Patellar tendinopathy exercises
Patellar tendinopathy, often called jumper's knee, is an overload injury of the tendon that runs from the bottom of the kneecap to the top of the shin bone. That tendon is the last link in the chain that straightens the knee, so it absorbs a great deal of force every time you land, decelerate or push off. Overload makes it irritated and less tolerant, not fragile.
It is common in sports with a lot of jumping, landing and rapid direction change - basketball, volleyball, netball, football and athletics - and it usually appears after a jump in training volume or intensity: pre-season, a new team, more court time, or a return after a break. Stiff or weak thighs and calves leave the tendon taking a bigger share of the work.
The pain is well localised at the lower pole of the kneecap and most people can point to it with one finger. It is typically worse with jumping, landing, decelerating, deep squatting and stairs, and it has a distinctive habit of warming up during activity only to feel worse hours later or the next morning. It rarely swells or gives way.
The tendon needs graded, progressive load to recover, and rest alone reliably fails because a rested tendon loses capacity. It is stubborn rather than dangerous, and most people take three to six months to get back to full sport, longer if it has been grumbling for a season or more. This programme moves from isometric holds that reduce pain, through heavy slow strength work, into springy jumping and landing, and finishes with return-to-play markers.
Who this programme is for
Active people with well-localised pain at the bottom of the kneecap that is clearly linked to jumping, landing and loaded knee bending. It suits both in-season management and an off-season rebuild. Pain that is diffuse, or a knee that locks, swells or gives way, needs assessment first.
Get urgent help now if
- Sudden inability to straighten the knee or lift it against gravity after a forceful effort - possible tendon rupture - go to an urgent treatment centre or A&E
- The area is hot, very swollen and red, especially if you also feel feverish or unwell - go to A&E now, or call NHS 111 straight away if you are not sure where to go. Do not drive yourself if you feel very unwell.
Get checked by a clinician first if
- The knee locks, catches or gives way repeatedly
- Marked or rapid swelling of the knee
- Pain that is worse at rest and at night rather than with loading
- The pain followed a significant accident, fall or direct blow and you have not been checked over
- You feel unwell with the pain - a fever, night sweats, or losing weight without trying
- Pain that is severe, steadily getting worse, or keeps you awake every night and does not ease with a change of position
Not sure it's this? Try a self-check
Quick movement tests you can try at home to see what your symptoms might point towards. A guide, not a diagnosis.
- Single-Leg Decline Squat CheckHow well the knee tolerates load through the kneecap tendon and the front of the knee
The staged programme
Settle
For a painful flare. Reduce jumping and change-of-direction load, and use isometric holds - a static wall sit or held knee extension - which often reduce tendon pain for hours afterwards.
Build strength
Load the tendon with heavy, slow strength work - controlled squats, step-ups and knee extension - three times a week, taking three seconds up and three seconds down. Some tendon pain during is acceptable if it settles by the next day.
Power and change of direction
Add faster, springier work once heavy strength is comfortable - split squats, controlled step-downs, and progressively hopping and landing drills, building volume gradually.
Return to play
You are ready to return when: pain on a single-leg decline squat is no more than 3 out of 10; heavy strength is equal left and right; you can jump, land and change direction repeatedly without the tendon flaring the next day; and you have completed a full training session and sport-specific drills without a reaction. Manage load carefully in the first weeks back - avoid sudden spikes in jumping volume. If unsure, get assessed before returning.
How long recovery takes
It depends on your condition; your physiotherapist will give you an estimate after your assessment. It can be stubborn, so in our plans load is managed through the season and heavier strength work is built up when your sport allows. We review your progress regularly and adjust your plan.
Knowing when to progress
Use a single-leg decline squat as your test: pain up to 3 out of 10 during loading that settles within 24 hours and does not increase morning stiffness means the load is right. Progress strength before power, and power before return to sport. Do not add jumping volume in the same week you increase strength load.
Common questions
Should I rest until it stops hurting?
No. Complete rest de-loads the tendon and the pain returns as soon as you jump again. The tendon needs progressive load to build capacity. Reduce aggravating volume, but keep loading it.
Can I keep playing?
Often yes, if pain during play stays at or below about 3 out of 10 and settles within 24 hours, and morning stiffness is not increasing week to week. If those limits are exceeded, reduce match and training load until they are back under control.
Do stretching and foam rolling help?
They may ease symptoms briefly but do not resolve the tendinopathy. Progressive strength work is the treatment. Very deep quad stretching can sometimes compress and irritate the tendon.
What about an injection?
Corticosteroid injections into or around the patellar tendon are generally avoided because of the risk of weakening it. Other injection types have weak and inconsistent evidence. Loading remains first-line.
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