Patellar tendinopathy: when the knee hurts during sport

Who is particularly at risk?

Patellar tendinopathy is particularly common in patients with:

• People between the ages of 15 and 30
• Athletes in sports such as volleyball, basketball, tennis and soccer
• Activities involving frequent jumping or rapid changes of direction
• More common in men than in women

Typical signs

The symptoms are usually very characteristic when the patellar tendon is stressed:

• Pain when climbing stairs
• Discomfort during squatting activities
• Pain during prolonged sitting

The “warm-up phenomenon” is interesting: the pain is present at the start of the sporting activity, but disappears during training. However, the pain can return the day after exercise.

Physiotherapeutic treatment

The good news is that patellar tendinopathy can be treated well with targeted physiotherapy. An important treatment approach comprises several components, with the individual situation and progression being of particular importance:

1. Precise diagnostics to identify the current need and rule out other diagnoses.
2. Individual exercise program: Depending on the previous history and current irritability, a different treatment approach should be started. Furthermore, the therapy should be adapted to the person’s individual situation.
   • If a tendon problem has been present for a long time and pathological changes to the tendon material are likely to have already occurred, the therapy may be as follows:
     1. Start with isometric exercises, focusing on pain reduction and activation of the quadriceps muscle.
     2. Transition to targeted strength building: Here it is important to gradually load the tendon again and lay a broad foundation for explosive activities.
     3. Progress to plyometric exercises (e.g. jumps). In this section, it is particularly important to master a large volume at the beginning. The intensity is then increased.
     4. Gradual return to sport – if desired.
3. Stress control: The correct dosage of activities is crucial for the healing process, although it must be clearly stated that pain can be a long-term companion to tendon complaints.
4. Complementary treatments: Depending on the case, techniques such as transverse friction or shock wave therapy are also used.

Time course

Patellar tendinopathy takes time to heal – typically 6-12 months before a full return to competitive sport. However, with professional support, steady progress is possible and many activities can often be resumed earlier. The recommendation is not to return to competition until you are completely pain-free. Training sessions are completed in advance.

On the road to recovery

Knee pain doesn’t have to permanently stop anyone from enjoying their favorite activities. Most people with patellar tendinopathy can return to their desired level of activity with targeted treatment. The scientifically based treatment approach, combined with active cooperation in the rehabilitation process, leads to very good results.

Physiotherapeutic support is the first step on the way back to pain-free movement. An individually tailored treatment plan takes into account personal goals and needs.

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