Patellar Tendinopathy: Causes, Treatment and Rehab
Pain in the tendon below the kneecap that flares when you jump, squat, run or climb stairs is often patellar tendinopathy, sometimes called jumper’s knee or patellar tendonitis. It is common in basketball, volleyball, netball and running, and can be stubborn if it is not managed well. The good news is that it responds well to the right rehab.
Our Cammeray physiotherapy team explains the causes of patellar tendinopathy, how to treat it and what you can do to get back to sport.
The patellar tendon connects your kneecap (patella) to your shin bone. It works like a spring, storing and releasing energy when you jump, land and change direction. Patellar tendinopathy occurs when the tendon becomes painful and less able to tolerate load.
You may hear it called patellar tendonitis or an inflamed patellar tendon. In reality, long-standing tendon pain usually involves changes in the tendon’s structure rather than ongoing inflammation, which is why rest and anti-inflammatories alone often do not fix it.
Patellar tendinopathy causes
The main cause is a change in load that is more than the tendon is ready for. Common triggers include:
- A sudden increase in jumping, running or training volume
- Returning to sport after a break
- A new training surface, such as switching to hard courts
- Lots of deep squatting or lunging under load
- Reduced strength in the quads, glutes or calves
- Limited ankle or hip mobility that changes how you land
- Inadequate recovery between sessions
- Pain in the tendon below the kneecap
- Pain that warms up during activity, then returns afterwards or the next morning
- Pain with jumping, landing, squatting, stairs or sitting for long periods
- Tenderness when pressing the tendon
- Calm it down by modifying load
Complete rest is rarely the answer, as tendons need load to adapt. Instead, we reduce the activities that aggravate it most, such as jumping, while keeping you active. - Isometric exercises
Holding a muscle contraction without moving the joint, such as a wall sit or a held leg extension, can help reduce tendon pain and is often used early in rehab. - Progressive strengthening
Heavy, slow strengthening exercises for the quads are the foundation of a good patellar tendonitis workout. We also strengthen the hips and calves. - Energy storage and return to sport
As strength improves, we reintroduce faster, spring-like loading such as skipping, hopping, jumping and sport-specific drills, before a gradual return to full training.
Squats can help or hurt, depending on how and when you do them. Early on, partial-range squats, wall sits or decline squats (on a slanted board) under guidance may be appropriate. As your tendon improves, we progress depth, load and speed. If squats are increasing your pain the next day, it is a sign the load needs adjusting.
A simple guide many physios use: mild pain during exercise (up to around 3 out of 10) that settles by the next morning is usually acceptable. Pain that is worse the next day means the load was too much.
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Book an Appointment
Struggling with pain below the kneecap? Book with our Cammeray physiotherapists for a tailored patellar tendinopathy rehab plan. Book online or call (02) 9072 1384.