Knee

Patellar Tendinitis (Jumper's Knee)

Patellar tendinitis — often called "jumper's knee" — is a chronic overuse tendinopathy at the origin of the patellar tendon from the inferior pole of the patella. It is one of the most common overuse injuries in jumping athletes and can be genuinely disabling, curtailing sports participation for months or years if not addressed with structured rehabilitation. At Maryland Orthopedic Specialists, our sports medicine physicians take a progressive, evidence-based approach to patellar tendinopathy that prioritizes restoring tendon load tolerance and returning athletes to full competition.

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What is patellar tendinitis (jumper's knee)?

Patellar tendinopathy is a degenerative condition of the patellar tendon — not a classic inflammatory tendinitis, despite the traditional name. Repetitive high-load stress (jumping, landing, sprinting) generates microtrauma in the tendon that overwhelms its repair capacity, leading to collagen disorganization, neovascularization, and thickening at the tendon's origin from the distal patellar pole.

Most commonly affected athletes include basketball players, volleyball players, long jumpers, and high jumpers. Prevalence among elite jumping athletes exceeds 40% in some series, making it a genuinely occupational hazard in these sports.

Key contributing factors:

High training volume and sudden load increases
Hard playing surfaces
Poor eccentric strength of the quadriceps
Tight hip flexors and quadriceps reducing shock absorption
Hyperpronation of the foot altering proximal mechanics

Treatment options

Patellar tendinopathy responds well to structured rehabilitation in most patients, with surgery reserved for the small minority who fail 6 or more months of conservative care.

Physical Therapy

Eccentric loading is the gold standard of patellar tendinopathy rehabilitation and should be the first and primary treatment in nearly every patient. The Alfredson decline squat protocol — single-leg eccentric squats performed on a 25° decline board at 3 sets of 15 repetitions daily over a 12-week program — isolates load specifically to the patellar tendon origin, and mild-to-moderate pain during the exercise is acceptable and does not indicate harm. Heavy slow resistance training, using isotonic loading through the full range of motion, has emerged as a comparable or in some studies superior alternative to eccentric-only protocols, with better patient adherence. Hip abductor and gluteal strengthening is added to reduce excessive proximal load transfer to the knee, and a graduated return-to-jumping program is introduced once the tendon tolerates consistent loading without flare-up.

Activity Modification and Bracing

A patellar tendon strap — an infrapatellar band worn just below the kneecap — shifts the mechanical load point away from the degenerative tendon origin and allows many athletes to continue participating in sport while completing their rehabilitation program. While the strap provides meaningful symptomatic relief, it does not address the underlying tendinopathy and should be used as an adjunct rather than a substitute for loading-based rehabilitation. Reviewing and correcting training errors — particularly sudden spikes in jump volume, changes to harder playing surfaces, or inadequate recovery periods — is equally important to prevent continued tendon overload.

Injectable Therapies

PRP (platelet-rich plasma) injection is the most evidence-supported injectable treatment for patellar tendinopathy, improving both structural integrity on imaging and patient-reported symptoms; it is typically used in athletes who have completed a structured eccentric program without adequate response and is superior to corticosteroid at six-month follow-up. Corticosteroid injection, while providing short-term pain relief, is associated with worse long-term outcomes and a meaningfully increased risk of tendon rupture in patellar tendinopathy and is avoided in most cases. Extracorporeal shockwave therapy (ESWT) offers a non-invasive alternative that stimulates neovascularization and collagen remodeling, and is a reasonable option for patients who cannot tolerate or do not respond to injectable approaches.

Surgical Procedure

Knee Arthroscopy

Minimally invasive joint scope using small portals to directly visualize and treat intra-articular knee pathology — meniscal tears, cartilage defects, loose bodies, synovitis, and ligament assessment — as an outpatient procedure.

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Frequently Asked Questions

Can I continue playing with patellar tendinitis?

Load management is key. Mild tendinopathy with VISA-P scores > 70 often permits continued sport with concurrent eccentric strengthening. Severe tendinopathy requiring complete rest is counterproductive — controlled loading is therapeutic.

Is patellar tendinitis the same as patellar tendon rupture?

They exist on a spectrum. Severe, longstanding tendinopathy with disorganized collagen is at increased risk of rupture, but most cases of patellar tendinitis do not progress to complete rupture. Early treatment reduces this risk.

How long does patellar tendinitis take to heal?

Healing time varies considerably based on severity and how long symptoms have been present. Acute, mild cases can improve within four to six weeks with load management and a targeted eccentric strengthening program. Chronic patellar tendinopathy — when symptoms have persisted for several months — often takes three to six months of consistent rehabilitation to resolve. The single most important factor in recovery is following a structured, progressive loading program rather than simply resting, as tendons need controlled stress to remodel and regain strength.

When does patellar tendinitis require surgery?

Surgery is reserved for cases that have not responded to at least six months of dedicated non-surgical treatment, including eccentric strengthening, load management, injections, and other adjuncts. At MOS we rarely recommend surgery as a first-line option, since the majority of patients recover with a well-structured rehabilitation program. When surgery is indicated, minimally invasive procedures such as tendon scraping or ultrasound-guided debridement are typically considered before open surgery.

What is the difference between patellar tendinitis and patellar tendinopathy?

Patellar tendinitis technically refers to acute inflammation of the tendon, while patellar tendinopathy is a broader term describing the degenerative changes that occur when the tendon has been repeatedly overloaded over time. Most chronic cases that people call tendinitis are actually tendinopathy — meaning inflammation has given way to structural disorganization within the tendon tissue. This distinction matters because tendinopathy responds best to progressive loading and strengthening rather than anti-inflammatory treatments alone.