How to Fix Patellar Tendinitis with Exercises

Patellar tendinitis, also known as jumper's knee, is an overuse injury involving inflammation and microtears in the patellar tendon, which connects the kneecap (patella) to the shinbone (tibia). It typically presents as pain and tenderness just below the kneecap, often worsening with activities like jumping, running, or squatting. This condition is common among athletes but can affect anyone with repetitive knee stress. Early intervention through rest and targeted exercises can lead to a full recovery in most cases. Symptoms may include swelling, stiffness, and pain that improve with rest but return during activity.

Causes of Patellar Tendinitis

Patellar tendinitis primarily results from repetitive overload on the patellar tendon, leading to small tears and inflammation. Key causes include:

Overuse and Repetitive Stress: Frequent jumping, running, or sudden increases in activity intensity cause accumulated microtrauma to the tendon.

Poor Biomechanics: Incorrect form during sports or exercises, such as improper landing techniques, places excessive strain on the tendon.

Muscle Imbalances: Tight quadriceps, hamstrings, or weak hip muscles alter knee alignment and increase tendon load.

Inadequate Recovery: Insufficient rest between high-impact activities hinders tendon healing, resulting in chronic inflammation.

In some cases, inflammation resolves with load adjustment, but persistent overuse can progress to degenerative changes in the tendon.

Who is at Risk?

Certain individuals are more prone to patellar tendinitis due to lifestyle, physical, or genetic factors. High-risk groups include:

 
Athletes in Jumping Sports: Basketball, volleyball, soccer, and track athletes face the highest risk from repetitive explosive movements.

 
Runners and Active Individuals: Those involved in running or high-impact activities, especially with sudden training increases.
People with Intrinsic Factors: Males, those with a higher body mass index (BMI), reduced flexibility (e.g., tight quads or hamstrings), or muscle weakness.

 
Occupational Risks: Workers in jobs requiring frequent kneeling, squatting, or stair climbing.
Adolescents during growth spurts and those with flat feet or poor footwear are also vulnerable.

Physiotherapy Treatment

Physiotherapy is the cornerstone of non-surgical treatment for patellar tendinitis, focusing on pain reduction, tendon healing, and preventing recurrence. Common approaches include:

 
Initial Management: RICE protocol (Rest, Ice, Compression, Elevation) to reduce inflammation, along with activity modification and NSAIDs for pain.

 
Manual Therapies: Ultrasound, Deep transverse friction massage (DTFM), or taping to improve blood flow and reduce pain.

 
Strengthening and Stretching: Targeted exercises to address muscle imbalances, often progressing from isometrics to eccentrics.

 
Advanced Modalities: shockwave therapy, or dry needling, if symptoms persist.

 
Education and Prevention: Guidance on proper technique, footwear, and gradual return to activity.
Treatment duration varies, but most see improvement in 4-12 weeks with consistent therapy.

Exercise Protocol According to the Phases of Tendinitis

Rehabilitation for patellar tendinitis is phased to match the tendon's healing stages: reactive (acute inflammation), disrepair (tendon degeneration), and degenerative (chronic changes). Exercises should be pain-guided (mild discomfort okay, but stop for sharp pain) and progressed under supervision. Start with 2-3 sets of 10-15 reps, 3 times a week, and incorporate self-massage or foam rolling.

Phase 1: Acute ( Pain Relief, 1-2 weeks)

Focus on reducing load and inflammation with isometrics and gentle stretches.
1. Isometric Quads: Sit with the leg extended; contract the quad muscle for 5-10 sec without moving the knee.

 
Reps/ Sets: 5-10 holds, 3 sets (Do 3-5 times/day; use a towel under the knee for support.)

 
2. Straight Leg Raises (SLR): Lie on your back; lift the straight leg 6-12 inches, hold 3-5 seconds, and lower slowly.

 
Reps/ Sets: 10-15/leg, 2-3 sets ( Keep core engaged; avoid arching back.)

 
3. Quad Stretch: Stand and pull the heel to the butt; hold gently.

 
Reps/ Sets: 30 sec/leg, 3 holds ( Avoid pulling too hard.)

Phase 2: Subacute ( Strength Building, 2-6 weeks) -

Introduce eccentric to remodel tendons; build quad and hip strength.

 
1. Eccentric Decline Squats: On a decline board, rise with both legs, lower slowly (3-5 sec) on the affected leg.

 
Reps/Sets: 15 reps, 3 sets ( Use proper support if needed; progress to single-leg.)

 
2. Step-Downs: From a 6-8 inch step, lower slowly until the opposite heel touches the floor, then rise.

 
Reps/Sets: 10-15 reps, 3 sets ( Focus on control; add height over time.)

 
3. Hamstring Curls: Lie prone; curl heels toward glutes with a resistance band.

 
Reps/Sets: 10-15 reps, 3 sets ( Strengthen antagonists; slow movement.)

Phase 3: Advanced/Degenerative (Functional Return, 6 weeks)

Add dynamic and plyometric exercises to enhance sport-specific strength, aiming for a full return to activity.
1. Heavy Slow Resistance Squats: Squats to 90 degrees with weights; slow down/up (3-4 sec).

 
Reps/Sets: 8-12 reps, 3-4 sets (Use leg press if available; monitor form).

 
2. Single-leg Jumps/Plyometrics: Jump squats or box jumps, starting low.

 
Reps/Sets: 10-15 reps, 3 sets. Only if pain-free, gradual progression.

 
3. Hip Flexor Stretch: Lunge forward; hold hip stretch.

 
Reps/Sets: 30 sec/leg, 3 holds (Improves alignment; daily).

Recovery may take 3-6 months for athletes; this can be combined with prevention strategies, such as proper warm-ups and 10% weekly load increases.

 
Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice. Consult a doctor for personalized guidance.