Patella tip syndrome

Patellar tendon syndrome: Pain under the kneecap

Our Patella tip syndrome, Also known as «Jumper's Knee» or patellar tendon tendinopathy, it causes pain directly below the kneecap. It mainly affects people who jump, sprint or brake a lot, for example in volleyball, basketball or football. Here you can read about how to recognize patellofemoral syndrome, what you can do yourself and what the current research says about treatment.

A typical symptom of patellofemoral syndrome is a localized pain at the lower edge of the kneecap, where the patellar tendon attaches:

• Pain when jumping, landing, braking, climbing stairs, or bending down deeply
• Pain at the onset of training, which subsides during warm-up and then returns more severely afterwards
• Pain when pressing on the tip of the kneecap
• Pain after prolonged sitting with bent knees, for example in the cinema or in the car

Causes of patellofemoral syndrome

The patellar tendon connects the kneecap to the shinbone and transfers the force of the upper leg when you jump or land. If this load increases faster than the tendon can adapt, it becomes overloaded. Typical triggers are the start of the season, additional training, many jumps on hard ground, or insufficient recovery.

In the past, inflammation of the tendon was referred to as an injury. Today, specialists mostly use the term tendinopathy: it describes a painful overload of the tendon tissue. Therefore, the treatment focuses on targeted load building rather than simply resting.

What you can do yourself for patellofemoral syndrome

• Adjusting the load instead of completely stopping: First of all, reduce jumping and deep landings. Use a pain scale from 0 to 10: If the pain during sports is mild and is not worse the next day, the load is usually appropriate.
• Holding exercise: Sit with your back against the wall like an invisible chair and hold the position for 30 to 45 seconds, 4 to 5 times. Many find this to be a pain reliever.
• Building strength: Slow knee bends and steps down, later with additional weight. Slowly down, controlled ascent.
• Have patience: The tendons are slowly adapting. Expect several months before full jumping load is possible again.

Patella tendon syndrome: When to see a doctor?

Immediately, if you feel a sudden, severe pain while jumping or landing and cannot extend the leg actively afterwards. This may indicate a tear in the tendon.

You should also have it medically checked if:

• swelling of the entire knee, redness, overheating or fever
• Pain at rest or at night
• Pain under the kneecap in children and adolescents in growth
• No improvement after a few weeks with adjusted load

Treatment of patellofemoral syndrome in physiotherapy

What the studies show

In a randomized study involving 76 participants, a stepwise loading training, ranging from static exercises through slow strength training to jumping, was compared with a purely eccentric training (knee bends on a inclined board). After 24 weeks, the value for pain, function and sports ability improved by 28 points with the stepwise training, and by 18 points with the eccentric training. 43% returned to full sports activity compared to 27%; however, this difference was not clear-cut (Breda et al., 2021).

To be honest, the evidence for patellofemoral syndrome is generally weak. A 2025 review by Cochrane found only seven small studies involving 211 female athletes. Whether strength training works better than no treatment is very uncertain after that. Compared with a cortisone injection or surgery, there may have been little difference (Lopes et al., 2025).

We still rely on training: It’s low-risk, you can control it yourself, and the best single study to date supports a gradual approach.

This is how we proceed

• Investigation: We determine whether the patellar tendon is really the cause or whether the joint behind the kneecap is, and measure the leg force, for example with the Power measurement.
• Load plan: We determine how much training and how many jumps are appropriate at the moment.
• Gradual program: Stretching exercises, then slow, heavy strength training, then quick and explosive exercises, and finally sports-specific jumping. The next step follows when the previous one is well tolerated.
• In addition: Manual therapy and Dry needling for a tense thigh muscle, for example with Trigger point therapy according to IMTT, can relieve pressure in the short term.

For the journey back into competition, we use our Sports Physiotherapy. For pain that is more on the side or front of the knee, read our article on Inflammation of the synovial membrane in the knee.

Frequently asked questions about patellofemoral syndrome

Can I continue to exercise with patellofemoral syndrome?

Often yes, but with fewer bursts and controlled over the pain scale. In case of severe or increasing pain, pause the triggering activity and seek advice.

How long does the healing process take?

That’s very different. The Breda study involved 24 weeks of training. So plan months rather than weeks, and keep up with strength training after that as well.

Does a patellar tendon bandage help?

Some find a band under the kneecap during sports to be comfortable. However, the cause, an overloaded tendon, does not resolve it. Training remains crucial.

Does a syringe help?

In the Cochrane review, a cortisone injection compared with exercise at the end of treatment may have shown little difference in pain. The level of certainty is low. Always discuss injections with your doctor.

Sources

• Breda S. J. et al. (2021): Effectiveness of progressive tendon-loading exercise therapy in patients with patellar tendinopathy: a randomized clinical trial. British Journal of Sports Medicine. PubMed
• Lopes A. D. et al. (2025): Exercise for patellar tendinopathy. Cochrane Review. PubMed

Date in Zürich Wipkingen and Höngg

Does your knee hurt under the kneecap when you jump or climb stairs? We will examine your knee and build a training plan with you that will safely get you back into sports. Book appointment online or by phone at 044 585 99 49.

This article does not replace medical advice.