Patellar Tendinitis (Jumper's Knee)

Also known as: Patellar tendinopathy, Patellar tendonitis, Patellar tendon inflammation, Inferior pole patellar tendinopathy, Jumper's knee

Last updated: December 18, 2024

Patellar tendinitis (jumper’s knee) is an overuse injury of the tendon that connects the kneecap (patella) to the shinbone (tibia). It typically develops from repetitive stress and causes pain and tenderness at the lower part of the kneecap, often in athletes in jumping sports. Pain may worsen with jumping, running, squatting, or stairs, and can progress from activity-related to constant. Many cases improve with load management and rehabilitation.

Key Facts

  • •Patellar tendinitis, known as jumper's knee, is an overuse injury affecting the tendon connecting the kneecap (patella) to the shinbone (tibia)
  • •Pain at the front of the knee, at the bottom of the kneecap
  • •Diagnosed through history, physical exam, and imaging
  • •First-line treatment includes exercise, weight management, and activity modification

What It Is

Patellar tendinitis, commonly known as jumper's knee, is an overuse injury affecting the tendon connecting the kneecap (patella) to the shinbone (tibia). The condition typically develops from repetitive stress on the patellar tendon, causing pain and tenderness at the lower pole of the patella. It is common in athletes who participate in jumping sports.

Affected Anatomy

This condition affects several structures in and around the joint:

  • •Patellar tendon (connecting patella to tibial tuberosity)
  • •Inferior pole of the patella (most common site of involvement)
  • •Tibial tuberosity (insertion point of patellar tendon)
  • •Patella (kneecap)
  • •Quadriceps muscles and tendon
  • •Infrapatellar fat pad

Common Symptoms

Symptoms can vary in intensity and may change over time. Common experiences include:

  • •Pain at the front of the knee, typically at the bottom of the kneecap
  • •Pain that worsens with jumping, running, squatting, or climbing stairs
  • •Pain may initially occur only during or after activity but can progress to constant pain
  • •Tenderness when pressing on the patellar tendon
  • •Stiffness, particularly in the morning or after prolonged sitting
  • •Swelling around the patellar tendon may occur
  • •Weakness or difficulty with activities requiring knee extension
  • •Pain that may limit athletic performance

Causes and Risk Factors

Multiple factors can contribute to the development of this condition:

Causes

  • •Repetitive stress and overloading of the patellar tendon
  • •Frequent jumping and landing (basketball, volleyball)
  • •Running, particularly on hard surfaces or with sudden increases in training
  • •Sudden increase in training intensity, frequency, or duration
  • •Inadequate recovery time between training sessions
  • •Biomechanical factors affecting load distribution through the tendon

Risk Factors

  • •Participation in jumping sports such as basketball and volleyball
  • •Sudden increase in training volume or intensity
  • •Tight quadriceps or hamstring muscles
  • •Muscle imbalances affecting lower extremity mechanics
  • •Hard training surfaces
  • •Being male (higher prevalence in male athletes)
  • •Playing position requiring frequent jumping
  • •Previous patellar tendon problems

How It's Diagnosed

Diagnosis typically involves a combination of clinical assessment and imaging studies:

  • •Medical history focusing on activity patterns and symptom progression
  • •Physical examination with palpation of the patellar tendon and assessment of tenderness
  • •Provocative testing such as single-leg decline squat
  • •Assessment of quadriceps and hamstring flexibility and strength
  • •Ultrasound can visualize tendon thickening, hypoechoic areas, and neovascularization
  • •MRI may show tendon thickening and signal changes if diagnosis is uncertain
  • •X-rays are typically normal but may be obtained to rule out other conditions

Treatment Options

Treatment approaches range from conservative measures to surgical interventions, often starting with the least invasive options:

Self-Care and Activity Modification

  • •Relative rest and activity modification to reduce tendon loading
  • •Ice application after activity
  • •Patellar tendon straps or braces may reduce symptoms during activity for some individuals
  • •Addressing flexibility deficits in quadriceps and hamstrings
  • •Extracorporeal shockwave therapy may be considered for refractory cases

Physical Therapy and Exercise

  • •Eccentric strengthening exercises, particularly decline squat protocols
  • •Physical therapy focusing on progressive loading and muscle balance

Medications

  • •NSAIDs may provide short-term pain relief but do not address underlying tendon changes

Injections and Office-Based Procedures

  • •Platelet-rich plasma (PRP) injections may be used in some cases with variable evidence

Surgery

  • •Surgery may be considered for chronic cases that fail extensive conservative treatment

Prognosis and Recovery

The course of this condition varies between individuals:

  • •Many cases improve with appropriate load management and rehabilitation
  • •Recovery often requires weeks to months, and patience with treatment is important
  • •Premature return to high-intensity activity may lead to recurrence or chronic symptoms
  • •Chronic patellar tendinopathy can be challenging to treat and may limit athletic participation
  • •Early intervention and proper load management may improve outcomes

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