Patellar Tendonitis & Jumper’s Knee:
How to Get Rid of It

Patellar Tendonitis & Jumper's Knee: How to Get Rid of ItLearn how to get rid of your Patellar Tendonitis in this ultimate guide to curing Jumper’s Knee.

My name is Martin Koban and I suffered from patellar tendonitis (aka “jumper’s knee”) myself. I know how frustrating it can be and since you’re reading this, I don’t have to tell you about it.

To cut a long story short, I almost quit sports altogether before I finally discovered a number of techniques that helped me heal my knees and get back to being active.

I collected this knowledge through years of research and self-experimentation. The techniques you will learn on this page have already worked for thousands of people and professional athletes are using them as well.

If you want to get rid of your patellar tendonitis, this is your holy grail.

What You’ll Learn on This Page

  • How serious your patellar tendonitis is
  • Why most treatments fail (and maybe yours did too)
  • The 4 Steps to Treat Your Patellar Tendonitis Successfully
  • Which jumper’s knee exercises you should be doing
  • How to recover as quickly as possible

Now let’s get started!

Are Your Symptoms Patellar Tendonitis?

Before we go any further, let’s make sure you’re on the right track by reading this article on jumper’s knee.

Do you feel pain on the side of your kneecap, in front of your kneecap, behind your kneecap, or in the patellar tendon right below the kneecap? If you answered yes, your symptoms indicate patellar tendonitis.

Where you will feel the pain (it can occur in one or both knees)

Where you will feel the pain (it can occur in one or both knees)

You use your patellar tendons every time you straighten your knees. All activities that involve this movement can worsen the pain. This includes climbing stairs, squatting, cycling, and walking downhill.

Explosive leg movements, such as jogging, weightlifting, jumping, and sprinting are very likely to worsen the pain, because they store elastic energy inside the tendon (like in a dense rubber band).

Does your pain get worse with any of these activities? If so, it’s another indicator for patellar tendonitis.

It’s not jumper’s knee if …

If your pain is on the side of the knee or behind the knee, you have a different knee injury.

Is your knee swollen? Can you no longer fully bend or straighten the knee? Go see a doctor immediately because you may have a knee injury that requires immediate medical attention.

Regardless of how sure you are about your injury, you always have to visit a doctor to rule out other injuries because if you don’t, you risk permanent damage and lifelong pain.

Is your injury already chronic? (aka “Patellar Tendinosis”)

Chronic jumper's kneePatellar tendonitis progresses in stages. Put simply, you can be in the acute stage and in the chronic stage. Resting will only help you get back to 100% if you’re in the acute stage.

You’re in the acute stage if you’re experiencing the pain for the first time and haven’t had it for more than a week or two.

You’re in the chronic stage (patellar tendinosis) if you’ve had the pain several times in the past or have suffered from it for more than a month. Resting alone will not be sufficient to heal your patellar tendon. Instead, you need the right combination of rest and treatment exercises (more on that later).

Chances are you’re in the chronic stage, since most people only start looking for answers once pain becomes more permanent. It’s just human nature. I made that mistake as well. Throughout the rest of this article, I will always talk about the chronic stage when I say tendonitis.

For more details on the injury stages, read 3 Red Flag Symptoms of Patellar Tendonitis. I also offer a comprehensive explanation of what happens inside your tendon as your injury progresses in the second chapter of my book.

red herring

Why You’re Still In Pain:
The Red Herring of Conventional Treatment

The conventional treatment for patellar tendonitis fails often because it is based on 3 stubborn fallacies that refuse to die. These three red herrings are like an unholy trinity that conspires to damage your patellar tendon even more.


Do you want get rid of your tendonitis ASAP? Join my advanced course today.

Fallacy #1: Anti-Inflammatories heal tendonitis

Ibuprofen slows recovery from chronic patellar tendonitis.Did you take anti-inflammatories for your patellar tendonitis? Bad news: you may have made things worse!

According to Australian researcher Dr. Jill Cook, using non-steroidal anti-inflammatories such as ibuprofen can be a treatment option in the early stages of tendonitis, but it slows tendon repair once your injury has become chronic (Cook, Purdam 2009, p. 413).

In other words, you MAY use anti-inflammatories to treat ACUTE patellar tendonitis. You have to stop your training during that time and take a few weeks to ease back into it after your treatment has concluded.

BUT, if you’re in the chronic injury stage, academic research says that taking Ibuprofen or other non-steroidal anti-inflammatories (NSAIDs) will slow down your healing (or even prevent healing altogether).

Even worse:

Hard training while on ibuprofen can cause tendonitis

Hard Training While on Anti-Inflammatories Actually CAUSES TENDONITIS!

If you’re taking anti-inflammatories while continuing your regular training, you risk causing tendonitis. Here’s why.

Anti-inflammatories slow down soft-tissue adaptation, which means it takes your tendons longer to grow stronger in response to physical training or rehab exercises. Consequently, your risk of soft-tissue injuries such as tendonitis increases when you’re taking anti-inflammatories.

So you may have taken anti-inflammatories for an unrelated health condition and because you continued your regular training, your tendons were too slow to adapt and tendonitis developed.

Damn it Jim! I’m an athlete, not a doctor.

Fallacy #2: Rest is always good

Did you try to heal your chronic patellar tendonitis by resting? More bad news: you wasted precious months doing nothing. But it’s not your fault, since you couldn’t possibly have known. Here’s why resting will not get you back to 100%.

In patellar tendonitis, the small fibers that make up the tendon have become disorganized. A healthy tendon has well-aligned fibers, but if you interrupt the tendon’s adaptation response to training too often (aka overuse), alignment breaks down.

I always liken it to the threads of a steel cable: in tendonitis, the threads have become frayed. The tendon will be weaker and it won’t be able to handle as much force without suffering further damage.

A weakened patellar tendon is like a frayed steel cable.

A weakened patellar tendon is like a frayed steel cable.

Normally, the body would repair the damage, but since the body’s attempts for repair have been interrupted so often, it has sort of given up on the repair job. By the way, interrupting this adaptation response is also how anti-inflammatories slow tendon healing.

In chronic tendonitis, the body is no longer actively trying to repair the damaged tendon. If you rest, the fiber alignment inside the tendon will NOT change. Even worse, academic research found that resting too much actually weakens the tendon. (Yamamoto et al. 1999; Cook, Purdam 2009, p. 409)

Resting is like putting the frayed steel cable into a drawer for a week in hopes of it magically repairing itself.

With rest, pain may go down, but the tendon is still weak since its fibers are still messy. If you return to being active, pain will promptly return, as the weakened tendon cannot handle the stress. Maybe you’ve experienced this.

We’ll talk about how you can restart your tendon healing in a moment, but first …

Fallacy #3: Once you’re pain-free, your knee is healthy

After helping people treat patellar tendonitis for years, I’m convinced that this fallacy is the main reason why it keeps coming back. If you can only remember one part of this article, it should be this:

Being pain-free DOES NOT mean your patellar tendon is healthy or strong enough for your sport! You MUST NOT trust your pain (or lack thereof).

In tendonitis, tissue damage occurs before you feel pain (Huisman et al. 2013; Khan et al. 1998, p. 351). Other scientific research discovered that two thirds (66 %!) of tendons so damaged that they’re close to rupture were still pain-free (Kannus, Józsa 1991).

So science says you shouldn’t pop the champagne just because your pain is gone. Even without pain, your tendonitis is lurking in the shadows like Michael Myers, patiently waiting for you to make a mistake (cue Halloween Theme).

Once you found a treatment program that works, follow a slow progression until your pain is completely gone … and then continue the same slow progression for another two or three months minimum, before you even attempt a slow return to sports.

During patellar tendonitis rehab, slow progress is fast progress. To learn more about this, check out Patellar Tendonitis Treatment: Do You Know These Secrets?

Bonus Fallacy: How a patellar tendon strap can worsen your jumper’s knee

Patellar tendon straps are small elastic bands you can use to reduce your pain from jumper’s knee. It sounds too good to be true. You need to be aware of these shortcomings:


Do you want get rid of your tendonitis ASAP? Join my advanced course today.

Patellar tendon straps can still be beneficial if you need them for pain management during unavoidable daily activities, but beyond that, I’d be careful with them, for the reasons mentioned in the video.

How to Treat Your Patellar Tendonitis Successfully

Everything I know I either learned by reading academic research, through self-experimentation, or by studying the material of movement experts like Dr. Kelly Starrett, Dr. Perry Nickelston, or Dr. Gray Cook (among many others).

I’ve refined the patellar tendonitis treatment I ultimately used to heal my knees down to the following 4 steps. Each step is critical and if you skip one, you’ll be back to where you started.

Again:

Skip any of these steps and you will NOT recover from patellar tendonitis. I’m handing you a detailed map that will guide you through a minefield. There’s no second-guessing involved. It’s not going to be fun all the time either.

Here’s the first step.

Step #1: Stop All Overuse

Here’s an email I get every other day:

    “Hey Martin, I was wondering if I could continue [INSERT ACTIVITY THAT CAUSED PAIN TO BEGIN WITH] while I rehab patellar tendonitis. Is that okay?”

And I get it, I’m an athlete too! I get depressed if I don’t train, so I can definitely relate.

But I’m here to help you get better, not make you worse. I’m not going to prescribe anti-inflammatories or sell you a patellar tendon strap and tell you to keep training. That would be grossly negligent.

Here’s the truth: you cannot rehab patellar tendonitis while you continue your regular training. If you try, you will fail.

