During jumping sports where great amounts of stress are suddenly placed on the lower extremities of the body, patellar tendinopathy, best known as jumper’s knee, can be a frequently reported type of injury. Patellar tendinopathy, or PT, ultimately alters an athlete’s overall performance, affecting their capacity to jump, land, run and change direction. While their decline in performance can lead to decreased training tolerance, the symptoms associated with the condition also often results in missed training days and competition for a majority of athletes.
For those individuals diagnosed with PT, managing the condition can be very challenging, especially for athletes during the competition phase of a season. Because increased amounts of force are constantly being placed against the tendon, patellar tendinopathy may commonly require many treatment sessions before it can truly begin to heal. It’s essential to be patient during the rehabilitation process to achieve a full recovery.
Taking this into consideration, several guidelines may be followed in order to properly formulate a rehabilitation program to restore the original state of the individual’s patella tendon and help athletes return to their regular training routines as soon as possible.
When an individual is experiencing symptoms suggesting the presence of patellar tendinopathy, a thorough subjective history must be taken before a clinical examination takes place to help give a more accurate diagnosis as well as give an understanding of the potential causes and the severity of the patellar tendinopathy. The injured athlete should be assessed for past history, as this may help conclude the state the tendon pathology is in. If said individual presents a long history of tendon pain, the tendon pathology may have become worse over time. This is best referred to as a degenerative tendon. Treating the condition may be different according to the varying stages of the tendinopathy. It’s also important to identify other possible musculoskeletal injuries which may have contributed to the weakening of the tendon. For example, a past knee injury may have altered the individual’s leg structure, weakening the supporting muscles. If the athlete’s tendon capacity has been previously affected, it may be at risk of developing further complications. Prior rehabilitation treatment received at the time of the first injury is also important information for healthcare providers. In some cases, trauma from an injury after being involved in an automobile accident can damage the tissues surrounding the knee, leading to symptoms similar to patellar tendinopathy, or PT.
Once the past history evaluation is completed, a healthcare provider may follow up with a primary diagnosis to further determine the damage or injury to the tendon, and understand the reasons behind the development of their PT, before continuing with a physical assessment. Athletes with patellar tendinopathy, or jumper’s knee, tend to experience specific symptoms, often located directly over the proximal patellar tendon. The location of pain is usually stationary. Patellar tendon swelling is a general indication of a reactive tendon. The inflammation can cause additional pain in the knee. Careful observation of the athletes muscle strength should be provided throughout the assessment as muscle atrophy and weakness signals a decreased capability to withstand pressure on the tendon.
Notice: Clinic News & Events
A physical assessment is focused on confirming the initial assumption, without considering other possible explanations for the damage or injury of the athlete’s patellar tendon, and conclude the irritability of the tendon to determine the individual’s level of disability. Tendinopathies are frequently described to be painful after participating in physical activity, most notably, after the first day. This assists with the diagnosis of a PT.
Furthermore, imaging using MRI and ultrasound can also be utilized to identify the presence of a pathology in the tendon. Ultrasound tissue characterization is used to demonstrate the current state of the tendon which can help identify the range of the structural pathology. However, the presence of a PT on imaging does not necessarily show the source of the individual’s symptoms and further diagnosis may be needed. Management of an injured tendon may be different depending on the phase of the tendinopathy.
Direct trauma from an injury as a result of an accident, especially on the knee, can aggravate the condition of the patellar tendon. A strong blow to this region can lead to pain and soreness. Alternatively, a tendinopathy occurs when the load being placed against the tendon is too great for its capacity, often as a result of a sudden and/or substantial change in pressure. A change or increase in training routines is often a frequent cause for patellar tendinopathy. Simply modifying your workout routines can allow the symptoms to resolve on their own, potentially avoiding them in the future. Aggravating activities for patellar tendons depend on the irritability of the tendon. Physical activities which usually aggravate patellar tendinopathy include kneeling, squatting, jumping and in particular landing, changing direction and decelerating, because these add direct pressure on the tendon.
