What is Patellar Tendinopathy?

Patellar tendinopathy, commonly known as jumper’s knee, is an overuse injury affecting the patellar tendon, which connects the kneecap (patella) to the shinbone (tibia). It is characterised by pain just below the kneecap, especially during activities that involve jumping, sprinting, or explosive leg movements.

What happens in Patellar Tendinopathy?

The tendon becomes overloaded from repetitive stress, leading to microscopic tears, degeneration of tendon fibres, and chronic pain. Unlike acute tendon tears, tendinopathy develops gradually and is worsened by ongoing loading without adequate recovery.

Common causes

  • Repetitive jumping, sprinting, or landing
  • High training volume without rest
  • Sudden increases in load or intensity
  • Poor lower limb biomechanics (flat feet, knee valgus)
  • Quadriceps or hamstring muscle imbalances
  • Playing on hard surfaces (e.g., basketball or netball courts)

Who is most affected?

  • Athletes in jumping sports (basketball, netball, volleyball, AFL)
  • Football players (soccer and rugby)
  • Males are slightly more affected, but high rates are also seen in netballers
  • In Australia, patellar tendinopathy is reported in up to 40–50% of elite volleyball and basketball players

Symptoms of Patellar Tendinopathy

  • Localised pain below the kneecap at the patellar tendon
  • Pain worsens with jumping, sprinting, or squatting
  • Tenderness when pressing the tendon
  • Stiffness or pain at the start of activity, improving with warm-up, but worsening post-activity
  • In chronic cases, swelling or thickening of the tendon

📞 If you notice knee pain that worsens with jumping or sprinting, book an assessment at Spinal and Sports Care Bella Vista or Parramatta.

Diagnosis of Patellar Tendinopathy

Clinical Tests:

  • Palpation of patellar tendon
  • Decline squat test (pain reproduced during single-leg squat on a decline board)
  • Load-based testing (hop tests, squat tests)

Imaging:

  • Ultrasound: Detects tendon thickening, degeneration, and neovascularisation
  • MRI: Useful for identifying tendon degeneration or partial tears
  • X-rays: Typically normal, but used to exclude other causes of knee pain

Treatment options

Patellar tendinopathy is managed non-surgically in the majority of cases.

Non-surgical:

  • Load management (reducing painful jumping activities initially)
  • Isometric exercises for early pain relief
  • Eccentric and heavy slow resistance (HSR) programs to remodel the tendon
  • Shockwave therapy and ultrasound therapy as adjuncts
  • Patellar tendon strap or taping for pain relief during activity

Surgical:

  • Only considered in long-term, severe cases unresponsive to rehab (over 6–12 months)
  • May involve tendon debridement or repair

Role of physiotherapy

  • Prescribe and supervise tendon-loading rehab programs
  • Address biomechanics and strength deficits in the quadriceps, glutes, and calves
  • Progress athletes safely back to full jumping and sports
  • Educate on recovery, load management, and prevention strategies

Recovery timeline

  • Mild tendinopathy: 6–8 weeks
  • Moderate: 3–6 months
  • Severe chronic cases: 6–12 months (with strict adherence to rehab)

Injury grading

  • Stage I (Reactive Tendinopathy): Acute overload causes tendon pain and mild swelling, which is often reversible with rest.
  • Stage II (Tendon disrepair): Ongoing overload leads to tendon fibre disruption and pain during daily activity.
  • Stage III (Degenerative tendinopathy): Chronic structural changes in the tendon, thickening, persistent pain, and risk of partial tearing.

Prevention of Patellar Tendinopathy

  • Eccentric strengthening of quads and tendon-specific loading programs
  • Adequate recovery between jumping sessions
  • Surface management (avoid sudden increases on hard courts)
  • Proper footwear with shock absorption
  • Pre-season strength and conditioning programs (netball and basketball prevention focus)

Taping and bracing

  • Patellar tendon straps (Cho-Pat straps) reduce strain on the tendon and relieve pain
  • McConnell taping may assist in offloading the patellar tendon during rehab

When to see a physiotherapist or chiropractor

📞 If knee pain has lasted longer than 2 weeks and is worsened by sport or daily activity, see Spinal and Sports Care for expert assessment.

Frequently Asked Questions

An overuse injury of the patellar tendon, often called jumper’s knee.

Very common in sports like volleyball, basketball, AFL, and netball — affecting up to 1 in 2 elite jumping athletes.

Tendinitis implies inflammation; tendinopathy reflects chronic degeneration and overload.

Light training may be possible, but continuing to overload the tendon often worsens symptoms.

Clinical assessment and imaging (ultrasound or MRI) confirm the condition.

It rarely improves without structured rehab. Tendon-loading exercises are essential.

Heavy, slow resistance and eccentric strengthening programs have the strongest evidence.

Mild cases may resolve in 6–8 weeks; chronic cases may take 6–12 months.

Yes, patellar tendon straps can reduce strain during activity, but do not replace rehab.

High if athletes return too quickly. Re-injury rates can reach 30% in elite athletes without proper rehab.