What Is Patellar Tendinitis or Jumper’s Knee?

Patellar tendinitis (often called “Jumper’s Knee”) is an overuse injury that affects the patellar tendon, which connects your kneecap (patella) to your shinbone (tibia). This condition often causes localized pain, stiffness, and tenderness directly below the kneecap, which makes activities like jumping, climbing stairs, or squatting difficult.

At Total Orthopedics and Sports Medicine, our surgeon, Dr. Charles Ruotolo, carefully evaluates the cause and severity of your patellar tendon pain using advanced diagnostic tests. After diagnosis, he guides you to targeted exercises, activity modification, and nonsurgical treatments to help reduce pain. If needed, he recommends advanced minimally invasive surgical options to support long-term recovery. Call 855-321-6784 to book an appointment in Commack.

What Causes Patellar Tendinitis or Jumper’s Knee?

Muscle imbalances, such as tight quadriceps or hamstrings, and structural misalignment can increase the risk of patellar tendinitis. Repetitive mechanical overload, accumulated microtrauma (tiny tendon damage), and sudden increases in training intensity can also place excess stress on the patellar tendon. In some cases, chronic health conditions such as kidney failure, diabetes, or lupus can reduce blood flow and weaken the tendon over time.

Here is how these risk factors and underlying conditions can contribute to jumper’s knee and increase the risk of tendon injury:

Accumulated Microtrauma

According to NIH research, repetitive activities such as basketball, volleyball, running, and other jumping sports can place repeated stress on the patellar tendon. If this stress persists without adequate recovery time, the tendon develops tiny tears called microtrauma. Over time, these small injuries can lead to collagen fiber breakdown and fibril degeneration (damage to the tendon’s structural fibers). As a result, the tendon gradually weakens and thickens, increasing the risk of patellar tendinopathy and other sports-related injuries such as:

• Anterior Cruciate Ligament (ACL) Injuries
• Meniscus Tears
• Patellofemoral Pain Syndrome
• Quadriceps Tendon Tears
• Knee Osteoarthritis
• Iliotibial (IT) Band Syndrome
• Stress Fractures

Muscle Tightness And Imbalances

The quadriceps muscle (front thigh muscles) attaches to the kneecap and helps straighten the leg during activities such as running or kicking. If these muscles are tight, they place constant tension on the kneecap and increase stress on the patellar tendon during movement. At the same time, muscle imbalances such as weak glutes and overly dominant quadriceps can place uneven forces across the knee joint. As a result, the tendon must absorb significant force during physical activity, which increases the risk of ongoing anterior knee pain.

Structural Misalignment

Structural misalignment can cause patellar tendinitis, or “jumper’s knee,” by disrupting the leg’s natural biomechanics. For example, a high-riding kneecap or flat feet can force the tendon to absorb uneven pressure during running, jumping, or landing. Similarly, ligamentous laxity (loose ligaments) and an excessive Q-angle (wide alignment of the kneecaps) can increase strain on the tendon. Over time, this added stress can cause small tears, chronic pain, and jumper’s knee.

Sudden Increases In Training Intensity

The patellar tendon connects the kneecap to the shinbone and allows movement such as kicking, running, and frequent jumping. If you suddenly increase your training intensity, the patellar tendon must handle significant forces. This added stress can increase the risk of patellar tendinitis and tendon strain. In fact, a PubMed study found that athletes with a tendon strain of 9% or higher had a 2.3 times greater risk of developing symptoms of patellar tendinopathy.

Excessive training loads and repeated movements can also contribute to long-term joint damage. For example, a systematic review published in the Journal of Global Health found that high activity levels were associated with a 26% higher risk of knee osteoarthritis than moderate activity levels. In this study, the researcher reviewed 14 observational studies involving 507,696 participants. They found that exceeding recommended activity guidelines increased the risk of knee osteoarthritis by 18%.

