Patella Tendinopathy | Education and GuidanceUpdated 10 days ago

What is Patella Tendinopathy?

The patella tendon connects your kneecap to your shin bone (tibia) and helps absorb load during activities like running, jumping, and squatting. When this tendon is repeatedly loaded beyond what it can currently handle, and can't keep up with demand, it can become painful and sensitive. This is called patella tendinopathy (often referred to as “jumper’s knee”).

It typically causes pain just below the kneecap, that is worse during or after impact activity (running, jumping), when climbing stairs, or when sitting for long periods with the knee bent.

What causes Patella Tendinopathy?

Patella tendinopathy usually develops gradually and is often due to a combination of factors, some of these factors may include:

• Sudden increases in training load: Doing too much too quickly is one of the most common triggers, particularly in running and jumping sports.
• Strength and capacity gaps: If the quads, glutes, or hips aren’t strong enough to absorb load well, more stress is transferred to the tendon.
• Reduced foot and ankle mobility: Reduced foot or ankle mobility can change the way the knee loads, increasing the stress placed on the patella tendon with every step, squat, or landing.
• Tissue stiffness: Quadricep or hip flexor stiffness can increase pulling forces through the tendon.
• Growth spurts (adolescents): Bones can grow faster than surrounding tissue can adapt, increasing tendon stress during sport. This can lead to issues with the patellar tendon or it’s attachment (Osgood-Schlatter's or Sinding-Larsen-Johansson).

What to do

• Capacity is a trainable skill: The patella tendon generally responds to the right amount of consistent loading over time. What that “right amount” looks like will vary person to person, and it often changes across different phases (flare ups vs. steadier periods).
• Reduce, don't eliminate: Reducing aggravating activities while you get things assessed is key, tendons generally respond better to modified load than to complete rest.”
• Foot function can influence knee load: The foot and ankle help absorb and redirect force from the ground. When the foot is stiff, unstable, or not coordinating well, more load can travel up the chain and show up at the knee. Building better foot strength, mobility, and coordination can change how force is managed.
• Footwear changes the forces going through the knee: Shoes that are overly cushioned, very rigid, or strongly heeled, may change how the ankle moves and how forces are distributed. In some cases, that can reduce symptoms short term, and in other cases it can increase load or “mask” the problem. The goal is to understand what your current footwear is doing, and make changes in a way your body can adapt to which is done best slowly and may require practitioner guidance.
• Work with a trained professional: A physiotherapist, podiatrist or other trained professional can help you understand what’s driving your pain, and help you build a plan that fits your body, lifestyle, and individual circumstances.
• Commitment, pacing and load management: Tendons respond best to steady, consistent approaches. A trained professional can help you work out what the right balance looks like for your situation including programming to your current capacity.

Where TFC starts with foot function

Feet are designed to be strong and stable, mobile and adaptable, sensitive and responsive. Most people have spent decades in footwear and environments that work against all three. TFC’s approach focuses on five fundamentals. They apply to every person, regardless of starting point.

Circulation: Movement drives blood flow through the foot. Feet that spend years in rigid, cushioned shoes receive less of it. The first step is simply getting the foot moving more, so the tissues and structures get what they need to function well.

Sensation: The foot is primarily a sensory organ. It reads the ground and feeds that information to your nervous system, which uses it to organise every movement you make. Feet insulated from natural surfaces over time become hypersensitive to them. Graduated exposure to texture and varied ground gradually rebuilds that sensitivity.

Mobilisation: There are 33 joints in each foot, and joints exist for movement. Modern footwear and inactive environments restrict many of them. Targeted mobility work restores the range of motion the foot was built to express.

Coordination: Range of motion needs to be controlled to be useful. Coordination is the foot responding to load and varied surfaces automatically, without conscious effort. It starts with focused practice and becomes subconscious over time.

Integration: The foot does not work in isolation. Every step integrates it with the ankle, knee, hip, and the rest of the body. Building foot function means working toward that full integration, not just isolated strength or flexibility.

TFC’s free training library on YouTube: https://www.youtube.com/watch?v=O51AY5yABWQ

TFC's free training library on YouTube covers each of these fundamentals and includes a routine you can start with today.

Looking for hands-on support?

Our practitioner directory connects you with professionals who understand TFC's approach to foot & lower body health. This article is general in nature - for guidance tailored to your situation, a practitioner from our directory is a great next step.

Find a practitioner at thefootcollective.com/pages/tfc-pro-directory