Patellar tendon or patellar ligament
The structure that hurts in jumper’s knee connects the lower pole of the kneecap to the tibial tuberosity. Because it connects bone to bone, anatomical nomenclature calls it the patellar ligament. In clinical practice it is more often called the patellar tendon: it is a continuation of the quadriceps tendon, transmits the muscle’s force to the shin bone and responds to load just like other tendons. Both names refer to the same place.
Tendinopathy develops when the number of jumps and landings grows faster than the tendon’s ability to adapt. It most often affects volleyball and basketball players and athletics jumpers, especially during busy periods of matches and training.
How we recognise jumper’s knee
The typical picture is pain in a very specific place – at the lower pole of the kneecap – that gets worse as the tendon is loaded: in a deeper squat, when jumping, when landing. Pain at the front of the knee can, however, also be patellofemoral pain, which is managed differently – we describe it on the page about anterior knee pain. We tell the two apart in the assessment.
In the assessment we check tendon tenderness on pressure and during a single-leg squat, quadriceps strength and the quality of your landing. Assessing your load matters too: how many training sessions, matches and jump sessions you have each week, and what changed before the pain appeared. We set a simple pain test that will serve as a reference point at the following visits.
Imaging is usually not needed to start treatment. Tendon changes visible on ultrasound are also found in players with no pain, so the plan is decided by the symptoms and the response to load.
Treatment – from isometrics to plyometrics
Treatment is based on graded loading of the tendon. At the start we use isometric exercises, meaning long holds without movement, which in some people reduce pain in the short term. Then we introduce heavy, slow resistance exercises – squats, knee extensions, the leg press – with the load increasing every week. These are what build the tendon’s capacity.
Once the tendon tolerates heavy weights, we add faster movements, low hops and later full plyometrics and sport-specific landings. We run the whole process as medical training. Manual therapy or tape can help in the short term, but they will not replace this process. Steroid injections into the tendon are not recommended – they can reduce pain temporarily, but they do not build the tendon’s capacity and may weaken it.
How long it takes and when to come in
Jumper’s knee is a problem that needs patience – a clear improvement usually comes after a few weeks, and a full return to jumping often takes several months. Cutting the strength phase short is the most common cause of recurrence.
During the season it is not always possible to take a break from playing. Then we agree with you, and if needed with your coach too, how many jumps and training sessions the knee can tolerate, and run the strength training in parallel. After the return it is worth keeping the strengthening exercises up for the whole season, because a tendon quickly loses capacity once it stops getting a stimulus. If pain below the kneecap has been getting in the way of your game for a few weeks, book a visit via the Contact page – we set out the details of the plan at the visit.