Patellar Tendinopathy Treatment in Norwest & Dural
The Short Version
Patellar tendinopathy, or jumper’s knee, is pain at one specific point at the bottom of the kneecap, worse with jumping, landing and decelerating. It’s a loading problem in the tendon rather than damage to the joint.
It responds to heavy, slow, progressive strength work, and it takes months rather than weeks. Even on the best programs, fewer than half of people are back at their pre-injury sport level at six months. Anyone promising resolution in six to twelve weeks is describing a different condition.
The most useful thing to know before you start is the timeframe, because almost everyone who tells us loading didn’t work for them stopped somewhere in the first two months.
The Knee We See Most
Two versions of this walk in most weeks.
A jumping athlete in volleyball, basketball or netball, with pain at the bottom of the kneecap that shows up landing and decelerating. It warms up during a session and hurts afterwards and the next morning. Usually it has been there far longer than they admit, and in jumping sports it is extremely common.
Someone in the gym who’s added squats, jumps or Olympic lifting and now has a specific sore spot below the kneecap. Same problem, different sport, and often easier to fix because the load is easier to control.
Both usually arrive having tried stretching, foam rolling and a few weeks off. None of those load the tendon, which is why none of them worked.
Do You Need a Scan?
Usually not. Patellar tendinopathy is a clinical diagnosis made from where it hurts, what provokes it and how it responds to load. An ultrasound will usually show a thickened tendon, which confirms what the history already told us without changing the plan. Tendon appearance on imaging correlates poorly with pain, and plenty of pain free athletes have abnormal looking tendons.
We would image or refer if the pain is at one point on the shin bone below the tendon rather than on the tendon itself, if it hurts at rest or at night, if you felt a pop with loss of ability to straighten the leg, or if you have had six months of genuine loading with no change.
Whether you need imaging is something we work out with you at the appointment. Your practitioner will talk you through whether a scan would change anything, and organise it if it would.
When You Should Be Seen Urgently
Two things that hurt in the same place as jumper’s knee need a different plan. Tell us when you book if either fits.
Go to emergency if you felt a pop at the front of the knee and now can’t straighten the leg or lift it against gravity, and especially if the kneecap looks like it’s sitting higher than the other side. That’s a suspected tendon rupture.
Book in with us soon, and tell us when you book, if the pain is at one specific point on the shin bone below the tendon rather than on the tendon itself. If it hurts at rest or at night. If you’re a teenager, because growth-related knee pain at the kneecap or the shin is common, behaves differently and usually resolves. Or if there’s unexplained weight loss, fever or a history of cancer.
If it’s pain at the bottom of the kneecap that’s worse with jumping and decelerating, you’re in the right place.
What's Actually Driving It
The tendon only changes when it is loaded the right way. These six things decide how quickly
it settles and whether it stays settled.
Quadriceps Strength
Calf strength and ankle range
Hip and glute control
A spike in jumping load
Running or jumping volume that climbed too fast
Resting it instead of loading it
How We Actually Treat It
This is a condition where the honest timeframe matters more than the protocol, so we’ll do that in order.
The protocol. Heavy slow resistance and eccentric decline squats have both been studied and both work about as well as each other. What matters is that the load is heavy, slow and progressive, and that you keep doing it. Anyone telling you their particular protocol is the proven one is ahead of what’s actually known.
The timeframe, which is the part people aren’t told. Even on the best loading programs, fewer than half of people are back at their pre-injury sport level at six months. Follow athletes up years later and about one in four still don’t feel fully recovered. That’s not a reason to be pessimistic. It is a reason to start properly rather than trying four weeks of something and moving on.
On isometrics. You may have been told that isometric holds switch tendon pain off for 45 minutes. That came from a study of six people and it hasn’t held up when anyone tried to repeat it. We still use them, because some people find them helpful and they’re a good way to load a knee that won’t tolerate much else. We won’t sell them as a pain switch.
Alongside all of that: managing how much jumping and decelerating you’re doing, because the tendon has to be loaded enough to adapt and not so much that it never gets a chance to.
What Recovery Actually Looks Like
Weeks one to six. Load starts, often at a level that feels too easy, and the knee is usually still sore. Pain during loading is expected and isn’t damage.
Months two to four. Progressive heavy loading. This is where the tendon actually changes, and it’s slow enough that most people quit somewhere in here.
