Patellar tendinopathy

Expert reviewer, Mr Damian McClelland, Trauma and Orthopaedic Consultant, and Clinical Director for Musculoskeletal Services at Bupa
Next review due December 2023

Patellar tendinopathy is a condition that can happen when the tendon that joins your kneecap (patella) to your shin bone (tibia) gradually wears down. Your tendon becomes weaker and painful, and is less able to cope with ‘loading’ (the weight on it), so affects how you walk and exercise.

An image showing the different parts of the knee

About patellar tendinopathy

Patellar tendinopathy is sometimes called ‘jumper’s knee’ because the injury often happens during sports that involve jumping, such as basketball, netball or volleyball. You can also get it if you run, particularly if you’re a downhill runner.

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 volleyball and basketball players often develop it. The strain on your patellar tendon when you land from a jump can damage, and gradually wear down your tendon.

You may be more likely to get patellar tendinopathy in your teens to thirties, but you can get it when you’re older too. It has also been linked to:

  • overtraining
  • poor technique
  • playing on hard surfaces
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Symptoms of patellar tendinopathy

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 after you exercise. As time goes by you may feel pain during exercise, which may get less after you warm up. This may then develop into constant pain during activity.

Patellar tendinopathy might not have any effect on how well you can perform in your normal activities at first. But as it gets worse, you’ll probably find that it starts to hold you back. As well as being painful, your knee may be tender to the touch.

If you don’t have treatment for patellar tendinopathy, there’s a possibility that your tendon will eventually tear (rupture). If this happens, you may have sudden pain and your knee may give way.

Self-help for patellar tendinopathy

If you injure your knee, 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.

Additionally, there are certain things you should avoid in the first three days after your injury so you don’t damage your knee further. These can be remembered as HARM, which stands for heat, alcohol, running and massage.

To find out more about POLICE and HARM, you can visit our page on what to do if you injure your knee.

You’ll need to reduce the amount of activity you do that causes you pain, such as jumping and squatting. Your doctor or physiotherapist may suggest some alternative exercises that put less stress on your tendon, such as swimming and cycling.

Treatments for patellar tendinopathy

The initial treatment for patellar tendinopathy is to reduce your pain and inflammation. You can do this with rest, ice and medicines. Further treatment includes stretching and strengthening exercises with physiotherapy to gradually get you back to your usual activities. You may need surgery if your patellar tendon ruptures.

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 long period of rest and rehabilitation before your symptoms go completely.

Medicines for patellar tendinopathy

You can take over-the-counter painkillers, for example non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. These may provide short-term pain relief of patellar tendinopathy for a couple of weeks.

Your GP may be able to prescribe stronger NSAIDs if your pain is really bad.

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 physio 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 physio will let you know how long it will take.

Your physio may suggest you wear patellar straps or braces, to help support 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 in order to reduce your pain.

Surgery for patellar tendinopathy

Most people with patellar tendinopathy don’t need surgery. But it may be an option if your symptoms don’t improve with other treatments after three to six months, or if your tendon tears (ruptures).

The aim of surgery is to repair your tendon and it’s usually done in an arthroscopy procedure, which is a type of keyhole surgery.

It takes about six to nine months to recover from surgery, and there’s a possibility that your knee still might not be the same afterwards. Ask your doctor or surgeon for more information.

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Related information

    • Jumper's knee. Medscape., updated 11 March 2019
    • Anterior knee pain. Brukner & Khan’s Clinical Sports Medicine: Injuries, Volume 1, 5th ed (online). McGraw-Hill Medical., published 2017
    • Tendinopathy. BMJ Best Practice., last reviewed 19 September 2020
    • Acute knee injuries. Brukner & Khan’s Clinical Sports Medicine: Injuries, Volume 1, 5th ed (online). McGraw-Hill Medical., published 2017
    • Treatment of sports injuries. Brukner & Khan’s Clinical Sports Medicine: Injuries, Volume 1, 5th ed (online). McGraw-Hill Medical., published 2017
    • Reinking MF. Current concepts in the treatment of patellar tendinopathy. Int J Sports Phys Ther 2016; 11(6):854–66.
    • Find a physio. Chartered Society of Physiotherapy., last reviewed 13 March 2018
    • Sprains and strains. NICE Clinical Knowledge Summaries., last revised April 2020
    • Treatment for knee pain. Chartered Society of Physiotherapy., last reviewed 26 March 2020
    • Dan M, Phillips A, Johnston RV, et al. Surgery for patellar tendinopathy (jumper’s knee). Cochrane Database of Systematic Reviews 2019, Issue 9. doi: 10.1002/14651858.CD013034.pub2
  • Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, December 2020
    Expert reviewer, Mr Damian McClelland, Trauma and Orthopaedic Consultant, and Clinical Director for Musculoskeletal Services at Bupa
    Next review due December 2023