Is Your Knee Pain Limiting Your Performance?
Do you experience persistent pain just below your kneecap, especially when jumping, squatting, or running? Does your knee feel stiff after long periods of rest? If so, you might be dealing with Patellar Tendinosis, commonly known as Jumper’s Knee—a chronic overuse injury affecting the patellar tendon.
Unlike patellar tendinitis, which involves acute inflammation, tendinosis is a chronic overuse injury characterized by tendon degeneration, microtears, and collagen breakdown. This condition is common in athletes involved in sports requiring repetitive jumping, sprinting, and rapid directional changes, such as basketball, volleyball, and soccer.
At Adaptive Physiotherapy & Massage in Booragoon, we take an evidence-based approach to treating patellar tendinosis, focusing on reducing excess tensile load on the quadriceps, improving biomechanics, and implementing progressive rehabilitation strategies to help you regain pain-free movement and long-term resilience.
In this article, we’ll break down what Patellar Tendinosis is, why it happens, and how to fix it with a structured approach that goes beyond temporary pain relief.
What is Patellar Tendinosis?
Patellar Tendinosis is a degenerative condition of the patellar tendon—the structure that connects the quadriceps to the tibia (shinbone). Unlike patellar tendinitis, which involves short-term inflammation, tendinosis is a chronic injury characterized by:
✅ Tendon degeneration and microtears.
✅ Collagen breakdown and weakened tendon structure.
✅ Persistent, progressive pain rather than acute swelling.
This condition develops over time due to repetitive strain on the tendon without adequate recovery, making it a common issue for athletes in jumping, sprinting, and high-impact sports such as basketball, volleyball, and soccer.
Common Causes of Patellar Tendinosis
1. Overuse and Excessive Quadriceps Load
🏋️ Repetitive stress from activities such as jumping, sprinting, and squatting overloads the patellar tendon, leading to chronic tissue breakdown rather than healing.
2. Poor Landing Mechanics
🦵 Inefficient force absorption during landings or deceleration increases stress on the patellar tendon, worsening microtrauma.
3. Training Errors
⚠️ Sudden increases in training volume, frequency, or surface changes (e.g., transitioning from grass to concrete courts) increase injury risk.
4. Lower Limb Muscle Imbalances
🔥 Weak glutes and hamstrings force the quadriceps to overcompensate, increasing patellar tendon strain.
5. Reduced Ankle and Hip Mobility
❌ Limited ankle dorsiflexion or hip flexibility alters movement patterns, redirecting excessive forces onto the knees.
Symptoms of Patellar Tendinosis
✅ Gradual onset of anterior knee pain just below the kneecap, worsening with activity.
✅ Morning stiffness or discomfort after prolonged sitting.
✅ Pain when jumping, squatting, or running—especially during explosive movements.
✅ Tenderness along the patellar tendon when pressed.
Unlike acute injuries, patellar tendinosis does not always present with significant swelling or redness, as the primary issue is tendon degeneration rather than inflammation.
Patellar Tendinosis Self-Test: Do You Have Jumper’s Knee?
Try this simple test to assess if your knee pain is due to patellar tendinosis:
1️⃣ Stand on one leg and slowly squat to a 45-degree angle.
2️⃣ Hold for 5 seconds and then return to standing.
✅ If you experience localized pain just below the kneecap, it may indicate patellar tendinosis.
📌 Next step? If the pain persists or worsens, consult a physiotherapist for a full assessment.
A Basketball Player's Road to Recovery
Michael, a 28-year-old competitive basketball player, had been struggling with nagging knee pain for over six months. Initially, he tried to push through, assuming it was just soreness from training. But over time, the sharp pain below his kneecap worsened, making it nearly impossible for him to explode off the ground for jumps or land comfortably after layups.
Frustrated with his lack of progress, Michael sought help at Adaptive Physiotherapy & Massage in Booragoon. After a thorough assessment, we diagnosed him with Patellar Tendinosis—a chronic overuse condition caused by repetitive strain on his patellar tendon.
Michael’s rehab program focused on: ✔ Manual therapy to release tension in his quadriceps and improve patellar mobility.
✔ Eccentric loading exercises to strengthen his tendon and stimulate tissue repair.
✔ Glute and hamstring activation drills to correct his muscle imbalances.
✔ Landing mechanics training to reduce excessive knee stress when jumping.
