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Condition guide
Patellar tendinopathy
Often called jumper's knee. A findable sore point on the tendon just below the kneecap, strongly associated with jumping, landing, and rapid deceleration.
What it is
Patellar tendinopathy is pain and degenerative change in the tendon connecting the kneecap to the shin bone, most often at the point where the tendon attaches to the lower pole of the kneecap. Unlike patellofemoral pain, which is diffuse and hard to localise, this one usually has a specific tender point people can put a finger on.
It is associated with sports involving repeated jumping, landing, and sudden changes of direction. Pain characteristically appears at the start of activity, sometimes eases as the tissue warms, and then returns afterwards.
How it typically presents
- A localised sore point just below the kneecap, tender to direct pressure
- Pain at the beginning of activity that may reduce during warm-up and return afterwards
- Aggravated by jumping, landing, deep squats, and running downhill
- Stiffness after sitting or after activity, particularly the following morning
- Usually gradual in onset, following an increase in training load or a change in surface
What tends to help
Progressive loading is the central element of management. Tendons adapt to graduated load, and structured programmes that build tolerance over weeks to months are the standard approach. Complete rest tends to work poorly here — symptoms often settle during a layoff and return promptly on resuming, because the underlying capacity has not changed.
Load management around aggravating activity sits alongside the loading programme. Progression and dosage are the parts that determine outcome, and getting those from a physiotherapist rather than from a website is worth doing, because loading a tendon too aggressively and too cautiously both fail, in different ways.
What a patellar strap does
A patellar strap, sometimes called a tendon strap or infrapatellar band, is a narrow band worn across the tendon below the kneecap. It is designed to alter load distribution across the tendon, and some people find it reduces pain during activity. It is a symptom-management adjunct used alongside a loading programme, not a treatment. The relevant verifiable specifications are the band width, the closure mechanism, whether it includes a pressure pad or tube, and the sizing method.
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Not the same as Osgood-Schlatter
In adolescents, pain below the kneecap centred on the bony bump at the top of the shin is often Osgood-Schlatter disease, a growth-related condition affecting the attachment point rather than the tendon body. It is managed differently and generally resolves with skeletal maturity. Pain in a growing child or teenager should be assessed rather than treated as adult tendinopathy.
Common questions
Should I rest completely?
Complete rest tends to work poorly for tendinopathy. Symptoms often settle during a layoff and return on resuming, because the tendon's load capacity has not changed. Standard management is progressive loading combined with modification of the most aggravating activities, guided by a clinician or physiotherapist.
Why does it hurt at the start of exercise and then ease?
This warm-up pattern is characteristic of tendinopathy and is one of the features that helps distinguish it from other front-of-knee problems. Pain often returns after activity and the following morning, so easing during a session is not a reliable sign it is safe to continue at the same load.
Do patellar straps work?
Some people find a strap reduces pain during activity, and they are inexpensive. They are used as a symptom-management adjunct alongside a loading programme rather than as a treatment in themselves. A strap that lets you keep training at a load your tendon cannot yet tolerate is not doing you a favour.
How long does it take?
Tendinopathy is typically slow, often requiring several months of consistent loading work, and progress is rarely linear. Consistency with the programme is generally the strongest predictor of outcome.
Sources
- American Academy of Orthopaedic Surgeons. OrthoInfo — patient education library. [URL NEEDS VERIFICATION]
- NHS. Tendonitis. [URL NEEDS VERIFICATION]