While the pathology of the tendon may not necessarily offer a solution, conservative, non-surgical treatment options, such as chiropractic and physical therapy, can be beneficial for PT. These alternative treatments focus on managing the symptoms with careful planning and education.
Getting plenty of rest is important to rehabilitate the tendon. Nevertheless, the athlete must make sure to remain physically active because stopping physical activity completely can decrease the overall capacity of the tendon. The overall capacity applies to the amount of pressure a tendon is able to endure during strenuous physical activity. To make sure the athlete doesn’t damage or injure themselves further while still remaining active, a healthcare professional may recommend isometric single leg knee extensions and/or single leg decline squats to help reduce the pain. Five repetitions of these for 10-60 second holds, four-times per day is a generally approved amount of these, to help individuals with PT. For reactive tendons, isometric contractions with mild to moderate amounts of pressure are believed to effectively reduce the symptoms for hours. Before attempting any of the above exercises, it’s important to consult your healthcare professional to properly determine the correct time and appropriate resistance of each exercise for every individual athlete to prevent other complications.
With reactive tendons, avoiding any pain trigger is crucial towards preventing further aggravation of the condition. For tendons affected with degeneration, single leg decline squats on a wedge followed by three vertical hops should be utilized to supervise the athlete’s pain and response to the added stress on a daily basis. Also, applying ice therapy after physical activity for about 20 minutes will help reduce the inflammation and swelling around the affected region of the patellar tendon.
An athlete should be well educated on the significance of rest on their injured tendon and how essential it is for them to not push past 3 out of 10 on the visual analogue scale, or VAS, for their pain symptoms, especially during the reactive stage of a tendinopathy or the symptoms may worsen. Mild soreness the next day after engaging in the recommended physical activity is normal. Moreover, the individual should be educated to gradually increase the amounts of pressure they place on their tendon. Suddenly and quickly raising the load could risk a flare up of symptoms. Likewise, avoid stretching the tendon through quadriceps stretches. Compressing the tendons once patellar tendinopathy has developed can further aggravate the condition. Soft tissue massages and/or acupuncture through the quadriceps and hip flexors may be used instead to maintain the range of motion of the knee and hip.
In some cases, a healthcare professional may recommend over-the-counter medications, such as ibuprofen, to help relieve the symptoms. In other cases, a physician and dietician can discuss the use of a high dose of fish oil and green tea to help improve the athlete’s symptoms.
Managing the symptoms of an athletes patellar tendinopathy is primarily focused on achieving the correct balance of rest and continuing fitness during recovery. Closely observing the injury provides the necessary information regarding the tendon’s response to the added pressure and stress throughout the rehabilitation process.
The athlete’s training programming should be heavily monitored during the competition season to ultimately reduce the amount of stress and pressure being placed against the tendon. The main goal is to modify the individual’s training routines to reduce the load being placed against the affected tissues. The new programing should cycle an athlete’s week into high, low and medium load days to allow the tendon capacity to adjust to the challenging workouts.
High-load days can involve heightened quantities of stretch shortening cycles, or SSC, including training routines with plenty of running and jumping.
Medium-load days can involve specific tendon strengthening exercise routines and/or moderate running and jumping activities.
Low-load days should involve isometric holds only.
Programming an athlete’s training week once diagnosed with patellar tendinopathy can be challenging, not only because the individual’s symptoms are being monitored, but because other athletic factors, including match schedules and overall recovery periods after a game, can often be difficult to manage on their own.
While an athlete is engaging in physical activity training routines during the competition phase of the season, it is difficult for the pain and discomfort associated with PT to ease entirely in order to gain strength. Specialized programs for many athletes can take time depending on the level of damage or injury to the tendon. A less than 3/10 pain level should be the athletes limit at this time and exercises should cease if this level of pain or higher is present.
Exit Criteria for Jumper’s Knee Pain
To start jogging after being diagnosed with PT, the athlete should no longer experience any pain while walking and they should be able to implement the following program while experiencing a score of less than 4 out of 10 level of pain after engaging in the recommended training session: four repetitions on each side of decline SL squats on wedge where the pain ranges less than 3 out of 10; SL calf raise repetitions of 25 on each side; 30 second on/off DL skip repetitions of 5; 40 second on/20 second off alternative skip repetitions of 10; DL hopping/landing progressing to SL hopping/landing sequences including forward, lateral and multi-directional hopping; and running progressions on a treadmill, if available, starting gradually from an entry level of 70 to 100 percent weight bearing.