Within four weeks, Michael noticed a significant reduction in pain. By eight weeks, he was able to return to light training. At twelve weeks, he was back on the court—jumping, sprinting, and cutting with confidence, without the fear of his knee giving out.
Michael’s journey highlights the importance of early intervention, structured rehabilitation, and patience in overcoming chronic tendon injuries.
Evidence-Based Treatment for Patellar Tendinosis
Effective treatment involves reducing quadriceps overload, restoring tendon health, and improving biomechanics. At Adaptive Physiotherapy & Massage in Booragoon, we follow a comprehensive rehabilitation approach to target the root cause of pain and prevent recurrence.
1. Manual Therapy for Quadriceps Tension & Knee Mechanics
While manual therapy does not directly “heal” the degenerative tendon, it plays a critical role in managing quadriceps tightness, joint mobility, and movement efficiency.
🔹 Soft Tissue Release & Myofascial Therapy – Targets tight quadriceps to reduce excessive tension on the patellar tendon.
🔹 Patellar Mobilization – Ensures optimal knee mechanics and tracking.
🔹 Hip & Ankle Joint Mobilization – Improves movement patterns to reduce knee stress.
By reducing quadriceps dominance and restoring normal movement patterns, manual therapy enhances the effectiveness of exercise rehabilitation.
2. Exercise Rehabilitation: Progressive Tendon Loading
Progressive loading of the tendon is the key to recovery. Unlike acute injuries where rest is recommended, tendinosis requires gradual strengthening to stimulate collagen repair and improve the tendon’s capacity to handle load.
✅ Eccentric Loading Exercises (slow lengthening of the muscle under tension) have been shown to stimulate tendon repair.
Key Exercises:
✔ Decline Squats – Slow-controlled lowering increases patellar tendon engagement.
✔ Single-Leg Step-Downs – Strengthens knee control during deceleration.
✔ Heavy Slow Resistance (HSR) Training – Squats and leg presses at controlled speeds help improve tendon function.
✅ Glute & Hamstring Strengthening to balance quadriceps dominance:
✔ Glute Bridges & Hip Thrusts – Reduces excessive knee loading.
✔ Nordic Hamstring Curls – Enhances posterior chain engagement.
✅ Proprioception & Landing Mechanics Training:
✔ Single-Leg Stability Drills – Improves neuromuscular control.
✔ Drop Jumps & Depth Landings – Retrains force absorption techniques to prevent reinjury.
3. Activity Modification & Return to Sport
🚀 Gradual Load Progression: Instead of complete rest, we modify training loads to maintain fitness without excessive tendon strain.
👟 Footwear & Orthotics: Proper shock-absorbing footwear can reduce ground reaction forces on the knee.
📊 Load Management: We implement structured training cycles to avoid overuse patterns.
When to Seek Professional Help
🚩 If knee pain persists beyond 2–3 weeks, despite modifying activity.
🚩 If symptoms worsen during daily activities like walking or stairs.
🚩 If knee stiffness or weakness limits your ability to train or compete.
At Adaptive Physiotherapy & Massage in Booragoon, we create individualized rehab programs focused on long-term recovery and injury resilience.
Conclusion: Get Back to Pain-Free Performance
Patellar Tendinosis is not a quick-fix injury, but with structured rehabilitation, progressive tendon loading, and movement retraining, you can recover fully and prevent recurrence.
At Adaptive Physiotherapy & Massage, we take a scientific and individualized approach to help you reduce pain, restore function, and return stronger than before.
If you’re dealing with chronic knee pain or Jumper’s Knee, contact us today for a tailored rehabilitation plan that gets you back to peak performance. 🚀
References
- Cook, J. L., & Purdam, C. R. (2009). Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. British Journal of Sports Medicine, 43(6), 409-416.
- Kongsgaard, M., et al. (2009). Heavy slow resistance training versus eccentric training as treatment for patellar tendinopathy: A randomized controlled trial. American Journal of Sports Medicine, 37(7), 1334-1343.
- Rio, E., et al. (2016). Isometric exercise to reduce pain in patellar tendinopathy. British Journal of Sports Medicine, 50(20), 1169-1175.
- van Ark, M., et al. (2016). Evidence-based treatment for patellar tendinopathy. Sports Medicine, 46(12), 1921-1939.
- Malliaras, P., et al. (2015). Achilles and patellar tendinopathy loading programs. Sports Health, 7(3), 239-254.
