Jumper’s Knee – What It Takes To Get Back in the Game

Progressive Loading For Patellar Tendinosis

Jump around…jump around…jump around…jump up, jump up, and get down…” If House of Pain’s lyrics to “Jump Around” describes the sequence you went through with your knee – lots of jumping followed by some aggravated down time – it’s likely you have Jumper’s Knee – or Patellar Tendinosis. But don’t get too discouraged, later in the song they sing “…so get out your seat and jump around!” With some guidance and some hard work, you too can get back to where you want to be.

Let’s take a look at what Jumper’s Knee looks like, what you can expect in terms of outcomes, and which exercises you should be doing to improve…

Jumper’s knee mainly affects young, taller, heavier athletes1. Repeated jumping, landing, cutting, and pivoting puts heavy stresses on the patellar tendon just below your kneecap2.

What You Should Expect With Jumper’s Knee

It’s best to know up front what you’re dealing with when it comes to Jumper’s Knee. You deserve a realistic outlook of what this process might look like and I’m going to give it to you.

First off, you should know that not everyone with Jumper’s Knee successfully returns to their sport. In fact, over half of athletes with patellar tendon pain end up retiring. And for those who do make it back, more than 1/3 are unable to return within 6 months3.

That’s the unfortunate reality. Personally, I think this is due to athletes trying to do too much, too fast, not allowing time to heal and train.

On the bright side, though, 2/3 of athletes are able to return to their sport within 6 months 4. Based on the current evidence, certain exercises that progressively load the patellar tendon and strengthen the muscles around it are best.

The Best Exercises for Jumper’s Knee

The power you need to jump, land, cut, and pivot requires your patellar tendon to store and release lots of energy5, like a spring – over and over again. To get your patellar tendon functioning at a high level of storing and releasing energy, you need to progressively start loading it 6 – with isometrics, concentrics, and eccentrics7. Here we’ll be looking at eccentrics.

Eccentrics are a lengthening contraction of the muscle/tendon. For our purposes here, we’re looking at lengthening the patellar tendon while it is under a load. This can be done with drop squats.

Progressive drop squats have been shown to reduce the pain of Jumper’s Knee in a 12-week period and allow a high percentage of athletes to return to their sport8 – all good things!

Your focus here should be on the slow eccentric, or lowering phase of the squat. Some level of discomfort is okay9 – about a 4 or 5 out of 10 pain – that should calm back down within an hour.

Drop Squats

 

Loading should be progressive – once body-weight squats become easy, you can advance to holding weights. After regular squats become easy with minimal pain, you can progress to single-leg exercises such as the lunge.

Lunges

 

Another popular exercise for Jumper’s knee is single leg squats on a decline board – with the heel 25 degrees higher than the toes. Squatting on a decline board puts maximal load on the patellar tendon10.

Next Steps

Once the leg feels strong and pain is under control with advanced exercises, it would be wise to train with more sport-specific activities, like jumping and landing. When landing, you should aim to land softly on the middle/front of your foot, with your hips and knees bent. This allows you to absorb the shock of the landing with your legs11,12.

Use of a mirror or video can give you feedback on what your landing looks like – and it’s always a good idea to get analyzed by a Physical Therapist.

Remember: progress can be slow – sometimes taking 6–12 months to get back13. My advice is to take it slow, follow the evidence of what works, and stick with it. Don’t try to go back to sports before you’re 100% – get your body ready and train hard.

Question: What are some exercises you want to get to that would be sport-specific? You can leave a comment by clicking here.


  1. Zwerver J, et al. Prevalence of jumper’s knee among nonelite athletes from different sports: a cross-sectional survey. Am J Sports Med. 2011;39(9):1984–1988  ↩
  2. Cook JL, Khan KM, Kiss ZS, Coleman BD, Griffiths L. Asymptomatic hypoechoic regions on patellar tendon ultrasound: a 4-year clinical and ultrasound followup of 46 tendons. Scand J Med Sci Sports. 2001;11:321–327. http://dx.doi. org/10.1034/j.1600–0838.2001.110602.x  ↩
  3. Kettunen JA, Kvist M, Alanen E, Kujala UM. Long-term prognosis for jumper’s knee in male athletes. A prospective follow-up study. Am J Sports Med. 2002;30:689–692  ↩
  4. Kettunen JA, Kvist M, Alanen E, Kujala UM. Long-term prognosis for jumper’s knee in male athletes. A prospective follow-up study. Am J Sports Med. 2002;30:689–692  ↩
  5. Alexander RM. Energy-saving mechanisms in walking and running. J Exp Biol. 1991;160:55–69  ↩
  6. Malliaras P, et al. Patellar tendinopathy: clinical diagnosis, load management, and advice challenging case presentations. JOSPT. 2015;45(11):887–898  ↩
  7. Cannell LJ, Taunton JE, Clement DB, et al. A randomised clinical trial of the efficacy of drop squats or leg extension/leg curl exercises to treat clinically diagnosed jumper’s knee in athletes: pilot study. British Journal of Sports Medicine 2001;35:60–64.  ↩
  8. Cannell LJ, Taunton JE, Clement DB, et al. A randomised clinical trial of the efficacy of drop squats or leg extension/leg curl exercises to treat clinically diagnosed jumper’s knee in athletes: pilot study. British Journal of Sports Medicine 2001;35:60–64.  ↩
  9. Visnes H, Bahr R. The evolution of eccentric training as treatment for patellar tendinopathy (jumper’s knee): a critical review of exercise programmes. British Journal of Sports Medicine 2007;41:217–223.  ↩
  10. Purdam C, Cook J, Khan K, et al. Discriminative ability of functional loading tests for adolescent Jumper’s knee. Phys Ther Sport 2003;4:3–9.  ↩
  11. Edwards S, Steele JR, McGhee DE, Beattie S, Purdam C, Cook JL. Landing strategies of athletes with an asymptomatic patellar tendon abnormality. Med Sci Sports Exerc. 2010;42:2072–2080. http://dx.doi.org/10.1249/ MSS.0b013e3181e0550b  ↩
  12. Prapavessis H, McNair PJ. Effects of instruction in jumping technique and experience jumping on ground reaction forces. J Orthop Sports Phys Ther. 1999;29:352–356. http://dx.doi. org/10.2519/jospt.1999.29.6.352  ↩
  13. Malliaras P, et al. Patellar tendinopathy: clinical diagnosis, load management, and advice challenging case presentations. JOSPT. 2015;45(11):887–898  ↩
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