Jumper’s knee is an overloaded patellar tendon, the thick band that joins the bottom of your kneecap to your shinbone. It hurts in one small spot just BELOW the kneecap, usually when you jump, land, squat or take the stairs.
The treatment that works best is not rest. It is the RIGHT amount of load: calm the tendon with steady muscle holds, then make it stronger with heavy, slow strength work.
Expect it to take time:
- Pain settling: often within a few weeks, once you cut back the jumping and start the holds
- Tendon getting stronger: most strength programs run for at least 12 weeks
- Long-standing cases: can take 6 months to a year to fully settle
What jumper’s knee is and who gets it
The patellar tendon works like a spring.
Every time you land, it stores energy and gives it back. When the load on it rises faster than it can adapt, the tendon becomes painful and its structure changes. Doctors used to call this tendinitis, which means inflammation. Most now call it tendinopathy, because inflammation isn’t the main problem.
- Jumping sports: it’s most common in volleyball and basketball. In one survey of elite athletes, about 4 in 10 volleyball players and 1 in 3 basketball players had symptoms at the time
- Sudden jumps in training: more sessions, a new jumping program, a harder surface or a fast return after a break
- Anyone who loads the knee: runners, and people who suddenly do a lot more squatting, hiking or stair climbing
Symptoms
- Pinpoint pain below the kneecap: you can often put one finger on it
- Warm-up pain: it hurts at the start of activity, eases once you’re warm, then comes back worse afterward or the next morning
- Pain with loading: jumping, landing, squatting, stairs and sitting for a long time with the knee bent
- A normal-feeling knee otherwise: little swelling, no locking, no giving way
Pain behind or around the kneecap is more likely patellofemoral pain. See runner’s knee. Pain on the outer side of the knee in runners points to IT band syndrome.
Why rest and injections disappoint
Rest takes the pain away. It doesn’t make the tendon any stronger. When you go back to the same jumping, the tendon meets the same load it couldn’t handle before, and the pain comes back.
- Complete rest: the tendon and thigh muscle lose capacity, so you often return weaker than before
- Cortisone shots: may ease pain for a short time, but cortisone can weaken tendons and make them more likely to tear. The Mayo Clinic’s page on patellar tendinitis explains this risk. See cortisone shot for the knee
- Other injections, such as PRP (platelet-rich plasma): the research is still unsettled, and no injection replaces the strength work
- Stretching alone: tight thigh muscles may play a part, but stretching doesn’t build the tendon’s capacity
A painful tendon needs the right load, not no load.
What helps: the loading program
Most programs move through the same stages. Move on when your pain allows, not by the calendar.
- Stage 1, calm it down: cut back jumping and anything that sets off the pain. Start isometric holds, where the muscle works hard without the joint moving. A wall sit or a leg extension machine held still for about 45 seconds, repeated about 5 times, once or twice a day. Many people find the pain eases for a while afterward, though not everyone does
- Stage 2, build strength: heavy slow resistance. Leg press, squats and split squats with a heavy weight, taking about 3 seconds to lift and 3 seconds to lower. Three or four sets, about three times a week, adding weight as you get stronger
- Stage 3, build spring: once strength is good, add faster work such as skipping, small hops, then jumping and landing
- Stage 4, back to sport: return to training gradually. Build the amount of jumping first, then the intensity
- The pain rule: some pain during exercise is fine if it stays mild, about 3 out of 10 or less, and is no worse the next morning. If it is worse the next day, drop back a step
- Keep the rest of you fit: cycling, swimming and upper-body training are usually fine. Strengthen the hips and calves too, since they share the landing load
Do straps and braces help?
A patellar tendon strap sits just below the kneecap. Some people find it reduces pain during sport, and it’s reasonable to use one if it helps. It doesn’t repair the tendon. Treat it as a short-term aid while the strength work does the real job.
Recovery time
- Mild, recent pain: often settles within a few months with load changes and exercise
- Months or years of symptoms: expect 6 months to a year, and it can flare again if training suddenly spikes
- Surgery: rarely needed, and only after a long, properly progressed exercise program hasn’t worked
Keep up a short strength routine once you’re back. The tendon that got strong can lose that strength again.
Get it checked urgently if
- You felt a pop or sudden give below the kneecap and now can’t straighten your leg or lift it straight off the bed. The tendon may have torn
- The knee becomes hot, red and swollen and you feel feverish or unwell
- The knee swelled up fast after a twist, or it locks and won’t straighten
See your doctor or physio if
- Pain isn’t improving after 6 to 8 weeks of a sensible, steady program
- Pain wakes you at night or is there even when you’re resting
- You’re a teenager with pain and a tender bump just below the kneecap or at the top of the shinbone. That can be a growth plate problem rather than a tendon problem
Rest quiets a tendon. Only load makes it strong.