Tendon load
Jumper's Knee & Patellar Tendinopathy — North Vancouver
That pinpoint ache right below the kneecap that bites on every jump and landing. It's the patellar tendon protesting its load, and the fix is loading it smarter — not resting it until it fades and comes straight back.
What it is
Understanding your jumper's knee / patellar tendinopathy.
Jumper's knee — patellar tendinopathy — is pain in the tendon that anchors the bottom of your kneecap to the shin. It's pinpoint: press just below the kneecap and you'll find the sore spot. Early on it's a warm-up ache that fades once you're moving; left unmanaged it creeps into landings, stairs, and eventually sitting with the knee bent.
The driver is load the tendon can't yet handle. Every jump, landing, and hard deceleration sends a big force through that tendon, and when the volume or intensity climbs faster than the tissue adapts, the fibres get overloaded and irritated. Tight quads, hamstrings, and calves, a sudden jump in training, poor jumping or landing technique, and weak or imbalanced muscles around the knee — especially the quadriceps and hamstrings — all raise the dose the tendon has to absorb.
This is a tendon problem, which makes it a different animal from the kneecap-tracking ache of runner's knee — and that distinction changes the treatment. A tendon doesn't respond to rest the way a sprain does; it gets weaker and more sensitive. What rebuilds it is the right kind of progressive load, which is the whole strategy here.
What to expect
Tendons are slow tissue and reward patience. A reactive tendon caught early often settles within 6–12 weeks of structured loading; a long-standing one that's been nagging for months can take a full season of progressive work. The honest message: this responds to consistent loading, not to rest — and the people who heal cleanest are the ones who don't bail on the program the moment the pain eases.
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Common questions
About jumper's knee / patellar tendinopathy.
How is jumper's knee different from runner's knee?+
Different tissue, different fix. Jumper's knee is the patellar tendon below the kneecap, and it's pinpoint and load-driven — worst with jumping and landing. Runner's knee is patellofemoral or IT band pain — a more diffuse ache around or beside the kneecap, tied to running mechanics. We treat both, but the loading plans diverge, so getting the diagnosis right matters. If your pain reads more like runner's knee, that page is the better fit.
Should I rest until it stops hurting?+
No — and that's the most common mistake with this one. Rest a tendon and it gets weaker and more sensitive, so the pain comes back the moment you load it again. Tendons rebuild through graded loading. We'll find the dose that calms the pain while still challenging the tissue, then build from there.
I play volleyball and basketball — can I keep playing while we treat it?+
Often yes, at a managed volume. Jumping sports are exactly where this tends to brew, but total withdrawal usually isn't necessary or helpful. We'll set a load you can train and sometimes compete on while the tendon's capacity catches up, and adjust based on how it responds the next morning.
Why are eccentric and heavy-slow exercises the main treatment?+
Because that's what tendons respond to. Slow, heavy, controlled loading — including the lowering (eccentric) phase — stimulates the tendon to remodel and build tolerance. It's dull, repetitive work compared with stretching or massage, but it's the part of the program that actually changes the tissue.
This page is for general information only and does not constitute medical advice, diagnosis, or treatment. Individual presentations vary — assessment findings and treatment plans differ from person to person. If you are experiencing severe symptoms, neurological changes (numbness, weakness, bowel or bladder changes), or a significant trauma, contact your physician or emergency services. Physiotherapy at Medstar Sport Physio & Health is provided by physiotherapists registered with the College of Physical Therapists of British Columbia (CPTBC).