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Performance Area => Injury, Prehab, & Rehab talk for the brittlebros => Topic started by: Dreyth on February 04, 2012, 12:55:32 pm

Title: Curing jumper's knee?
Post by: Dreyth on February 04, 2012, 12:55:32 pm
I now have patellar tendonitis in both my knees, but much more so in my left knee. I plant LR when I jump, and it hurts the most when I jump. When I jump, it hurts both knees. If I don't warm up before squatting, it hurts a lot when I squat (only left knee here).

It's extremely annoying because I can't practice my jumping and my squat progress has stalled. My reps on the squat are done VERY slowly so it won't hurt as much, plus I'm contracting the abs MUCH more to stay stable.

Does anybody have any advice on how to fix it? I don't want to get rid of the pain, I want to get rid of the problem. Thanks.
Title: Re: Curing jumper's knee?
Post by: Raptor on February 04, 2012, 03:30:55 pm
http://www.higher-faster-sports.com/jumpersknee.html
Title: Re: Curing jumper's knee?
Post by: Kingfish on February 04, 2012, 06:19:54 pm
when lower 2/3s or my quads got tender because of 14+ straight days of 440x1 non-paused reps i did a couple of weeks back, i used a 2.5lb plate to "foam roll" the muscle. dig into those thick leg mass and twist that round plate and you will feel the tightness go down a bit..

there always the contrasting bath, post-workout static stretching, lots of water and elevate legs during sleep.

don't force the lifts/jumps if the legs are sore. injury sucks.
Title: Re: Curing jumper's knee?
Post by: Daballa100 on February 04, 2012, 07:21:44 pm
I've never tried that Kingfish, I feel like a pussy now, because I roll my quads with a lacrosse ball.  SMR work on the quads definitely helps with the pulling on the knee.

The Kelly B. article looks good too, it really helps to improve pelvic posture, and stretch the rectus femoris when your knees are fucked up.  I'm assuming it's real jumper's knee, because you squat 400+ lbs.

When you do SMR on the quad, you should also try some "tack and stretch" meaning you enter flexion and extension while SMRing.  You "tack" down the tissue using your implement, and then you flex the knee, to stretch the quad while it's pinned down.  You should focus mostly on the suprapatellar pouch.  It's very effective, almost like ART.

If that doesn't work you can also do some compression wrapping.  Basically you just take a single band(a strip, not an actual loop) and wrap it around your quad tightly(to the point where it almost feels numb), right above the knee, around the supra-patellar pouch.  Then you can proceed to do bodyweight squats, and other movements.  This is similar to the tack and stretch, albeit more effective.  You can even combine this compression wrapping with a Rectus Femoris stretch, to really get at that quad.

Don't be afraid to do extra hip mobility in your free time, and soft tissue work.  Really try to get aggressive with that stuff.

Oh yeah, if you don't have a band you can cut in half to make a strip, you can order them on jumpstretch.com, look for "PT strength strips."  If you're cheap like me you can buy a bike innertube tire, cut the stem off, and cut the thing in half, so you get strips as well.
Title: Re: Curing jumper's knee?
Post by: Dreyth on February 04, 2012, 08:45:21 pm
http://www.higher-faster-sports.com/jumpersknee.html

Holy shit when I started getting the pain I had LITERALLY every symptom that he put there. (low cardio, very strong quads, right quads)

It's time to work on my hamstrings directly. And it's weird, I think I have the REAL jumper's knee as he states it, yet I definitely don't have pain on the top of my knee. It's on the bottom before the top of the tibia. In that tissue area.

Now I'm really lost. To help cure it, he says that you should drop ALL quad work that causes the pain, but if it's LOWER knee tendonitis, then quad work actually HELPS.

WTF do i do? I know for sure I'll maintain the squat because if I don't go too heavy it doesn't hurt. I'll strengthen my hamstrings. I'll stretch and foam roll the quads. I'll add in hip mobility work, and I'll continue taking 3 caps of fish oil a day.
Title: Re: Curing jumper's knee?
Post by: LBSS on February 05, 2012, 11:24:48 pm
ask a qualified PT.
Title: Re: Curing jumper's knee?
Post by: Dreyth on February 06, 2012, 02:45:47 pm
ask a qualified PT.

does PT = personal trainer?
Title: Re: Curing jumper's knee?
Post by: T0ddday on February 06, 2012, 03:57:51 pm
ask a qualified PT.

does PT = personal trainer?