Academic research confirms that continuing your regular training stops healing and that athletes should be removed from sports activity during rehab. (Visnes et al. 2005; Visnes, Bahr 2007)

Specifically, you need to avoid all running, jumping, heavy squatting, lunging, and heavy hiking during your rehab, unless it’s part of your rehab protocol. If possible, avoid all activities that cause pain. Focus on training your upper body during the treatment.

This will help you avoid further damage and it’s necessary for step #2 to work. Here’s why.

Step #2: Use Your Pain to Create Your Rehab Program

Before we get to the treatment exercises you will be using, let’s talk about the methodology. The exercises are just minutia compared to how important understanding the methodology is.

To rehab patellar tendonitis, you have to do just the right exercises at just the right time intervals. The goal is for you to achieve a positive adaptation that strengthens your tendon like so:

How to strengthen the patellar tendon

For your patellar tendon to get stronger you have to do just the right amount of training at the right time.

You will use your pain to discover how often you should train, as well as what type of exercises you should be doing. Once you’ve found the right combination, pain will decrease from week to week.

Pain may stay a bit higher than normal right after your training, but it should drop down to baseline within 24 hours. If pain stays elevated longer than that, you’ve trained too hard.

If pain doesn’t decrease from week to week, you need to experiment by changing one of the following variables during one training month:

  • Removing rest days
  • Adding more rest days
  • Using less intense exercises
  • Using more intense exercises

Again, don’t change all variables at once. You’re like Sherlock Holmes, revealing new evidence to discover how you can crack the case. You need to be systematic and cold-blooded for this to work.

Now you can understand why continuing your regular training will totally screw this process up. Any type of unneeded training will make it harder for you to find the rehab program that works because you won’t be sure if pain is the result of the rehab exercises or your regular training.

Once you found a combination of treatment exercises and rest days that help you reduce your pain, stick with it until it stops decreasing your pain. Then slowly increase the intensity of your exercises by using more resistance without causing a return of pain (hint: go much slower than you think you can).

Step #3: Pass the Secret Test

This is where most people flush all their rehab progress down the toilet: the secret test! It’s like a rite of passage designed by the tendonitis gods and most folks fail this test, unfortunately.

Do you remember treatment fallacy #3? Being pain-free doesn’t mean your patellar tendon is healthy or strong enough for your sport! You MUST NOT trust your pain (or lack thereof). Knowing this is your cheat-code to beat the odds.

During your rehab, you will encounter a point at which your pain is almost completely gone. You’ll feel better than you have in a long time and you will have an itch to return to your favorite activity. If you scratch that itch, you’ll be back to square 1 with your treatment. Here’s why.

Your patellar tendon has gotten stronger as you progressed through your treatment. It’s strong enough for everyday activities and so pain is no longer an issue.

HOWEVER, the tendon is not nearly strong enough for your return to sports yet and if you tried, you’d immediately have a major setback, wasting many weeks of progress.

This is the secret test and to pass it, you need to continue your safe rehab program for at least another 2 months AFTER pain is completely gone before you even attempt a return to your sport. Let’s repeat the important point:

Even after your pain is gone, you need to continue the safe strengthening regimen you discovered in step 2 for at least another 2 months before you attempt any high impact activities.

Step #4: Be Wise Beyond Your Years

Remember back when your parents told you not to do stuff and you did it anyway? Like we tell kids not to touch the hot stove because it’s … well … hot, but they still have to try it, thinking that maybe the laws of the universe didn’t apply to them.

Treating patellar tendonitis is very similar. You’ll be tempted to do things you know you shouldn’t do. For me, this usually was a round of pickup basketball when I knew I wasn’t ready. For you, it’s probably something completely different.

Don’t let your guard down. Increase your activity level gradually, always respecting your patellar tendon’s need for at least 2 or 3 days of rest between intense activities. Remember, the pain is still lurking in the shadows, just waiting for you to make one small mistake.

It’s cold-blooded and calculating, but life is just more fun without pain.

That brings us to the next important topic…

Don’t Add Months to Your Recovery Time by Making These Mistakes

Are you adding months your recovery by making one of these 3 mistakes? Watch the video to learn more or read this article about patellar tendonitis recovery time.


Do you want get rid of your tendonitis ASAP? Join my advanced course today.

Enough talk about the theory, let’s finally get to what you probably came here for, treatment exercises!

Your Rehab: Use These Patellar Tendonitis Exercises and Stretches

To get rid of your patellar tendonitis, you have to do two types of exercises. Skip them and you’ll eventually have a setback. Here’s the first group.

Exercises to Fix Hidden Causes of Tendon Overload

The patellar tendon is overused through a combination of training too much and hidden biomechanical problems that place excessive stress on the tendon.

As an analogy, think about how wearing tight and wet jeans restrict your movement. You have to exert more energy and moving around is a little tougher on your joints. The same happens to your patellar tendon, as hidden biomechanical problems place more tension on the tendon.

Here’s a list of the most common causes for jumper’s knee:

  • Low ankle mobility
  • Tight calves
  • Tight quadriceps muscles
  • Tight hamstrings
  • Weak gluteal muscles
  • Low hip mobility
  • Soft-tissue problems (muscle knots, trigger points, etc.)

I explain each of these in detail in my book Beating Patellar Tendonitis (Click here to have me send you the two most important chapters for free). We’ll only address the most serious problems in this article.

Again, these issues overload your patellar tendon over time. This happens slowly, over many weeks. To prevent patellar tendonitis from coming back, you need to fix them! Here are exercises you can use to do that.

#1: Self-Massage Exercises for Instant Pain Reduction

The best way to reduce pain from an overused patellar tendon is to release as much tension as possible from your leg muscles. Stretching may be the first thing on your mind in that regard, but for maximum effect, you need to combine stretching with self-massage.

Soft-tissue problems can cause patellar tendon overload

Soft-tissue problems can cause patellar tendon overload.
Click here to learn my favorite technique for fixing them.

Self-massage reduces tension in your legs by releasing soft-tissue restrictions in your muscles and it can be very uncomfortable. These restrictions happen when tissues that should glide freely on top of each other are stuck together (after an injury or because of too much sitting and general lack of movement).

Self-massage of the quads led to an immediate pain reduction for many of my readers. It’s like when your stomach hurts after eating too much and the first thing you do is undo your belt buckle. It feels soooooo much better!

To do self-massage, you will need a foam roller or another round object (e.g., a PVC pipe or a tennis ball). Place the roller under your legs and then roll each leg muscle and the muscles on the side of your hip.

Foam Rolling for Jumper's Knee

I share a video of a great massage technique that you can do at home without a foam-roller in my free advanced course on how to get rid of jumper’s knee. Click here to have me send it to you.

Once you’re done with the self-massage, you can move on to stretching.

#2: Patellar Tendonitis Stretches (for healthy quads, calves, and hamstrings)

People with jumper’s knee tend to have tightness in the calves, the hamstrings, and the quadriceps muscles. They all cross the knee, so any excess tightness places more tension on the patellar tendon.

knee anatomy quads itb hamstrings gluteals

If you’re running and jumping with tight leg muscles, your legs are working against additional resistance and pain eventually develops. It’s like driving with your handbrake on: instead of breaking records, you’ll break your body.

Before you do any stretches, you must remove all soft-tissue problems in the respective muscle. A muscle with knots and trigger points doesn’t like being stretched and often reacts by becoming even tighter, which we definitely don’t want.

Calf Stretches

Years ago, I discovered that stretching my calves before basketball games helped me reduce pain. Today, I recommend calf stretches to everyone I work with because of how common tight calves are. The most convenient way to stretch your calves is by using a slanted board:

slantboard calf stretch

You can achieve a similar effect by placing the balls of your feet on a step and letting your heels drop down like so (You need to wear shoes with a solid but flexible sole for this stretch):

Calf stretch for jumper's knee

You can also do this stretch by placing the balls of your feet on the curb of the street and letting your heels sink down. That’s what I used to do before basketball games. I cover this variation in detail in my free advanced course on how to get rid of patellar tendonitis (subtle hint: sign up now, I made this for you!).

Hamstring Stretches

Tight hamstrings are very common today, but you have to be careful with stretching them. Make sure you’ve trained your gluteal muscles because weak gluteal muscles will cause your hamstrings to become overworked, which leads to tightness. We’ll do that with the exercises further down.

For now, here’s how you can stretch your hamstrings:

Hamstring stretch

Lie on your back and use a strap to pull one foot closer to your body. Push against it with your foot for 10 seconds while you pull with your hands. Then release the tension by breathing out with an audible sigh. As you relax, pull your foot a little closer. Repeat for about 2 minutes per side.

Quad Stretches

If these particular patellar tendonitis stretches aggravate your pain, don’t do them. Find an alternative version or stick with the self-massage.

You will need a padded surface for the first quad stretch and I don’t recommend doing without padding, as it’s painful and may injure your knee.

Kneel down in a lunge position and grab the ankle of the rear leg. Next, pull it to your hip. If you notice discomfort in your knee, try moving your knee a bit. I usually lean forward after I grabbed my ankle and then sit up again.

Quadriceps stretch

Push your hip forward and sink deeper into the stretch. You can make the stretch more intense by pulling your ankle closer to your hips.

Another variation of this stretch is the couch stretch. Dr. Kelly Starrett of San Francisco Crossfit popularized this variation. Here’s what the couch stretch looks like:

Couch Stretch for tight quads

Put your knee into the back corner of the couch and then sit up straight. Don’t round your lower back. Keep your abdominal muscles braced as if you’re bracing for a punch and keep the gluteal muscles of the leg you’re stretching tight.

