Jumper's Knee

[kiwihill3000]

This topic may be better suited to the riders with health issues forum, but after seeing the lower response rate there, I’m turning to this forum. Also, I would like input on biomechanics specifically of jumping + dressage on the rider’s knee… so hoping y’all can help- sorry if this is the wrong place!

I have intermittent knee pain, specifically in the front of my knees (patellar ligament region). I went to see a sports medicine therapist, who ultrasounded a knee and diagnosed me with Jumper’s Knee. Essentially, my patellar ligaments in my knees are angry with me. I did PT which helped some, but not a ton.

My question is, what in riding would cause such stress to this ligament? I’m trying to figure out how to explain what stresses riding applies to my knees to my doctor(s) who know nothing about horseback riding. Anyone have similar experiences? Can someone explain the biomechanics of riding and the knees? I do both dressage and jumping. I currently am couch-bound (weight bearing hurts a lot) BUT I have none- little pain when I ride.

I ride a lot (a couple hours a day) and while I’m not great about working out other than that, I try to stay active. I certainly don’t do any of the activities that Google says causes Jumper’s knee. Plenty of people comfortably ride much much more than I do…so what gives?

[Highflyer]

Could it be mounting/ dismounting? Jumping off a tall horse onto a hard surface is the only thing that really bothers mine-- I try to remember to slide down off the big guys.

[jonem004]

I wonder if it’s the actual work over fences. Like cantering in 2point, and especially the landing side of a jump. If you’re jumping the big sticks, that could be significant. Idk anything about jumpers knee, but is the constant bent kneed position an irritant for that?

I blame riding for my shortened hamstrings. We’re always in a semi squat position, especially when riding in a jumping saddle. Riding can also put significant torque on your knee as you try to wrap the inside (not back) of your leg around a round horse. Knees just aren’t meant to bend that way and the current “toe forward” equation probably doesn’t help.

Maybe none of this is you, but those are the potential knee stressors I see.

[Wanderosa]

Caveat: I’m a yoga teacher and not a PT or an MD.

As you know, ligaments connect bone to bone and serve to stabilize the joint. They can’t stretch much - just a 6% stretch can cause a tear. Even if the ligament doesn’t tear, a loose joint is a destabilized joint and is much more prone to injury. Why is the ligament stretching? Chances are the problem is coming from unhealthy movement patterns in the shoulders, hips, or even the feet. Impingement in the shoulders especially tends to create a movement pattern that disproportionately loads the quads. After a while you’ve got a knee problem. The most common example is an older person who is hunched and rounded in the shoulders. They will typically have issues rising to standing from a seated position due to that hunching and have to lean very far forward with their upper body to do so. This overloads the quads and the knees suffer. My mother never exercised, has osteoporosis, and just had to have a knee replacement for this exact scenario.

The riders I know with knee problems are usually hunters. My theory is this is because the current trend in Eq is to arch your back and really push down into the heels. That means that they’re leaning forward on a very closed hip angle which loads the quads disproportionately. Then they’re pushing their heels way down. This pretty much takes the hamstrings 100% out of the equation. The muscles around the joint are what stabilize it but my hamstrings can’t do much of anything in this position and my quads can’t effectively do it alone. This creates conditions where the ligaments are vulnerable to stretching with high potential for injury to the knee and ankles.

Finally, feet contain 26 bones, 33 joints, and over 100 muscles, tendons, and ligaments. If you’ve never stood square on both feet and then experimented with rolling the weight to the different parts of your feet I recommend trying it. You’ll feel a chain reaction in different parts of the leg depending on the part of your foot where your weight is concentrated. Pretty much the same way a horse goes lame from unbalanced farrier work.

With the doctor’s blessing, two things things you might check out are doing myofascial release work (I use Travell’s trigger points) to break up heavy fascia adhesions before they start causing unhealthy movement patterns and doing exercises to strengthen the muscles that stabilize the joint.

Did the doctor mention if there was any bursitis going on in the joint?

[bornfreenowexpensive]

If it’s not hurting while you ride…I would think then that riding isn’t the issue but agree…getting off probably is. Try only getting off at a mounting block. At least when I’ve had ligament tears in my foot and shoulder…if it hurt, that is how I knew not to do something.

[Mango20]

Are you fighting your saddles for balance? I know when I ski, and am not balanced properly over my boots, I feel a lot of strain over the kneecap from fighting to hold my balance when I’m not leaning forward enough. I would think the same would happen if your saddle makes you fight to keep your position because the balance is too far back.

[kiwihill3000]

Thank you all so much! All your responses have definitely helped me think about it more. @Highflyerand @bornfreenowexpensive I don’t think that dismounting is the cause of my knee pain, but it certainly can’t be helping matters. I’ve been very cautious to sliiiiiide down my horses the past couple days and that has certainly the helped the pain upon hitting the ground at least. Unfortunately it’s also started to hurt while riding, so I guess I probably need to slow down and allow them to rest.

@jonem004those points really make sense! I ride on my college’s equitation team, and the heels jammed way down, toes forward thing DEFINITELY are putting strain on my knees, cause of my issues or not. The last 2 days (since I’ve had the most recent bad pain issues) I’ve had 2 rather intense jumping lessons and it actually started bothering me while I was riding which was a first. Didn’t bother me in my dressage lesson earlier this week.

@WanderosaThank you so much for your input, everything you said really made sense. The doctor did not mention bursitis, only said that the ligament looked “inflamed” and a “little frayed looking” at one end and then sent me to P.T. Unfortunately the other ligaments have also been causing me pain in the past few days sooooo shrug The imbalance between my hamstrings and quads definitely makes sense for me. My hamstrings definitely aren’t as strong, and the same goes for the outside portion of my hips/upper thighs. I’m an unbalanced wreck lol.

@Mango20That definitely could be true for my own saddle. It doesn’t put me in the best of positions unfortunately. However, I do ride in many other saddles that put me in better positions, so I’m not sure! Definitely something to think about though!

[Gardenhorse]

Many people who have knee pain when they ride do better with the jointed/flexible stirrups that have a little more give. Don’t know if that would help you since you said that it usually doesn’t bother you when you are actually riding, but might be worth a try.

[bornfreenowexpensive]

Yup. If it hurts while riding you need rest. I always explain to doctors that it is a similar move as a squat. So if they don’t want you to squat…then you need to limit you riding in a jump saddle. Perhaps a longer stirrup or no stirrups in a dressage saddle. Rest. I use a laser that we have for our horse on myself and our PEMF… both help me a lot.

but a LOT of us older riders try and get off at mounting blocks to save our knees!!!