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I'm starting my senior year in high school with a bad case of jumper's knee. I'm also the captain of our volleyball team. I really want to play this one last year. Therapy hasn't helped. Should I try steroid injections?

"Jumper's knee" or patellar tendinitis is a common problem in athletes who repeatedly jump. The landing puts stress loads of up to 11 times the volleyball player's body weight on the extensor (knee) mechanism.

Without enough time to heal, microtearing of the patellar tendon from frequent loading results in chronic tendinitis. Continued sports participation will only aggravate the condition. Steroid injections may put the tendon at risk for rupture. They are not advised unless everything else has been tried without success.

If you have tried the usual treatment of rest, physical therapy, taping or bracing, and antiinflammatory drugs, then further treatment may be needed. Experts advise using warm, moist heat before activity. Wear an elastic knee support during play.

Once the inflammation is under control, then a special exercise program can be started. The physical therapist will instruct you in eccentric strengthening exercises. Warm-up and stretching before the main program of exercises should be followed by cool down stretching and ice. Ice is used on the patellar tendon for five minutes after the program.

If you have a more advanced condition, then treatment may include shockwave therapy or surgery. Shockwave therapy is still an experimental type of treatment. Surgery to clean the tendon of all inflammation and dead tissue is a final effort to help stimulate healing. Surgical treatment is only advised for patients with persistent, disabling pain who have had at least six months (or more) conservative care.

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