#3: Hip exercises for better leg alignment

Here’s an analogy to illustrate why good leg alignment is important for a healthy patellar tendon: lifting things off the floor. If you lift with good back alignment, it’s much easier on your spine than if you were to lift with a rounded back, much like running and jumping is easier on your patellar tendon if you move with good leg alignment.

Your feet need to point forward and your knees should track over your toes when you move.

When I go shopping, I usually see many people with knees that cave in towards the midline of their body. Don’t let this happen, it puts excessive strain on the tendon. Also, don’t let your knees come forward when you jump or squat. The shin should stay as close to vertical as possible.

The following hip exercises will help you maintain good leg alignment and thereby help take stress off your patellar tendon. Do 3 sets of 10 to 15 repetitions of each exercise:

Hip Abductions

Hip Abductions

Lie down on your side with your body in a straight line. Lift the upper leg by leading with the heel. Keep your hip in a right angle to the ground and never move it. You should feel the exertion on the outside of your hip (not your thigh). Here’s what it looks like:

Clamshells

Clamshell Exercise

Lie on your side with your legs slightly bent and in front of you. Rotate the upper leg out, just using your hip muscles. Don’t move your hip and don’t push off with your feet.

Glute Bridges

Glute Bridge Exercise

Lie down on your back. Next, slide your heels in so that your middle fingers gently touch your heels. Now, push through your heels to form a straight line from your knees to your shoulders. Poke your buttocks muscles and your hamstrings to make sure your buttocks muscles are tighter.

Finally, here’s how you can stimulate healing in your tendon.

Get Rid of the Pain with This Exercise

All of the previous exercises on this page will help you take tension off the patellar tendon. Reducing tension is crucial to allow healing. Like you have to jack up a car before you can change a flat tire.

This is the BARE MINIMUM of what you need to do to treat your patellar tendonitis. I cover the whole topic in a lot more detail, including a complete training plan, in my book Beating Patellar Tendonitis. Let’s get back to stimulating healing…

In chronic patellar tendonitis (“patellar tendinosis,” as some call it), your body has given up on healing the patellar tendon because you’ve interrupted these healing attempts too frequently.

The fibers in the weakened tendon are a chaotic mess and if all you do is rest, this won’t change. Instead, you need to place controlled tension on the tendon to restart the healing mechanism and then let your body finish its work, before you place higher tension on it again.

Academic research has revealed one exercise to be particularly good at stimulating healing in a damaged patellar tendon: eccentric squats on a slanted board.

How to Do Eccentric Squats for Patellar Tendonitis

This is actually a common physical therapy exercise. Here’s a video demonstrating the technique.


Do you want get rid of your tendonitis ASAP? Join my advanced course today.

I explain the technique in detail in this article: eccentric slant board squats for patellar tendonitis (or watch the above video). Here are two pictures to give you an idea:

Patellar tendonitis exercise: eccentric squats on a slanted board

Patellar tendonitis in one knee: place more weight on the injured leg on the way down.

Patellar Tendonitis in both knees

Patellar tendonitis in both knees: support your weight on the way up.

If you don’t have access to a slanted board, you can improvise something similar or build one yourself, if you have tools. Alternatively, do the exercise on flat ground. It’s not as efficient, but it works as well.

banner

We covered a lot of ground in this article. It’s almost 20 pages. My goal is to help you get rid of your patellar tendonitis, so I’ve created a free course that will give you everything you need to get back to enjoying life.

What I will send you:

  • A training plan with all treatment exercises
  • A printable PDF of this article with all exercises
  • My favorite exercise for instant pain relief (video)
  • Whenever I discover a new method to heal even faster, you’ll be the first to know
  • FAQ sessions in which I answer your questions

Have me send you this advanced material and start healing your knees today.

 

Lastly, please remember what I said earlier:

Martin KobanMy goal is to help everyone with patellar tendonitis get back to enjoying their life and I’ve collected the very best techniques to do so on this very page, but I can’t reach everyone myself. I need your help!

Please help me spread the link to this page. Share it with your friends on social media or on your blog.

thanks

 

Show Citations
Cook, J. L.; Purdam, C. R. (2009): Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. In British Journal of Sports Medicine 43 (6), pp. 409–416. DOI: 10.1136/bjsm.2008.051193.

Huisman, E.; Thornton, G.; Roberts, C.; Scott, A. (2013): IDENTIFICATION OF BIOMARKERS FOR EARLY TENDON DEGENERATION USING AN IN-VIVO RABBIT MODEL. In British Journal of Sports Medicine 47 (9), pp. e2. DOI: 10.1136/bjsports-2013-092459.57.

Kannus, P.; Józsa, L. (1991): Histopathological changes preceding spontaneous rupture of a tendon. A controlled study of 891 patients. In J Bone Joint Surg Am 73 (10), pp. 1507–1525.

Khan, K. M.; Maffulli, N.; Coleman, B. D.; Cook, J. L.; Taunton, J. E. (1998): Patellar tendinopathy: some aspects of basic science and clinical management. In Br J Sports Med 32 (4), pp. 346–355.

Kongsgaard, M.; Kovanen, V.; Aagaard, P.; Doessing, S.; Hansen, P.; Laursen, A. H. et al. (2009): Corticosteroid injections, eccentric decline squat training and heavy slow resistance training in patellar tendinopathy. In Scand J Med Sci Sports 19 (6), pp. 790–802. DOI: 10.1111/j.1600-0838.2009.00949.x.

Visnes, Håvard; Bahr, Roald (2007): The evolution of eccentric training as treatment for patellar tendinopathy (jumper’s knee): a critical review of exercise programmes. In Br J Sports Med 41 (4), pp. 217–223. DOI: 10.1136/bjsm.2006.032417.

Visnes, Håvard; Hoksrud, Aasne; Cook, Jill; Bahr, Roald (2005): No effect of eccentric training on jumper’s knee in volleyball players during the competitive season: a randomized clinical trial. In Clin J Sport Med 15 (4), pp. 227–234.

Yamamoto, E.; Hayashi, K.; Yamamoto, N. (1999): Mechanical properties of collagen fascicles from stress-shielded patellar tendons in the rabbit. In Clin Biomech (Bristol, Avon) 14 (6), pp. 418–425.

Show Picture Credit

Comments

  1. Jelani says

    I feel a part of my patella where its degenerating. I’ve had patella tendinitis for 2 years now it gotten worse. I made it heal last summer but it came back. I don’t know what to do. Can you plz help.

    • Martin Koban says

      Hey Jelani,

      What did you do to make it heal last summer?

      What else have you tried since then?

      – Martin

      • Jelani says

        I did the exercises on this website. http://www.knee-pain-explained.com/knee-strengthening-exercises.html .I did them for about three months but now that I think about it might have not healed completly. Then when it came back this time it was even worse. My right leg is the one giving me problem. I can also feel the tear on the inner side of my patella. I don’t know what to do I just started doing eccentric squats yesterday. Could you tell me how I can move forward. I’m looking to be better by September.

  2. Nir says

    I have had patellar tendinitis for 8 years now. Obviously, I’m deep into the chronic stage thanks to incompetent orthopedics. I only discovered your website about 6 months ago and bought the book about 2 months ago. I will start the plan soon, but I must salute you for your efforts in spreading the word for free. This actually increases your reliability in my eyes. I hope soon I’ll be able to message you again, saying the is an evident improvement.

    • Martin Koban says

      Hello Nir,

      Thank you for your kind words!

      I’ve compiled the very best knowledge about patellar tendonitis into the book and I’m sure that by applying all the advice, you’ll find some way to reduce your pain.

      I wish you all the best for your recovery.

  3. Luka says

    Hi Martin,

    I’ve had Patellar Tendinosis in both knees for about 2 years, and for more than a year and a half I didn’t know that I had it. Unfortunatelly I continued my training and made it worse in that period. Last 6 months I’ve been trying to beat PT. I came across your website and I really liked your aproach and dedication to the subject. I started your training plan about 3 months ago (after full rest of 2 weeks), and everything seemed to be getting better until 2 months ago when the pain accompanied almost all movement and knees were really sore when I woke up. Then I went to a specialist who confirmed PT and gave me NSAID medication to take for 10 days as he did an ultrasound and found a small amount of water in the knees due to inflammation. I’ve read already your warnings (and from other sites) about the dangers of NSAID’s for recovering tendons, but the pain was obstructing my day to day activities. After 1 week the pain was mostly gone and I rested another 2 weeks after that. Now I am back to your training plan and feel no pain during workouts or after, but I am really careful and going slow. Just thought that maybe some people would benefit from taking NSAID just at the start of the rest phase? Just wanted to hear your stance on this.

    My plan: I’ve started caring about my posture, got quality shoes and somewhat changed my diet so I am really dedicated. I’ll follow your training plan and hope to slowly begin playing football in a month or two. My main problem is that I have to sit at work for long periods of time and probably because of that I have really tight hamstrings. I try to get up and walk as much as I can, but it seems it is not enough. Also, a standing workplace is for now not an option. Is there something I can do while sitting dow to make things easier for me?

    Thank you!
    Luka

    • Martin Koban says

      Hey Luka,

      There’s no doubt NSAIDs can be useful. However, you were in a unique position in that you already knew about the risks. I’d say 99% of people don’t know about the risks and their doctors don’t tell them either, so they keep on training hard and then bad things happen. I’m glad your situation turned out so different.

