Patellar tendinopathy is a painful, load-related problem of the tendon that joins the kneecap to the shin bone, felt just below the kneecap. It is most common in people who jump, sprint or change direction, such as volleyball and basketball players. Gradually progressed loading exercise is the main treatment.
Also known as jumper's knee, patellar tendinitis, patellar tendon pain
Symptoms
- Pain at the bottom tip of the kneecap or in the tendon just below it
- Pain that starts with loading, such as jumping, landing, squatting or stairs, and eases when you stop
- Pain that may warm up during exercise but is worse afterwards or the next morning
- Pain when sitting for long periods with the knee bent
- Reduced jumping or sprinting performance
Causes and risk factors
- A sudden increase in jumping, sprinting or training volume
- Sports with repeated jumping and landing, such as volleyball and basketball
- Being male and an adult athlete
- High weekly training hours and total tendon load (including physical work)
- Reduced strength or capacity of the thigh and calf muscles
What the evidence says helps
- Exercise therapy is the first-line treatment. A large evidence synthesis found exercise for tendinopathy is safe and beneficial, and most patients are satisfied with the results.3
- A network meta-analysis concluded that progressive tendon loading, traditionally eccentric (lowering) exercise, should remain first-line treatment, with slow resistance and isometric (holding) exercise also showing promise.4
- Isometric exercise appears about as effective as other strengthening for short-term pain relief, which can help people keep training.4
- Shockwave therapy did not appear to add benefit over exercise alone in pooled trials.4
- Resistance training can be continued during the playing season, and patellar straps or taping may give short-term pain relief during sport.5
Things you can try at home
- Reduce jumping and sprinting volume for a while rather than stopping all activity
- Do regular strengthening, such as slow leg presses or wall-sit holds, at a level that keeps pain manageable
- Monitor your tendon the morning after training; if it is much worse, ease off the next session
- Build jumping and landing back in gradually once strength improves
- Be patient: tendons often take three months or more to respond to loading
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- You feel a sudden pop or tearing below the kneecap and cannot straighten your leg or lift it while lying down: go to A&E, as the tendon may have ruptured.
- Your knee is suddenly hot, red and swollen and you feel feverish or unwell: get same-day medical help (NHS 111, or A&E if very unwell), as a joint infection needs urgent treatment.
- After a fall, collision or twisting injury you cannot put weight on the leg, the knee looks deformed, or it swells up within a few hours: go to A&E or an urgent treatment centre.
- Pain below the kneecap in a growing child or teenager, especially with a tender bony lump: see a GP or a children's practitioner for assessment.
How Apollo can help
We confirm where your pain is coming from and explain how tendons respond to load. We then plan a staged loading programme, from holds through to heavy strengthening and back to jumping, and help you manage training so you can stay active where possible. VALD testing lets us track strength and jump measures as you progress.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
Should I rest completely with jumper's knee?
Usually not. Complete rest can reduce tendon strength. Most people do better by reducing the most aggravating activities while doing a planned programme of strengthening exercise.
How long does patellar tendinopathy take to heal?
Tendons adapt slowly, so improvement often takes three months or more, and longstanding cases can take longer. Research shows it is not always self-limiting, so a structured plan is worthwhile.
Do injections help jumper's knee?
Several injection treatments have been studied, but the evidence is limited and low quality. Exercise remains the recommended first-line treatment, and injections are usually only considered when a good exercise programme has not helped.
References
- Nutarelli S, et al. (2023). Epidemiology of patellar tendinopathy in athletes and the general population: a systematic review and meta-analysis. Orthopaedic Journal of Sports Medicine. View source
- Lian ØB, et al. (2005). Prevalence of jumper's knee among elite athletes from different sports: a cross-sectional study. American Journal of Sports Medicine. View source
- Cooper K, et al. (2023). Exercise therapy for tendinopathy: a mixed-methods evidence synthesis exploring feasibility, acceptability and effectiveness. Health Technology Assessment. View source
- Challoumas D, et al. (2021). Management of patellar tendinopathy: a systematic review and network meta-analysis of randomised studies. BMJ Open Sport & Exercise Medicine. View source
- Burton I (2022). Interventions for prevention and in-season management of patellar tendinopathy in athletes: a scoping review. Physical Therapy in Sport. View source
This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.
