Anatomy of the Knee
Muscles, Tendons & Bones
Back View of Knee
Patellar Tendonitis or Jumper's Knee is a Tendon Injury.
Yes, exercise can be beneficial, but only after you are well into the healing process.
If you exercise and it makes the pain worse, stop immediately to avoid additional injury to your Patellar Tendon.
The patellar tendon is a thick, strong, rigid rope that connects the leg bone to the bottom of the knee cap.
(The knee cap is actually called the 'patella'.)
It is not supposed to stretch and it is not a muscle, so it does not get stronger with exercise the way a muscle does.
It does, however, adapt and "remodel" when you increase activities.
It slowly adapts over time as you do more.
The tendon increases tensile strength, which is a fancy way of saying it can handle more load.
But these changes occur gradually over a period of months.
The frequency and duration of the exercise is more of a factor than intensity.
That's important.
Light exercise for longer strengthens your patellar tendon better than heavy exercise for a short time.
Short bursts of heavy exercise are actually much more risky.
When you suddenly put too much activity or sudden load on a tendon you can end up with an injury.
The classic example for this is a person who sits most of the time but takes up a sport and suddenly plays intensely.
The big, sudden, increase in activity can cause micro-tears that add up to tendonitis.
Or it can cause the tendon to tear as an acute injury.
One example is, deciding to jump from something that is too high.
The sudden impact could cause a tear.
Patellar Tendonitis is often called Jumper's Knee because jumping is a common way to overstress the tendon.
It happens frequently with sprinting as well, but really, any activity that overstresses the tendon can do it.
It could be in the form of micro-tears from pushing the tendon just a little too far over and over again.
Or you can get a larger tear in the tendon when you suddenly overload the tendon beyond its current capacity.
Either way, once this happens the tendon needs rest so healing can begin.
Once you're injured, you need to rest.
You don't want to tear your tendon more.
Exercising too early in the healing process can make Patellar Tendonitis worse.
The good news is, you can heal Jumper's knee, or a more focused patellar tendon tear, quickly if you take the right steps.
Patellar Tendonitis is one of those subjects where the internet is full of bad advice.
If you follow the wrong advice, that will make it take longer to heal.
Exercise is a common suggestion for healing any knee injury.
But you need to know that exercise is just one tool in the healing process, and you need to know where it should fit into the whole picture.
First you need to deal with the inflammation in the tendon.
Exercising too soon is a common cause of making the inflammation worse.
First, you need to protect the tendon from reinjury.
The injury needs to stabilize before you take up any exercise.
Even once you have the pain and inflammation in hand, continue to be careful.
If you exercise and it causes pain, you should stop and keep resting the injured tendon.
You will see sites online suggesting various exercises to fix your Patellar Tendonitis.
People will tell you to exercise to fix muscle imbalances or increase blood flow.
A lot of that can be some pretty bad advice.
Your doctor might suggest it and send you to physiotherapy to get specific exercise treatments.
The key there, is that they are assuming that you have stopped doing whatever it is that caused the issue in the fist place.
Exercise can play a role in healing.
But timing is very important.
Increasing blood flow does speed up healing of injured tendons.
Tendons rely on movement to increase blood flow in the surrounding tissues to get the nutrients needed for repair.
While you are healing though it's best to just rest the area.
Especially at first.
The normal blood flow from basic movement will be enough during this time.
No need to add additional exercise movement that will bring more irritation and swelling.
Focus on rest and cold compression to reduce the inflammation at first. Then, once you are well into the healing process, you can use exercise for increased blood flow. If you want to stimulate blood flow earlier on in the process, you can use BFST. This diathermic process allows you to stimulate blood flow without movement, so you won't add irritation to the tendon.
Most people heal without this extra step. It may just take longer. Athletes and people who want to heal as fast as possible will use BFST. But for most minor injuries, this proactive treatment is not usually required.
All those sites promoting exercise for Patellar Tendonitis never mention this key point.
If you exercise too soon you are just making the problem worse.
Exercise at the wrong time is like pouring gas on the fire of inflammation.
It keeps the cycle going and even makes it much worse.
Take a break from sports or anything strenuous for a few weeks.
When you have to move around for work, keep the area taped up all day so it is protected from further injury.
The tape will limit the movement of the skin over the top of the injured tissue.
This limits the movement of the injured tissue below the skin as well.
Tape is like armor for your injured tendon.
The reason you see professional athletes taped up all the time is because it works.