PT means physical therapist.  Which I'm not, but I'll still give some advice.  The first thing to ask is what's the cause of the pain?  I have also suffered from jumpers knee and while sprinting, squatting, bounding all aggravate my tendinitis; they don't cause the inflammation cycle to begin.  For example, if I just squatted and didn't jump or play basketball I would be fine.   But the day after basketball my knees hurt and squatting seems to cause knee pain. 

If that's the case with you, and it likely is because repetitive jumping on hardwood is SOOOOO terrible for your body, then I would do the following.  Swim and wait for the pain to subside.  When the pain is gone, resume squatting and get to the track.  Track work will build hamstring muscle and is excellent mobility work.  If your lucky you can find a track with goalposts or something so you can continue practice jumping on soft turf.  You can still train your jumping, sprinting, bounding on grass.  It's not quite as specific as jumping in a gym but it's much easier on the body.  While doing this you can start doing tempo runs and continue them as necessary to lose weight.

Losing weight is about the only thing that works for every case of tendinitis, simply put less weight is less stress on the knees.  For the long term losing weight is a must.  If you have a heavy build then you might be pretty powerful and strong and have the capacity to create a 38 inch vertical at 200 pounds.  If you weigh 170 you might be a lot weaker and only jump 36 inches.  But at 200 pounds your knees will hurt and you will need a week off every time you play basketball and as you get older it will only get worse.   It's not worth it.
Title: Re: Curing jumper's knee?
Post by: Dreyth on February 06, 2012, 07:46:59 pm
Ok thanks for the help guys. Here's a little plan I've made for myself:


Stop jumping completely
This is what started the pain in the first place. It's also the most stressful thing on the knee. Good bye jumping. I'll see you some other time. Maybe this summer. Jumping is a skill I can get back relatively quickly compared to say, squat strength.

Put squat on maintenance, if pain gets worse, stop squatting completely
Definitely can't just stop completely. I've hit so many walls where I've made progress and then lost a lot of the progress I've made. I can't let this happen again. But if my pain gets worse from squatting, then I'll stop it.

Strengthen hamstrings and calves
It's possible that my injury is caused by muscle imbalances. My quads and glutes are HUGE compared to my hamsrings and calves. It could be that my quads are taking over movements that should be aided more by my calves and hamstrings, like walking. I step pretty hard on my heels naturally and there isn't much toe-off. If my injury isn't caused by this, this will prevent further injuries anyway.

Foam roll and stretch quads and hip flexors
I may just have overactive and tight quads and hip flexors. I sit at the computer all day. I never stretched my quads anyway. Also, I've been reading that the quad does a lot of pulling on the patellar tendon and that can cause some pain through repitition, so I can alleviate this pulling by making my quad more flexible and pliable. I stretch hip flexors before squatting, foam roll quads before and after squatting, and stretch quads after squatting.

Hip mobility work + glute activation
If my quads are overactive, it could be they are doing part of the job that my other muscles should be doing. Whether or not this issue caused my injury, I should be doing this anyway.

Lose weight
Losing weight will put less stress on the knee in pretty much every single activity out there. Jumping especially. I was at 210lbs, looking to go down to 190lbs. Today I was 203lbs so I'm on track.


I'm pretty sure this combination should almost completely alleviate my knee pain before July. If it doesn't, I don't know what to do.
Title: Re: Curing jumper's knee?
Post by: LBSS on February 06, 2012, 09:38:08 pm
If it doesn't, I don't know what to do.

if it doesn't, i know what to do: http://www.premierptny.com/Services/JointRehabilitation.aspx
Title: Re: Curing jumper's knee?
Post by: Dreyth on February 06, 2012, 10:24:04 pm
If it doesn't, I don't know what to do.

if it doesn't, i know what to do: http://www.premierptny.com/Services/JointRehabilitation.aspx

oh snap... a location 10min walking from my house. thanks a lot!

ha, and another one 5 min from my gym. in fact, i pass by it almost every day on my walk to the gym!


edit: actually, i just realized my uni has a physical therapist. D1 sports, so I assume they have someone decent. Maybe I can get a free appointment/assessment or something there if not at those other places.
Title: Re: Curing jumper's knee?
Post by: TheSituation on February 07, 2012, 12:05:10 am
ask a qualified PT.

Why waste money (like 150 a session) when he can fix it himself? If he actually has jumper's knee it's relatively easy to fix.

I wouldn't squat if it makes your knee feel tender at all. Even if it's not getting worse, the only way you're going to heal is stopping anything that makes it flare up.
Title: Re: Curing jumper's knee?
Post by: Raptor on February 07, 2012, 09:59:09 am
Why don't you go with bulgarian split squats with a long stance (a lot of glute contribution, no knee bending forward) + RDLs for a while? No squatting. See how that goes.
Title: Re: Curing jumper's knee?
Post by: LBSS on February 07, 2012, 11:23:45 am
ask a qualified PT.

