Why Does It Hurt Below My Kneecap? Understanding Patellar Tendinopathy

Why Does It Hurt Below My Kneecap? Understanding Patellar Tendinopathy

Patellar tendinopathy ("jumper's knee") is an overuse injury affecting the tendon below the kneecap, most common in sports involving jumping, running, or rapid direction changes, though it can also affect people ramping up a new exercise routine too quickly. Recovery is highly achievable through a structured physiotherapy programme centred on progressive tendon loading, with most people noticing improvement within weeks, though full recovery can take several months. Additional treatments like shockwave therapy or injections are typically reserved for more persistent cases.

What Is Patellar Tendinopathy?

Patellar tendinopathy, commonly known as jumper's knee, is a frequent cause of knee pain, especially in active individuals and athletes.

It affects the tendon that connects the kneecap (patella) to the shinbone (tibia) and typically develops due to repetitive stress or overload.

It is commonly seen in sports involving jumping, running, and rapid direction changes, but it can also affect people starting new exercise routines or increasing activity levels too quickly.

The most common symptom is pain located just below the kneecap, particularly during or after activity.

What Are the Signs and Symptoms of Patellar Tendinopathy?

Typical symptoms include:

• Pain and tenderness below the kneecap
• Swelling around the tendon
• Stiffness, especially after rest or in the morning
• Weakness or reduced knee function during activity
• Pain that worsens with jumping, running, or squatting

Symptoms often begin gradually and may initially only be noticeable during activity, becoming more persistent if left untreated.

What Are the Causes and Risk Factors?

Patellar tendinopathy is mainly caused by repetitive stress on the tendon. Common contributing factors include:

• Overuse from repetitive jumping or running
• Muscle imbalances placing uneven load on the knee
• Tight quadriceps or hamstrings increasing tendon strain
• Poor movement mechanics or technique
• Sudden increases in training intensity

Certain sports place higher demands on the patellar tendon, including basketball, volleyball, football, tennis, gymnastics, and track and field events.

Risk is also higher in individuals who are younger and highly active, particularly those involved in jumping or high-impact sports.

What Are the Treatment Options for Patellar Tendinopathy?

Treatment focuses on reducing pain, restoring strength, and improving load tolerance of the tendon. A structured, progressive approach is essential for recovery.

• Physiotherapy and Exercise Rehabilitation – A tailored physiotherapy programme is the cornerstone of treatment. This includes progressive strengthening exercises designed to improve tendon capacity, reduce pain, and restore knee function. Exercises are gradually increased based on tolerance to avoid overloading the tendon.
• Activity Modification and Load Management – Reducing or modifying aggravating activities is often necessary in the early stages. High-impact movements such as jumping or sprinting may need to be temporarily reduced while the tendon recovers. A gradual return to activity helps prevent flare-ups.
• Manual Therapy – Hands-on treatment techniques such as soft tissue work and joint mobilisation can help reduce stiffness, improve mobility, and support overall function. This is typically used alongside exercise-based rehabilitation.
• Ultrasound Therapy – This uses sound waves to promote blood flow, reduce inflammation, and support tissue healing. It is a non-invasive treatment often used to complement other rehabilitation methods.
• Shockwave Therapy – Also known as ESWT, shockwave therapy delivers high-energy sound waves to the affected tendon to stimulate healing, improve circulation, and reduce chronic pain. It is particularly useful in longer standing or persistent cases.
• Acupuncture – This can help manage pain, improve blood flow, and support the body's natural healing processes. It is often used as part of a broader treatment plan for symptom relief.
• Injection Therapy – In some cases, injection therapy may be considered to help manage pain and inflammation. Options may include corticosteroid injections or other clinically appropriate treatments, typically reserved for more persistent or severe cases.

At Relive Physiotherapy, treatment is tailored to each individual using a combination of these approaches, with a strong emphasis on rehabilitation and long-term recovery rather than short-term symptom relief.

How Long Does Recovery Take?

Recovery from patellar tendinopathy varies depending on severity and consistency with treatment. Many individuals notice improvement within weeks, although full recovery may take several months.

Adherence to a structured rehabilitation programme and appropriate load management plays a key role in achieving the best outcome.

What Are the Prevention Strategies?

To reduce the risk of developing patellar tendinopathy:

• Gradually increase training intensity and volume
• Maintain strength in the quadriceps, hamstrings, and glutes
• Use proper technique during exercise and sport
• Include regular stretching and mobility work
• Wear supportive footwear
• Incorporate rest and recovery into training schedules

Consistent strength and load management are key to preventing recurrence.

Bounce Back from Patellar Tendinopathy

Patellar tendinopathy is a common but manageable cause of knee pain, particularly in active individuals. With the right combination of physiotherapy, exercise, and load management, most people can recover and return to their usual activities safely.

Early assessment and structured rehabilitation are essential to prevent the condition from becoming chronic.

Experiencing knee pain below the kneecap? Book an assessment with our physiotherapy team today and start a personalised treatment plan to support your recovery.

Frequently Asked Questions

What is jumper's knee?

Jumper's knee is the common name for patellar tendinopathy, an overuse injury affecting the tendon that connects the kneecap to the shinbone, typically caused by repetitive jumping, running, or rapid direction changes.

How long does patellar tendinopathy take to heal?

Many people notice improvement within weeks, though full recovery can take several months depending on severity. Consistency with a structured rehabilitation programme plays a big role in the outcome.

Can patellar tendinopathy be treated without surgery?

Yes, in almost all cases. A structured physiotherapy programme focused on progressive tendon loading is the main treatment, with additional support from manual therapy, shockwave therapy, or acupuncture if needed.

Who is most at risk of developing patellar tendinopathy?

It's particularly common in younger, highly active individuals involved in jumping or high-impact sports like basketball, volleyball, football, or gymnastics, though it can also affect people increasing activity levels too quickly.

How can I prevent patellar tendinopathy from coming back?

Gradually increasing training load, maintaining strength in the quadriceps, hamstrings, and glutes, using proper technique, and building in adequate rest and recovery all help reduce the risk of recurrence.

About the Author:

Shivani Darira

Senior Specialist Physiotherapist

As a Senior Specialist Physiotherapist at Relive Physiotherapy, Shivani has a particular interest in treating musculoskeletal and sports injuries. She holds an MSc in Sports Medicine from the University of Chester and brings a strong clinical foundation to her work with athletes and active clients alike.

Shivani's approach is guided by the principle that movement aids healing, and she takes a dynamic, personalised approach to every client's recovery journey.

Outside the clinic, Shivani enjoys HipHop and Bollywood dance and is currently learning to swim and play tennis.