Liam practiced extra time to play his best at the awaited high-stakes match.

But recently, an ache crept in just below his kneecap whenever he jumped or sprinted. At first, he let it slide. “Just sore from training,” he told himself.

But it got worse rather than going away.

That tight, burning feeling that came every time he landed was more than soreness; it was patellar tendonitis.

You’re in the right place if you’ve ever had that same sharp ache under your knee, especially when squatting, jumping, or climbing stairs.

What Is Patellar Tendonitis?

Patellar tendonitis, or jumper’s knee, is an injury caused by repetitive overuse. It happens when the tendon connecting your kneecap to your shinbone is irritated or malfunctions down due to overstress-Cleveland Clinic. This tendon helps your leg straighten by carrying a heavy load, especially during basketball, volleyball, soccer, or other high-impact sports. Anyone active, including runners, gym-goers, and weekend hikers, can get it.

Common signs include the following:

● Pain and stiffness just below the kneecap

● Soreness during or after activity

● A burning sensation with jumping or climbing

● Tenderness when you press below the kneecap

Over time, if left untreated, this tendon can degenerate. That’s why getting the right rehab early is key.

Phase 1: Calm Things Down

Rest is important when the pain first hits, but that doesn’t mean total bed rest. You just need to avoid activities that make it worse, such as jumping or deep squats.

Here, we focus on:

● Reducing inflammation with ice, gentle movement, and activity modification

● Gentle quad sets (tightening your thigh muscles without moving the knee)

● Using heel props or doing straight-leg raises to keep the knee mobile

● Light stretches for the hamstring and calf

I had a nice chat with Lisa from IV Physiotherapy. I asked her what is one of the first thing she does when working treating a new patient. She said “When treating patellar tendonitis, the first thing I would focus on is reducing pain and inflammation in the area. This might include modifying activities or reducing aggravating factors, off-loading with a temporary brace or using other pain-relief strategies. Then, as symptoms settle down, a progressive strengthening program is very important for restoring the tendon's working capacity and preventing recurrence.

Your physiotherapist might tape the knee or recommend a patellar strap to ease tension. The goal at this point is to give the tendon space to heal and recover.

Phase 2: Rebuild Strength—Slowly

Once the pain settles down, it's time to build strength slowly. This is where many people get ahead of themselves and make things worse.

Here’s what’s included in this phase:

Isometric Exercises

These involve pushing against resistance without moving the joint. For example:

● Wall sits (hold for 30–45 seconds)

● Quad press using a resistance band

Isometric exercises reduce pain and start reloading the tendon without overdoing it.

I had a physio weigh in on this and she said “The hardest part of rehabbing patellar tendonitis isn’t the pain, it’s the patience,” says Lalitha, who practices physiotherapy in Calgary at Brentwood Physio. “You can’t rush tendon healing, I wish we could but it doesn't work like that. We see the best results when people commit to gradual progress not instant gains.”

Eccentric Loading

Eccentric loading is a term used to refer to slow, controlled movements, especially the lowering part. Eccentric squats, such as slowly lowering yourself on a decline board, are great examples of patellar tendonitis.

Tip: A bit of mild pain during these is okay, as long as it doesn't cause sharp pain or swelling afterward.

Phase 3: Bring Back Function

Your tendon is now stronger. We therefore ensure you move like you used to, though safely.

In this phase, your psychosis routine may include:

● Single-leg squats and step-downs

● Lunges (starting small, then deeper)

● Resistance band exercises for glutes and hips (these help support the knee)

● Balance work like standing on one leg or using a wobble board

You’re retraining your body to handle everyday movements, but with better control and less stress on the knee.

Phase 4: Return to Sport or Activity

This is the time Liam was most enthusiastic about. He could at long last move pain-free. But his physio reminded him to finish the plan.

Even if you're feeling good, skipping this final phase is risky, as the tendon might not be fully ready for full impact.

Here’s what’s typically included:

● Plyometrics (jump training), starting with double-leg hops

● Sport-specific drills (running drills, cutting, jumping)

● Continued strength training for legs, core, and hips

By now, your tendon is stronger and more flexible, but you still need to build up to game speed. Take it one step at a time.

A Few Final Thoughts

Rehab isn't about doing plenty of random exercises and hoping for the best. It’s a step-by-step, careful rebuild. Think of your tendon like a rope that’s been frayed. If you rush the repair, it only wears out faster.

Liam stuck with his plan. He rested when needed, showed up for physio, and slowly worked his way back. He was back on the court, a few months later, stronger and smarter than before.

If you're dealing with patellar tendonitis, don’t ignore it or push through the pain. You’ll heal and return better than ever with the right physio program.

Patellar Tendonitis Rehab: Physio’s Step-by-Step Plan