Jumper's Knee: Patellar Tendinopathy in Basketball and Volleyball Players

It usually starts quietly. A bit of stiffness below the kneecap at the start of training that eases once you warm up. You play on, because it doesn't stop you. Then, a few weeks later, it hurts on the first jump, on the stairs home, or when you stand up after a long day at your desk. If that sounds familiar, you may be dealing with jumper's knee.

Jumper's knee is the common name for patellar tendinopathy, a problem with the tendon that connects your kneecap to your shin bone. It is very common in basketball and volleyball players, but also turns up in football, athletics, badminton and anyone who jumps and lands repeatedly. The good news is that it responds well to the right rehab. The less good news is that it rarely settles by itself if you keep ignoring it.

What is actually going on in the tendon?

Your patellar tendon works like a spring. Every time you jump, it stores and releases a huge amount of force, and every landing sends several times your body weight back through it. Tendons are built for this, but they need time to adapt and recover.

Tendinopathy develops when the load on the tendon outpaces its ability to cope. The tendon's internal structure becomes less organised and more sensitive to load. Despite old-fashioned labels like "tendonitis", it isn't simply an inflamed tendon, which is why anti-inflammatory tablets and rest alone tend to disappoint.

The typical picture is:

• Pain at a specific spot, usually just below the kneecap
• Pain with jumping, landing, sprinting, squatting or deep knee bends
• Stiffness or discomfort after sitting for a long time
• A "warm-up" effect early on, where it eases as you get going but flares afterwards

Why basketball and volleyball players are especially prone

Both sports involve high volumes of jumping on hard indoor floors, often with little recovery between efforts. A few patterns come up again and again in clinic:

• Sudden increases in training. Pre-season blocks, tournaments, or returning from a break and going straight back to full sessions.
• Too many jumps, too little variety. Repeated hops, blocks and rebounds with few lighter days.
• Lower-body weakness. Weak calves, quads or glutes mean the tendon takes more of the load than it should.
• Stiff landing mechanics. Landing with little knee and hip bend sends more force into the tendon.
• Life load. Long hours sitting, poor sleep and work stress all affect how well your body recovers.

For recreational players in London, the pattern is often a busy desk job, one or two evening sessions a week and a league game at the weekend. That mix of long sitting and sudden bursts of jumping is a classic recipe.

Why complete rest usually isn't the answer

Taking a few weeks off often brings the pain down, which feels like a fix. The trouble is that the tendon loses capacity while you rest, so the pain returns as soon as you resume jumping.

Tendons generally get better by being loaded progressively, not by being protected from load. Modern rehab focuses on rebuilding the tendon's strength and tolerance in stages:

1. Calm it down. Reduce the most aggravating activities, such as repeated high jumps, while keeping you moving. Isometric holds, such as a static squat position or leg extension hold, can ease pain in the early phase.
2. Build strength. Slow, heavy resistance work for the quads, calves and glutes, such as leg press, split squats and slow squats, increased gradually.
3. Add speed and spring. Hopping, skipping and low-level jumping drills once strength is good.
4. Return to sport. A staged return to training volumes and match play, with jump counts you can actually track.

This is where good strength and conditioning support makes a real difference, because the progression matters as much as the exercises themselves. Too fast and it flares; too slow and you lose weeks.

When to get it assessed, and what to expect

A tendon that has been sore for more than a few weeks, or that is starting to affect your training, deserves a proper look. Pain at the front of the knee can also come from the kneecap joint, the fat pad or other structures, and the treatment differs, so it helps to know exactly what you're dealing with.

At an assessment, a physio will take a full history of your training and load, test how the knee handles jumping and squatting, and check strength and movement through the hip, knee and ankle. From there, a tailored physiotherapy plan can be built around your sport and schedule. For stubborn cases that haven't responded to exercise alone, shockwave therapy may be a useful addition alongside the loading programme.

Meanwhile, a few sensible steps:

• Don't stop moving altogether. Keep up gentle, comfortable activity.
• Avoid stacking lots of jumping sessions on consecutive days.
• Track how the knee feels the following morning, not just during play.
• Be wary of repeated painkillers or injections as a way to keep playing. They can mask the problem without improving the tendon.

Getting back to jumping with confidence

Jumper's knee can be frustrating because it often lingers, but most people improve well with consistent, progressive rehab. It is usually a matter of weeks to months rather than days, so patience and a clear plan really help.

If your knee pain keeps returning or is limiting your game, we're happy to help. You can book an assessment at our Vauxhall clinic, where we'll work out what's driving the problem and build a realistic plan to get you back on court. We also see many patients through their private health insurance, including Bupa, AXA and Vitality.