Patellar tendinopathy
Your health expert: Mr Damian McClelland, Clinical Director for Musculoskeletal Services, Bupa
Content editor review by Sheila Pinion, July 2022
Next review due August 2025
Patellar tendinopathy is a condition that can cause knee pain. Your patellar tendon joins your kneecap (patella) to your shin bone (tibia). You might develop patellar tendinopathy if you play sports that involve jumping – for example, basketball, netball or volleyball. You can also get it if you run.
About patellar tendinopathy
You can get patellar tendinopathy when repetitive, small injuries happen to your patellar tendon. Afterwards, the tendon can become thickened as it heals, and this can cause pain. When this happens, your tendon is less able to cope with weight on it (loading), which can affect how you walk.
Causes of patellar tendinopathy
The exact reasons why you can develop patellar tendinopathy aren’t known. But it’s thought to be an overuse injury, which means it can develop after repeated stress on your patellar tendon. This may happen if you jump a lot, which is why patellar tendinopathy is sometimes called ‘jumper’s knee’. Factors such as age, muscle weakness, and body weight, are also thought to be involved.
You may be more likely to get patellar tendinopathy in your teens and 20s, but you can get it when you’re older too. It has also been linked to:
- overtraining
- poor technique
- playing on hard surfaces
Patellar tendinopathy symptoms
The main symptom of patellar tendinopathy is pain or aching just below your kneecap. You’ll probably start to notice a gradual increase in pain, rather than having an injury that suddenly causes it. When you first feel pain, it will probably only come on when you start exercising and fade away after you warm up. This may then develop into a dull pain after activity. Eventually, you might feel pain during exercise.
As well as being painful, your knee may be tender to the touch especially when you extend your knee.
Although it’s uncommon, patellar tendons can tear (rupture) if they’ve become very weakened. If this happens, you may have sudden pain. You might also find it difficult to walk because your knee gives way.
Self-help for patellar tendinopathy
Bupa's POLICE infographic (PDF, 0.5 MB), illustrates how to manage any type of soft tissue injury to your knee. You can also click on the POLICE image below to download the PDF.
Here’s what to do if you injure your knee . At first you should follow the POLICE procedure to manage any type of soft tissue injury to your knee. POLICE stands for protect, optimal loading, ice, compression and elevation.
Protect. Protect your injury from further damage. Rest immediately after the injury but not for long. Consider using some form of support or crutches.
Optimal loading. Get active sooner rather than later. Start to put weight on your knee and build up your range of movement. Do this gradually – be guided by what feels right for you.
Ice. Place a cold compress such as a bag of ice or frozen peas wrapped in a towel onto your knee. Do this for around 20 minutes every couple of hours for the first two to three days.
Compression. Apply light compression to your knee.
Elevation. Elevate your knee above the level of your heart to reduce swelling. Sit or lie on a chair and use a cushion to raise your leg.
You won’t need to stop activity completely. But you’ll need to reduce the amount of activity you do that causes you pain – for example, jumping and squatting. Your doctor or physiotherapist may suggest some alternative exercises that put less stress on your tendon – for example, swimming and cycling. These activities should be less painful and will help your tendon to heal.
Patellar tendinopathy treatment
The initial treatment for patellar tendinopathy is to reduce pain and inflammation. You can do this with ice and medicines. Further treatment includes stretching and strengthening exercises with physiotherapy to gradually get you back to your usual activities.
You may find it helpful to see a sports medicine professional, such as a physiotherapist or a sports doctor. Your GP may refer you or you can book an appointment with a physiotherapist yourself.
There’s no quick fix for patellar tendinopathy. You may need a few months of rehabilitation before your symptoms go completely.
Medicines for patellar tendinopathy
If you can take non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, these may provide pain relief for patellar tendinopathy for a few days. If your pain is very bad and over-the-counter painkillers aren’t working, your GP may be able to prescribe stronger NSAIDs.
Always read the patient information that comes with your medicine, and if you have questions ask your pharmacist or GP for advice.
Physiotherapy for patellar tendinopathy
Your physiotherapist will carefully assess your knee and then plan an individual programme of rehabilitation exercises to help strengthen your knee and leg muscles gradually. Treatment may involve stretching, and specific strengthening exercises . Make sure you follow these exercises as they’re an important part of your recovery. Most people completely recover if their tendon isn’t torn – your physiotherapist will let you know how long it will take.
Your physiotherapist may suggest you wear patellar tendon straps or patellar braces. These are supports that can help stabilise your knee when you’re active. They may also offer you treatment with extracorporeal shockwave therapy (ESWT). This involves applying shockwaves to the affected area to reduce your pain and to try and increase healing.
Surgery for patellar tendinopathy
Most people with patellar tendinopathy don’t need surgery. But it may be an option if your symptoms don’t generally improve with other treatments after six months or if your tendon tears (ruptures). You’ll need to discuss this option with a surgeon.
It can take up to 12 months to recover from surgery and there’s a possibility that your knee still might not be the same as it was before your injury. Ask your doctor or surgeon for more information.
Looking for physiotherapy?
You can access a range of treatments on a pay as you go basis, including physiotherapy.
To book or to make an enquiry, call us on 0370 218 6528∧
It can take several months for your patellar tendon to heal. For most people, symptoms should generally improve after six months of treatment. If they don’t improve or your tendon tears, you may need surgery. For more information, see our section on treatment.
You can treat patellar tendinopathy by following the POLICE procedure (protect, optimal loading, ice, compression and elevation). Try to reduce pain and inflammation using ice and over-the-counter painkillers. Strengthening exercises and physiotherapy can also help your knee recover. For more information, see our sections on self-help and treatments for patellar tendinopathy.
You should be able to walk with patellar tendinopathy, but you should reduce any activity that causes you pain – for example, jumping and squatting. Optimal loading of your tendon should help it heal, so you don’t need to stop activity completely. Your doctor or physiotherapist can also advise you on the activities you can do. For more information, see our section on self-help for patellar tendinopathy.
More on tis topic
Posterior cruciate ligament (PCL) injury
With a PCL injury, it’s common to injure other ligaments, or other parts of your knee, at the same time.
Anterior cruciate ligament (ACL) injury
An ACL injury can be a partial or a complete tear, an overstretch, or a detachment of the ligament.
Medial collateral ligament (MCL) injury
The MCL is the most commonly injured knee ligament. It often gets injured during sports such as rugby.
Lateral collateral ligament (LCL) injury
An LCL injury is often associated with injuries to the ligaments and tendons in this area, as well as to other parts of the knee.
Meniscal tear
Tears of the menisci are a common injury. When people talk about a ‘torn cartilage’ in their knee they usually mean a meniscus injury.
Patellofemoral pain syndrome
Patellofemoral pain syndrome is sometimes called ‘runner’s knee’ because it’s particularly common in people who run or do other sports.
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