Condition guide
Jumper’s knee is pain in the tendon just below the kneecap (the patellar tendon) caused by overloading it. It is common in sports that involve jumping, such as volleyball and basketball, but it can also affect people who do not play sport. Rest alone is often not enough; the core of treatment is exercise that gets the tendon used to load again, step by step.
The diagnosis is usually made from your symptoms and an examination; a scan is often not needed.
In a study of 76 patients in the Netherlands, most participants had had pain for about two years. Half were assigned to a four-stage programme and half to slow-lowering (eccentric) squats on a slope only. After 24 weeks the progressive programme group had improved more; 43% versus 27% returned to sport, but this difference was not statistically significant.
Participants moved on to the next stage when pain during a single-leg squat was 3 out of 10 or less and the current stage had been done for at least a week.
You can cut down on activities that make the pain worse, such as running, jumping, and long or hilly walks. The tendon needs load to heal, but too much makes the pain worse.
You can make sure pain during exercise does not go above 3 out of 10. When an exercise becomes pain-free, move on to the next one.
You can apply ice wrapped in a towel for 10–15 minutes, 2–3 times a day.
A jumper’s knee strap worn just below the kneecap can reduce the load on the tendon. You can ask your pharmacist which painkiller is suitable.
For pain around the kneecap, see the anterior knee pain guide; for tendon pain above the heel, see the Achilles tendinopathy guide.
Exercises at home
Work through them in order: do not move on to the next exercise until the current one is pain-free. Pain during exercise should not go above 3 out of 10.
Lean your back against a wall and slide down until your knees are at roughly a right angle; if this is hard, stay higher up. Hold still. Pain should not go above 3 out of 10. As it gets easier, you can put more of your weight on the painful leg.
45 seconds, 5 times, every dayLie on your back or sit with your leg stretched out, and place a rolled-up towel under your knee. Press the back of your knee down into the towel; the muscle at the front of your thigh will tighten and your heel will lift slightly. Hold for 5 seconds.
10 reps, 2–3 times a daySit up straight on a chair. Slowly straighten one knee and lift your leg until it is parallel to the floor, tightening the muscle at the front of your thigh. Hold for 5 seconds, then lower slowly.
10 reps on each leg, twice a dayLie on your back with your knees bent and feet flat on the floor. Squeeze your buttocks and lift your back off the floor so that your shoulders, hips and knees form a straight line. Hold for 3–5 seconds, then lower slowly.
10–15 reps, 1–2 times a dayStand with your back against a wall and your feet a step away from it. Keeping your knees in line with your toes, slide down only as far as you can without clearly increasing the pain, hold for a few seconds and come back up.
8–10 reps, 2–3 setsStart once the half squat against the wall is pain-free. Holding lightly onto a worktop, stand on your painful leg and bend your knee as far as is comfortable; do not let your knee drop inwards. Then push back up.
10 repetitions, 3 setsThe tendon needs load to heal, but too much load makes the pain worse. Rather than resting completely, you can cut down on running, jumping and long walks that make the pain worse and start gradual exercise.
It can often take months. In a study of athletes, most of whom had had symptoms for about two years, fewer than half had returned to their previous level of sport by 24 weeks. Regular, patient exercise matters.
You can carry on as far as the pain allows, with a reduced load. In the study, athletes moved on to the next stage and gradually returned to sport once pain during a single-leg squat was 3 out of 10 or less. When symptoms flared up, they were advised to stop or substantially reduce activity for at least 4 weeks.
In jumper’s knee the pain is just below the kneecap, over the tendon. In anterior knee pain the pain is felt more around and behind the kneecap. For details, see our anterior knee pain guide.
Sources
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