As previously mentioned, once the athlete begins to introduce running into their training routines, it must be closely monitored and programmed to include high, low and medium days.
In conclusion, patellar tendinopathies can be challenging to manage for athletes during the phase of a competition season, therefore it’s important to take a thorough history check of the individual to understand the cause of the injury. Once diagnosed, relative rest and a high, low, medium programming modification of training days should be established to relieve the stress on the tendon. Properly managing the symptoms of PT are crucial towards the athlete’s recovery. By focusing on a series of isometric exercises, pain relief can be achieved. If the symptoms of the condition are monitored and properly cared for on a daily basis, the athlete has a higher chance of ensuring they continue to compete for their season without further aggravating their jumper’s knee.
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Sourced through Scoop.it from: www.elpasochiropractorblog.com
By Dr. Alex Jimenez
These canons of professional ethics are based upon fundamental principles of moral and professional behavior and recommended for all doctors of chiropractic and chiropractic assistants. The following basic principles should be guiding factors in the practice of chiropractic and upheld at all times:
Consider the well-being of the patient. The primary effort and ultimate goal is for the greatest good of our patients.
- Dr. Alexander D. Jimenez D.C., C.C.S.TChief Clinical DirectorPhone: 9155408444Email: firstname.lastname@example.orgSpecializing in Severe Pain: Sciatica, Neck-Back Pain, Whiplash, Headaches, Knee Injuries, Sport Injuries, Dizziness, Poor Sleep, Arthritis. We use advanced proven therapies focused on optimal mobility, health, fitness, and structural conditioning. We use Patient Focused Diet Plans, Specialized Chiropractic Techniques, Mobility-Agility Training, Cross-Fit Protocols and the "PUSH System" to treat patients suffering from various injuries and health problems.
Message from: Dr. Alex Jimenez D.C., C.C.S.T
( Biography and my promise to you )
My name is Dr. Alex Jimenez, I am Chiropractic Doctor specializing in advanced therapies focused on total joint health, strength training and complete fitness conditioning. We use patient Focused Diet Plans, Advanced Chiropractic Techniques, Agility Training, Cross-Fit and the PUSH System to treat patients suffering from various injuries and health problems. Our goal too is to help your body heal itself naturally. When your body is truly healthy, you will arrive at your fitness level and proper weight efforlessly. We want to help educate you on how to live a new and improved lifestyle. Our doctors have spent over 25+ years researching and testing methods with thousands of patients. We strive to create fitness and better the body through researched methods and total programs...
My goal too is to help the body heal itself naturally. When your body is truly healthy and balanced, you will move pain free and ultimatly arrive at your optimal fitness levels and proper weight effortlessly. We want to help educate you on how to live a new and improved lifestyle. Our doctors have spent over 25 years researching and testing methods with thousands of patients. We strive to create fitness and better the body through researched methods and total programs. These programs are natural, and use the body's own ability to achieve goals of improvement, rather than introducing harmful chemicals, controversial hormone replacement, surgery, or addictive drugs. We want you to live a life that is fulfilled with more energy, positive attitude, better sleep, less pain, proper body weight and educated on how to maintain this way of life.
The focus on spinal and skeletal adjustments is what makes doctors of chiropractic unique in their approach to treating patients with spinal complaints. This hallmark chiropractic adjustment, however, is not the only procedure a chiropractor may employ in managing a patient's care. I am very proud to bring my patients a variety of treatment options beyond the typical scope of care. With the advances in physical therapies and modalities we bring El Paso option that better aid in the rehabilitation process. Tissue healing is a wonderful process that begins the moment an injury occurs. How the injury is managed determine the final outcome in terms of healing. It is critical we implement immediate procedures as soon as we can in order to gain optimal recovery. The old day of let it rest until it gets better is not the only option.
