Treating Jumper's Knee

A Treatment Plan for "Jumper's Knee"

If you've had tenderness and anterior knee pain on that little bony bump in front of the upper shin bone, where your kneecap tendon attaches, or tenderness at the lower end of the kneecap, then you've become acquainted with "jumper's knee." Technically, the pain is from a tendonitis, or an inflammation of the attachment of either end of the patella tendon to the bone. It generally comes about from trauma, by excessive or repetitive pulling on the tendon, as when jumping, hence, the name.

Microscopically, tiny, thin cords of fibrous tissue, called Sharpey's Fibers, which anchor the tendon to its bony insertion, are literally pulled out of the bone. It's not comparable to a rupture, in which the entire tendon is severed; just a few fibers are avulsed from the bone. But these few fibers are enough to stimulate local inflammation. This inflammation is manifested by tenderness, pain and swelling. Once you have it, it's difficult to resolve the condition, because you're constantly using your knees.

Treatment is simple, but takes time. Initial treatment is mainly rest and "tincture of time," aided initially by measures to relieve inflammation. This is followed by progressive rehabilitation, until symptoms have been resolved and full function regained.

For the acute case:
1. Cold applications, or ice for the first 24 - 48 hours.
2. Thereafter, intermittent moist heat, 20 minutes, 4-6X/day.
3. OTC anti-inflammatory medications (NSAID's or Non-Steroidal Anti-Inflammatory Drugs),
like ibuprofen (Advil, or Motrin IB), or naproxen (Aleve) are helpful, too.
4. Natural measures to reduce inflammation include:

a. Avoid red meat (potent source of arachadonic acid--a precursor of prostaglandins, chemical mediators of pain)

b. Fish Oil (or other sources of Omega 3 Fatty Acids, like Flax Seed Oil) 4000-6000mg/day

c. Ginger

d. Devil's Claw

e. Turmeric

f. Bromelain
5. Local application of DMSO +/- 1% hydrocortisone cream 2X/day
6. Prolotherapy (injection of highly irritating compounds into areas of degeneration, to provoke a proliferative tissue response and restore strong fibrous tissue where it is lacking) may be helpful in refractory cases.

Once acute inflammation has been controlled, you can begin tendon strengthening exercises:
1. Wall Sitting
2. Isometric squats.
3. Quadriceps stretching
4. Deep squatting and running should be avoided, until symptoms have been gone subjectively for at least a week or so.
5. Gentle jogging for short distances should precede full bore running or jumping, and only when no pain is elicited.

Collagen, the protein from which the tendons are made, has been shown to take about six to eight weeks to heal in the laboratory. Based on this observation, it's likely that the tendon will require that amount of time to heal. So, it's important not to rush the process. Be patient. Orthopaedic injuries take time to heal. If you rush it, you may be right back where you started.