about a client I worked with who was having a lot of knee pain when they jumped while playing basketball and volleyball. He had a history of an ACL repair in this same knee awhile back and was fearful to go all out because of the pain and weakness he felt in this leg. He had some weakness in his quad and it was smaller than his other side from the surgery and not gaining the strength back afterwards.
We spent the first couple of weeks strengthening his quad and glutes before we began to focus on how to activate these muscles during activity and finally with sport-specific movements. Through the course of 6 weeks, he was able to progress back to jumping, changing directions, and quickly starting and stopping without any pain or feeling of weakness.
The last step that he had to master was getting confidence in his knee when practicing his sports in slow motion so that he was 100% confident when he goes out onto the court to play in a game. In my experience, the athletes who do not feel 100% confident in their body after an injury are the ones who tend to reinjure themselves because they are timid and it causes them to mess up their movements or over-think them.
Reach Out For Help
If you need help with your knee pain and figuring out which steps to follow and how to get back to playing at 100%, you can reach out to me for help. I provide a No-charge phone consultation to discuss your pain and see if working together is the best option for you. From there, we can plan a time for an evaluation, if it is appropriate, and get you on the path to a quick recovery and back on the court. You can schedule a phone consultation with me by clicking here. Let’s get you feeling better and playing at your best!