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)

 

11 comments on Jumper’s Knee

  1. Carlos Moreno - ikemoreno@hotmail.com says:

    I have worked with Blain through all of my years at BYU and,
    I can say that he is truly the best at what he does.
    Props to GMS. Nice catch.
    Looking forward to the next great post.
    Thanks!

  2. Mike Wall says:

    Hi Carlos – Thanks for posting! Are you still playing?

    Mike

    1. Carlos Moreno - ikemoreno@hotmail.com says:

      Hello Mike!
      Yeah, I’m still playing overseas.
      Hows Idaho treating you?

    2. Sorin says:

      If you are a middle or an ouditse or a right side work on your hitting, if you are a setter work on setting, work on making accurate passes, also work on making your serve powerful and accurate, and finally make sure that you are ready to be friendly and to show team work and team spirit. Here are some exercises that you could also do to get in shape:Wall Squats: Place your back firmly against a wall and bend your knees as tho you are sitting in a chair, hold that position for 60seconds.Wall Hits: Take a volleyball in both hands and extend your arms up, face a wall and stand so you are almost touching the wall, jump up and hit the ball against the wall at the peek of your jump, keep going for 60seconds straight and as fast as you can.Shuffle Jumps: Mark two parallel lines 10 feet apart, stand in the ready position’ with the line in between your legs, staying in the ready position’ shuffle as you would in a game as fast as you can to the other line, when you reach the line extend your arms in the air and jump as high as you can, then shuffle back to the other line and jump, repeat for 60seconds straight.Towel Running: On a hard wood floor mark 15 feet, place the towel on the ground at the beginning of the 15 feet. Place your hands on the towel and keep your feet behind you, push off with your feet keeping your hands on the towel well walking’ you should look similar to a cat. go back and forth as fast as you can for 60seconds.Exploding Jumps: On a set of steps place one foot on the step and one foot on the ground. Launch off the step with the foot that is on the step and extend your arms in the air as you jump, quickly change the feet so the foot that was on the step is on the ground and the foot that was on the ground is on the step and repeat as before for 60seconds at a high speed.The Almost Push-Up: Place your fore arms on the ground and your toes so you are in the push-up position but insted of on your hands you are on your fore arms, and then hold that position for 60seconds.Also you can sprint, jump rope, do sit ups and push ups.Good Luck and I hope that I helped!

  3. Jeremy says:

    Thanks for the article! I experienced the evil of jumper’s knee off and on in high school and club and as a coach it is good to know how to help prevent the same misfortune in my athletes!

  4. Brett says:

    Lots of useful information. Really looking forward to the article about shoulder issues. As a high school coach, I have more girls complain about shoulder pain.

  5. Josh Taylor says:

    Helpful! Please post on shoulder issues as well!!!!!

  6. Coach GB says:

    Thanks for the much needed info.

    I think there are other factors out of our (coaches) control that may contribute to athlete injuries; tournament formats where athletes get no break to refuel and hydrate but must either play or officiate all day, small free space perimeter around the court-we train in an open gym and then get to a tournament with very limited space around the court and must adjust on the fly, hard concrete floors with minimal absorption court surface at most big tournaments, inadequate prevention of stray balls flying on your court during intense play, etc. These type issues need to be addressed by the governing bodies. I had 2 separate incidences of potentially dangerous errant balls on our court during match play this season, with no stoppage in play. It seems tournaments are more concerned with running on time than preventing potential hazards on the court. I have instructed my team to grab the errant ball and hold it until the ref sees them rather than try and kick it out of the way and make a play from an awkward body position.

    Thanks again for the info, I look forward to your posts.

    1. Nataly says:

      Passing: Let’s call it the Speed Control Drill Needed:you and a ballTake a ball, throw it against a wall, nice and high. Pass that as close as you can to a desgtnaied area on the same wall. (pretend it’s a setter, so make it your height.)Take the same ball, throw it harder against the wall, pass it to the target.Continue throwing hard and soft and vary the direction. You will learn how to take some power off the ball on hard-driven serves and you’ll learn how to power soft free balls.Setting:Let’s call this the Target Control Drill Needed: You, a ball, and a trash can or twoPlace a garbage can somewhere off the wall, anywhere is fine at first. Bounce the ball off the ground so that it bounces upwards off the wall (The pass). Approach the pass keeping the wall to your left to simulate the pass coming from your left. Receive the pass and set the ball into the trash can (The set) Try to get 10 successful sets out of 50 and increase that number the better you get.As you get better, move the garbage can around to any difficult spot, you can also set up a court with chalk and set the OH, MH, and OPP. getting this control down is important. Coaches can teach you tempo sets once you get the control.Hitting:Let’s call this the Dual-hand training Drill.Needed: A Ball and YouStand about 10 feet from the wall and set yourself straight up. Hit the ball down so that it hits the floor first, then the wall. The ball will return to you if done right. Get better at using one hand, then practice using the other non-dominant hand. Try to keep the ball going without stopping for 2 minutes.As you get better, increase the time-limit. This will help you become more proficient at using and controlling your lefty (if you are right handed) and add another hit to your arsenal making you a more lethal force as a hitter.Key to this drill is control. If you have no control, the drill won’t last long. Don’t get frustrated, you’ll get it.Hope that helps. I tried to make these drills as game-like as possible. I’m sure some others will add some of their tricks as well.

  7. Evzusa says:

    It’s thes ekind of topics that are in rare discussion. Yes, I know, you can “Google” and find a plethora of links, articles and sponsor sites. I found this article informative and precise. Keep them coming. Thanks

  8. Great post,VERY USEFUL INFORMTION.

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