Patellar Tendonitis (Jumper's Knee): Why It Lingers and How to Fix It
Patellar tendonitis is one of those injuries that can be incredibly frustrating because it often seems to come out of nowhere and then refuses to leave.
I've seen it in basketball players, volleyball players, runners, CrossFit athletes, and even active adults who simply increased their activity level a little too quickly.
It usually starts as a mild ache just below the kneecap. At first, it only hurts during activity. Then it starts lingering afterward. Eventually, it may hurt going up stairs, squatting, getting up from a chair, or even after sitting for long periods.
The frustrating part is that many people do exactly what they think they're supposed to do—they rest.
And while rest may temporarily reduce symptoms, it rarely solves the problem.
What is patellar tendonitis?
The patellar tendon connects your kneecap (patella) to your shin bone (tibia).
Every time you squat, jump, run, land, sprint, or climb stairs, that tendon is helping transfer force through the knee.
Over time, if the tendon is exposed to more load than it can tolerate, it begins to become irritated.
Despite the name "tendonitis," many chronic cases aren't actually inflammatory in nature. They're better described as tendinopathy, meaning the tissue has undergone structural changes and is no longer handling load efficiently.
This is why anti-inflammatory treatments alone often don't fully solve the problem.
Why does it keep coming back?
One of the biggest mistakes people make is assuming the tendon simply needs more rest.
The reality is that tendons become stronger when they're exposed to the right amount of load.
Too much load causes irritation.
Too little load causes deconditioning.
The goal is finding the sweet spot.
Research published in The British Journal of Sports Medicine consistently shows that progressive loading programs are among the most effective treatments for tendon injuries, including patellar tendinopathy.
In other words, the solution isn't avoiding activity forever.
It's teaching the tendon how to tolerate activity again.
What contributes to patellar tendonitis?
The tendon itself is often only part of the story.
When evaluating patients in my Scottsdale clinic, I'm also looking at:
Quadriceps strength
Hip strength
Landing mechanics
Ankle mobility
Training volume
Recovery habits
For example, I frequently see athletes with weak hip musculature who place excessive stress through the knee every time they jump, land, or change direction.
If we only treat the tendon and ignore those contributing factors, the symptoms often return.
How I treat patellar tendonitis
Treatment starts by determining why the tendon became overloaded in the first place.
From there, I typically build a program that combines symptom reduction with progressive strengthening.
Depending on the individual, treatment may include:
Dry needling
Shockwave therapy
Soft tissue treatment
Mobility work
Progressive tendon loading
Quadriceps strengthening
Hip strengthening
Return-to-sport progression
Shockwave therapy can be particularly helpful in chronic cases that have been lingering for several months. Research has shown it can help stimulate healing and improve outcomes when combined with exercise.
The key phrase there is "combined with exercise."
No passive treatment fixes a tendon on its own.
The tendon ultimately needs to become stronger.
Why athletes often struggle with recovery
Athletes are notorious for one thing.
Doing too much too soon.
Trust me, I get it.
When you feel a little better, the temptation is to immediately jump back into full activity.
Unfortunately, tendons don't always appreciate that enthusiasm.
One of my biggest jobs as a physical therapist is helping patients progress their activity in a way that builds resilience without constantly re-irritating the tissue.
That's where having a structured plan matters.
The bottom line
Patellar tendonitis can be stubborn, but it's very treatable when approached correctly.
At Modern Movement Physical Therapy in Scottsdale, I focus on identifying the factors that caused the tendon to become overloaded and then building a plan that restores strength, improves movement, and allows you to return to the activities you enjoy.
Because resting forever isn't the answer.
Building a stronger tendon is.
Take good care of your body, it's the only one you have.
Yours in health,
Dr. Michael Price