Letting it rest may even be an irresponsible approach considering what we now know. The implementation of active and movement based treatments have clearly shown increased and improved outcomes in many instances.
As a doctors focused on the greater good for a patient, we must assess each patient individually and apply the appropriate protocols. It is also very important to denote, that El Paso has fine doctors in many specialties of healing and repair. The direct relationship we have with specialist of these disciplines is clearly what allows us to bring the highest quality of care to our patients.
My promise to my patients is clear for all to read here. I, with Gods help, will do what ever it takes to assist you in your recovery. I too will draw upon all the specialist in this town to find you the collaborative care that is required with the disorders being tended to.
With Great Regards to you.Read moreRead lessEducation:
Affiliations and Certifications:
Visit websiteServices Provided:
- Texas Chiropractic Association
- Chiropractic Care
- Physical Therapy
- Strength Training
- Crossfit Doctor
- Return to Competition Rehabilitation
- Truide TorresExecutive Director / Patient LiasonPhone: 9152526149Email: email@example.comDirector: Patient Relations Advocate Dept.
Truide has been working for the past 20 years in claims resolutions. She works hand in hand with patients and is availible to resolve dispute resolutions.
Truide Torres (Bio)
Driven by the passion of doing what is in the best interest of the patient, I wake up every morning with the drive to help those in need. The claims process for health care is full of pits, valleys and difficult obstacles designed to strike fear in those in need. My duty is to do what is within the confines of the law, "what ever it takes" to get those involved to pay attention to those who need help. That is what I am honored to do for our patients.
Personally, I have seen great injustices transpire on those that do NOT have a voice. Whether, a language barrier or just not knowing the rules. My job is to find out how I can help. If I personally can not help, I will find the right sources to open the possibilities. I get the job done.
As a wife and mother of 2 children, 3 dogs and 2 Cats. My passion is for God, Family and the mission of serving my fellow man.
Let it be clearly stated... I am here to help. My phone 915-850-0900Read moreRead less
- Daniel AlvaradoExercise PhysiologistPhone: 9152038122Email: firstname.lastname@example.orgDaniel Alvarado is the owner and the top trainer at PUSHasRx® CrossFit Fitness Facility. Since becoming a Trainer Daniel has kept up to date on many continuing educational classes, ensuring that his clients receive the most comprehensive and advanced training. Working directly with the Doctors, he develops and collaborates on care plans that are patient specific. No patient ever gets the same clinical protocol. His expert clinical kinesiology experience spans over 2 decades. He has trained injured patients and NCAA National Champion Athletes. His technical ability to create programs that are clinically sound and second to none. He too has used his physical therapy and recovery experience to take broken top tier athletes into strict recovery protocols assisting them to achieve highly competitive national championships. He certainly will not admit it but, he is a top national champion trainer. Daniel, also develops youth programs that are sport specific to aid young athletes achieve great success. His mastery of clinical recovery is applied applied to all patients and top tier athletes alike. All patient programs are specifically designed with patient focused recovery priorities. He is happily married to beautiful Victoria Alvarado has one child. He enjoys strength training, movies, singing, conducting, writing poetry and being a CrossFit champion. Just a way cool dude. We think you will agree.Read moreRead less
- Dennise AcostaHead Office ManagerPhone: 915-850-0900Email: email@example.comDennise has been at Injury Medical & Chiropractic Clinic for four years. Known as the master multi-tasker. Dennise, handles patient care from the moment you walk in the door. She is akin to the air traffic controller. She will assist you in matter requiring clinical preparation and effective inter-office communication. She unifies all department and clinical providers making sure all important information reaches all clinicians in a timely manner. She also loves to work out, stay in shape, watch movies and help people.Read moreRead less