      I can understand the problem with sitting a lot. In my opinion, a stand-up desk doesn’t even work well if you’re healthy. At least that’s my own experience from when I used one.

      Instead, I recommend doing hip mobility work such as hip flexor stretches and glute bridges. You can also do standing gluteal activation by tensing your gluteals hard just when standing/walking/taking stairs.

      While sitting, you need to avoid placing your feet directly under the chair. Instead, keep your knees as straight as possible. If you can, place your feet up on a small chair or box under your table. The quads should be fully relaxed to place minimal tension on the patellar tendon.

  4. N says

    Hi Martin, I left you a reply here but and I’m not sure why it wasn’t posted, maybe because I wrote it from my phone. Anyway, I have most equipment necessary to begin the program, but I’m just missing a slant board. There are absolutely none I can find in Australia, so the only option is to build one.
    However, I did find this one:
    http://www.66fit.com.au/balance-boards-cushions/achillies-calf-hamstring-stretchers/66fit-multi-adjustable-stretch-board.html

    Will this be suitable?

    Thanks

  5. DVSSLNRAO says

    Thank your very much for your valuable information and I feel these exercises are much helpful even for prevention of knee pain.

    with regards

    DVSSLNRAO

  6. Nate says

    Thank you so much for all of your material. I am in the process of trying to heal my patellar tendonitis and you have been very helpful. One quick question… what do you think of massaging across the tendon as explained in this video? https://www.youtube.com/watch?v=K1-LibsbxWY
    Every time my tendon hurts a little, this seems to get rid of the pain temporarily. Obviously I know it will not heal it, thats why I am following your training exercises. Do you think it can help in the long term healing process by increasing blood flow? Or can I possibly be doing in damage? please let me know

    • Martin Koban says

      Hey Nate,

      Instead of cross-friction massage (going in a right angle to fiber alignment), I’d recommend massaging parallel to fiber alignment. Either way, the goal of massage is to break down scar tissue, but if you do it incorrectly, you’ll cause more damage to the tendon. My rule of thumb is to only do direct tendon massage once your healing progressed has stalled for more than a couple of weeks.

  7. Isaac Salazar says

    The patellar tendon on my bad knee feels much softer than the other one is this normal?

    • Martin Koban says

      As tendonitis worsens, your body pulls more water into the tissue and it collagen alignment breaks down. So it could also feel softer as a result.

  8. David Johnson says

    Hi Martin,
    Thanks for all the good work. I’m just starting the rehap program and have just bought your book. I’ve been using a patellar strap for about 8 months and I kept telling everyone that it “cured” me. I had minor discomfort, but the strap seemed to “cure” the PT. But recently, the pain has increased. My question, would you ever recommend using a strap under any circumstances? For example, if I rehap well and then slowly start back training (running and basketball), should I use it maybe only for running. (I got to where I was wearing all the time except when I slept.) Or should I throw my straps away?
    Again, thanks.
    David

    • Martin Koban says

      Hey David,

      The straps can be very useful if you’re in a situation where you absolutely have to move in potentially painful ways (like in work or maybe on vacation) to help reduce the pain, but outside of these scenarios I don’t like using them. You can learn more about my thoughts on them in this article/video: http://www.fix-knee-pain.com/patellar-tendon-strap/

      I don’t like using them during rehab either, because they can lead to bad judgments and decisions.

  9. sonia says

    Hi
    6 months ago i had a bad knee sprain and was sent to physical therapy where she did nothing to help me. Slowly i began to lose muscle in my quad .i could not walk..i used a cane and my knee would shake and give out .i went to see an orthopedic and i was told i had tendinitis and patella femoral syndrome and suggested i change therapist. I did change and the one got me back to bending and straightening my knee and i am getting muscle strength back but it is still hard to walk. I feel my kneecap blocks and shifts and that is painful. I walk with my leg flexed all the time afraid to bend it so the kneecap does not shift. I wear a knee sleeve with patella hole on both knees. My ither knee is hurting from over compensating. It helps a little. What now…this is not a life.

    • Martin Koban says

      Hey Sonia,

      If you want to work on it on your own, use the hip strengthening exercises and the self-massage drills I explained on this page. You can also sign on to my email course on jumper’s knee, where I share more information on it: http://www.fix-knee-pain.com/tendonitis

      However, what I’d most recommend you do is work with an SFMA-certified healthcare professional. They can help you find movement dysfunction in your body that is contributing to your knee becoming overloaded. You can find one in your area here (be sure to select SFMA-certified): http://www.functionalmovement.com/experts

  10. Joshua says

    Hi Martin,
    I’ve had tendonitis in my left knee for at least a year now and I’ve started doing the hip exercises and eccentric squats on a slant board. I do the stretches, self massages, and hip workouts everyday and I do two sets of five squats on the board every other day. the day after I do the squats, the pain in my knee is usually a little more aggravated. by the time I do the other workouts it goes back to normal. I just wanted to know if that is normal or if im over doing it. I don’t feel much pain to where I need a knee brace but like I said the days after I do the squats my knee is a little more aggravated until I do the hip workouts and stretches. thanks for the help

  11. joshua says

    hi martin
    I just wanted to know, is it normal for my knee to get aggravated for a day after doing the slant board squats? also as i go up on the eccentric squats my bad knee has a little pain even when I shift my weight.
    Thanks for listening

  12. Chirag says

    I have knee problem, currently i joined gym according to my Pilates instructor advise me , also i m doing stretching exercise as regular basis , i am working in security industry during the shift i have to walk and stairs up and down a lot but i am suffering a lot while i am stairs up and down.i am very active person but since 3 to 4 months i am suffering with my pain.

    please advise me to get rid of all this pain

    Thanks a lot

    Chirag

  13. Sara Nichols says

    Hi Martin,

    Thanks so much for this. I have been in terrible pain for 6 months and have not had any health practitioners who knew how to treat it. It has been my intuition that staying off it and icing and elevating and lots of NSAIDS is actually making my knee worse but everything I try hasn’t worked.

    I’m going to try the suggestions you have but there are two things that I want to get your feedback on:
    1) everything you talk about seems to be focused on “athletes” and I’m wondering if that means they won’t work for me. I guess I’m an athlete in the sense that I was very active at the time I started getting this pain–running, biking, swimming every day, weight lifting–I had done two sprint triathlons (one as recently as last year). My severe pain this year began after my first full fledged long tennis singles match in years. But I am not in the kind of tip top athlete condition that you and lots of people I hear talking about this are in. And the only “jumping” I did was dancing–but I did do a lot of that. When the pain came I was about 20 pounds overweight and now with reduced activity and without being able to find any good exercise that I can do (EVERYTHING hurts it, even swimming!), I have gained another 18 pounds (and this is even with a strict food plan with a nutritionists help). It doesn’t help that I am a menopausal 54 year old woman so it’s all hitting at once and Ithink the weight is making it harder to heal.
    2) what do you think about bikram (hot) yoga as a component of healing? I was going bikram for the year and a a half leading up to the pain and then continued for a while. For a while it actually seemed like it was the only thing that made it better but then it felt worse. The exercises that are excruciating involve bending the knee and putting lots of weight on it at the same time. Most of the others feel great.

  14. Anita says

    Hello,

    Ive had knee pain on both knees for almost two months. It’s from spinning and my knees going inward. My PT told me its because of inward knee and weak glutes. Since I don’t have insurance she recommended that I take pilates. It’s really basic pilates with clam shells, monster walk, leg press. What are your thoughts on that?

    Last week when I corrected my walk I was pain free in 1 day but now its hurting again not sure why.

  15. Pablo says

    Hello Martin,

    1 year ago, after a leg training at the gym I was climbing the stairs of my appartment by taking 3 steps at a time when I felt a sharp pain bellow my knee (to be precise, right at the insertion of my patellar tendon in the tibia).
    That pain persisted for some weeks when I climbed stairs, run, stand up from a sitted position, etc. Then I stopped training legs at the gym and the pain disappeared. But, 1 month ago it came back do to more intense trainings (I started practicing CrossFit to be precise, which includes a lot of leg work).
    I went to the doctor and he told me that I have an Insertional Tendinopathy at the tibial insertion of the patellar tendon, but he didn’t really told me what to do.
    My questions are:
    – Should I do the same exercises and stretches that you mention on this website? Or is there anything more specific for my type of tendinopathy?
    – I am already starting to do some of your exercises but there is absolutelly no pain, so should I progress as the pain allows me to? (like incresing frequency/intensity/speed or even add some weight?)

    Thank you very much, and congratulations for your work.

    Pablo

  16. simon Bowman says

    Hi Martin

    I was diagnosed with PT yesterday and immediately had physio which included thigh massage ultra sound and accupunture

    I immediately scoured the internet and found your amazing article. I spent all day reading it. Thank you so much for putting it out there . Consequently I did not take any anti inflammatory drugs to ease the paid nor the swelling

    As a novice in this field when is it best to start the stretches as my knee is still swollen nd sore. I assume that I can commence rolling straightaway.

    Your advice would be most appreciated.

    regards

    Simon

    please can you advise.

  17. simon Bowman says

    Hi Martin

    I was diagnosed with PT yesterday and immediately had physio which included thigh massage ultra sound and accupunture

    I immediately scoured the internet and found your amazing article. I spent all day reading it. Thank you so much for putting it out there . Consequently I did not take any anti inflammatory drugs to ease the paid nor the swelling

    As a novice in this field when is it best to start the stretches as my knee is still swollen nd sore. I assume that I can commence rolling straightaway.