Months four to six. Reintroducing jumping and deceleration, in that order, built up gradually.
Beyond six months. Continuing the strength work in-season, because tendons detrain and this one comes back.
The realistic picture: fewer than half of people are back at their pre-injury sport level at six months, and a minority are still dealing with it years later. Anyone promising resolution in six to twelve weeks is describing a different condition.
What Else It Could Be
Pain at the front of the knee has several sources, and jumper’s knee is a specific one.
Patellar tendinopathy. Pain at one specific point at the bottom of the kneecap, worse with jumping, landing and decelerating, and it warms up then hurts again afterwards.
Patellofemoral pain. Pain around or behind the kneecap rather than at one point, worse on stairs, squatting and after long sitting. Different problem, different plan, and far more common.
Fat pad irritation. Pain just below and either side of the kneecap tendon, often worse with the knee held straight and hyperextended.
Osgood-Schlatter or Sinding-Larsen-Johansson. Growth-related pain at the shin bump or the bottom of the kneecap in adolescents. Common, self-limiting, and managed differently.
Quadriceps tendinopathy. Same problem above the kneecap rather than below.
Bone stress injury or a patellar tendon tear. Uncommon, but pain at rest or a sudden loss of power changes the picture.
Related pages: Knee Pain, Achilles Tendinopathy.
Frequently Asked Questions
How long does jumper's knee take to fix? Longer than you want to hear. In the best randomised trial, only 43 percent were back to their pre-injury sport level at six months. Five years on, about a quarter of the same group still didn't feel fully recovered. Three to six months of consistent heavy loading is the realistic starting expectation.
Should I stop jumping? Usually not completely. The tendon needs load to adapt, and it also needs enough recovery between loads. What normally changes is volume and frequency rather than stopping, and in-season we'll often work around your fixtures rather than pull you out.
Are isometrics a pain switch? No. That idea came from a study of six athletes. A larger study of 21 people found pain dropped by under one point out of ten, the effect had gone by 45 minutes, and isometrics were no better than ordinary resistance work. They're useful, they're just not magic.
Is heavy slow resistance better than eccentric squats? No, on the evidence. Both work, and a network meta-analysis of ten trials found no approach statistically better than another. We'll pick based on your knee, your equipment and what you'll actually keep doing.
Should I get a cortisone injection? We'd advise against it. In the trial that tested it, all three groups improved at twelve weeks, but by six months the injection group had gone backwards while both exercise groups had held their gains.
Do I need a referral to book? No. You can book directly with any of our chiropractors or physiotherapists. If you've got a GP care plan or you're claiming through a fund, bring the paperwork and we'll work with it.
Who Treats This at Strive
Knee pain is treated at both clinics by our chiropractors and physiotherapists. Who you see depends on your presentation and what you are training for, and we will move you internally if someone on the team is a better fit.
Tammy Ong
Women’s Health Physiotherapist
Rehabilitation Pilates Instructor
Tammy helps women and active individuals recover from injury, improve movement, and return to the activities they love.
Warren Zhou
Chiropractor, competitive powerlifter, and trail runner who treats athletes from the gym floor to the platform to the start line.
Tegan Webster
Chiropractor
Providing evidence-based care to help patients achieve their health goals.
Richard Kan
Sports Chiropractor
Strength and Conditioning Coach
Helping athletes and active individuals recover, perform, and stay injury-free.
Rawan Haydar
Physiotherapist
Passionate about personalised care that supports recovery and long-term wellbeing.
Jess Larder
Physiotherapist
Passionate about rehabilitation, movement, and helping people achieve their goals.
Getting Here
We treat knee pain at both our Norwest and Dural clinics.
Norwest
301/10 Century Circuit NORWEST NSW 2153
Inside Norwest Central Building Complex - 8 - 12 Century Circuit
Entry doors next to Zaatar and Zucchero Cafe
Operating Hours
Mon - Fri 8am - 6pm
Sat 8am - 12pm
Sun CLOSED
Ready to Sort Your Knee Out?
We see patients with knee pain from across The Hills, including Dural, Round Corner, Kenthurst, Glenhaven, Castle Hill, Kellyville, Baulkham Hills, Cherrybrook and Bella Vista, at our Norwest and Dural clinics, and in Canberra at Giralang. Book online or call and we will get you assessed.