The JUMPER’S KNEE PROJECT has been triggered by the prevalence of Jumper’s Knee in sports we specialize in, namely Basketball and Volleyball. Consider that over 60% of athletes that participate in these sports will develop Jumper’s Knee, which in the majority of cases results in chronic injury, lasting years. To address this condition involves an injury prevention strategy that involves coaches, sport organizations, health care professionals and strength and conditioning specialists.  

We can’t wait for an injury to occur; we can prevent or at least manage them so that all our athletes have the opportunity to fulfill their potential. Here are some other alarming statistics and facts regarding Jumper’s Knee:

  • Day to Day Impact. Athletes affected by Jumper’s Knee, depending on severity, will have great difficulty walking up and down stairs, getting up after sitting down, and will demonstrate decreased sport performance.
  • Extremely Common. The prevalence of Jumper’s Knee in jumping sports like Basketball and Volleyball is profound, affecting
  • Irreversibility. Many athletes that develop Jumper’s Knee will never completely resolve their symptoms.
  • Poor Performance. Studies have shown Jumper’s Knee to decrease performance – 30% decreased landing control [1],
  • Increased Injury Risk.
  • Relationship with Ankle Mobility.
  • Higher Training Volume is associated with increased injury rates.  Playing hours and training hours beyond 12 hours / week
  • Surface Impact.

This does not have to be the case.

 

The JUMPER’S KNEE PROJECT represents three methods you and your organization can engage in with FITS to reduce the incidence and severity of Jumper’s Knee in your athletes. Here are the methods:

NUMBER 1: Presentation

1. Set up a Presentation for your team and organization, either @ FITS or @ your facility – simply give us a call or email us.

In this workshop, the FITS Team will take athletes, parents and coaches through 5 critical concepts that can help athletes prevent Jumper’s Knee and other common injuries related to motor control. Following the talk, attendees will be put through a workshop that will provide them with practical, hands-on instruction on how to perform key exercises that will help prevent Jumper’s Knee.

 

Patellar Tendinopathy

NUMBER 2: Education and Resources

  • Visit our blog at www.fitstoronto.com for information about Jumper’s Knee and methods to prevent Sport Injuries
  • VISA Jumper’s Knee Severity Index – This free online tool has been posted on our website and it will give you an indication of the severity of your Jumper’s Knee that has been scientifically validated*

 

Patellar Tendinopathy

NUMBER 3: Therapy Referral

Therapy Referral to FITS

  • We have two great locations (Toronto and Oakville) to serve your needs.
  • Our approach to Jumper’s Knee focuses on motor control once we are able to manage symptoms through load modification and physiological modalities (i.e. US, laser, electrical, ART, Graston, etc.). Our approach to develop movement control is unparalleled.

For coaches and organizations that refer into our clinic for Jumper’s Knee, we will provide the referring coach and the athlete’s family physician the following correspondence:

  • FITS Jumper’s Knee Report of Findings
  • Recommendations on how to modify practices to promote healing

Together we can greatly reduce the prevalence and severity of Jumper’s Knee. This effort needs a systematic approach in which coaches are the first line of defence.

Be an advocate for sports safety! Help us spread the word about this valuable resource – better yet, set-up a presentation date. If you have any suggestions on how we can spread the word, please don’t hesitate to call.

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Resources

Physioedge Podcast with world renowned Tendinopathy researcher Jill Cook

“What causes tendon breakdown? What are the stages of tendinopathy, and how do they effect your treatment? Is treatment just about eccentric training? When should NSAID’s be used?”

  • Factors that contribute to tendinopathy beyond biomechanics
  • Eccentrics – what the future of training to rebuild tendons is
  • Return to sport or running after tendinopathy
  • Avoiding tendinopathy
  • Treatment at each stage of tendinopathy
  • Rehab for achilles tendinopathy
  • Rehab for hamstring tendinopathy

BJSM Podcast with Jill Cook

VISA Score: An index of severity of symptoms in patients with Jumper’s Knee (Patellar Tendinosis) – FITS developed tool where we’ll send you a report highlighting the severity of the Jumper’s Knee symptoms.

References:

(will be continually updated)

1.         Sorenson, S.C., et al., Knee extensor dynamics in the volleyball approach jump: the influence of patellar tendinopathy. J Orthop Sports Phys Ther, 2010. 40(9): p. 568-76.