    Your advice would be most appreciated.

    regards

    Simon

    • Martin Koban says

      I’m not familiar with that particular product, but as for increasing blood flow and circulation in the respective area, applying heat will do the same.

      I’ve been using a warm water bottle or a heating blanket for that purpose (not too much heat and not for more than 10 minutes at a time).

  18. Ulrik Schmidt says

    Hi Martin,

    I have had PT for a few month now – fairly mild pain, however I am taking it very seriously, as I am hoping to be able to go back to running . It is (judging by pain) only in my right knee and the pain is only felt where the tendon attaches to the kneecap – i.e. on the lower edge of the kneecap, a little to the right side of the centre to be exact. Any thoughts as to why the injury has occurred in exactly this spot/area? I have had PT once before, about 10-12 years ago, also due to running. At that time it was in both sides, a little lower in the centre of the tendons – and more serious (took me nearly a year to get completely pain free but I stopped running for 2-3 years, as I didn’t want to risk anything – then slowly returned without any problems). I am currently following your program and it is going pretty well. I have days/periods without any pain, but then it comes back a little – especially if I have had my knee bent for a while (even without putting strain on it, so I am trying to avoid this). Your program works well, however I am considering heavy slow resistance training (HRS). What are your thoughts on this – any experience? Could anyone safely try this approach or should it be considered by top athletes only?

    Regards,
    Ulrik

  19. Umit says

    Hello Martin;
    i started to run 3 weeks ago and 2 weeks ago my 2 knees injured. Dr said pes anserinus tendinitis. because my pain is inner side of my patella. im using nsai for 10 days and resting. but offcourse i have to walk too. but its difficcult to walk for me. i have pain with movement. but especialy in mornings my knees are better. but following a few hours pain again. im worry about this is going to be cronic.
    what do u think about my situation? should i rest or do exercises? is this acute or cronic? what can u advice for me ? Thank you very much.

  20. Juan says

    Hey Martin,
    My name Juan I’m 19 and I play baseball. I’ve had knee pain for about 2 years now on my right knee. The pain came from playing a lot of pick up basketball and football. I didn’t really paid much mind to it until the pain started getting worse. So I decided to go to the doctors and have them take a look at this. I went to several professionals but all they can say was ice and rest. They even sent me to physical therapy which was making the pain worse. Until I decided to seek for another opinion from another doctor. They told me I had right knee patella tendonitis in the center of my knee cap. So on July 15 2015 I went and got “right knee arthroscopy and open excision patella tendon”. It’s almost been 4 months since the procedure and my knee is still in pain. I came across one of your videos on YouTube which lead me to your site. I truly believe you have to information that I need to recovery from this pain. My dream is to become a prossional baseball player but this is just holding me back from what I know I can do. I would really appreciate if you replied and give me your opinion on my situation. Thank you

    • Martin Koban says

      Hello Juan,

      In your situation, a lot of things need to be considered. If you’re on any kind of medication, you need to check whether the side-effects can include impaired soft-tissue healing. You can read the package inserts for that information and then talk to your doctor about it.

      Next, I’d start with a very gentle approach for unloading the patellar tendon with daily self-massage and stretching the calves. You can support healing with vitamin c, hydrolyzed collagen, and liquid fish oil.

      Then you’d have to find a way to strengthen the patellar tendon … either with eccentric squats, or isometric wall-sits, or slow strength training … one of my readers from Germany was very creative and decided to slowly walk stairs instead, taking 3 stairs at a time and moving very slowly and carefully (only going up and taking the elevator to do down).

      Once you find something that works, stick with it for at least 3 months and only progress slowly.

      I also recommend you get my book Beating Patellar Tendonitis off of Amazon. It explains everything in more detail.

      It’s important that you deal with this right now, before you begin your sports career (because then you won’t have time).

      Also, check out Eric Cressey’s stuff on keeping your shoulders healthy: http://www.ericcressey.com/shoulder-hurts-start-here

  21. Mike B. says

    Hi Martin thank you for all of this great information! I have just stumbled across your site and plan on ordering your book as well but had a few preliminary questions.

    I have all the classic symptoms of patellar tendonitis. I have very tight quadriceps hamstrings and calves, pain over the top of the knee, etc. I also have a desk job so I do sit quite a bit, which I imagine causes my glutes to become weak as well. I visited the doctor and he took xrays (no further testing) and indicated that this is most likely what I have. I have just started doing yoga to increase my overall flexibility and muscle balance. Is there any reason why you would recommend against doing yoga, in addition to your program as well (subject of course to using common sense in monitoring my pain and work load)? I like to run but it sounds like I should give that a rest for a while.

    I have crepitus in my knee which make popping noises during the extension movement. is this common to have when someone has patellar tendonitis? If so, does fixing the tendonitis often times also help/fix the crepitus? My understanding is that crepitus could be a result of many different issues but it can also be fairly harmless. I guess I’m hoping that it’s related to the tendonitis so that when that is fixed, the crepitus is also decreased.

    Thank you for all your help and information!

    Mike B.

    • Martin Koban says

      Hey Mike,

      What I found worked best for crepitus was to avoid squatting on the balls of your feet. So if you have to squat, place all your weight on your heels and sit back, keeping the shins vertical. In most cases, the sound is nothing to worry about (unless it’s painful, of course).

      Crepitus does not commonly happen with patellar tendonitis in my experience, but some people have both issues at once.

  22. Vince says

    I’ve been struggling with patellar tendonitis for seven months now. I initially recovered but had a major setback from rushing back too soon. Since then both my knees have pain/discomfort when I am not wearing my patellar straps. This is mostly during the end of the day. Plus my knees feel stiff when I try to sleep.

    I’ve been stretching and doing very light eccentric exercises for two weeks now, but the pain seems to have gotten a bit worse, although I’m not experiencing any direct pain while rehabbing. Should I be going to physical therapy? I’m very discouraged.

    • Martin Koban says

      Hey Vince,

      I’m sorry to hear about your setback. For your stiffness, experiment with heat before going to bed. You can use an electric heating blanket or a warm water bottle. This helped me deal with stiffness due to patellar tendonitis.

      If your condition doesn’t improve after following the suggestions in the article (i.e., regular self-massage, hip strengthening, etc.), you should see a doctor to rule out other problems with your knees.

      • Vince says

        Update –

        I’ve been doing physical therapy for over a month now and I no longer have any pain or stiffness, even when jumping! It turns out that my hips and hamstrings were weak and that was causing my symptoms, so my therapist worked on strengthening those areas. I’m starting short-distance running and will be working my way back toward sporting activities soon.

        • Connor McCloskey says

          Awesome to hear you have your tendonitis under control. Do you mind sharing those hip and hamstring exercises as nothing I have tried has worked.

          Thanks.

  23. James says

    Hi Martin. I have been doing your slanted board and stretching exercises for 7 weeks now and have felt improvement but feel that it isn’t quite healing that last little bit for 100%. As when I press the base of my knee I still feel abit of pain. Do you think some single leg presses will help? Should I quad stretch before and after slanted exercises? Would appreciate some feedback. Thanks

    • Martin Koban says

      Hi James,

      With this injury, getting back to 80% or 90% of full function usually happens much faster than the “small” remaining step to 100%. So patience is important.

      If possible without an increase in pain, you can indeed progress the eccentric exercises to slow single-leg squats. That will stimulate the tendon to grow even stronger.

      As for stretching quads, it doesn’t matter when you do it, as long as you do it at least daily (better: two or three times per day). Try to find what works best for you.

  24. Sebastian says

    Hey Martin Koban

    I live germany and I am a 18 year old experienced football player. I’m sorry for my bad english.
    I suffered PT since November last year and started resting since January this year, in hope the injury would heal itself. after 7 months of resting the pain was almost gone, but then i knew it was my and the fault of orthopedics just to rest. In August I started Rehabilitation (strenghtening muscles). I did some good progress and I’ve been able to play football with my team for one month now. I don’t fell any pain while the acitivities. It just hurts, when i poke on the injured point after i have done some activities. Is this a problem, if it only hurts, when i push against the patellar and not while playing football? The pain reduces normally after 24 hours. I also felt a little pain at the other knee for 3 weeks now, but also just if i push at this point.
    And my other question is: What exercises or drills should I do, if I am not able to do a regular squat, because my lower back is rounding when I am in a deep position?

    Thanks for your work and this website, it helped a lot.

    • Martin Koban says

      Hallo Sebastian,

      Ich antworte mal auf Deutsch.

      Solange wie die Patellarsehne sensibel auf Druck reagiert, würde ich die Kräftigungsübungen fortsetzen (exzentrische Kniebeuge oder langsame Beinpresse oder Wandsitzen).

      Bezüglich der Rundung im Lendenwirbelbereich haben Sie mehrere Möglichkeiten:

      1) Ausführung der exzentrischen Kniebeuge nur bis parallel. Erst ab parallel wird sich die LWS beugen. Sollte es schon vorher problematisch sein:

      2) Langsame einbeinige Beinpresse im Fitnessstudio … hier mit wenig Gewicht anfangen und 3 – 5 Sekunden runter, 3 – 5 Sekunden hoch. Sie werden merken, wie Ihr Rücken es verkraftet. Generell belasten einbeinige Variationen den Rücken weniger.

      3) Wandsitzen … die wohl rückenfreundlichste Variante.