Chronic Health Conditions

Chronic health conditions can affect blood flow and reduce the tendon’s ability to handle daily stress. For example, diabetes can reduce circulation to the lower extremities, while kidney failure can affect tissue health. As a result, the patellar tendon may experience more strain during physical activity and reduce tendon strength. Moreover, the following conditions can place additional stress on the tendon and increase the risk of patellar tendinitis:

• Lupus: Triggers inflammation throughout the body.
• Rheumatoid Arthritis: Affects joints and surrounding tendons.
• Obesity: Places extra pressure on the knee joint.
• Metabolic Disorders: Can interfere with normal tendon repair.
• Chronic Inflammatory Condition: Increased tendon irritation and slow tissue healing.
• Connective Tissue Disorders: Reduce tendon strength and stability.

Why Do Athletes Commonly Develop Patellar Tendinitis?

Athletes are at a higher risk of patellar tendinitis because jumping sports such as basketball, volleyball, and track and field repeatedly stress the patellar tendon. Excessive training volume and intensity also increase tension across the knee and affect tendon health. In fact, a PubMed cross-sectional study reports that nearly 45% of elite jumping athletes experience symptoms of patellar tendinopathy at some point in their careers.

Beyond sports-related stress, poor recovery between workouts can also increase the risk of jumper’s knee. In addition, NIH research found that playing on hard surfaces can further increase stress on the tendon. The researchers reported a 38% prevalence of patellar tendinopathy among athletes playing on concrete surfaces compared with 20% among athletes playing on other surfaces.

Can You Get Jumper’s Knee Even If You Don’t Play Sports?

Yes, repeated stress on the patellar tendon can cause jumper’s knee even without sports participation. For example, suddenly starting a new hobby such as hiking, jogging, or gardening can overload the tendon during movement. Similarly, certain jobs require heavy lifting, frequent kneeling, squatting, or climbing stairs, which can place continuous stress on the knee. Over time, this ongoing strain can cause small tendon damage, which may lead to patellar tendinitis and persistent knee pain.

Moreover, the following factors can increase the risk of jumper’s knee even without participating in sports:

• Muscle Imbalances: Weak or tight leg muscles can place extra stress on the patellar tendon.
• Obesity or Weight Gain: Extra body weight increases pressure on the knee during daily activities.
• Unsupportive Shoes: Poor cushioning or arch support can increase impact forces on the knee.

How Does Repetitive Stress Affect the Patellar Tendon?

Repeated stress can cause tiny tears in the patellar tendon, especially during frequent running or jumping activities. If this stress continues, the tendon may not have enough time to recover between activities. As a result, the tendon fibers gradually lose their normal structure, leading to patellar tendinopathy (tendon degeneration) and thickening. Over time, the tendon becomes weaker at handling force, which may lead to persistent pain, especially among basketball and volleyball players.

What Symptoms of Patellar Tendinitis Should You Notice?

You should notice pain and tenderness just below the kneecap, especially during or after physical activity. As the tendon becomes more irritated, you may also notice mild swelling, thickening, or a burning sensation at the front of the knee. The discomfort often begins as a mild ache after exercise and may become more noticeable during activities such as jumping, running, or climbing stairs. Over time, the pain may last longer and become noticeable during everyday movements.

In addition, you may notice the following signs of patellar tendinitis:

• Morning Stiffness: A tight or stiff feeling in the knee after waking up or sitting for long periods.
• Pain on Touch: Tenderness when pressing directly over the patellar tendon.
• Burning Symptoms: Mild swelling, thickening, or a burning sensation at the front of the knee.
• Knee Weakness: A feeling that the knee lacks strength during daily activities or physical activity.

What Does Stage 1 Knee Tendon Pain Feel Like?

At an early stage, knee pain often feels like a mild, dull ache after strenuous physical activity or a hard workout. You may also notice slight tenderness when pressing on the patellar tendon and mild stiffness after resting. However, the discomfort does not usually affect your ability to run, jump, or perform daily activities. In most cases, pain improves with rest, activity modification, and slow, resistance-based exercises.

What Symptoms Develop as Tendon Damage Progresses?

