– by Consultant Physio Andy Renshaw
Patella tendinopathy, often referred to as “jumper’s knee,” is a chronic overuse injury affecting the patellar tendon, most commonly seen in athletes involved in jumping and sprinting activities. Management focuses on pain reduction, optimising tendon load, and progressive rehabilitation to restore function.
Initial management should focus upon reducing aggravating activities to decrease tendon overload while avoiding complete rest, which can weaken the tendon further. Ice, analgesics (such as NSAIDs), and activity modification can help manage acute pain, although NSAIDs should be used cautiously due to their potential impact on tendon healing.
A cornerstone of treatment is an exercise programme, carefully progressed in response to the patient’s symptoms. I use a heavy/slow resistance training programme but aim to minimise tensile load on the tendon- a huge factor in managing this condition. These exercises help remodel tendon structure and improve load tolerance. Isometric exercises may also be used early in rehab for analgesic effects without high strain.
Biomechanical factors such as poor hip control, quadriceps/gluteal/calf muscle weakness, or foot posture should be assessed and corrected with targeted strengthening or orthotic support as needed. Addressing kinetic chain deficits helps reduce abnormal loading on the tendon.
Adjunct therapies like shockwave therapy, platelet-rich plasma (PRP) injections, or dry needling might also be used, but the evidence surrounding these is inconclusive, and their use should never replace exercise therapy as the primary intervention.
In persistent cases unresponsive to conservative management over several months, surgical options (e.g., debridement or tendon scraping) may be considered, though recovery can be prolonged and outcomes vary.
Return to sport is guided by pain levels, functional capacity, and tendon load tolerance. A gradual progression in sport-specific training is essential to prevent recurrence.
Overall, successful management requires a patient-specific, load-managed, exercise-based programme, with ongoing monitoring and long-term tendon health in mind.