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Health condition · Clinically reviewed

Patellar tendinitis, the "jumper's knee" that loading exercise actually fixes.

Pain below the kneecap from jumping, running or squatting is rarely solved by rest alone. A structured eccentric-strengthening programme is the evidence-based route back to sport.

Jump to treatment
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Sourced from guidance

    Checked against NICE, sports medicine society guidance and peer-reviewed sources you can see at the end.

  • 03

    Current for 2026

    Reflects modern practice, including eccentric loading protocols, shockwave therapy and platelet-rich plasma.

Key facts

Patellar tendinitis at a glance.

The essentials, in plain English - what it is, who gets it, and how it's treated in the UK today.

  • What it is

    An overuse injury of the patellar tendon, the band connecting the kneecap to the shin bone - often called "jumper's knee".

  • Who gets it

    Athletes in jumping and running sports - basketball, volleyball, athletics - though it affects recreational exercisers too.

  • Where it hurts

    Pain localised precisely to the inferior pole of the patella, just below the kneecap, worsening with load.

  • Tendinitis vs tendinopathy

    Chronic cases are usually degenerative tendinopathy rather than true inflammation, which shapes how they're treated.

  • Cornerstone treatment

    Eccentric strengthening exercises - a specific, evidence-based rehabilitation programme, not simple rest.

  • Surgery

    Rare - reserved for refractory cases that fail extensive conservative management over many months.

Why this guide matters

Loading, not rest, is the real fix.

Patellar tendinitis is common, treatable and - with the right programme - usually recoverable without surgery. The three points below shape everything else on this page.

  • Eccentric exercise is the cornerstone

    Specific eccentric strengthening, not simple rest, is the best-evidenced way to rehabilitate the tendon.

  • It's often tendinopathy, not tendinitis

    Chronic cases are usually degenerative rather than truly inflamed - which is why anti-inflammatories alone often disappoint.

  • Load management prevents recurrence

    Addressing training volume, technique and biomechanics stops the problem coming straight back after recovery.

How the diagnosis is made

From first twinge to a clear rehab plan.

The steps a UK GP, physiotherapist or sports medicine clinician will normally follow, in order - so you know what to expect and why.

  1. 01

    Assessing

    History and training review

    A review of sport, training load, recent volume changes and where exactly the pain sits on the knee.

  2. 02

    Assessing

    Palpation of the inferior pole

    Localised tenderness at the lower pole of the patella, where the tendon attaches, is the hallmark finding.

  3. 03

    Assessing

    Resisted knee extension test

    Pain reproduced on resisted straightening of the knee supports the diagnosis clinically.

  4. 04

    Confirming

    Functional load tests

    Single-leg decline squat and hop tests reproduce symptoms and help grade severity and monitor progress.

  5. 05

    Confirming

    Ultrasound or MRI if uncertain

    Imaging assesses tendon structure and degeneration when the diagnosis is unclear or symptoms persist despite treatment.

  6. 06

    Preparing

    Biomechanical assessment

    Looking at quadriceps strength, landing mechanics and lower-limb alignment that may be driving overload.

  7. 07

    Preparing

    Physiotherapy referral

    A structured eccentric-loading programme is set up early - the single most important step in recovery.

Typical timeline: a first assessment to a structured rehab plan within a week or two.

Symptoms

What patellar tendinitis actually feels like.

A very specific pattern of pain, localised just below the kneecap and closely tied to jumping, running and squatting load.

  • Localised inferior pole pain

    Pain focused precisely below the kneecap at the tendon's attachment - not diffuse knee pain.

  • Worse with jumping

    Landing loads the tendon hardest - jump-heavy sports typically bring symptoms on first.

  • Worse with running

    Repetitive impact from running aggravates the tendon, especially on hard surfaces or after a training spike.

  • Worse with squatting

    Deep knee bend loads the extensor mechanism and reliably reproduces tendon pain.

  • Worse on stairs

    Going down stairs is often more painful than going up, because of the eccentric load through the tendon.

  • Pain progression

    Starts as pain only after activity, then during activity, then - if ignored - pain that limits activity altogether.

  • Tenderness on palpation

    Direct pressure over the tendon just below the kneecap reproduces the familiar pain.

  • Red flag - sudden tendon pain

    A sudden snap, gap or inability to straighten the knee needs same-day assessment for possible rupture.

Treatment

How patellar tendinitis is treated in the UK.

Eccentric strengthening and load management first, adjunct therapies for persistent cases, and surgery only as a last resort.

  • Relative rest

    Reducing - not necessarily stopping - the loading activities that provoke pain, while staying active elsewhere.

  • Eccentric strengthening

    Specific eccentric loading exercises, often on a decline board, are the cornerstone of evidence-based rehabilitation.

  • Physiotherapy programme

    A structured, progressive plan combining eccentric work, strength and control training over several months.

  • Ice and analgesia

    Ice after activity and simple analgesia for symptomatic relief alongside - not instead of - active rehabilitation.

