The knee is another joint that can break a playing career. As you can see (right) the structures are many, with each causing their own set of issues.
Injuries fall into two categories; acute and chronic. Acute injuries usually occur suddenly as a result of trauma and it is always recommended to get these looked at by your GP or a quick visit to the A&E Department may be necessary.
Chronic injury develops slowly over time and usually as a result of soft tissue deficit and/or biomechanical malfunction. They often begin with a ‘niggle’ that may go away but will always return. If these ‘niggles’ go untreated they become constant and the longer a chronic injury goes untreated, the harder they are to recover, often leaving surgery as the only option.
There are a few chronic injuries that can blight the rugby knee and this month we will be looking at a condition called ‘Jumpers Knee’ (Patella Tendonitis). It gets its common name as it is a result of jumping and landing activities, although it is more to do with the landing! This puts strain on the patella tendon, causing inflammation. Degeneration of the tendon is far more common and referred to as patella tendinopathy.
Micro tears can develop in the tendon through poor mechanics or increased frequency and/or intensity without building good strength in this area. The body copes incredibly well in this situation and if young, repairs remarkably quickly. However, if these factors continue the tears will become progressively worse and will increase faster than the tissue’s capacity to regenerate.
- Gradual onset of pain below the patella (see illustration);
- Increased pain with activity;
- Stiffness when you get out of bed;
- Tendon may appear thicker than usual;
- Area painful to touch
When the first niggles appear a patella tendon strap may help. There are many brands which can be purchased at sports stores or online. The strap helps to distribute force which reduces strain and thereby relieves symptoms.
NSAIDs are not recommended as they can inhibit the body’s own healing mechanism; reducing its capacity to regenerate. However, applying ice (not directly to the skin) for 20 minutes every two hours may help with any inflammation.
Failure to initiate treatment at the early stages may result in a three-month rest until recovery is complete. If this is the case, consult your GP for a clear diagnosis. Fitness can be maintained by swimming and/or exercises in the pool.
I see many more cases of Jumpers Knee at the beginning of the season when players go straight from relatively sedentary lifestyles to constant running and jumping. Preseason training can go a long way to prevent all injuries and especially Jumpers Knee. A gradual introduction to these activities will slowly build the necessary strength along with off-season fitness training.
Wearing the correct footwear with shock absorbing insoles for training as well as playing can prevent injury but it is also extremely important to ensure correct mechanics are used, particularly knowing how to land safely.
A good warm up and cool down routine with stretches is also vital. The quadriceps assist to control the landing, allowing a slight bend at the knee. A good developmental stretch at the end of activity whilst the muscles are still warm will help keep them in good condition. This can be done standing, kneeling, lying on your front, side lying etc but I quite like the following to first strengthen and then stretch the quadriceps and knees:
I hope that you have found this blog useful. If you have any questions or comments on knee injuries or on any other rugby injuries that you would like to see covered in the next blog, please email me at firstname.lastname@example.org with “Rugby Sports Injury Blog” in the title, and I will be happy to help.