2.         Zwerver, J., et al., No effect of extracorporeal shockwave therapy on patellar tendinopathy in jumping athletes during the competitive season: a randomized clinical trial. Am J Sports Med, 2011. 39(6): p. 1191-9.

3.         van der Worp, H., et al., The impact of physically demanding work of basketball and volleyball players on the risk for patellar tendinopathy and on work limitations. J Back Musculoskelet Rehabil, 2011. 24(1): p. 49-55.

4.         van der Worp, H., et al., Risk factors for patellar tendinopathy in basketball and volleyball players: a cross-sectional study. Scand J Med Sci Sports, 2011.

5.         van der Worp, H., et al., Risk factors for patellar tendinopathy: a systematic review of the literature. Br J Sports Med, 2011. 45(5): p. 446-52.

6.         van Ark, M., J. Zwerver, and I. van den Akker-Scheek, Injection treatments for patellar tendinopathy. Br J Sports Med, 2011. 45(13): p. 1068-76.

7.         Longo, U.G., et al., Patellar tendinopathy in master track and field athletes: influence of impact profile, weight, height, age and gender. Knee Surg Sports Traumatol Arthrosc, 2011. 19(3): p. 508-12.

8.         Dimitrios, S., M. Pantelis, and S. Kalliopi, Comparing the effects of eccentric training with eccentric training and static stretching exercises in the treatment of patellar tendinopathy. A controlled clinical trial. Clin Rehabil, 2011.

9.         Culvenor, A.G., et al., Infrapatellar fat pad size, but not patellar alignment, is associated with patellar tendinopathy. Scand J Med Sci Sports, 2011. 21(6): p. e405-11.

10.       Zwerver, J., et al., The TOPGAME-study: effectiveness of extracorporeal shockwave therapy in jumping athletes with patellar tendinopathy. Design of a randomised controlled trial. BMC Musculoskelet Disord, 2010. 11: p. 28.

11.       Zwerver, J., F. Dekker, and G.J. Pepping, Patient guided Piezo-electric Extracorporeal Shockwave Therapy as treatment for chronic severe patellar tendinopathy: A pilot study. J Back Musculoskelet Rehabil, 2010. 23(3): p. 111-5.

12.       Souza, R.B., et al., Patellar tendinopathy alters the distribution of lower extremity net joint moments during hopping. J Appl Biomech, 2010. 26(3): p. 249-55.

13.       Rutland, M., et al., Evidence-supported rehabilitation of patellar tendinopathy. N Am J Sports Phys Ther, 2010. 5(3): p. 166-78.

14.       Pecina, M., et al., Patellar tendinopathy: histopathological examination and follow-up of surgical treatment. Acta Chir Orthop Traumatol Cech, 2010. 77(4): p. 277-83.

15.       Parkinson, J., et al., Change in proteoglycan metabolism is a characteristic of human patellar tendinopathy. Arthritis Rheum, 2010. 62(10): p. 3028-35.

16.       Kongsgaard, M., et al., Fibril morphology and tendon mechanical properties in patellar tendinopathy: effects of heavy slow resistance training. Am J Sports Med, 2010. 38(4): p. 749-56.

17.       Brown, J. and M. Sivan, Ultrasound-guided platelet-rich plasma injection for chronic patellar tendinopathy: a case report. PM R, 2010. 2(10): p. 969-72.

18.       Zwerver, J., T. Kramer, and I. van den Akker-Scheek, Validity and reliability of the Dutch translation of the VISA-P questionnaire for patellar tendinopathy. BMC Musculoskelet Disord, 2009. 10: p. 102.

19.       Samiric, T., et al., Changes in the composition of the extracellular matrix in patellar tendinopathy. Matrix Biol, 2009. 28(4): p. 230-6.

20.       Pedrelli, A., C. Stecco, and J.A. Day, Treating patellar tendinopathy with Fascial Manipulation. J Bodyw Mov Ther, 2009. 13(1): p. 73-80.

21.       Kongsgaard, M., et al., Corticosteroid injections, eccentric decline squat training and heavy slow resistance training in patellar tendinopathy. Scand J Med Sci Sports, 2009. 19(6): p. 790-802.

22.       Zwerver, J., [Patellar tendinopathy (‘jumper’s knee’); a common and difficult-to-treat sports injury]. Ned Tijdschr Geneeskd, 2008. 152(33): p. 1831-7.

