Jumping on Knee's

[Thorxes]

Hey everyone,

A brief summary of my (knees') background: I'm 29. I play volleyball quite a bit, or at least used to. I was having really bad knee pain just below (not under) the kneecap. Went a few months without seeing a doctor. They got so bad that I couldn't bend over to pick up something from the ground.

I saw a doctor early January of this year. They said it was patellafemoral and gave me some PT stretches/exercises. I did them, but still played volleyball. 5 months later I had acquired new symptoms (static knee pain while sitting), and the pain had only gone down marginally. Got a second opinion, had an MRI, was told it was tendonosis. Was given 1 PT exercise and told to use patella straps along with Voltaren Gel.

Saw a third doctor. He said to do PT, stay off the legs and vball and gave me a cortisone shot in my left knee (which I regret letting him do).   My pain level is reduced significantly, and at least for another 2 weeks I plan on not playing volleyball.

So here's what I think happened: I had patellafemoral syndrome (PFS).  That along with continuing volleyball turned into a severe tendonosis. The PT fixed my tracking issue with PFS, but the damage to the tendon had been so bad that I still continued to have pain. Based on some reading I've done, one of the only things that will help the collagen alignment in my tendon is to do eccentric decline squats, which I've been doing. This should help realign the collagen in the tendon and build the strength back up.

My question is, whenever I start being active and jumping again, what should I focus on to help prevent this from happening again. I plan on keeping up with the strengthening and flexibility exercises to keep my tracking normal. But as far as jump form and landing, I'm not entirely sure.

I've read that you should use your calves to help take the initial shock off a jump when landing. Can I start doing exercises now to help with that that won't hurt the tendon while it's healing? If so, what should I do?  Or should I focus on landing another way?

As far as jumping, is there a particular way to jump that will help? Should I focus on using more hamstrings and glutes rather than quads? or vice versa? With all the exercises I've been doing, I have a lot more strength in my legs. It's to the point where I can flex and feel muscles at the top of my shin and around my knee. SHould I be flexing these muscles while jumping? Or does that end up doing more harm than good?

I've tried searching this stuff, but all I ever find is vertical jump programs that help you jump higher. Nothing that really focuses on form and injury prevention or injury consideration.

Thanks in advance for any feedback.

[allyd]

I don’t know much about tendonitis, what can/can’t help this specific injury, along with prevention. But with any knee injury focus on a complete leg strength, quads, hams, glutes, hips and core.

In terms of jump form and landing… It should be (in my judgment, and my PT’s) the same principles as doing a proper squat. When jumping or landing - Knees shouldn’t go past your toes, and take caution that your knees are not turning/caving inwards on impact. Well rounded strength will make proper form much easier.

[Thorxes]

I plan on doing exactly that.

Do you know if I should focus on jumping from my heels more than rolling onto my toes when jumping? This would be more inline with the squat form, but I don't think that's right. But then again, that's why I'm here.

Any information on landing would be appreciated as well. I assume that PFS causes damage when jumping...but I've heard that landing incorrectly can also cause damage to the tendon, so I'd like to avoid that and find out how to train.

[allyd]

I wouldn't say to jump from your heels (or land especially) but just watch your overall body allignment when rolling onto the balls of your feet to launch. The common mistake is that people lean/shift their weight forward and bend only at the knees. THis takes your knees past your toes and all the stress of that jump is on the knee. To correct my form, my PT always just tells me to stick my butt out and back when going into a squat - same principle applies to jumping/landing. When landing, you definitely want to absorb the landing on the balls of your feet, but again, watching your overall allignment... I don't know if that makes sense in words? It would be a lot easier to demonstrate! lol. I guess the short answer is yes, you'll want to use more of your hips/glutes/hamstrings to jump than just your quads.

As my doctor likes to point out overall: When we get injured contributing to it is poor mechanics/form/etc. We don't want to "re"hab afterwards, as if we simply rehab we end up with the same mechanics etc that caused the injury in the first place. What we want to do is habituate our bodies to more ideal movements for prevention. Perfecting your form on squats (both single leg and double) will eventually become part of your subconscious movements and translates when you go to jump... at least I know it has for me. That plus a lot of reps on glute, hip and core exercises...