As tendon irritation increases, you may experience burning pain, knee weakness, and reduced mobility during daily activities. The pain may also occur during prolonged sitting, squatting, stair climbing, or sustained knee bending, often called the movie theater sign. Beyond that, ongoing stress on the tendon can lead to tissue thickening and a crunchy or crackling sensation during movement. Without timely treatment, these changes can restrict joint movement and lead to the following complications:

• Tendon Tear or Rupture: A partial or complete tear can cause sudden pain, weakness, and difficulty moving the knee.
• Tendon Thickening: Repeated stress can lead to scar tissue buildup and tendon thickness.
• Reduced Mobility: Knee stiffness can make it difficult to bend, squat, climb stairs, or participate in physical activity.
• Muscle Weakness: Reduced activity due to pain can gradually weaken the muscles that support the knee.
• Bone Spurs: Long-term tendon stress can lead to calcium deposits and small bone spurs where the tendon attaches to the bone.

How Is Jumper’s Knee Diagnosed?

Our sports medicine surgeon, Dr. Charles Ruotolo, performs a detailed physical examination and reviews your symptoms, activity level, and medical history to diagnose patellar tendinitis. During the evaluation, he palpates the area around the kneecap to identify the exact location of pain and tenderness. He also assesses knee movement, flexibility, strength, and functional movement patterns.

In addition, he may examine Bassett’s Sign (a test comparing tenderness with the knee straight and bent) to help identify irritation of the patellar tendon. However, if symptoms persist, Dr. Charles Ruotolo may order the following imaging tests to confirm the condition:

• X-Rays: Help identify bone spurs, kneecap alignment problems, or other bone-related conditions.
• Ultrasound: Shows tendon thickening, small tears, and changes within the patellar tendon in real time.
• Magnetic Resonance Imaging (MRI): Provides detailed images of the tendon and surrounding soft tissues to assess the extent of damage.

How Can You Recover From Patellar Tendon Pain?

To ensure a smooth recovery from patellar tendon pain, you should limit activities that place excessive stress on the tendon. At the same time, load modification, progressive strengthening exercises, and patient education can help the tendon gradually adapt to activity again. Ice therapy and supportive devices, such as a patellar strap, may also help reduce discomfort during movement.

Once pain decreases, you should progress from isometric exercises (muscle contractions without movement) to heavy, slow resistance training. This progression is then followed by sport-specific exercises that prepare the tendon for a safe return to activity. During recovery, your doctor may also recommend eccentric training, stretching of the patellar tendon and lower-limb muscles, and adjustments to training volume or frequency. These strategies can help reduce stress on the tendon while lowering the risk of future irritation. Beyond these approaches, the following treatments may also support recovery:

Dry Needling

A randomized clinical trial by the National Library of Medicine found that dry needling reduces patellar tendon pain and improves knee function during rehabilitation. The researchers found significant improvements in pain scores, knee function, and activity levels. These improvements were observed throughout the 4-week treatment period.

Extracorporeal Shockwave Therapy (ESWT)

Extracorporeal Shockwave Therapy (ESWT) may help when patellar tendinopathy symptoms persist despite conservative treatment. This non-surgical therapy uses sound waves to stimulate healing within the damaged tendon and improve blood flow to the area. As healing progresses, many patients experience reduced pain and improved knee function without surgery.

Which Exercises Are Most Effective for Recovery?

Light walking, stationary cycling, and balance exercises can help reduce stress on the tendon while keeping the knee active during recovery. Gentle yoga and foam rolling can also improve flexibility and reduce muscle tightness around the knee. These activities increase blood flow to the area without placing excessive strain on the healing patellar tendon. They also support ACL prevention by improving balance, movement control, and lower-extremity stability.

As symptoms improve, strength training and eccentric exercises often support recovery. In fact, a randomized controlled trial published in PubMed found that eccentric training led to significant improvement similar to that of surgery after 12 months. The researchers also found that patients should continue eccentric exercises for at least 12 weeks before considering surgery. Another ScienceDirect study found that sport-specific balance training was associated with a lower incidence of patellar tendinopathy.

Do Knee Braces or Patellar Straps Help With Tendon Pain?

Yes, knee braces and patellar straps can help relieve tendon pain caused by conditions such as patellar tendinitis. For example, knee braces with specialized pads support patellar tracking (kneecap alignment) and reduce stress on the irritated tendon during movement. Similarly, patellar straps apply gentle pressure below the kneecap, which helps reduce strain on the tendon during activity.

