Patellar Tendinopathy (Jumper’s Knee)
Patellar tendinopathy, often called jumper’s knee, is a condition affecting the patellar tendon at the front of the knee.
It is the injury that quietly ends seasons. The knee hurts on the first few jumps, loosens off once you are warm, then aches that evening and hurts again the next session. Training carries on, the tendon does not recover, and three months later you are still managing it rather than past it.
It is particularly common in sports involving repeated jumping, running and rapid changes of direction, but it also affects recreational athletes and people who have recently increased their activity. It can be persistent — and most people are managed without surgery.
Where is the pain in patellar tendinopathy?
The patellar tendon connects the kneecap, or patella, to the shin bone.
Patellar tendinopathy most commonly causes pain at the lower edge of the kneecap, where the tendon begins. The pain is usually very localised, and most people can point to it with one finger.
Symptoms are typically aggravated by:
- jumping and landing
- running or sprinting
- squatting
- stairs
- gym exercises such as lunges or leg press
- sudden increases in training
The warm-up pattern is characteristic. The tendon feels painful or stiff at first, becomes more comfortable once you are warm, then flares again afterwards.
What causes patellar tendinopathy?
It is not simply inflammation of the tendon.
The problem develops when the demands placed on the tendon exceed its current capacity to tolerate them. That can follow a sudden increase in training volume or intensity, adding more jumping or running, returning to sport after a break, or changing the type of training you do.
Strength, recovery, previous injury and general health all influence how much a tendon can take.
Is all pain below the kneecap patellar tendinopathy?
No.
Pain at the front of the knee has several possible causes, including patellofemoral pain, knee osteoarthritis, fat-pad irritation and bursitis. In younger athletes there are also growth-related conditions affecting the tendon’s attachment.
Getting the diagnosis right matters, because these are not treated the same way.
Do I need an ultrasound scan?
Not everybody with patellar tendon pain needs a scan. The condition can often be diagnosed from the history and examination, and rehabilitation can begin without imaging.
Diagnostic ultrasound is useful when symptoms are persistent, the diagnosis is uncertain, or a more significant tendon problem is suspected. It shows the thickness and structure of the patellar tendon and its attachment to the patella, and Doppler can assess increased blood flow within and around it. The tendon can also be examined dynamically, while the knee moves and the quadriceps contracts.
Scan findings do not always match symptoms. Structural tendon changes are regularly found in athletes with no pain at all, so the images are read alongside your symptoms, examination and functional testing rather than treated on their own.
Physiotherapy and tendon loading
For most people, progressive tendon loading is the treatment.
Complete rest is rarely the long-term answer. Rehabilitation aims to find a level of activity the tendon tolerates, then progressively build its capacity — controlled strengthening at first, moving towards heavier resistance work.
For athletes, that eventually has to prepare the tendon for the far higher forces involved in running, acceleration, jumping, landing and changing direction.
Managing overall training load matters as much as the exercises. Doing the strengthening while continuing to load the tendon heavily in sport is a common reason progress stalls.
Recovery takes time, particularly where symptoms have been present for several months.
Where do procedures fit?
Most people with patellar tendinopathy never need an injection.
Where symptoms persist despite an appropriate and well-progressed rehabilitation programme, additional options may be considered. That decision takes account of how long symptoms have been present, the examination, the ultrasound findings, what rehabilitation has already been done, and what you need the knee to do.
High-volume injection
High-volume injection has been used for persistent patellar tendinopathy. A relatively large volume of fluid is injected around the tendon, not into it, under ultrasound guidance. The proposed aim is to influence the abnormal small blood vessels and associated nerve fibres that can develop around a longstanding tendinopathy.
The evidence for high-volume injection in patellar tendinopathy remains limited and evolving. It is not a first-line treatment and not a replacement for rehabilitation. Where it is considered, it forms part of a wider plan built around progressive tendon loading.
What about steroid injections?
A steroid injection, sometimes called a cortisone injection, is not routinely used for patellar tendinopathy.
Steroid can give short-term pain relief in some musculoskeletal conditions, but injecting it into a load-bearing tendon is generally avoided because of its potential effects on tendon tissue. This is one of the situations where the right answer is often to decline a procedure rather than offer one.
If inflammation of a separate nearby structure is contributing to your symptoms, that is a different clinical situation and would be assessed individually.
Monitoring recovery and return to sport
In selected cases, ultrasound can add useful information while a patellar tendon is monitored through rehabilitation.
The tendon does not need to look normal on a scan before you return to sport. Structural changes and Doppler findings often persist after pain and function have improved.
Return to running, jumping and sport is based on your symptoms, strength, functional testing, tolerance of increasing tendon loads and the specific demands of your sport. Imaging complements that assessment; it does not decide it.
The clinician who assesses your knee and scans the tendon is the same one who builds and progresses your loading programme, so the rehabilitation and any procedure are planned together rather than handed between people.
When is further investigation needed?
Further investigation may be appropriate where the diagnosis remains uncertain, there is significant weakness or loss of function, symptoms followed a major injury, or the condition is not responding as expected.
Depending on the presentation, an X-ray, MRI or specialist referral may be more appropriate than ultrasound.
What does it cost?
Every appointment lasts a full hour. Where a diagnostic scan is needed, that appointment is charged at the scan rate, which replaces the standard consultation fee rather than being added to it. Current prices are on our prices page.
Patellar tendinopathy treatment in Weybridge
Persistent pain below the kneecap is not always patellar tendinopathy, and an abnormal-looking tendon on a scan is not necessarily the cause of it.
Meyer Physio assesses and treats tendon problems at its clinic on Baker Street in Weybridge, Surrey, combining clinical assessment, functional testing, diagnostic ultrasound and rehabilitation in one place. You can come to us directly — no GP referral is needed to book, and there is no waiting list.
For most people the answer is progressive rehabilitation and careful management of tendon load. For persistent cases, ultrasound may help determine whether further investigation or an ultrasound-guided procedure should be considered.
Written by Suegnet Meyer, Advanced Practice Musculoskeletal Physiotherapist and MSK Sonographer. HCPC registered [PH55635]. Chartered Society of Physiotherapy member [66175]. Last reviewed: 28 October 2026.