Jumper's knee

What it is

Patellar tendinopathy affects the tendon running from the bottom of the kneecap to the shin, usually at its attachment to the kneecap. It is a degenerative condition, not an inflammatory one, produced by repeated high-rate loading - jumping and landing above all.

The characteristic feature is that it warms up. Pain is worst at the start of activity, eases during, and is worse afterwards and the following morning. That pattern is a useful diagnostic feature and it also makes the condition easy to train through until it becomes entrenched.

What it feels like

• Pain at a specific point at the bottom of the kneecap
• Worst jumping, landing, squatting deep and going downstairs
• Warms up during activity and hurts more afterwards and next morning
• Tender to press on that one point with the knee straight
• Aching after sitting with the knee bent for a long time

What causes it

Most people have more than one of these at once, and they feed each other. Read the list looking for the two or three that sound like your week rather than for the one true answer — the ones that describe you are the ones worth acting on.

Repeated high-rate loading

Jumping and landing produce very high forces through the patellar tendon at high speed. Volleyball and basketball players have the highest rates, which is why it is called jumper's knee.

A failed healing response

The tendon responds to repeated overload with disorganised collagen and new vessel and nerve ingrowth rather than repair. It thickens and weakens simultaneously.

A rapid increase in jumping volume

Preseason, a new training block, or a return after a break. Tendon adapts more slowly than fitness, and the gap is where this appears.

Quadriceps weakness

A weak quadriceps transfers more of the landing load to the tendon rather than absorbing it. Quadriceps strength deficits are consistently found and are the main treatment target.

Poor landing mechanics

Stiff-legged landings without hip and ankle contribution concentrate load at the knee. Teaching a softer, hip-dominant landing reduces the tendon load meaningfully.

Reduced ankle dorsiflexion

A stiff ankle limits how much the ankle absorbs and shifts the landing load to the knee. It is a common and easily missed contributor.

Hard surfaces

Training on hard courts and floors increases the rate of loading. Surface changes are a common trigger for a first episode.

Body composition and load

Higher body weight increases the absolute load through the tendon on every landing.

Continuing to train through it

Because it warms up, athletes train through the early stage. That converts a manageable reactive tendon into a degenerative one and substantially lengthens the recovery.

Who tends to get it

• Volleyball, basketball and other jumping sport athletes
• Anyone increasing jumping or plyometric volume quickly
• Athletes with weak quadriceps or stiff ankles
• People training on hard surfaces
• Anyone who has trained through the early stage rather than modifying

What makes it worse, and what settles it

The qFIT routine for this

Ready-made routineKnee Pain/Bulletproofing

qFIT already has this one built. It runs massage first, then stretching, then strength — the order that works on a body that is already sore — and every activity in it carries the reason it is there.

The button below opens your Checklist with this routine already selected, so instead of your whole list you land on just its Categories, Targets and Exercises, each with its checkbox, ready to tick as you work through them.

Have more than one problem? Tick yours under My Problems on My Profile and your Checklist's Routine list gains Recommended for my problems — every routine for the problems you picked, merged into one. Your picks stay private; that filter is the only thing they feed.

Get it checked if…

Pain in an adolescent at the tibial tubercle is Osgood-Schlatter instead

And whatever the body part: chest pain or unusual breathlessness on exertion; a fever alongside the pain; unexplained weight loss; pain that is constant and unrelated to how you move; new numbness, weakness or loss of bladder or bowel control; or one calf that is swollen, warm and painful. Any of those, stop and get assessed.

How it usually goes

This is slow: three to six months of progressive loading is realistic, and longer in entrenched cases. Isometric holds often relieve pain within minutes and are useful for getting through training while the heavy loading does the structural work. The pain resolves before the tendon capacity does, which is why the programme must continue past symptom resolution - stopping there is the commonest cause of the recurrence this condition is famous for.

Prevalence basis: Sports medicine prevalence

Others the same routine covers

These share the Knee Pain/Bulletproofing routine, so the work is the same. If one of them also sounds like you, that is a reason to expect more from it, not less.

This is general information, not a diagnosis, and it cannot examine you. If it matches you, use it to ask better questions of a clinician rather than to replace one.