      Die Hauptsache ist, dass die Patellarsehne langsam und ohne Explosivität belastet wird.

      Nach dem Spielen immer mindestens 3 Ruhetage lassen, damit sich die Verletzung nicht weiter verschlechtert.

  25. Chris says

    Hi Martin,

    I am 13yrs old and do parkour and basketball, and I suffered an ankle sprain and big fall which was heavy on my knees. It has been about 1 year. I suffer regular pt issues and I need to heal because I’m a runner and parkourist so please help me I play basketball at school and my knees hurt a little sometimes after. When I do a walk run and then jump down it hurts a little. It’s these small pains that atop me. I’m a kid and I cant enjoy life like this. Please help me :'(

  26. Abdul basith says

    Sr,
    Iam abdul basith. Im a volley ball player and i have pain in my knees. Itz startd when im doing my higjer secondary education 3 years back. And the pain is in the upper part of the patella and now the pain is in the bottom portion of the patella and i cant even jump. The pain is getting worse. Can u help me to rid from this pain.

  27. Leon says

    I’ve had Patella Tendonidis for about a year and a half I didn’t know i had it for about 6 months. I believe i got it from playing netball and landing on it too hard. Ive been very athletic and did boxing for nearly two years the training consisted with lots of running and i never had a problem with my knees. Up until i boxing for a year. Since my knee injury I haven’t done boxing for two years and it’s pretty much depressed me because i love boxing. About 2 months ago i had a platelet rich plasma injection to my affected knee and rested it two months after it. However I still have pain. I am going to start your approach. Im 16 and will i have this forever i cant live like this.

  28. Damien says

    Hi Martin- thanks for your dedication to helping others with pt.
    Regarding the progression tests would your consider that being “mostly pain free” is experiencing no pain during of after the exercise? Can I disregard the tenderness/pain when I push on my patellar tendon wth my finger?
    Thank you

  29. Josh Fitzgerald says

    Hi Martin,

    Thank you for your dedication to this crippling injury. I used to be extremely athletic and in excellent shape, however I am now at the mercy of my knee which has been both frustrating and depressing.

    I am 25 and have battled tendinopathy in my right knee for about a year. When I was 17 I had it in my left knee from basketball, but I don’t remember that injury holding me back like my right knee has. My left knee pain is no longer an issue (thankfully).

    I stand all day at work and I find this aggravates my right knee pain and aching. What are your thoughts about prolonged standing with patellar tendonitis? Also, what are your thoughts on corticosteroid injections into the cartilage space (vs into the tendon itself)? I had this done and it helped my pain immensely which has helped me implement your training regimen. Unfortunately, I have been foolish and returned too early to sports.

    I refuse to live with this pain forever as it hinders daily activities like going down stairs, sitting down, etc. Thank you so much for any response or advice!

    Josh

  30. Charlie says

    Hello Martin!
    I have a more specific question about PT and how it’s diagnosed properly; I have had (or rather think I have had) PT since July this year (when my knee pain started) after returning to weightlifting, after a month off for some exams. I have checked again and again and I seem to have basically all the symptoms of PT, though I’m aware a lot of knee problems can cause similar symptoms so can sometimes be improperly diagnosed; the pain has been going since im not squatting or doing classic lifts, and now is almost non-existent at rest, however it’s noticeable if my leg is bent for an extended period like when sitting, when i press on the tissue at the edge of the kneecap (more painful), when i go up or down stairs occasionally, and flared up a lot when i was trying to squat, and clean and jerk earlier this year when i didnt know what the pain really was;

    since then, last month i told my doctor about my problem and he booked me in for an ultrasound scan; the results apparently said there was no ‘damage’ to the cartilage or ligaments or bones etc. and he gave me the all clear and sort of inferred that i no longer have PT, but since i do still have pain in my knee i know something is still wrong. my question is do you think PT would ‘show up’ on an ultrasound scan? since as you said PT is basically frayed fibres, i think perhaps my doctor said my knee is fine because the scan simply doesn’t show that form of damage, and doctors in a lot of cases dont really want to help you but rather to just process you quickly. if i have in fact got PT despite the scan showing im ok (or rather NOT showing i’m NOT ok) then i will at least know for certain how to deal with it using your regime.

    thanks so much for all the information here! you’re doing fantastic work

  31. Seth McFarland says

    Hi Martin, My name is Seth McFarland. I am 19 years old and have had Patellar Tendonitis for 2 years. I got it from playing basketball from jumping trying to dunk. I am a one footed jumper so it’s just my left knee that is bad. It all started before my junior year during pre-season . Instead of taking care of it and doing rehab, I continued and played my whole junior year. I never did anything for it up until my senior year and I struggled to make it through my senior year. I could barely run or jump and had to even take practices off to lower the pain. It was not fun. After the season was over I was not able to play college ball because of my knee. Right now I am currently 2 months into rehab and it’s going ok. They are having me do eccentric loading exercises. While doing the exercises my knee feels great, but the next day not so much. It’s not bad pain but it’s just still there. I have noticed progress though, during and after my senior year I could not even do a one legged squat. I would just collapse or have to use two feet to come back up. After 2 months of rehab I am able to do one legged squats now pain free. I’m just wondering why I have that pain after. Is it bad? whats your take on it. They also have had me doing rehab every day. Should I be doing it every other day? I would really love to play ball again but I’m taking rehab serious and I want to do it right. Any advice?

  32. Harishaan Suthan says

    Hi Martin. I was wondering if I still need to do ankle mobility, hip, stretching, and massaging exercises once my rehab is completed. Can I stop them when I am training normally with a healthy tendon, or will the biomechancial issues return? Thank you

  33. Wouter says

    Hi Martin,

    First of all, great and informative website! I just found it today and have immediately built my own slant board.

    I like to run a lot, but For the second time in my life, I’m suffering from a runner’s knee. Fysiotherapist and running coach have already seen something about the way I run. I tend to not keep my hips leveled, which somehow causes my knees to fall inside. I currently try to correct this by thrusting my knees more forward, and by keeping my hips leveled. Hopefully this is my biomechanical ‘mistake’ :-)

    However, what to do next? At the moment, I can run between 7-10 km, and then the pain in my left knee slowly begins. When doing your exercises with a slant board, there is (almost) no pain, only a tiny bit because I ran a bit today.

    Would you recommend to stop running at the moment, and only do exercises? It is so hard for me to know when I can start running again because apart from during and straight after a run, there is no pain.

    Best regards,
    Wouter

  34. Jeff Vincent says

    Hey Martin!

    I was diagnosed with P.T. after a thru hike of the Appalachian Trail. I’ve had it for over a year. My problem…I can’t stop hiking! I’m hoping to take your advice and get the rest I need this winter and take the proper steps to get rid of this once and for all.

  35. Sam says

    Hey Martin,

    Just purchased your book – excited to dive deeper.

    Question – I just started having minor pain (2 or 3 on scale of 10) after practicing dunking a basketball for 20 minutes earlier this week. Does this still warrant not playing for ~2 months to do rehab exercises/stretching?

    I’ve been playing 2x/week recreationally for about 4 months now and it makes me sad to think about stopping but am willing to do what I need to in order to play for the next 20-40 years.

    Best,

    • Martin Koban says

      Hey Sam,

      Limit yourself to two training sessions per week (either dunking or playing). Should your knee regress, you know it’s still too much unfortunately.

  36. Connor McCloskey says

    Hello Mr. Koban I have recently purchased your book and was looking for more info on tendon stage diagnoses.

    I injured my tendon a year ago and after 6 months of exercises including eccentric squats the pain went away.

    Now recently the pain has come back over night and was wondering if I should be starting eccentric squats immediately again or if I am back in the acute phase where I need rest?

    I didn’t stress the tendon all that much, only thing I did was stationary biking which must have aggravated it.

    Thanks, awesome book btw.

  37. Damyan says

    Thank you for all the feedback and facts you have provided for everyone! I have been battling recurring and chronic tendinitis for the last couple of years in sports. I am once again taking time off to gradually strengthen my patellar tendon and improve the biomechanics that are preventing a 100% recovery. I believe one of the problems that should be emphasized is to not return to sports so abruptly. It should be a gradual return to high-intensity activities in order to prevent an acute shock to the tendon! And of course, alignment problems and hidden biomechanics are very hard to address. Do you have any recommendations for improving alignment for athletes who do a lot of jumping? Thank you!

  38. jack gayle says

    Some of your exercises seem like it would help my problem, which is right in the middle of the knee, one knee worst than the other. Your Patellar tendonitis diagram although, looks to be lower than my problem?

  39. Christoph says

    Hey Martin,

    I bought your book 2 years ago and wanted to share my story here:

    I tried expensive therapies at one of the best doctors in my area, who is specialized on soccer players. However only after starting your program I felt that my tendon started to heal and I had less pain. Before I started with your program, I couldn’t even walk stairs without pain in my tendon.

    Doing your stretches and strengthening program made me feel relief already after 2 weeks. But it was still a long way to go.

    So when I did your program for a long time, I felt like its much much better and almost healed, so I started to run on grass (soft ground is always better in the beginning).

    The running which I did in combination with all your excersises made me heal up to the point that I am now able to play my favorite sports again!

    I just wanted to say thank you for your outstanding work, which no doctor here in Germany has and no one understands the problem of healing the patella tendon as you do. Your work is based on outstanding research!!!

    Thank your very much Martin!
    Best regards,
    Christoph

    • Martin Koban says

      That is fantastic Christoph.