- Sandra MartinezHead Clinical TherapistPhone: 915-850-0900Email: firstname.lastname@example.orgSandra has been working at Injury Medical & Chiropractic Clinic for over 5 years. As the head Licensed Massage Therapist, she manages and directs critical aspect of clinical care. The patients love her ability to make you laugh while removing those pesky trigger points causing pain. She is able to relax and bring comfort to all she touches. There just simply is no patient that escapes her talented touch. Trained in advance myofascial techniques, she is an integral part of patient recovery. You will never see anything but a kind smile and resolute persona ready to correct your condition and aid in your recovery. She definitely enjoys helping people, has 1 dog and loves movies. She loves flowers too.Read moreRead less
- AlejandraBilling AgentPhone: 915-850-0900Email: email@example.comAlejandra works in accounts & billing. She is the radar of the bunch. Nothing appears to escape her mind. Highly intelligent and appears not to need a computer for recall of facts. She provides information retrieval for patients and clinical staff. She has been at Injury Medical & Chiropractic Clinic for three years and ready for any task at hand. She performs interoffice communications with attorneys and medical director of ancillary offices. She loves her family and places know how to prioritize well.Read moreRead less
- Mike ContrerasPersonal TrainerPhone: 915-203-8122Big Mike was born and raised in El Paso and is an excellent personal trainer and CrossFit coach. Mike works hand in hand with each patient’s clinical care plan in order to achieve optimal outcomes. A trusted clinical representative of the PUSHasRx System along with his advance protocols. Mike not only trains the injured and recovering. Mike is a sincere human that has great talent of brining out the best in every individual he works with. He will never admit it, but we will share with you a secret. He with his God given talents trains the greatest athletes and champions in El Paso. Many champions in our community know of his commitment. As a youth, he also played football (wide receiver), basketball, and track at Bel Air High School. Educated in Clinical Human Kinesiology at UTEP and loves playing football and basketball with his little nephews in his free time. Mike has three sisters and one brother, most of which live nearby in El Paso. When he’s not watching the Cowboys or Spurs play, he’s usually lifting, sleeping or watching movies. We are blessed to have this soul on our team.Read moreRead less
- Alexander Isaiah JimenezCollegiate Athletic Consultant & NCAA Wrestling ChampionPhone: 915-820-9443Email: firstname.lastname@example.orgAlexander Isaiah Jimenez leads the power and agility education programs for the high school athletes. While still studying for his medical degree he provides physical performance testing in order to collaborate with clinicians. He is gifted in creating physical performance programs no matter what the clinical presentation is. As national fitness champion and collegiate wrestler, he too understands what performing at high levels entails. He too has had to recover from debilitating injuries only to return better then before an win national titles. He understand how the recovery process is different for clients, patients and extreme athletes. We are blessed to have his counsel.Read moreRead less
- Ethan PadillaPersonal Trainer & Strength CoachPhone: 915-203-8122Ethan was born and raised in El Paso and is one of our most outgoing and friendly coaches. Ethan earned his nickname “rampage Ethan” from his years at El Dorado High School, where he played inside linebacker. He has placed twice in the Strongman Competition and also recently competed in the Desert Games with his fellow PUSH Athletes as a team and placed 4th overall! Ethan is currently pursuing his Bachelor’s Degree in Kinesiology at UTEP. His focus on clients is obvious to all. Ethan is able to manage very large groups of individuals like no other. His awareness of the dangers while exercising is his greatest concern. When he’s not coaching or studying for class, he likes to spend time with his family (who are here in El Paso) or with his weimaraner puppy. Fun fact: Ethan loves any food with sprinkles (especially donuts with sprinkles) and is a diehard Seattle Seahawks fan.Read moreRead less
- AndresRecovery & NutritionAndres has been at PUSHasRx for two years. He brought his company Recovery and became the official juicer. Andy will fix you right up. Andres, will make sure that your nutritional recovery programs fits within your standards. Also, there is great care in making sure the nutritional requirement are clinically met. Patients and high performance athletes depend on high performance nutritions. Upon your completion of the physical medicine portion of therapy you will be offered specialized organic recovery drinks and supplementation to help aid in your recovery. You will be confident that from your pushing to recovery, you will be taken care of.Read moreRead less