Why waste money (like 150 a session) when he can fix it himself? If he actually has jumper's knee it's relatively easy to fix.


true, although (A) no one knows whether he's actually got jumper's knee, including him; (B) the point still stands about seeing one if he hasn't gotten better in a couple of months; and (C) if he's got insurance, and as a student i assume he does, it wouldn't cost $150. laws and different about this stuff state-by-state but i've never paid more than $20 out of pocket for PT.

all that aside, it was more a comment on the request for an e-diagnosis from strangers than anything else.
Title: Re: Curing jumper's knee?
Post by: Dreyth on February 07, 2012, 11:25:59 am
Why don't you go with bulgarian split squats with a long stance (a lot of glute contribution, no knee bending forward) + RDLs for a while? No squatting. See how that goes.

Not a bad idea. It's been years since I did other kind of leg work other than squats really. In fact, maybe I'll switch over to a low-bar squat and see how that feels. If that hurts, then deadlifts (variations) and BSS aren't a bad idea.

LBSS I'll see how much it costs me, thanks again.
Title: Re: Curing jumper's knee?
Post by: TheSituation on February 07, 2012, 02:22:43 pm
ask a qualified PT.

Why waste money (like 150 a session) when he can fix it himself? If he actually has jumper's knee it's relatively easy to fix.


true, although (A) no one knows whether he's actually got jumper's knee, including him; (B) the point still stands about seeing one if he hasn't gotten better in a couple of months; and (C) if he's got insurance, and as a student i assume he does, it wouldn't cost $150. laws and different about this stuff state-by-state but i've never paid more than $20 out of pocket for PT.

all that aside, it was more a comment on the request for an e-diagnosis from strangers than anything else.

That's true, because a torn meniscus has a lot of the same symptoms. If none of the "cures" work after 2-3 weeks or so, seeing a PT is a good idea.

That's weird how it was only 20 dollars for you. It was 100ish when I saw one a few years ago and I had insurance.

Also, I disagree with Kelly that it always has to do with weak hamstrings. For me, strengthening my VMO and working on ankle mobility helped mine from coming back. Unfortunately, you can't really strengthen your VMO without deep squattish movements, so you'd have to wait until your jumper's knee went away to start with that.
Title: Re: Curing jumper's knee?
Post by: LanceSTS on February 07, 2012, 04:54:17 pm
  The vmo can definitely be an issue, especially dependent on the training background.  Single leg squats can help if they dont aggravate the injury due to the instability, forcing the vmo to work harder and contribute more, even with reduced rom.  However, most of the time the vmo issues tend to show up in guys that have been deadlifting/box squatting/squatting high or parallel in my experience and not nearly as frequently in athletes that have been full squatting for the majority of their training.

 Its fairly rare to see someone who has been squatting full have much of an issue with the vmo, and much more common for them to have a hamstring issue, especially at the knee end of the spectrum.  High rep hamstring curls done with a high frequency are unbelievably effective for this, giving both a tonic blood flow effect to the knee and prehab as well. Doing things like rdl's and deadlifts dont work as well in this case as it tends to hit more at the hip joint rather than the knee end.


lbss brings up a good point too, be careful taking random advice on injuries from someone on the internet.  Its always good to hear different peoples experiences with similar situations, but there are a lot of people who go around reading different articles/forums online, then state what they read as fact, without any prior experience or knowledge of what they are speaking about.

 
As far as dreyth in this case, if you dont remember a specific time and place you felt the knee "give" or "shift", or any type of acute pain/injury, the odds are in favor of a tendonitis issue but thats definitely not fool proof.  The way you squat would definitely favor the vmo and overall quad development if I was making an educated guess at it, and you may very likely need to do some remedial hamstring work at the KNEE END.  If money is an issue then trying that while making sure mobility and soft tissue work is up to par first, if not then getting a professional to look at it is always a good idea.
Title: Re: Curing jumper's knee?
Post by: Raptor on February 08, 2012, 05:41:31 am
I'm curious to see Dryeth low bar squat :P
Title: Re: Curing jumper's knee?
Post by: Dreyth on February 08, 2012, 09:03:11 pm
I'm curious to see Dryeth low bar squat :P

I used to do it actually.


update, did tons of foam rolling and hip flexor stretching and hip mobility work before squatting.
pain was almost non-existent! also definitely noticed a difference while playing basketball afterward. Two full court games, I wanted to hang on the rim to see how much pain I would have but I resisted the temptation.