  • Training load management

    Addressing volume spikes, technique and biomechanics that are driving the overload in the first place.

  • Extracorporeal shockwave therapy

    Considered for persistent cases that haven't responded fully to a structured loading programme.

  • Platelet-rich plasma injection

    An option for refractory tendinopathy under specialist guidance, alongside continued rehabilitation.

  • Surgery (tendon debridement)

    Rare - reserved for cases that don't respond to extensive conservative management over many months.

What this guide is based on

The sources behind every claim on this page.

UK national guidance and sports medicine society standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP or physiotherapist knows your knee, your sport and your history and can tell you which parts apply to you. If in doubt, get seen.

  • NICE. Clinical Knowledge Summaries - knee pain assessment in adults.

  • British Journal of Sports Medicine. Guidance on patellar tendinopathy management and eccentric loading.

  • Royal College of General Practitioners. Overuse tendon injury in sport - primary care guidance.

  • Cochrane Review. Interventions for treating patellar tendinopathy.

Red flags

When knee pain needs urgent attention.

Most patellar tendinitis is manageable with structured rehabilitation. These are the situations that aren't - and where prompt or urgent care is needed.

  • Sudden tendon rupture

    A sudden tearing sensation, gap felt below the kneecap, or inability to straighten the knee needs same-day assessment.

  • Inability to weight-bear

    Significant pain preventing normal walking after an acute episode warrants urgent review, not a wait-and-see approach.

  • Visible swelling or deformity

    Marked swelling, bruising or an abnormal position of the kneecap should be assessed promptly.

  • Failure to improve after months

    Symptoms not settling despite a proper structured rehabilitation programme deserve specialist sports medicine review.

  • Bilateral or unusual tendon pain

    Widespread or bilateral tendon symptoms, especially with other joint problems, may need a broader rheumatological work-up.

  • Adolescent knee pain

    Growing athletes with anterior knee pain may have Osgood-Schlatter disease or a related growth-plate condition rather than tendinopathy.

  • Fever or systemic illness

    Knee pain with fever, redness and systemic upset raises concern for septic arthritis and needs urgent same-day care.

  • Locking or giving way

    Mechanical locking or the knee giving way suggests an intra-articular problem such as a meniscal or ligament injury, not tendinopathy alone.

  • Night pain or unexplained weight loss

    Persistent night pain or systemic symptoms alongside knee pain should prompt a wider assessment to exclude other causes.

Living with it

A treatable injury, with a clear route back.

Four things that make the biggest difference day to day - smart load modification, sticking with the exercises, a sensible warm-up and a staged return to sport.

A quiet reminder

Consistency beats intensity, every time.

Small, steady loading - kept up for months - does more for a tendon than a heroic week that doesn't last.

  1. 01 Load

    Modify, don't stop

    Reduce jumping, running and deep squatting rather than resting completely - some controlled loading speeds recovery.

  2. 02 Consistency

    Stick with the exercises

    Eccentric loading programmes take 8 to 12 weeks of consistent work to show real benefit - don't judge it after a fortnight.

  3. 03 Warm-up

    Warm up and build gradually

    Sudden increases in training volume or intensity are the most common trigger - progress load in small, planned steps.

  4. 04 Return

    Return to sport in stages

    Rebuild through running, then jumping, then full sport-specific drills before returning to competition.

Frequently asked

Everything we get asked about patellar tendinitis.

Quick answers on eccentric exercises, imaging, shockwave therapy and getting back to sport.

  • What is patellar tendinitis?

    An overuse injury of the patellar tendon, which connects the kneecap to the shin bone. It's common in sports involving repetitive jumping and running - basketball, volleyball and athletics - and is often called "jumper's knee".

  • Is it tendinitis or tendinopathy?

    In chronic cases it's usually tendinopathy - a degenerative change in the tendon - rather than pure inflammation. This matters because it explains why anti-inflammatory approaches alone are often disappointing, and why loading exercises work better.

  • Why do eccentric exercises help?

    Eccentric strengthening, often performed on a decline board, is the best-evidenced rehabilitation approach for patellar tendinopathy. It stimulates the tendon to remodel and strengthen rather than simply resting it, which tends to leave the underlying problem unresolved.

  • Should I stop sport completely?

    Usually not. Relative rest - reducing but not necessarily stopping all loading - combined with a structured exercise programme gives better long-term results than complete rest, which can lead to deconditioning and a slower return.

  • When is imaging needed?

    Ultrasound or MRI isn't routine for a typical presentation. It's used when the diagnosis is uncertain, symptoms are persistent despite proper rehabilitation, or a clinician wants to assess the degree of tendon structural change.

  • What if conservative treatment doesn't work?

    Extracorporeal shockwave therapy or platelet-rich plasma injection can be considered for persistent cases. Surgery, involving tendon debridement, is rare and reserved for refractory cases that haven't responded to extensive conservative management.

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