- Iylene AvalosPUSHasRx TrainerPhone: 915-203-8122ylene has been working with us for over 4 years. In her spare time she enjoys working out and running. She has 2 dogs and loves movies. Iylene is extremely aware of body mechanics and mindfully watches rehabilitation movements. She is always standing ready to assist and respond to client needs. Her commanding voice is always clear to all, no matter what floor you are on. Iylene is always ready and willing to answer any question you may have regarding fitness and recovery.Read moreRead less
- Rick CanoPersonal Trainier Level VPhone: 915-203-8122Most early-rising PUSHasRx members know Rick well as a fantastic coach who focuses strongly on form and will always make you laugh. He was born and raised in El Paso and loves to train his athletes and coach CrossFit. Rick is a very diligent, kind and considerate trainer. He is always mindful of client techniques and aware of client goals. When he’s not coaching, Rick loves to work on cars, especially his ’69 Chevelle (his next car will hopefully be a ’69 Charger). He not only became a certified Automotive Mechanic at 17, but while working on his certification at EPCC, he won 1st place in a bench competition when he was 16 (approx. 56 reps at 155#). His favorite movements are clean & jerks and snatches. He loves oreos (eats them every night), loves watching the CrossFit games, and loves his three bulldogs. He spent one year full-time personal training before he started coaching CrossFit two years ago. He is CrossFit Level 1 Certified and hopes to get his Level 2 Certification soon. Rick has competed in several competitions, including WOD for Toys in 2014, where his team placed 1st.Read moreRead less
- Astrid OrnelasBlogger/Research/CuratorPhone: 915-850-0900Astrid has been at Injury Medical & Chiropractic Clinic for about three years. Astrid has taken her love for writing to an new level. She is a gifted and talented copywriter able to create amazing storylines. She creates content for patient consumption. She is able to bring words to life in a way that perplexes even the elite authors of the day. She loves nutrition and the healing power of clean eating. A naturalist at heart you will never see her eating processed foods that would be contra to clean living. She enjoys movies and creating storylines for Anime.Read moreRead less
- AdamVideographer & Graphics SpecialistPhone: 915-850-0900Adam has been at Injury Medical & Chiropractic Clinic for about a year. He enjoys designing and various forms of art. A story teller by trade he can see things people don’t see until his masterpieces are revealed. Adam is a director of many medias using the top graphics, audio and video medias to tell the story of our patient. Modest to the core, you would never know what he is about to create. We are blessed to have his talents telling the world about Chiropractic using any and all medias available.Read moreRead less
- Our PassionsEmail: email@example.comWe Welcome You 👊🏻.
Purpose & Passions: I am a Doctor of Chiropractic specializing in progressive cutting-edge therapies and functional rehabilitation procedures focused on clinical physiology, total health, functional strength training and complete conditioning. We focus on restoring normal body functions after neck, back, spinal and soft tissue injuries.
We use Specialized Chiropractic Techniques, Balanced Diet Plans, Agility Training programs, Cross-Fit techniques, the PUSH-Rx Rehabilitation System and a highly specialized program for our Veterans.
We've been blessed to use our methods with thousand of El Pasoans over the last 27 years. This has allowed us to improve health and restore true fitness through researched non-surgical methods and wellness programs. These programs are natural and use the body's own ability to achieve goals of improvement, rather than introducing harmful chemicals, controversial hormone replacement, surgery, or addictive drugs. We want you to live a life that is fulfilled with more energy, positive attitude, better sleep, less pain, proper body weight and informed on how to maintain this way of life.
As an extension to dynamic rehabilitation, we too offer our patients, disabled veterans, athletes, young and elder a diverse portfolio of strength equipment, high performance exercises and advanced agility options. We are very proud to have teamed up with the cities premier therapist and trainers in order to provide high level competitive athletes the option to push themselves to their highest abilities within our facility.
Come learn how to improve your health for yourself and your loved ones.
With a bit of work, we can achieve optimal health together, no matter the age or disability.
Its all about: LIVING, LOVING & MATTERING! 🍎
2 CONVENIENT LOCATIONS:
(LOCATION#1) CENTRAL ELPASO:
6440 Gateway East, Suite B
(LOCATION#2) EAST SIDE ELPASO:
11860 Vista Del Sol, Suite 128
PHONE: 915-850-0900 ✔️Read moreRead less