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Effective Strategies for Managing Patellar Tendon Pain in Youth Athletes

Patellar tendinopathy, also known as jumper's knee, is an overuse injury that is common in youth athletes training at elite levels, Jumper's knee is an injury of the knee's extensor mechanism due to repetitive, high-intensity mechanical stress that occurs in sports that require jumping, landing, acceleration, deceleration, and cutting. Identifying the patellar tendon as the source of pain, not bursitis or Osgood-Slatters will help direct treatment. This can be done by straightening the knee and pushing right below the knee cap onto the patellar tendon. If this causes pain, then the patellar tendon is involved.


First, identify the severity of your tendinopathy by when you feel the pain, the intensity level of the pain, and how long you have been feeling the pain. If your pain level is under a 4/10 (on a pain 1-10 pain scale with 10 being the highest), occurs during or after training, and/or started less than 6 weeks ago, then focus treatment on eccentric quad strengthening, patellar tendon support during training, and mobility of your quads, hamstrings, and glutes.


If your pain is 4+/10, you feel pain both while training and outside of training like walking up or down stairs, and/or started over 6 weeks ago, then begin with rest and activity modification, cross-training, ice therapy, and patellar tendon support. Once the pain starts to subside, then move to eccentric quad strengthening.


Treatments

  1. Rest and Activity Modification: Reduce or temporarily stop activities that exacerbate the pain. This might mean taking a break from soccer or modifying training routines to avoid high-impact exercises.

  2. Ice Therapy: Apply ice to the affected area for 15-20 minutes after training to reduce the pain.

  3. Isometric Quadriceps Strength Training: Isometric exercises are when the muscle contracts without movement of the muscle or knee. Start with quad sets and straight leg raises. Sets and reps 30-15-15-15. Because we are limiting the force being applied, using a BFR cuff improves the body's ability to increase the strength of the quad while performing these isometric exercises.

  4. Eccentric Quadriceps Strengthening: Eccentric exercises occur when the muscle contracts as it is lengthening. Start with wall slides and then progress to single-leg wall slides. If your pain level increases above a 3 when performing these exercises, stop and return to isometric quad strengthening exercises. Performing these exercises with BFR cuffs tends to decrease the pain and will help increase muscle mass without having to place higher stress loads on the knees such as squatting with weight.

  5. Hamstring, Quad, and Glute Mobility: Stretching these muscles can relieve tension on the patellar tendon and help improve your running biomechanics.

  6. Patellar Tendon Support: Wearing a patellar tendon strap or using KT Tape during activities can help distribute pressure and reduce pain.

  7. Patellar tendon mobs: Sometimes the patellar tendon is tight and needs to be mobilized, along with stretching your quad. This is best done initially by a physical therapist.

  8. Cross-Training: Incorporate low-impact activities such as swimming or cycling to maintain fitness without putting additional stress on the knee.


Preventative Measures

  1. Warm-Up and Cool-Down: Ensure a proper warm-up before practices and games, and include a cool-down routine with stretching.

  2. Quad Strengthening: Performing the single leg wall slides 2 times per week to improve quad strength, especially while young athletes are growing will help to decrease patellar tendon pain.

  3. Gradual Increase in Activity: Gradually increase the intensity and duration of activities to avoid overloading the tendon.

  4. Proper Technique: Ensure that the player is using proper technique during training and games to minimize unnecessary strain on the knee.


NSAIDs and steroid injections should be discouraged in managing the jumper's knee.


When to See a Sports Medicine Specialist

If you are unsure how to implement the treatment provided or if pain persists despite conservative treatment or if the injury significantly impacts daily activities, schedule an appointment with a Sports Medicine Specialist who can provide a more detailed assessment and recommend additional treatments or interventions as needed.




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