      Congratulations and great work!

      Thank you for sharing your story.

  40. Jon Hjartar says

    Hi Martin,

    I’ve had PT pains and symptoms on and off for many many many years while playing b-ball and various other sport and undergone 3 surgeries with mixed result. Must say that your book has been very helpful in trying to reach pain free but I’ve had a setback recently, probably pushing myself too hard – and trying football again.

    I’ve found that a sudden change in load activities are more likely to cause symptoms. I’m in excellent shape but I usually don’t do a lot of running – usually in some form of 450/900m sprints. I’m doing the whole Crossfit thing now and eased into it and for a while was feeling like the knee was holding up, despite training a lot.

    But suddenly going to fooball or suddenly doing 5K run or suddenly do some different semi-extreme exercise with heavy knee load without first slowly building knee strength for that particular movement seem to the main trigger for me.

    Being able to do heavy squat or lots of high box jumps or lots of double unders does not allow you do suddenly do football or b-ball if you are prone to PT – not at my age anyway (40)

    Anyway, while rebuilding i’m trying to figure out which exercises to do and which to avoid + resting more. I’m probably chronic but very actively trying to remedy the situation with rolling, stretching, eccentrics etc.

    Do you have an opinion if exercises such as “power clean/snatch” would be “bad” for PT? This involves bending the knees a little bit and a bit of kinetic energy involved but not in the same region as jumping or squatting? And the rowing and cycling – are these to avoid in the first 2 months?

  41. Darren Farrar says

    Hi Martin,

    I love the book Beating Patella Tedonitis, best purchase of my year so far,

    I was diagnosed with patella tendonitis after 8 months of achy awkward pain at the insertion of the patella tendon at the knee cap. One day I’d been kneeling all day at work and the pain was so sharp I could not kneel down again.. and have been scared to since.
    After being diagnosed I was asked to attend ultrasound with some steroid injections – basically the clinician did the ultra sound and I had a 3-4mm void on the medial side of the left leg patella tendon at the join with the knee cap. I am now very concerned, having stopped training and doing your exercises (I brought your book after the diagnosis so I have treated it as tendontis) but seeing the black gap on the ultrasound has scared me off.. even though the decline eccentric squats had been making me knee feel the best it has felt in months.
    I really need some guidance, the clinician has offered me physio and referral to an orthopedic surgeon – something I really don’t want to do, the idea of surgery and 3-6 months in a cast, with 6-12 months of rehab is not what I want as a footballer to a good standard and I snowboard! I’d love to do both these sports again one day, but at present I feel a bit lost! Please help!

  42. Alex says

    Dear Martin,

    Thanks very much for all this information it has helped me tremendously in reducing the pain I have from patellar tendonitis. I have quick question though in reference to decline board squats.

    When you squat down where are putting your weight? Are you supposed to put it through your heal (taking direct stress of the knee) or consciously put it through the effected knee. I have seen improvements using a mixture of these but I was curious on your take on it.

  43. Lisa says

    Hallo,

    Ich schreibe meine Frage auf Deutsch, da ich mir mit den medizinischen Begriffen etwas schwer tue. Ich habe mir mit 17 mal das Bein verdreht und hatte seither dumpfe Knieschmerzen, vor allem beim Sitzen.

    Da man bei mir auf den MRT und Röntgenbildern nie etwas gesehen hat, und die Physiotherapie nicht wirklich geholfen hat, bin ich letztes Jahr im Februar Arthroskopiert worden (da war ich 27). Bei dieser OP hat man mir ein Plicasyndom diagnostiziert worden, dass auch gleich behoben wurde.

    Gleich am nächsten Tag kam die Physiotherapeutin und machte mit mir Übungen (Bein heben, Stufen steigen mit Krücken) wobei ich furchtbare Schmerzen hatte, was die Dame aber nicht wirklich interessiert hat. Weiters hatte ich einen riesen internen Bluterguss (ich glaub, meine Schmerzen kamen damals von dem großen Druck des angesammelten Blutes auf mein Knie und die Nerven).

    Die Heilung des Knies hat sehr lange gedauert und ich brauchte ca. 4 Wochen lang Krücken (die letzten Zwei zumindest nur noch eine). Einen Monat später konnte ich zumindest wieder normal gehen, jedoch hatte ich seitdem große Schmerzen, beim in die Knie gehen, auf dem Boden knien und beim Stufen-runter-steigen.

    Das ganze ist jetzt ein Jahr her und mittlerweile wurde mir bei einer weiteren Untersuchung das Patellaspitzensyndrom diagnostiziert. Die Schmerzen sind etwas besser geworden, aber beeinträchtigen mich immer noch im Alltag. Ihre Übungen sind super und haben mir schon einiges an Schmerz genommen, obwohl ich sie erst 3 Wochen mache.

    Meine Fragen wären folgende: Wie kann man von einer OP dieses Syndom bekommen (ich habe immer nur gelesen, dass das vom Sport kommt). Außerdem hilft mir das Dehnen zwar sehr, jedoch fühlt sich mein Knie seit ich damit angefangen habe etwas instabil an (manchmal knickt das Knie nach hinten ein und schmerzt sehr). Ist das Knie vielleicht zu gedehnt? Oder sollte ich einfach viel mehr Kraftübungen machen?

    • Martin Koban says

      Hallo Lisa,

      Diese Physiotherapie klingt ja wirklich schrecklich. Es tut mir sehr leid, dass Sie da durch mussten!

      Patellar Tendonitis kann man nicht nur vom Sport kriegen, sondern auch von Medikamenten wie zum Beispiel bestimmten Antibiotika (Cipro, Levaquine). Im Rahmen der postoperativen Medikamentierung kann es auch zur Beeinflussung der Bindegewebsheilung kommen, im Rahmen welcher sich eine Tendonitis wesentlich schneller entwickelt. Nicht zuletzt kann bei einer Op auch die Sehne selbst beschädigt werden, was dann eine Schwächung zur Folge hat. Kurzum, es gibt sehr viele Möglichkeiten, Tendonitis zu kriegen. Sport ist nur der offensichtlichste Faktor, aber meistens gibt es noch verschiedene andere Ursachen.

      Wenn Ihr Knie durch eine Dehnung des Quadrizeps instabil wird, sollten Sie diese Dehnung vorerst nicht machen. Stattdessen können Sie die reguläre Hüftbeugerdehnung machen (“Hip Flexor Stretch”). Ein Überdehnen des Knies geht oft mit verkürzten Hüftbeugern einher (“tight hip flexors”), weswegen eine Dehnung der Hüftbeuger und eine Stärkung der Hüftstrecker (“Gluteal Muscles”) hier helfen kann.

      Davon abgesehen ist es sehr wichtig, möglichst immer im schmerzfreien Bereich zu arbeiten. Lieber eine etwas langsamere Progression als Übereifer und zurückkommende Schmerzen.

      Viele Grüße und von ganzem Herzen gute Besserung!

      – Martin

      • Lisa says

        Vielen Dank für die rasche Antwort!
        Ich finde das so toll, dass Sie sich so viel Mühe machen! Ich werde Ihre Ratschläge befolgen und von meinen Erfolgen berichten. Seit meinem ersten Eintrag hat sich der Schmerz noch weiter verbessert :)
        Liebe Grüße,
        Lisa

  44. Jason Nwachukwu says

    Hi Martin,
    I have had PT for 18 months now and I have literally tried everything. I am a semi-professional footballer and all I want to do is become a professional and fulfill my dream. I have done all the eccentric squats, stretches and self-massaging and nothing seems to give me a breakthrough. Even after doing all this for nearly two years, the tendon is still tender even when I touch it. Please Martin can you give me some advice to help me get rid of this once and for all so I can work towards my dream.
    Thanks
    Jason

  45. Jason Nwachukwu says

    I have had PT for 18 months now and I have literally tried everything. I am a semi-professional footballer and all I want to do is become a professional and fulfill my dream. I have done all the eccentric squats, stretches and self-massaging and nothing seems to give me a breakthrough. Even after doing all this for nearly two years, the tendon is still tender even when I touch it. Please Martin can you give me some advice to help me get rid of this once and for all so I can work towards my dream.
    Thanks
    Jason

  46. Marlou says

    Hi Martin!
    I am struggling with patellar tendonitis for 3 months now. Pain is not a problem anymore, but it returns when I do something wrong. The one thing that puzzles me is that I feel pain above my kneecap occasionally. I never feel the pain below and above my kneecap at the same time though. Could the pain shift a bit or do I have quad tendonitis as well? Could it be something like chondromalacia patella ?If so what can I do about it?
    Thanks for the great website! Your advice did miracles already!
    Marlou

  47. Tara Winston says

    I’d like to order your book, please.

    As a 55 yo veteran of 3 hip surgeries per hip, I have biomechanical Patellar tendonitis in both knees, particularly my R knee – which is my weaker hip. After two rounds of PT, working with a personal trainer, swimming, etc. , I recognize many of your precepts and hope to read a slow & steady detailed knee plan.

    My hips actually are much better finally, but 2 years post op chronic serious knee pain had left me hopeless, mostly bedridden, and now using a cane to take one step. Thanks for a great website and sending me ordering info on your book.

    Sincerely,
    Tara

    • Martin Koban says

      Dear Tara,

      I can’t imagine what it must have been like for you to go through all this. I don’t think anyone can truly relate to how tough these injuries are unless they’ve been through something similar.