23.       Warden, S.J., et al., Low-intensity pulsed ultrasound for chronic patellar tendinopathy: a randomized, double-blind, placebo-controlled trial. Rheumatology (Oxford), 2008. 47(4): p. 467-71.

24.       Tan, S.C. and O. Chan, Achilles and patellar tendinopathy: current understanding of pathophysiology and management. Disabil Rehabil, 2008. 30(20-22): p. 1608-15.

25.       Lorbach, O., et al., The influence of the lower patellar pole in the pathogenesis of chronic patellar tendinopathy. Knee Surg Sports Traumatol Arthrosc, 2008. 16(4): p. 348-52.

26.       Knobloch, K., The role of tendon microcirculation in Achilles and patellar tendinopathy. J Orthop Surg Res, 2008. 3: p. 18.

27.       Gemignani, M., et al., The patellar tendinopathy in athletes: a sonographic grading correlated to prognosis and therapy. Emerg Radiol, 2008. 15(6): p. 399-404.

28.       Garau, G., et al., Traumatic patellar tendinopathy. Disabil Rehabil, 2008. 30(20-22): p. 1616-20.

29.       Wang, C.J., et al., Extracorporeal shockwave for chronic patellar tendinopathy. Am J Sports Med, 2007. 35(6): p. 972-8.

30.       Visnes, H. and R. Bahr, The evolution of eccentric training as treatment for patellar tendinopathy (jumper’s knee): a critical review of exercise programmes. Br J Sports Med, 2007. 41(4): p. 217-23.

31.       Lian, O., et al., Excessive apoptosis in patellar tendinopathy in athletes. Am J Sports Med, 2007. 35(4): p. 605-11.

32.       Frohm, A., et al., Eccentric treatment for patellar tendinopathy: a prospective randomised short-term pilot study of two rehabilitation protocols. Br J Sports Med, 2007. 41(7): p. e7.

33.       Crossley, K.M., et al., Clinical features of patellar tendinopathy and their implications for rehabilitation. J Orthop Res, 2007. 25(9): p. 1164-75.

34.       Bisseling, R.W., et al., Relationship between landing strategy and patellar tendinopathy in volleyball. Br J Sports Med, 2007. 41(7): p. e8.

35.       Taunton, J.E., Comparison of 2 eccentric exercise protocols for patellar tendinopathy in volleyball players. Clin J Sport Med, 2006. 16(1): p. 90-1.

36.       Rabin, A., Is there evidence to support the use of eccentric strengthening exercises to decrease pain and increase function in patients with patellar tendinopathy? Phys Ther, 2006. 86(3): p. 450-6.

37.       Ogon, P., et al., Arthroscopic patellar release for the treatment of chronic patellar tendinopathy. Arthroscopy, 2006. 22(4): p. 462 e1-5.

38.       Bahr, R., et al., Surgical treatment compared with eccentric training for patellar tendinopathy (Jumper’s Knee). A randomized, controlled trial. J Bone Joint Surg Am, 2006. 88(8): p. 1689-98.

39.       Young, M.A., et al., Eccentric decline squat protocol offers superior results at 12 months compared with traditional eccentric protocol for patellar tendinopathy in volleyball players. Br J Sports Med, 2005. 39(2): p. 102-5.

40.       Cook, J.L. and C. Purdam, Is compressive load a factor in the development of tendinopathy? Br J Sports Med, 2012. 46(3): p. 163-8.

41.       Parkinson, J., et al., Involvement of proteoglycans in tendinopathy. J Musculoskelet Neuronal Interact, 2011. 11(2): p. 86-93.

42.       Cook, J., Tendinopathy: no longer a ‘one size fi ts all’ diagnosis. Br J Sports Med, 2011. 45(5): p. 385.

43.       Gaida, J.E., et al., Is adiposity an under-recognized risk factor for tendinopathy? A systematic review. Arthritis Rheum, 2009. 61(6): p. 840-9.

44.       Rees, J.D., N. Maffulli, and J. Cook, Management of tendinopathy. Am J Sports Med, 2009. 37(9): p. 1855-67.

45.       Cook, J.L. and C.R. Purdam, Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. Br J Sports Med, 2009. 43(6): p. 409-16.

46.       Gaida, J.E., J.L. Cook, and S.L. Bass, Adiposity and tendinopathy. Disabil Rehabil, 2008. 30(20-22): p. 1555-62.

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