Jumper’s Knee

We have had several requests for a blog post that address common volleyball injuries. So I spoke with Blain Empey, an athletic trainer about the most common injuries in volleyball. There are a lot of  injuries on the volleyball court, jammed fingers and twisted ankles. However, those are difficult to predict or prevent. After talking with Blain, we decided that the best blog posts for the readers of the GMS blog would address injuries that are caused by overuse or lack of proper strength training.  We also wanted to address injuries that could be treated through proper preventative and rehabilitative exercises.

This blog post will address patella tendinitis–or jumper’s knee. At the end of the article there is a link to some stretching and workout recommendations that can be done OUTSIDE of practice to help improve jumper’s knee.  Blain’s next installment will address shoulder injuries. However, Blain said that the only way that there would be a second installment is if people found this post useful. Let us know if this article is helpful to you.

Dealing with Jumper’s Knee in Volleyball

By Blaine Empey, MS in Physical Therapy (Columbia)

Jumper’s knee is so prevalent in volleyball that many athletes endure it as a normal part of playing.  However, athletes can do many things to help alleviate the problem.  The amount of time at practice, landing technique, weight room activity, landing forces, and muscle weakness/tightness all contribute to this kind of knee pain.  Addressing these may not only decrease pain, but also help improve your athlete’s performance.

The total time an athlete uses his or her knees is the number one factor causing patella tendinosis—the medical term for jumper’s knee.  Although no one wants to hear the word ‘rest’ in athletics, it’s a vital part of dealing with overuse problems—but rest doesn’t mean the athlete has to stop playing!  A coach can control an injured player’s overall load by simply decreasing their court time:  skip repetitive jumping drills, give one or two days off a week, substitute other players in more often, avoid excessive punishment drills.  Simply keep practice intense, effective, and short!  All the treatment in the world won’t help unless a coach decreases the overall load.

Part of controlling overall load is to remove abnormal loads.  Correcting an athletes landing technique can significantly decrease stress on knees. A coach would never allow a player to do a max squat with their knees bowing inward over toes, but may not check how a player lands when jumping.  Correcting landing mechanics takes some time and specific exercises in the weight room (discussed below), but can alleviate abnormal loads.

Speaking of the weight room, making changes there can also help.  Teach those with jumper’s knee to decrease weight when sore.  Also, check their lifting mechanics.  Emphasize core, hip, and hamstring strength. This alleviates ‘quad dominance’ or primarily using the quadriceps muscles to jump.   Doing deep squats seems counter-intuitive; however, these also address the quad dominance problem by strengthening gluts over quads—skip these, though, if they increase pain.  Finally, decrease impact exercises (running, jumping, and plyometrics).  Use biking instead—great for increasing an aerobic base as well as improving cartilage/tendon health.

An athlete can’t stop all impact, but landing forces can be controlled by altering footwear.  Using a store-bought insole or simply purchasing a good athletic shoe with cushion and support can help decrease the pounding knees take.  Foot pronation is normal, but for those with pain, products designed to control pronation can make a difference.  Inexpensive shoe inserts are readily available at drugstores.  Although custom made orthoses are expensive—anywhere from 100 to 500 dollars—they may be worthwhile for someone who does not get better by other means.

Before practice, have the athletes use hot packs or similar and have a good dynamic warm-up.  Use patella straps/knee sleeves and pain relieving ointments during practice.  After practice, have players cool down, stretch lightly, and use foam rollers/massage sticks to relax tight muscles.  If the athlete has little or no pain at the end of practice, avoid using ice.  But if they are in pain, use ice massage (rub an ice cube or ice in a paper cup over the tendon for 5-10 minutes) or put an ice bag on for 20 to 30 minutes.  Ice massage, however, lasts longer and gets deeper.

One of the most important things is to address muscle tightness and weakness contributing to jumper’s knee.  Specific stretching and strengthening exercises can solve these problems.  Stretch tight hip-flexors, quads, and calves.  Strengthen hip muscles and hamstrings, both with power and endurance exercises.  Use eccentric (or negative) contractions for the quads.   Part two of this article outlines some specific techniques of stretching and strengthening for jumper’s knee.

Utilizing these ideas probably won’t completely cure jumper’s knee in athletes who continue to play.  But they will alleviate symptoms of pain and weakness and allow them to perform better and finish the season.  Be cautious, though; if the athlete’s performance becomes compromised, or when pain causes lifestyle changes, it’s time to have them see the doctor, athletic trainer, or physical therapist.  But before that becomes necessary, athletes don’t have to suffer through the pain—have them try these simple suggestions!

Here is the link to part two of this article: www.goldmedalsquared.com/documents/blog/Jumpers_Knee.pdf

(Please note that this article is no substitute for a proper diagnosis from a doctor or treatment from a physical therapist. This article is not intended to diagnose or treat knee injuries)