Patellar Tendinopathy (Jumper’s Knee): 5 Ways To Fix It Without Making It Worse

Patellar tendinopathy, or “jumper’s knee,” is a common issue that brings pain to the front of your knee, making daily activities and exercises harder than they should be.

This pain typically happens when your patellar tendon, which connects your kneecap to your shinbone, is repeatedly stressed and can’t keep up with the demand.

Interestingly, studies show that this condition isn’t driven by inflammation, as you expect, but by small, degenerative changes in the tendon itself.¹

If you’re feeling that familiar ache every time you jump, squat, or climb stairs, you’re not alone. Patellar tendinopathy is common among people who are active or put regular stress on their knees.

Without the right care, this pain can worsen over time, potentially leading to tendon tears or even a complete rupture.

My goal here is to help you understand why this happens and guide you through proven steps to manage and relieve it so you can stay strong and active.

What is Patellar Tendinopathy?

Patellar tendinopathy, or “jumper’s knee,” is a condition where the patellar tendon—connecting your kneecap to your shinbone—becomes painful due to tiny degenerative changes.

This happens most often from repeated strain, especially in sports like basketball or volleyball, which involve lots of jumping.²

Who’s Most Affected?

Patellar tendinopathy is common in athletes, particularly men, who play high-impact sports. In fact, up to 45% of elite basketball and volleyball players experience it at some point.¹

However, anyone with regular knee strain, including some workers, can develop it.

Why It Develops

The tendon endures stress every time you jump, squat, or lift, leading to micro-tears that build up if rest is insufficient. This continuous strain weakens the tendon over time, causing persistent pain.³

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Common Signs You Have Patellar Tendinopathy

• Pain Right Below the Kneecap: You feel a dull or sharp ache just under your kneecap, especially after being active.
• Knee Hurts When You Squat or Jump: Squatting, jumping, or even climbing stairs makes the pain flare up and often gets worse the more you do it.
• Knee Feels Stiff After Sitting: After sitting for a while or first thing in the morning, your knee feels stiff and sore until you move around a bit.
• Tender Spot Under the Kneecap: Pressing on the area right below your kneecap is painful or sensitive to the touch.
• Pain When Slowing Down or Stepping Down: Lowering yourself down, like stepping off a curb, can make the pain spike.
• Slight Swelling Around the Knee: Sometimes, the area under your kneecap looks a bit puffy, especially after a lot of activity.
• Knee Feels Warm: The area around the pain may feel a little warmer than usual after you use your knee a lot.
• Pain Sneaks Up Gradually: The pain often starts small and slowly gets worse over weeks or even months.

Why Does Patellar Tendinopathy Happen?

Every time you jump, squat, or run, the patellar tendon takes on a load, stretching slightly with each movement. Normally, this stress helps your tendon adapt and grow stronger.

However, when the load is too much or too frequent, small tears develop in the tendon fibers. Instead of healing fully between activities, these tears keep building up, causing the tendon to lose its strength and elasticity over time.

This breakdown is known as “degeneration” and is the main reason for the ongoing pain.¹

Why the Pain? Blood Vessels and Nerves

As the tendon wears down, your body tries to repair it by creating more blood vessels and nerve fibers in the damaged area. This is an effort to bring in more healing cells, but it also leads to increased sensitivity.

As a result, even simple movements like stepping down or standing up can become painful, as the nerves are now extra responsive to the load on your knee.⁴

A Condition of Degeneration, Not Inflammation

Unlike typical injuries, patellar tendinopathy isn’t caused by swelling or inflammation that eventually fades. It’s a slow, ongoing degeneration of the tendon tissue.

This means that usual anti-inflammatory treatments, like ice or pain relievers, often don’t help much.

What’s needed instead is a treatment approach that gradually rebuilds the tendon’s tolerance to load, helping it adapt and strengthen over time.⁵

Common Conditions That Could Be Causing the Pain

Patellofemoral Pain Syndrome (PFPS)

Pain around or behind the kneecap, especially with knee bending. Differs from patellar tendinopathy by involving cartilage instead of the tendon.⁶

Quadriceps Tendinopathy

Pain above the kneecap rather than below, often triggered by sudden acceleration or heavy lifting.⁸

Osgood-Schlatter Disease

Pain where the tendon meets the shinbone, common in adolescents, and is more localized than patellar tendinopathy pain.¹

Sinding-Larsen-Johansson Syndrome

Pain at the lower kneecap, typically in growing adolescents and linked to bone growth rather than tendon degeneration.⁹

Meniscal Tear

Sharp pain and possible locking or catching in the knee, typically along the inner or outer side of the knee joint rather than under the kneecap. Swelling is also more common than in patellar tendinopathy.⁷

Common Mistakes People Make When Dealing With Patellar Tendinopathy

Over-Resting or Overdoing It

Total rest weakens the tendon, while pushing through pain worsens damage. A balanced, gradual exercise plan is key.¹⁰

