Patellar tendinitis (jumper's knee): treatment, symptoms, causes and recovery time

NHS Lanarkshire says patellar tendon pain generally does not get better by itself if you continue to put the tendon under too much stress. It can resolve, but this takes time. Physiotherapy exercises are recommended to strengthen the tendon and improve its stress tolerance.

You may need to adapt your activity levels for the knee pain to settle, for example reducing impact activities such as jumping, but it is recommended that you remain active. Low-impact activities such as cycling and swimming help you keep fit while you recover. During activity, NHS Lanarkshire recommends your pain stays below 3 out of 10 and settles within a 24-hour period.

For short-term relief, NHS Borders suggests icing the painful area for 10 to 15 minutes, two to three times a day with a towel between the ice and skin; reducing aggravating activities like running, jumping and hill walking; asking a pharmacist about suitable pain relief; and considering a jumper's knee support to help offload the kneecap. The NHS tendonitis page also says a pharmacist can recommend the best painkiller, and that if pain is severe or long-lasting you may be offered physiotherapy, and some people with severe tendonitis may be offered steroid injections for short-term relief. If physiotherapy does not help, referral to an orthopaedic specialist may lead to a discussion of surgery.

NHS Lanarkshire says a graded exercise programme is the best way to help improve pain and function. The exercises are divided into early, middle and late stages: start with the early exercises, and progress only when you find them easy. It stresses not to overdo them, because that can irritate the tendon.

The NHS Borders leaflet gives examples of early exercises: lying on your back with knees bent and lifting your bottom (a glute bridge), tightening the thigh muscles with the backs of the knees pushed down, and holding a straight leg lift while sitting. Each is done as 3 sets of 10 repetitions, with a 5-second hold for some. It says load is needed to aid recovery but overload may worsen your pain, so work at a level no higher than 2 on its pain scale.

NHS Lanarkshire also describes pacing and spacing: breaking activities into parts, taking regular breaks, and setting a baseline of what you can manage on a good or bad day without increasing symptoms. If an exercise worsens your symptoms, stop and seek advice from a health professional.

NHS Lanarkshire says symptoms normally appear gradually, but can also develop after a bump to the knee. Pain is the most common symptom, localised to the front of the knee and either mild or severe. There may be tenderness at the front of the knee, a slightly thickened tendon, tightness or weakness in the thigh (quadriceps) muscles, stiffness (especially in the morning) and mild swelling.

NHS Borders adds that pain beneath the kneecap increases with squatting and going down hills and stairs, and that swelling can be beneath or on top of the kneecap.

NHS Lanarkshire says it is not fully clear why some people develop patellar tendinopathy, but it is normally due to several reasons: repeated stress on the tendon, being overweight, a sudden increase in body weight, tightness of leg muscles, weakness in thigh muscles, changing activity levels or progressing too quickly, inappropriate footwear and exercising on hard surfaces.

NHS Borders lists increased or excessive load, such as lots of walking or running downhill, weakness in the quadriceps and sometimes the buttock muscles, and repetitive activity such as squatting or jumping. It says the condition is more common between the teens and thirties but can happen at any age.

The NHS tendonitis page says tendon problems are usually caused by sudden, sharp movements or repetitive exercise such as running, jumping or throwing. NHS Lanarkshire describes structural changes in the tendon from overload, while NHS Borders describes the tendon as irritated and inflamed, which is why both "tendinopathy" and "tendinitis" are used.

NHS Lanarkshire says an appropriate exercise programme can take more than 3 months to complete. You may see improvements before then, but it may take longer for symptoms to fully resolve. It adds that you may need 6 to 12 weeks of doing specific exercises to notice a difference, and if your symptoms have not improved within 6 to 12 weeks, a referral to a physiotherapist may be beneficial.

The NHS tendonitis page says a mild tendon injury treated yourself should feel better within 2 to 3 weeks, but that is for simple tendonitis; patellar tendinopathy from long-standing overload usually takes longer.

NHS Borders says you do not normally need a scan to diagnose this problem. A health care professional will make a diagnosis from a history and specific tests. They will ask about your sport, training changes and where the pain is, and examine the knee.

The NHS says to see a GP if you have injured a joint and your symptoms do not improve within a few weeks. In many areas you may be able to get help such as physiotherapy from NHS community musculoskeletal (MSK) services without a GP referral, and NHS Lanarkshire offers an online self-referral form.

NHS Lanarkshire says to phone 111 for immediate medical attention if you have a knee trauma or injury with a sudden pop or snap sensation, severe pain or swelling, or the inability to straighten your knee. The NHS tendonitis page says the same for pain that is sudden and severe after an accident or activity, which may mean a torn tendon, and to get help from NHS 111 if you are in a lot of pain.

If you have swelling, redness with heat around the knee, seek advice from your GP. Call 999 for a life-threatening emergency.

On the NHS, community MSK physiotherapy is the usual route, often with self-referral, and a GP can refer you if needed. Scottish services also offer the MSK Help app and an MSK advice and triage line.

Some people choose private physiotherapy or sports medicine. The UK sources used here do not describe private services or costs, so this guide does not either. Whichever you use, ask for a graded loading programme with clear progression rather than rest alone.