As an osteopath in a busy clinic each week I see patients with a wide range of mechanical or musculo-skeletal problems. Typically, these revolve around lower back pain, sacro-iliac joint pain and a growing number of neck and shoulder problems.
I recently saw a teenage gymnast who was suffering with pain at the front of the knee. The pain had been gradually worsening and had started to become more difficult to settle down between training sessions. After I examined the knee, I concluded that the diagnosis was most likely to be ‘jumper’s knee’ otherwise known as patella-femoral pain syndrome. This is a problem that occurs in people of various ages but is quite common in sporty youngsters. It occurs at the point at which the tendon of a muscle attaches itself to the bone.
‘Jumpers knee’ is more common in athletic situations where the knee has to bend under tension for example when a long jumper lands in the sand pit or you’re running around a pitch or court and changing direction. It is also seen in gymnasts and ballerinas. The repetitive stress of this movement can overtime cause micro tears and the insidious start of pain. There are various stages of progression which begin with pain only at the end of activity to pain that is eventually pretty well constant.
As with so many problems osteopaths see, the trick is to understand the bigger picture to allow the issue to be fixed properly. We look at ‘intrinsic’ and ‘extrinsic’ factors. In this example, the intrinsic factors amongst others include the individuals overall mobility, the angle of their knees to start with, their muscle flexibility and the balance of strength between the hip and thigh muscles. Extrinsic factors include the frequency and intensity of training, what surface they train on and how good (or old) is their foot wear. A study showed that playing on harder cemented surfaces increased your chances of this condition seven fold and playing four or more times a week significantly increased the likelihood of a problem compared to playing just twice a week.
To fix this problem, it was important to understand the surrounding circumstances. Apart from the use of various treatment techniques, the use of ice in the early stages and eventually the correct application of a stretching and strengthening regime. We needed to modify the frequency and intensity of the training, review the footwear and educate the individual on adequate warming up procedures and demonstrate flexibility exercises to do.
Doing all of this, should not only improve the likelihood of a successful outcome but hopefully go some way to prevent future reoccurrences which is what it is all about.
If you have an injury that is troubling you – please feel free to contact the practice where one of the osteopaths or the remedial sports therapist will be happy to help.