Knee pain in Indian classical dancers is a very common complaint. The location of pain may sometimes help with the diagnosis. Quadriceps tendonitis may cause pain on top of the knee cap. Pain along the sides of the knee cap can be related to arthritis, injury to the ligaments of the knee joint or menisci. Patellofemoral pain syndrome is usually described as pain under the kneecap and is the most common cause of knee pain in young adults. Patellar tendonitis usually causes pain along the inferior portion of the knee. This article will briefly discuss patellar tendonitis. Articles that follow will discuss the rest of the causes of knee pain.
The knee joint consists of two articulations (tibiofemoral and patellofemoral). In other words, the knee joint is a hinge joint, that is made of parts of the thigh bone (femur), shinbone (tibia) and the knee cap (patella). It is stabilized by several ligaments. There are also two cushion-like menisci, which act as “shock absorbers” and dissipate forces. The quadriceps are muscles involved in knee extension. They are the group of muscles located on the front of the thigh. Here is a simplified diagram of the knee:
Patellar tendonitis is an overuse injury, and is also known as “jumper’s knee.” The patellar tendon is located just below the patella (knee cap), and attaches to the tibial tuberosity on the tibia (shin bone).
The patellar tendon transfers the force of the quadriceps muscles and allows the knee to extend. The greatest level of stress through the patella tendon is during jumping and landing activities. Repetitive knee flexion (bending the knee) and extension (straightening the leg out) puts the dancer at risk for this condition.
As we know, flexion and extension of the knee and jumps are present in the majority of the steps in Indian classical dance. Examples in Kuchipudi include the third fundamental step, the Tham Tha Thadinda series, the Thom thom tha dha series, the Thai tha kita thaka series, etc.
Dancers with patellar tendonitis will have pain right below the knee cap, or anywhere along the tendon. Pain is worse with jumping, landing or running. The onset of pain is usually gradual and is associated with a sudden increase in training intensity.
Sometimes there are biomechanical deficits that can lead to unequal distribution of forces along with the links in the kinetic chain. This is why the proper technique is crucial. Treatment usually includes rest, ice, anti-inflammatory medications, quadriceps stretching and strengthening. Tendinopathies respond best to an eccentric based rehabilitation program. Sometimes a patellar strap helps alleviate pain. It is also important to address the biomechanical deficits and correcting those (more on this in later articles).
This post discusses a common cause of knee pain in Indian classical dancers and is not medical advice.