Jumping knee

Jumper's knee, also known as patellar tendonitis, is an overuse injury that occurs at the tendon attachment below the kneecap. It often affects athletes in sports such as volleyball, basketball, and long jump, where the body is subjected to repeated jumps and landings. Contrary to its name, it's not always just jumpers who are affected – runners, soccer players, and recreational athletes can also develop the injury from excessive load. To understand how to manage and prevent jumper's knee, it's important to review symptoms, causes, treatment strategies, and preventive measures.

Symptoms of jumper's knee

• Localized pain below the kneecap, at the patellar tendon insertion
• Tenderness when pressing on the tendon attachment
• Pain during load-bearing activities such as jumping, standing up, or climbing stairs
• Stiffness after rest, especially at the beginning of activity

These symptoms clearly describe the classic signs of the condition. In mild cases, it is felt after training or when rising from a seated position, while in more pronounced stages, the pain can occur even during activity or at rest.

What causes jumper's knee?

When you jump, the thigh muscle is loaded, and its tendon attaches to the lower edge of the kneecap. Repetitive or explosive movements can lead to the tendon becoming overloaded and injured. Small micro-tears occur, leading to increased vascular activity and fluid accumulation, which means that even everyday movements such as getting up from a seated position can trigger pain. Athletes in jumping and landing-intensive activities such as volleyball, basketball, and athletics, as well as runners on hard surfaces, are particularly vulnerable. Strong and frequent activation of the quadriceps without sufficient recovery is the typical trigger for secondary inflammation at the attachment below the kneecap.

Making the right diagnosis

Diagnosis is usually based on clear symptoms and examination findings such as tenderness upon palpation below the kneecap and specific loading tests, for example, heavy squats on an inclined surface. If necessary, the diagnosis is supplemented with ultrasound or MRI, which can reveal swelling or vascular activity in the tendon.

Treatment and rehabilitation

Adapted loading

The first measure is to reduce the load on the tendon – stop jumping and explosive movements while maintaining the level of activities such as cycling or light strength training. It is important to follow a gradual progression, according to the parmesan principle, where the load is increased within the pain-free limit.

Training and exercises

While isometric training can be effective for short-term pain relief, eccentric training has been shown to yield the best long-term results. Study protocols show that eccentric calf raises on an inclined surface and slow lowering squat exercises strengthen the tendon and restore tissue.

Complements and relief

Knee braces or patellar straps can alleviate the pain of jumper's knee by relieving the tendon attachment. Short-term use of NSAIDs can also be used, but should be avoided for long-term use. Low-dose laser, EPTE, and shockwave therapy are evidence-based complements that stimulate healing.

Injections and surgery

Cortisone injections often provide short-term relief but are associated with the risk of tendon deterioration. PRP (platelet-rich plasma) may be useful in chronic and therapy-resistant cases, especially leukocyte-rich PRP according to studies. In chronic complaints (>6–12 months) that do not respond to conservative treatment, surgical opening and removal of degenerated tissue can be discussed.

Preventive strategies

To avoid recurrence of jumper's knee, one should regularly train the quadriceps, hip, and gluteal muscles, both eccentrically and concentrically. Stretching the quadriceps, hamstrings, and hip flexors is important to maintain flexibility. Studies show that neuromuscular and proprioceptive training in combination with eccentric training improves long-term results.

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