Cold compression and tape are two very effective ways to reduce the inflammation and irritation in the tendon.
They will stabilize and protect your knee.
To be effective, you need to wear the tape all day, so use medical tape not athletic tape.
Athletic tape, including the big brands like Rock Tape and KT Tape is not designed to be used all day and the glues often have toxic chemicals in them.
Have you read you need to fix muscle imbalances for your Patellar Tendon to heal?
Many crazy theories are discussed online about how Jumper's Knee starts.
90% of it is completely crazy.
95% of cases are just because of a one time injury or because intense exercise was started too quickly.
Yes, some people do have a muscle imbalance.
Those are people who do really odd exercise that focuses on one small muscle group and not another.
It may be from a very focused and unbalanced exercise program at a gym.
Maybe, if someone does a lot of heavy hamstring exercises and no quadricep exercise for a long time, and then they go out to do a heavy sport, that strains both muscle groups.
Then, perhaps, the possibility of a Patellar Tendon tear is higher.
But that would be a very unusual scenario and doesn't apply to people with a balanced lifestyle and exercise routine.
Most often, there is simply a sudden increase in jumping or running or other activity that puts a lot of new stress on the tendon.
And that sudden increase causes irritation and micro injury or causes a strain or tear in the tendon.
Muscle imbalance is not the issue.
A sudden increase in intense activity is to blame.
Perhaps you like basketball but you do not get to play that often.
Then one weekend you get together with friends and play all day.
The next day you notice swelling and pain around your knee.
Your Patellar Tendon was just not ready for this sudden increase in running and jumping.
You just need to take some time off to heal.
You did not suddenly get a muscle imbalance that needs to be fixed.
Your Patellar Tendon was simply not conditioned enough to handle the sudden increase in stress.
Regardless of the cause, once injured, you still need to rest the knee and reduce the inflammation and protect the area from more injury.
After you have stabilized the injury, it is a good idea to exercise to slowly recondition the tendon to handle more activity and load.
The muscles in the leg may have weakened from the rest as well, but they will quickly strengthen with exercise.
Just take it easy.
The Patellar Tendon will take longer to recondition so take your time and gradually increase activity.
Bottom line, to heal this condition you want to rest and reduce the swelling, protect the area from further injury, and if you want to speed up the healing, use blood flow stimulation therapy like BFST.
The compression band has to be the worst advice for this condition. Not only are some stores online promoting these bands which will squeeze the already inflamed tendon but some are suggesting you exercise with them on. This is a very bad idea. It will add to the irritation of the injured Patellar Tendon. Do not do this.
Instead, use tape to protect the injured Patellar Tendon. Tape will do what bands could never do. It will help prevent further injury. And it does not constrict the area or put too much pressure on the tendon. Tape right where it hurts.
Just run a strip of tape right over the painful area.
Make a "T" with the tape right where the pain is and you will be amazed at how much more stable the area feels immediately.
Run one strip of tape left to right over the pain area.
And another strip straight up the Patellar tendon.
You will marvel at how much this stabilizes the tendon and helps you avoid further injury.
Some people prefer to do an 'X' with both pieces on the diagonal.
Pick whichever method you feel most support from.
Your injury is unique.
Stay taped up the whole time you have to move around.
Many tapes are not designed to use all day. They often have toxic chemicals in the glue that would be on your skin all day.
Use a high quality medical tape like KB Support Tape.
Then use cold therapy after activity.
But do not use cold before activity.
If you are speeding up your healing with BFST you should use it right before any physical activity.
This is a common idea with lots of injuries. If something is tight or sore then stretch it. The idea is often that it will loosen the muscles attached to the injured tendon and that will help somehow. This does not make sense though. Yes, stretching may make your muscles less tight. But this does not heal the inflammation or soothe the irritation in the Patellar Tendon.
Stretching isn't bad.
In many cases it increases your muscles' range of motion and that's not a bad thing.
It just won't help your Patellar Tendonitis.
Patellar Tendonitis isn't a range of motion kind of problem.
Really, the area just needs enough time to heal and for the inflammation to subside.
If you enjoy stretching, it's not likely to make your condition worse, so enjoy it as much as you like.
For a little while - not forever - it is really helpful to give your Patellar Tendonitis a rest. In many cases, resting your knee for a few weeks will give it time to heal to a point that your body gets ahead of the healing / reinjury cycle. It's important to realize that once the pain and any swelling go away, your underlying injury will not be healed completely, so take it easy. Go back to regular life gradually, once the pain and swelling are gone.
