Patellar tendinopathy (jumper’s knee)
Why does the bottom of my kneecap hurt when I jump or squat?
Load-related pain in the tendon just below the kneecap, common in jumping sports. Progressive tendon loading is the core treatment.
What it feels like
Pain at the bottom of the kneecap that comes on with jumping, landing, squatting or stairs, often warming up during activity and returning afterwards or the next day.
What is actually happening
The patellar tendon becomes less tolerant of load after loading has increased faster than it adapted, common in basketball, volleyball and jumping sports. It is a load problem, not inflammation that needs rest.
How it is assessed
Assessment includes where the pain is, how it responds to graded loading tests such as single-leg squats and hops, strength of the thigh and calf, and your training load.
How it is treated
A systematic review and network meta-analysis concluded that eccentric loading should remain the first-line treatment, with slow resistance and isometric exercise as promising options, although the evidence is of low quality. Treatment progresses through tendon loading, from isometric holds to heavier strength work and then jumping and sport-specific loading, while adjusting training volume. Shockwave is sometimes offered, but trials have not shown a clear added benefit over exercise alone.
What to do first
Reduce jumping volume rather than stopping all training, keep strengthening the legs, and have it assessed to start a structured loading programme.
Where this is assessed
- The Runner's Academy St. Clair West · Mon/Wed/Fri · 3:00 PM – 6:30 PM Book at Runner's Academy
- Athlete's Care Sports Medicine Centres Yonge & Eglinton · Mon/Wed/Fri · 8:00 AM – 2:00 PM Book at Athlete's Care
- Push Pounds Sports Medicine Downtown Toronto · Tue/Thu · 8:30 AM – 6:30 PM Call Push Pounds to book
References
This page is based on the following clinical practice guidelines and research.