However, these devices do not repair the damaged tendon or address the underlying cause of pain. For this reason, doctors often recommend rehabilitation exercises alongside braces or straps to improve tendon function.

What Types of Injections Are Used for Tendon Pain?

An expert knee doctor may use corticosteroid injections (glucocorticoid injections) or hyaluronic acid injections to reduce inflammation and relieve tendon pain. They may also recommend platelet-rich plasma (PRP) therapy to support healing in areas of chronic tendon damage. In fact, research published in the BioMed Research International Journal found that PRP contains natural growth factors that help repair damaged tendon tissue and support healing. The researchers also reported that PRP may regulate fibrosis (scar tissue formation) and angiogenesis (new blood vessel growth). In some cases, the following injection treatments may help reduce pain and improve movement:

Prolotherapy

Prolotherapy uses a concentrated dextrose (sugar) solution that is injected into the tendon or nearby ligaments. This solution triggers a mild healing response in the treated area. As a result, your body sends repair cells to the tendon and surrounding tissues. Over time, this process may help strengthen weakened tissue, reduce swelling, and improve tendon function.

Saline Injections (Hydrodissection)

A knee specialist may recommend hydrodissection when scar tissue restricts movement or places pressure on nearby structures. During the procedure, the doctor injects sterile saline around the affected tendon using ultrasound guidance. The fluid helps separate scar tissue and reduce friction in the area. As a result, this treatment may improve movement and reduce pain in chronic tendon conditions.

When Is Surgery Recommended for Tendon Damage?

Our fellowship-trained surgeon, Dr. Charles Ruotolo, may recommend surgery for a complete patellar tendon tear or significant damage that severely limits knee function. He may also recommend surgery if your symptoms fail to improve after 3 to 6 months of nonsurgical treatments, such as bracing and anti-inflammatory medications. In these cases, surgical treatment can help restore tendon strength and improve the function of the knee extensor mechanism. In fact, PubMed research found success rates of 87% for open surgery and 91% for arthroscopic surgery.

However, before surgery, our orthopedic surgeons, Dr. Charles Ruotolo,  carefully evaluate the following factors:

• Extent of Tendon Damage: The size and severity of the tear.
• Duration of Symptoms: Ongoing pain, weakness, or functional limitations despite treatment.
• Knee Strength And Function: Ability to walk, climb stairs, squat, and perform daily activities.
• Activity Level: Your work demands, lifestyle, and sports participation.
• Overall Knee Health: The condition of the surrounding tendons, muscles, and joint structures.
• Recovery Goals: Your expectations for returning to activity and long-term function.

How Soon Can You Get Back to Normal Activities?

Most people return to normal activities within 6 to 12 months after patellar tendon tear surgery. However, recovery time can vary based on the severity of the tendon damage and the type of procedure performed. Your age, overall health, activity level, and commitment to rehabilitation can also affect recovery. For this reason, our expert knee surgeon, Dr. Charles Ruotolo, may recommend a structured recovery plan that supports smooth healing and a safe return to activity:

• Early Healing (Weeks 0–6): Wear a brace and use crutches to protect the tendon during early healing.
• Strengthening Phase (Weeks 6–12): You can gradually regain knee motion and begin strengthening exercises.
• Functional Recovery (Months 3–4): Walking, climbing stairs, and other daily activities become more comfortable.
• Return To Sports (Months 4–6+): You can gradually return to sports or physically demanding work.

Get a Personalized Recovery Plan for Jumper’s Knee From Dr. Charles Ruotolo!

Persistent knee pain can make walking, climbing stairs, and physical activity more difficult. In this situation, you may avoid activities that trigger your symptoms. Without proper treatment, ongoing damage can lead to prolonged recovery and concerns about your long-term mobility and knee health.

Recognized by Castle Connolly as a Top Doctor, our surgeon, at Total Orthopedics and Sports Medicine, reviews your symptoms, activity level, and recovery goals. He also identifies the extent of tendon damage and the underlying cause of your pain before creating a personalized treatment plan. Beyond treatment, he provides clear guidance on activity progression and recovery expectations to help you avoid reinjury. Call 855-321-6784 or visit our clinic for a personalized treatment

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