Know Your Knees, Part 3: Patella Tendinopathy

Welcome to the third instalment in our four part series on one of the most commonly injured body parts - your knees!

This week we are looking at:

Patella Tendinopathy


  • Aching or sharp pain through the area just below the knee cap (patella)

  • More painful first thing in the morning

  • Irritated by activities such as running, walking or lower body exercises at the gym

  • Especially worsened by repetitive jumping activities such as basketball

  • In some instances, the tendon itself may appear to be thicker and harder than the unaffected side with some associated local tenderness upon touch.


This is considered an overuse problem where the patella tendon, which attaches the knee cap (patella) to the bone of the lower leg, is under ongoing stress. The tendon is designed to withstand a high level of stress, and any stress creates small micro-tears and damage but after the stress the body is able to heal and strengthen the area. However, in this circumstance the overuse or prolonged loading of the tendon means there is no chance for full recovery.

Also, In many cases there is weakness in the muscles of the lower leg which leads to poor stability and control of the joints causing excessive stress through these tendons.

Technique is another aspect that can cause this injury. People often have poor techniques with running or in their daily gym exercises which can load up the patella tendon rather than the intended muscles.


The latest research in the area of tendinopathies suggests that they respond best to isometric loading which is where a force is applied throughout the tendon without any movement. As the patient is able to improve their symptoms the next progression is eccentric loading which is controlled lengthening of the muscles/tendons.

As well as this tendon rehab other factors to work on are:

  • Address running and exercise techniques to ensure optimal loading through intended muscle groups and not excessive tendon loading

  • Glute strength to stabilise the entire lower limb

  • Associated muscle tightness or imbalances

  • Address biomechanics of feet and referral for orthotics if necessary

  • Education regarding return to sport timelines

Keep an eye out for next weeks instalment!

If you have a pain, injury or simply a question - give us a call on (08) 9448 2994, or book an appointment online here!

#physiotherapy #physio #doctororphysio #knowyourknee #knee #patellatendinopathy

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