Understanding "Jumper's Knee"
Patellar tendinopathy, commonly called jumper's knee, is a breakdown of the tendon connecting the kneecap to the shin bone. It's caused by repetitive strain instead of a single injury. This is especially common in athletes who jump, sprint, or change direction frequently.
Causes
Patellar tendinopathy develops from repeated overload of the tendon:
Repetitive jumping or running activities
A sudden increase in training frequency or intensity.
Tight quadriceps muscles increasing tendon strain.
Biomechanical factors like poor landing mechanics or patella alta (a higher-riding kneecap).
Prior tendon injury that didn't fully heal.
Symptoms
Common symptoms include:
Pain at the bottom of the kneecap, where the tendon attaches.
Pain that worsens with jumping, squatting, kneeling, or climbing stairs.
Localized tenderness directly over the tendon.
Pain with resisted knee straightening.
Stiffness after periods of rest, easing somewhat with activity in early stages.
Seek prompt medical care if: The knee becomes hot, red, and swollen, especially with fever; you can't bear weight after an injury; or the knee locks and won't straighten. New calf pain and swelling can signal a blood clot and needs urgent evaluation.
Imaging Studies to Consider
Imaging confirms the diagnosis and assesses severity:
Ultrasound is usually the first test; shows tendon thickening and areas of tendon breakdown, and can guide injections.
MRI of the knee is used for surgical planning or when the diagnosis is unclear.
X-ray helps rule out other bony causes of anterior knee pain, particularly in younger patients.
Physical Therapy, Home Exercise & Other Conservative Techniques
A progressive loading program is the best-studied treatment for patellar tendinopathy and is typically the foundation of care:
Physical Therapy
A progressive loading program, moving from isometric holds to heavy, slow resistance exercises.
Eccentric strengthening, like decline squats.
Hip and quadriceps mechanics assessment.
Home Exercise Program
Eccentric squats on a decline board.
Isometric wall sits.
Quadriceps and hip strengthening.
Other Studied Techniques
Activity and load modification, with a gradual return to jumping or running sports.
A patellar tendon strap, which some patients find helpful during activity.
Ice after activity.
Interventional Treatment Options
When activity modification and a structured loading program aren't enough, several non-opioid procedures can help:
Ultrasound-guided PRP injection: Earlier individual studies looked promising, but a 2024 multispecialty consensus review of the fuller evidence reached a more cautious conclusion and does not currently recommend PRP as a routine adjunct for patellar tendinopathy. It can be considered in select cases following a discussion with your healthcare provider, with realistic expectations, once other conservative measures have been tried.
Peritendinous (not intratendinous) injections: Medication is placed around, not directly into, the tendon substance to avoid weakening it.
Dry needling or percutaneous tenotomy: A minimally invasive technique that stimulates a localized healing response in the degenerated tendon tissue.
Extracorporeal shockwave therapy: A non-injection adjunct treatment that can stimulate tendon healing.
Acupuncture or dry needling: May help reduce tendon-related pain as part of a broader rehabilitation program.
Surgical referral: Reserved for tendon cases that remain refractory to extensive conservative and interventional treatment.
How Strong Is the Evidence?
A summary of the evidence supporting key treatments for patellar tendinopathy:
How to read this: Strong means consistent results from multiple high-quality studies. Moderate means generally favorable results with some limitations. Mixed or early means results so far are inconsistent or still emerging. Limited means few or lower-quality studies; these options can still be considered in select cases following a discussion with your healthcare provider.
Platelet-rich plasma (PRP): Limited evidence; can be considered in select cases.
Extracorporeal shockwave therapy: Moderate evidence.
Dry needling or percutaneous tenotomy: Mixed or early evidence.
Acupuncture: Mixed or early evidence.
Evidence reviewed November 2026. These ratings summarize published research and major medical society guidelines available at that time. Research continues to evolve, and we will go over the most current evidence for your situation at your visit.
Pain Psychology Techniques
Tendon healing takes time, and pain psychology techniques help support a full recovery:
Graded activity pacing: a gradual, structured loading program is the cornerstone of tendinopathy recovery.
Cognitive behavioral therapy (CBT) for pain helps manage frustration with a slow, non-linear recovery.
Pain neuroscience education: understanding that some discomfort during loading exercises is normal and expected.
Relaxation training and diaphragmatic breathing.
Non-Opioid Medication Options
Medications play a supporting role alongside a structured exercise program:
For pain relief
Short-term NSAIDs or topical NSAID gel can help during flare-ups, though prolonged oral use is generally avoided as it may impair tendon healing.
Acetaminophen is a good ongoing option that doesn't affect tendon healing.
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Talk With Us About Your Options
Call 650-507-4113 or send us a message to schedule a consultation at our Daly City, Los Altos, or Stockton office. We will review what may be causing your pain and walk through the risks, benefits, and alternatives of each option with you.
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This information is provided for general patient education and does not replace individualized medical advice. Please discuss your specific symptoms, diagnosis, and treatment options with your pain management physician.
