If you play volleyball, basketball, CrossFit, or any sport with a lot of jumping and cutting, and you’ve started noticing pain right at the front of your knee just below the kneecap, there’s a good chance you’re dealing with patellar tendinopathy, what most athletes call jumper’s knee. I’m first going to describe what it is and why it happens, then share some tips you can implement right away to start addressing the root cause.
Why jumping athletes get this
Every jump and landing puts load through the patellar tendon. The tendon is designed to handle that load, but only up to its current capacity. When training volume spikes faster than the tendon can adapt, the tissue starts breaking down. The fix isn’t stopping jumping. It’s building the tendon’s capacity so it can handle the demands of your sport.
In the same way that you have to build muscle strength to tolerate a specific amount of weight in a lift, you also have to build “strength” (load tolerance) in your tendons so they can tolerate the forces that your muscles, and gravity, generate.
The lower chain problem
Limited ankle dorsiflexion changes how the knee loads during a landing. Weak hip abductors let the femur drift inward, stacking asymmetric load on the tendon. Poor hip extension mechanics shift more of the workload to the quads and away from the glutes. Ever heard of being “quad dominant?” It’s not the #1 issue, but it is certainly on the list of things we must fix as a part of providing a robust, long term solution.
Think of it like this- the tendon is hurting because it’s weak (has a low load tolerance). Resting, or do nothing, makes it weaker. Thus, more susceptible to pain and injury.
If it is weak, we need to strengthen it. How do we strengthen it without just flaring it up? Here’s the key:
The more painful it is, the slower you need to move while strengthening it. The slowest you can move is to not move at all (isometrics). For very painful tendons, this is usually where you need to start, then build from there.
What the rehab actually looks like
Isometric loading first, to reduce pain. Heavy slow resistance next: slow squats, step downs, split squats, with a tempo that actually loads the tendon. Plyometric and sport-specific loading last, where we reintroduce the jumping demands in a way the tendon is now prepared for.
For athletes who’ve been dealing with this for more than a few months, we often add StemWave shockwave therapy. Chronic tendon tissue often stops responding to load alone. StemWave restarts that process at the cellular level.
If jumper’s knee is keeping you from training or competing at your best, come in for a proper assessment. We’ll get it all sorted out for you.
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Dr. Jonny Blue is a Doctor of Physical Therapy and founder of Land and Sea Physical Therapy in Oceanside, CA. He specializes in orthopedic PT, root cause methodology, and helping active adults in North County San Diego get back to the activities they love without surgery or pain medication.