Relying on Painkillers

Painkillers only mask pain and don’t address tendon degeneration. Over time, this can worsen the tendon’s condition.¹

Skipping Rehab Exercises

Rehab exercises help restore tendon strength. Skipping them often leads to persistent pain and a longer recovery.³

Consequences of Neglecting the Patellar Tendinopathy

Increased Pain and Limited Mobility

Ignoring symptoms can lead to severe pain, making everyday activities difficult.⁴

Risk of Tendon Rupture

Severe neglect may lead to tendon rupture, requiring surgery and lengthy rehab.¹¹

Chronic Degeneration

Long-term neglect can make the tendon resistant to treatment, resulting in chronic pain and reduced knee function.⁷

Types of Scans for Patellar Tendinopathy

Ultrasound

An ultrasound is a quick and painless scan that uses sound waves to create images of your tendon. With ultrasound, we look for any thickening in the patellar tendon, irregularities in the tendon fibers, and areas of increased blood flow.

These signs tell us that the tendon may be damaged or inflamed.³

MRI (Magnetic Resonance Imaging)

An MRI provides detailed images of both the tendon and surrounding tissues. It helps us see the exact location and extent of any tendon damage. With MRI, we look for tendon thickening, degeneration, and fluid build-up.

It’s especially helpful if we suspect more extensive issues around the knee.⁷

X-Ray

While an X-ray doesn’t show soft tissues like tendons, it can help rule out other conditions, like fractures or bone spurs, that might cause similar knee pain. We mainly use X-rays to ensure there’s no bone-related issue contributing to your symptoms.¹

Surgical Treatment for Patellar Tendinopathy

Surgery is considered for patellar tendinopathy when conservative treatments, like exercise therapy and physical therapy, have not improved symptoms after 6–12 months.

Surgical options generally involve removing damaged tissue from the tendon or, in some cases, reshaping part of the kneecap. This aims to reduce pain and improve knee function, especially in patients wanting to return to high-impact activities.¹³

Open Surgery: The surgeon removes damaged tissue through an incision, which can sometimes involve reshaping the kneecap. This approach provides direct access to the tendon, helping in severe cases but requiring a longer recovery.¹³

Arthroscopic Surgery: Arthroscopy is a minimally invasive approach where the surgeon uses small tools and a camera to remove damaged tendon tissue. It typically results in a faster recovery and less postoperative pain compared to open surgery.¹⁴

Importance of Physiotherapy After Surgery

Post-surgery, physiotherapy plays a key role in recovery. Through structured exercises, we work to rebuild strength in the knee and restore the tendon’s ability to handle stress gradually.

Key areas of focus are flexibility, muscle control, and increasing the load on the tendon over time. A well-guided physiotherapy program also helps prevent re-injury, ensuring a better long-term outcome.⁷

Treatment Options for Patellar Tendinopathy

Exercise Therapy

Exercise is the foundation of treatment. Progressive tendon-loading exercises, like isometric (holding still) and eccentric (slowly lowering) movements, gradually strengthen the tendon, reduce pain, and improve knee function over time.¹⁵

Myofascial Release

Gentle pressure on the fascia around the patellar tendon eases tightness, reduces pain, and improves knee flexibility.¹⁶

Orthopedic Manual Therapy

Hands-on techniques help restore knee joint mobility and reduce discomfort, supporting tendon healing and making movement easier.¹²

Laser Therapy

Laser therapy targets cells in the tendon, speeding up repair and reducing pain, especially useful for chronic cases.¹⁷

Dry Needling

Dry needling releases tension in the tendon, boosts blood flow, and can provide longer-term pain relief when combined with exercise.¹⁸

Strapping and Taping

Patellar straps or sports tape stabilize the knee, reducing strain on the tendon during activities, which can temporarily relieve pain.¹⁹

Conclusion

As your physiotherapist, I want you to know that patellar tendinopathy doesn’t have to limit you. With a steady, consistent approach, you can relieve pain and get back to doing what you love.

Recovery takes small, gradual steps—sticking to exercises, moving mindfully, and giving your body time to adapt. Each bit of effort counts and brings you closer to lasting relief.

This condition is challenging, but with tools like strengthening exercises, manual therapy, and options like shockwave or taping, we can rebuild your knee’s resilience.

I’m here to support you, answer questions, and adjust your plan along the way. Trust the process, and soon you’ll return to your regular activities, pain-free.

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References

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7. Wilczyński, B., Taraszkiewicz, M., de Tillier, K., Biały, M., & Zorena, K. (2024). Sinding-Larsen-Johansson disease. Clinical features, imaging findings, conservative treatments and research perspectives: a scoping review. PeerJ, 12, e17996. https://doi.org/10.7717/peerj.17996
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