What does patellar tendonitis feel like?

The pain is a sharp spot just below the kneecap, at the top of the tendon that connects it to the shin. You can usually put one finger on it. It hurts at the start of a run or a game, eases as you warm up, and comes back worse afterward. Stairs, squats, kneeling and getting up from a deep chair all bite.

It is not the same as arthritis inside the knee joint, which aches more broadly and stiffens the knee. Our knee pain page covers the joint. This page is about the tendon in front of it.

Who gets patellar tendonitis?

Basketball and volleyball players, runners who add hills, and anyone whose job means stairs, ladders and squats. In the Metro East that includes roofers, warehouse pickers, mechanics on creepers and farmers climbing in and out of cabs all day. It is common in teenagers who are growing fast and in adults who come back to a sport after years off.

How do we confirm patellar tendonitis?

Pressing the spot just below the kneecap brings on the pain. So does a slow single-leg squat. Ultrasound shows a thickened tendon, often with small tears and extra blood vessels inside it, and it shows the exact spot to treat. We check the joint behind the kneecap too, since it can ache in the same area. In growing teens, pain lower down on the bump of the shin bone is usually a growth plate problem, not this tendon.

While you wait to be seen, two things help. Cut back on jumping and deep squats without stopping all activity. And start a simple hold: sit against a wall with your knees bent to where it hurts only a little, and hold for 30 to 45 seconds, five times a day. That hold often eases the pain for a few hours.

Why do jumpers and climbers get it, and why does it last so long?

The spring in a jump is stored in this tendon. In a study of 613 Norwegian national-level athletes, 14.2% had jumper’s knee at the time they were examined. It struck 44.6% of volleyball players and 31.9% of basketball players, and not one cyclist. Among those with symptoms, the pain had lasted an average of 32 months. This is a tendon that does not simply wear off.

Two things inside the body slow it down. Sugar that stays high in the blood binds to tendon collagen and stiffens it, and short sleep cuts the growth hormone pulse that runs overnight repair. The third thing is the calendar. A desk job all week, then a Saturday league game or a weekend of roofing, takes the tendon from no load to full load in a day. The tendon is built for steady work, not for a weekly spike. So the plan spreads the load across the week, puts protein at breakfast and dinner so the tendon cells have amino acids for new collagen, and treats a seven-hour night as part of the rehab, not a reward for finishing it.

Dr. Padda arrived in this country without English and grew up the only kid with a turban in his neighborhoods. He tells his children and his patients to embrace the insane thing. For a sore patellar tendon, the insane thing is loading it on purpose, with weight, while it still hurts a little. Done slowly, that is exactly what rebuilds it.

Why does the pain keep coming back after rest?

A tendon gets stronger by being loaded. Rest takes the load away, so the pain fades, but the tendon also gets weaker. Then you go back to the stairs or the court, and the weakened tendon flares again. Under a microscope a stubborn patellar tendon is not inflamed so much as disorganized, with frayed fibers and stray blood vessels. That is why anti-inflammatories and rest give such short relief.

Steroid shots are not a good fit for this tendon. Steroid near a tendon that carries your whole body weight can thin it, and the risk is not worth a few weeks of relief.

Does PRP work for patellar tendonitis?

A 2025 network analysis of 19 randomized trials compared every injection used for this tendon. Leukocyte-poor PRP, alone or combined with an ultrasound-guided high-volume injection, was clearly better than no injection, mostly at six months. A 2022 analysis found PRP beat shockwave therapy for pain and function at the medium and long term.

What the studies agree on is this. PRP is not a stand-alone cure. It works best as a reset for a tendon that is then put through a proper loading program. The tennis elbow research adds a useful lesson: results rose with the platelet dose actually delivered. So we prepare a concentrated, leukocyte-poor product and place it into the worn part of the tendon under ultrasound.

What rehab works after PRP?

Heavy, slow loading. After a short calm period, you start with holds, such as a wall sit at a depth that does not hurt much. Then come slow squats and leg presses, about three seconds down and three seconds up, with weight that rises week by week. Jumping and running come back last, in steps. Pain during the work should stay mild and settle by the next morning. That rule keeps you from doing too much or too little.

Blood sugar and sleep matter here as they do with any tendon. High sugar stiffens collagen and slows repair. We check it, because a tendon in an inflamed body takes longer to rebuild.

What happens on the day of the injection?

You are awake. We numb the skin with local anesthetic and guide the needle with ultrasound. There is no sedation, and most people drive themselves home. The front of the knee is sore for about 48 hours. A second injection depends on how the first one does.

Hurt it on the job in Illinois? Illinois generally lets the injured worker choose the treating doctor. Our injured at work page explains how that works.

When does patellar tendonitis need surgery?

Rarely. Surgery to clean out the damaged part of the tendon is an option when a long, well-run program has failed. A tendon that has torn needs a surgeon quickly. We tell you which group you are in and coordinate the referral when it is needed.

What knee symptoms after a jump need same-day care?

• A pop, then a knee you cannot straighten, or a kneecap that sits higher than the other one. A torn tendon needs a surgeon within days.
• A hot, swollen knee with fever.
• A knee that locks and will not unlock.
• A swollen, warm, aching calf, especially after a long drive or time in a brace. That can be a clot. Go to the emergency room.

See when it is an emergency for the rest.

Frequently asked questions

Do I need a referral for jumper’s knee?

No. Book the visit yourself by phone, text or online. Some insurance plans want a referral on file before they pay, mostly HMOs, so check your card before the appointment. The first visit from Illinois explains what happens when you arrive.

Should I stop running with patellar tendonitis?

Cut back, do not stop moving. Keep activity at a level where pain stays mild and is gone by the next morning, and add the loading program.

Does a knee strap help jumper’s knee?

A strap just below the kneecap can ease pain during sports. It does not heal the tendon, so pair it with the rehab.

How long does patellar tendonitis take to heal?

With proper loading, many people improve over three months. A tendon that has hurt for years can take longer.

Can I keep doing squats at the gym?

Yes, slowly and with control, at a depth and weight where the pain stays mild. Fast, deep, bouncing squats and jump training wait until the tendon is stronger.

Is PRP covered by insurance for patellar tendonitis?

Most plans do not cover it. That is a budgeting decision by the plan. HSA and FSA funds can generally be used.

Can teenagers get PRP for jumper’s knee?

Most growing athletes do well with loading alone. We look at age, growth plates and the scan before suggesting any injection.

Related reading

• Knee pain
• Genicular nerve block
• Hip bursitis
• Plantar fasciitis
• Injured at work
• Orthobiologics for Metro East knees and tendons