Patellar Tendinopathy
Overuse pain in the tendon below the kneecap
Quick Facts
- Type: Knee tendon overuse injury
- Common name: Jumper's knee
- Main symptom: Pain just below the kneecap
- Common in: Jumping and running athletes
Overview
Patellar tendinopathy, often called jumper's knee, is an overuse injury of the patellar tendon, the strong band that connects the kneecap (patella) to the shinbone (tibia). This tendon helps straighten the knee and absorbs force when you jump, land, run, and squat. With repeated stress, tiny areas of the tendon become irritated and damaged, leading to pain and weakness.
The condition is most common in athletes who do a lot of jumping, such as in basketball and volleyball, but it can affect anyone who repeatedly loads the knee. The pain usually centers just below the kneecap. Although it can be stubborn and slow to heal, patellar tendinopathy generally improves with the right loading exercises and a gradual return to activity.
Symptoms
The main symptom is pain at the front of the knee, just below the kneecap, where the tendon attaches.
- Pain and tenderness just below the kneecap
- Pain that worsens with jumping, running, squatting, or climbing stairs
- Stiffness or pain after sitting for a while, or first thing in the morning
- Pain at the start of activity that may ease as you warm up, then return afterward
- Weakness in the knee with jumping or landing
Early on, pain may appear only after activity; as it progresses, it can occur during activity and eventually with everyday tasks.
Causes
Patellar tendinopathy is caused by repeated overload of the patellar tendon that outpaces its ability to recover. Over time this leads to small-scale tendon damage rather than simple inflammation.
- Repetitive jumping and landing: The most common driver, especially in sports like basketball and volleyball
- Sudden increases in training: Ramping up intensity, frequency, or volume too quickly
- Hard surfaces and frequent direction changes: Which increase load on the tendon
- Muscle tightness or weakness: In the thighs and hips, which changes how force passes through the knee
Risk Factors
- Sports involving frequent jumping and landing
- A rapid increase in training load
- Tight or weak thigh (quadriceps and hamstring) and calf muscles
- Poor jumping or landing technique
- Being overweight, which adds load to the tendon
- Playing or training on hard surfaces
Diagnosis
Patellar tendinopathy is usually diagnosed from the history and a knee examination:
- Physical exam: The clinician presses on the tendon just below the kneecap to check for tenderness and asks about pain with jumping and squatting.
- Functional tests: Watching a squat or single-leg movement can reproduce the pain.
- Imaging: Ultrasound or MRI can confirm tendon changes and rule out other causes when the diagnosis is unclear or symptoms persist, though it is not always needed.
Treatment
Treatment centers on gradually loading the tendon so it can rebuild its strength, rather than complete rest. Recovery often takes time and patience.
- Activity modification: Reducing, not necessarily stopping, aggravating activities while keeping the tendon working.
- Exercise rehabilitation: Progressive strengthening, especially controlled exercises that load the tendon (such as slow squats), is the most effective treatment.
- Pain management: Ice and simple pain relief can ease symptoms, though strengthening is the key to healing.
- Addressing contributors: Improving thigh, hip, and calf strength and flexibility and refining jumping and landing technique.
- Further options: For stubborn cases, a physical therapist or doctor may consider additional treatments; surgery is rarely needed.
A gradual, guided return to sport reduces the chance of the problem coming back.
Prevention
- Increase training intensity and volume gradually, not suddenly
- Keep the thigh, hip, and calf muscles strong and flexible
- Warm up before activity and allow recovery days
- Work on safe jumping and landing technique
- Address early knee pain before it becomes persistent
When to See a Doctor
See a doctor or physical therapist if pain below the kneecap persists for more than a couple of weeks, worsens, or limits your activities or sport. Seek prompt care if you feel a sudden pop with severe pain and are unable to straighten the knee or bear weight, which can indicate a tendon tear or rupture that needs urgent evaluation.
Frequently Asked Questions
What is jumper's knee?
Jumper's knee is the common name for patellar tendinopathy, an overuse injury of the tendon connecting the kneecap to the shinbone. It causes pain just below the kneecap, especially with jumping, landing, running, and squatting.
Should I rest completely with patellar tendinopathy?
Complete rest usually is not the best approach. The tendon heals better with gradual, controlled loading, such as slow strengthening exercises, while reducing the most aggravating activities. A physical therapist can guide a safe loading program.
How long does patellar tendinopathy take to heal?
It varies and can be slow, often taking several weeks to a few months, sometimes longer. Consistent strengthening exercises and a gradual return to activity give the best results, and patience is important because pushing too hard too soon can prolong it.
When is knee pain an emergency?
Most patellar tendinopathy is not an emergency. However, if you feel a sudden pop with severe pain and cannot straighten the knee or put weight on it, seek prompt care, as this can mean the tendon has torn or ruptured and may need surgery.
References
- American Academy of Orthopaedic Surgeons (OrthoInfo). Patellar Tendon Tear.
- Mayo Clinic. Patellar tendinitis.
- MedlinePlus, U.S. National Library of Medicine. Knee pain.
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Sports Injuries.