Snapshot of Takeaway Points
- Using full range of movement at the knee and the hip is of paramount importance
- Control the inflammation with the treatments/therapies provided
- 8 week training program included
Jumper’s knee (patellar tendonitis) is an injury related to the patella tendon. Think of it as inflammation due to overuse. I’ve had countless clients start with me with this problem and it’s usually gone within 2-4 weeks. There are a variety of reasons it manifests so here is a full proof plan to help you get rid of the problem and stay ahead of it.
Reasons for it
Within strength sports I see when it when knee wraps are over used. Often this is the fix that is chosen to overcome the knee pain. This though is avoidance of the actual problem. Also when a squatter uses predominantly a myotatic reflex in the squat which is using your stretch reflex to bounce out of the hole.
Both of these when used long term lead to a strength imbalance in the bottom range of movement which is one of the fixes for the problem. The same can be said for partial squatters. Not including any movements that enforce a full range of movement at the knee and hip joint is a recipe for an imbalance which will lead to an injury.
Within competitive team sports it’s much the same where the predominant movement pattern calls for partial range of movements. This is within the sport and is completely fine. Within the weight room though and in the strength and conditioning program you need the opposite.
I had a youth football/soccer goalkeeper train with me for 6 weeks in his off season. He came in with jumper’s knee and left without it. Unfortunately it returned during the season. Why? The strength and conditioning coaches endorsed a quarter squat only. It was immediately fixed with a properly written program where I advised him to perform full range, leave a stain on the floor, squats.
When I consulted Dr Peter Lundgren on the issue he also said you need to pay attention to the knee’s two bad neighbours. Namely, the hip and the foot. A lack of dorsiflexion in the ankle, poor big toe extension, weak glutes and loss of internal rotation at the hips will all lead to compensatory movement patterns which can end up in jumper’s knee/patellar tendonitis.
So analysing the above we need: full range movements and eccentric strength through the full range. Here’s an 8 week program for the lower body to help fix these issues.
Week 1 & 2
- A1) Back Squat (Narrow, Cyclist): 4 x 8 reps, 4020, 75s
- A2) Unilateral Lying Leg Curl (Plantarflexed, Inwards): 4 x 6-8 reps, 5010, 75s
- B1) Poliquin Step Up: 3 x 20-25 reps, 1010, 60s
- B2) Unilateral Lying Leg Curl (Dorsirflexed, Inwards): 3 x 6-8 reps, 3210, 60s
- C1) Low Cable Split Squat (Front Foot Raised): 3 x 8-10 reps, 3210, 60s
- C2) Low Cable Pull Through: 3 x 10-12 reps, 3012, 60s
Week 3 & 4
- A1) Front Squat (Narrow Cyclist): 5 x 5 reps, 5010, 100s
- A2) Unilateral Lying Leg Curl (Plantarflexed, Neutral): 5 x 5 reps, 3012, 100s
- B1) Low Cable Split Squat (Feet on Floor, 1 & Quarter): 5 x 5 reps, 4110, 90s
- B2) Flat Back Extension (DB Across Collarbone): 5 x 5 reps, 3014, 90s
Week 5 & 6
- A1) Back Squat (Heels on 2.5kg Plates): 4 x reps, 4210, 90s
- A2) Unilateral Lying Leg Curl (Plantarflexed, Outwards): 4 x reps, 3210, 90s
- B1) Petersen Step Up: 3 x 15-20 reps, 1010, 75s
- B2) Unilateral Lying Leg Curl (Dorsirflexed, Outwards): 3 x 6-8 reps, 3012, 75s
- C1) Low Cable Split Squat (Back Foot Raised): 3 x 6-8 reps, 3210, 60s
- C2) 40° Incline Back Extension (SG Barbell): 3 x 8-10 reps, 3012, 60s
Week 7 & 8
- A1) Front Squat (Heels on 2.5kg Plates): 6 x 3 (+1ecc), 50X0, 120s
- *+1ecc = eccentric only with same weight for 10 seconds after 3rd Set up safety’s
- A2) Glute Ham Gastroc/Nordic Curl (DB Across Collarbone): 6 x 6 reps, 2010, 120s
- B1) DB Split Squat (Front Foot Raised, Double Barrel): 4 x 6 reps, 3111, 90s
- B2) Reverse Hyperextension: 4 x 10-12 reps, 2010, 90s
The cyclist squats will take care of full range at the knee and should be started slowly. I’ve had people utilise just the 20kg bar in the first week and squat pain free close to their repetition max by the 8th week. The split squats will help improve and take care of hip mobility.
Balancing the knee flexors is important within this case study as well. Leg curls I always see avoided and programmed poorly hence their inclusion here.
If you are to perform a second lower body day use eccentric-less/modified strongman movements only. Sled drags are a fantastic option here. Remove plyometrics completely for the 8 weeks or only include low intensity efforts. Progressing plyometric volume too quickly and not periodising plyometrics is a contributing factor to jumper’s knee/patellar tendonitis.
Remove any push press/jerks/Olympic lifts or utilise a slow eccentric tempo on the knee bend/dips and/or paused push presses. The short, sharp, violent dip as you use your legs to drive the weight up will be a contributing factor to inflammation that we want to minimise for the moment.
Should you not wish to sacrifice your current program completely, add in cyclist squats and split squats to your assistance work whilst still making the adjustments to the plyometrics and Olympic weightlifting movements as outlined previously
Knee towel release: I learned this trick from Dr Peter Lundgren who uses it to decompress the knee capsule
Dry needling: ask your practitioner to needle the Popliteus and knee capsule
Traumeel: This is a fantastic homeopathic and anti-inflammatory cream which I recommend using just before bed. They also provide intramuscular vials which are a god send for speeding recovery from injury. (Please find a suitable healthcare practitioner to administer the shot.)
- Kaprex: Reduces inflammation without the negative affect on the gut associated with long term use of non-steroidal anti-inflammatories (NSAIDs).
- Chondro Jointade: Packets containing a complete spectrum of research-backed joint and soft tissue supporting ingredients.
- High EPA content Fish Oils: EPA is the constituent of fish oil that is proven to reduce inflammation.
If you have access to Frequency Specific Microcurrent then using the Joint/Ligament/Tendon protocol directly on the knee is another way of speeding recovery as would Red Light Therapy/Photobiomodulation.
The sooner you get inflammation under control, the sooner you will recover to full health. Deficiencies in your lifestyle will therefore delay healing. The three biggest factors I would try to improve are sleep, gut health and food rotation on a three day rule minimum. (Eg: if you had ‘X’ on Monday, don’t eat it again until Thursday)
I’ve made quite a few recommendations, especially in the treatment section. You shouldn’t feel like you need to incorporate all of them but I don’t like to leave any stone un-turned. Someone may experience relief just from the 8 week program and some Traumeel cream. Another may need to fix their sleep patterns and include some full range squats within their assistance exercises. Either way, you have all the tools within this article to fix the problem.
Article written by: Tom Hibbert
Published on: 7/3/2019