      You can find the book on Amazon: http://www.amazon.com/Beating-Patellar-Tendonitis-Treatment-Pain-free/dp/1491049731 – if you’re in Canada, the UK, or other countries, just go to their local Amazon page and search for “Beating Patellar Tendonitis” and it will come right up.

      In the meantime, be sure to sign up to my advanced course on tendonitis: http://www.fix-knee-pain.com/blog/tendonitis/ … You can get in touch with me directly by replying to the course emails you will receive and I share new insights first through email.

      I hope you get better soon.

      Best,

      Martin

  48. Steven says

    Hi Martin

    I have a question. When no pain is experienced anymore, it isn’t necessarily a sign that your jumper’s knee is healing, right? Now I was wondering, what are signs of a healing jumper’s knee and how do I recognize them?

    Thank you in advance for answering my question!

    Best regards,
    Steven

    • Martin Koban says

      Hey Steven,

      You need to expose your knee to increasing demands very slowly. The rehab should fluidly transition back into sports. If you don’t do sports, continue doing eccentric exercises until the knee is strong enough (up to 3 sets of 15 single-leg squats).

      The only way to know your knee has healed is if you can do the sport you want to do without pain and they only way to get there is to transition back slowly, with enough rest days and a slow increase in intensity.

  49. Jacek Kaczmarek says

    Hi Martin!
    Is skipping good excersise to strenghten all leg muscles?
    Jumper knee is caused because of jumping too much but jumping in right repetition can strengten pattelar tendononisi.
    And when to start one-leg squat? When i am able to do 5×15 double leg squat without any pain?
    I really apprichiate your job

    • Martin Koban says

      Hey Jacek,

      If you’re talking about rope skipping, it’s a good plyometric exercise, but I wouldn’t recommend it if you have patellar tendonitis.

      You transition to one-legged squats by placing more weight on one leg when doing two-legged squats. You can decide how much weight to place on your leg based on how much the patellar tendon can take.

      • Jacek Kaczmarek says

        Thanks for fast reply.
        Martin I remember about streching and rolling legs but i also would like to have strong quad muscles like Ronaldo. Could you recomend me some strenghting excersises on legs muscles(i have acess to gym).
        I am doing bridge excersieses and squats but i thing it is too little. I also work on calf on the gym.
        Or do i dont need extra excersises to have super strong leg muscles to cure this injury?

        • Steven says

          Hi Jacek,

          I can tell you that building leg muscles will not solve the jumpers knee problem! To build strong quad muscles, you have to expose your knee to a lot of stress which will only worsen your knee. I have been weightlifting for three years and the jumpers knee I got from playing basketball still bothers me. I have build a lot of leg muscle and power, but it has not cured the knee at all.

          You will have to follow Martin’s book for at least 3 months and you will have to forget about building quad muscles during the rehabilitation period. It is possible to build glute and hamstring muscles during the rehab period though! If these muscles are lagging, then its even a must to strengthen and grow them. Your quad muscles might be way too strong compared with the muscles on the back of your legs. This was the case when I played basketball and probably was one of the causes I got my jumpers knee.

          Good luck with the rehab!

          • Jacek Kaczmarek says

            Ok so doing martins Koban program-working on hidden causes and doing right portion on knee and after 3 motnth it will be ok yes?
            And doing right amount of knee stress you mean doing ecstrentic squat? And what about physical education? If it pain no, and if it doesn’t pain i can go to PE?

    • Martin Koban says

      That depends on your physical condition Patrick.

      The two-legged exercises should be rather easy, but once you progress to single-leg variations, it’s normal to feel some exhaustion.

      Which exercise do you find most tiring?

      • Jacek says

        For me bridge excersise is the most hard and excersises on hips, eleveting leg e.g. Bigger problem for me is a pain than being exhausted. Is it okay if i fell a little pain during excentric squat?

        • Rich says

          If there’s pain, you should stop or reduce excerise intensity. Pain usually is a signal that your body is taking more than it can handle.

  50. Connor McCloskey says

    Is biking bad for chronic tendonitis?

    I am currently going through your book and creating an exercise routine but was wondering if I should eliminate biking while I recover.

    I can’t really tell if it’s making it worse as my knees hurt all the time anyways whether I bike or not.

    Thanks.

    • Martin Koban says

      Biking is not bad per se, but it can feed into the muscular imbalances that contribute to patellar tendon overload (tight quads and hips) because there’s a lot hip flexion when biking.

  51. Kevin says

    Hi Martin!
    I am working on hidden causes since 01.01.2016 and since one 6 weeks i am working on my hidden causes on the gym very hard. I am working on low ankle dorsliflexion(rolling calf and massage, your recomended excersise and streching) and i am improving my gluteal muscle strenght and i am improving bad leg alignment. And you now what?
    I think my legs are good and i do not overuse my knee because of these reasons.
    You said that our body is like a car and if tire is broken because of bad alignment new tire would be also destroy. So my quetstions:
    1. I know that if i improve my hidden causes doesn’t mean that i can stop working on them, but can my knee improve by itself? My knee won’t be overuse so why not?
    2, If i have repaired hidden causes it is the best time to do squat, because patellar tendon wont’t imprve by itself?
    And the last 2 question
    If i would be able to do 5×15 one leg deep squat, i can go slowly back to sport. And if i can still do 5×15 squat and doing sport it means that everything is okay, and if not then injury is slowly comming back :(. Is it good idea to chceck our knee condition?
    And on your viedos you don’t do very deep squat but only to 90 degrees.
    Why? Are deep squat bad for knees? or if i start doing squats i should start with NOT deep squat and then try with deep?

    • Martin Koban says

      Kevin, the crucial point when practicing the squats is always to do them so they lessen pain from week to week. So reaching the ultimate goal of 3 sets of 15 single-leg squats is only useful if you can do them pain-free.

      You need to increase the difficulty of the type of eccentric squat you do slowly as you approach this. Start at whatever variation you can do now without an increase in pain longer than 24 hours. This may be two-legged squats to parallel. Work from there as I explained in the other comment.

  52. Kevin says

    Hi Martin!
    I am working on hidden causes as of 01.01.2016. Since 6 weeks i am working on the gym, earlier at home. So i am strenghtening my gluteal muslce (The Glute Bridge with extra weight 15kg on one leg, Hip Abductions and Clamshells with band, Deadlift on one leg) , i am working on my ankle mobility(rolling calf, your recomended excersise with drawer, and streching calf). I also take care of my legs alignment and i think they are alright. Generally i think that i improved all these 3 hidden causes and i don’t overuse my knee because of them. But i am not able to do one leg squat yet :(. But me knee won’t improve only because it is not overuse,yes? . I have to strenghten pattelar tendonisis to go back to football. I am correct thinking?
    And about squats. Why don’t you recomend to do deep squats, only to 90 degrees. It depends of knee condition? And e.g if i am able to do 3×15 onle leg single squat it means my pattelar tendonisis is strong, and if i return to sport and i overuse my knee because of too much stress i won’t be able to do one leg squats? It is good idea to recognize pattelar tendonisis condition?

    • Martin Koban says

      Hey Kevin,

      The important difference between the hip exercises and stretches in comparison to the eccentric exercises is that the hip drills and stretches take stress off the knee to prevent further overuse, but to strengthen the tendon, you need the eccentrics. So the stretches and hip drills do not strengthen the knee directly.

      For the eccentric squats, you need to start with the variation you can do safely and without an increase in pain. For some people that will be single-leg squats already, others will have to start with the two-legged version and build up from there as the tendon grows stronger.

      Finally, if you can do full ROM squats, by all means, do them. I demonstrate squats to parallel only because it’s the safer approach in the beginning.

      Thanks for dropping by. Let me know if this answers your questions.

      – Martin

      • Kevin says

        Thanks for answer. I think now i know a lot about squats, but i still have questions about knee rehab at all. I have break for almost 5 months and i am a bit upset because of my knee. I just wanna know if i am right thinking about injury and my body so:
        Why do i have this injury?
        Because of hidden causes, or i just done too much training and after time some part of my body has to give up?
        If i improve hidden causes my knee won’t be overuse again because of e.g low gluteal strenght but it doesn’t mean that injury won’t come back. It will come back if i do too much, but not because of hidden causes. So before injury:
        Problems were hidden causes and doing too much stress.
        After rehab problems that can appear:
        Doing too much stress

        And Martin i am reading all your email very carefuly and you are writing about different hidden causes but i may not have most of them, my injury can be caused only because of low gluteal strenght or maybe not, but if i work on every part of the body i will be more certain that i have good leg alignment.

        And if my muscles aren’t overuse, and i can roll them without pain, it means that my knee can’t be overuse (IF I DON’T OVERUSE MY KNEE BECAUSE OF HIDDEN CAUSES).

        Thanks for patient and help
        Kevin

  53. Gavin says

    Hello!

    I am 20 years old, and a sophomore in college. Soccer is my game, and I play whenever I get the chance. I have been experiencing patellar tendinitis since freshman year of high school. I was told it was a growing problem and went to PT for about 6 months. At the end my knee felt great and I was cleared. My legs were stronger than ever. I was playing soccer again! This relief of pain didn’t last long though, it came back. I decided to just touch it out and play through it. I was expecting to just grow out of it, but this was not the case. It has been over 5 years and I still suffer from the same pain. In these 5 years I have gone through countless cheap braces and used plenty of tape. Today I decided to do some research and find a better brace that will last. While watching a review on Youtube I came across your channel. I want to get to 100% more than anything. This program sounds like the answers to my prayers. Thanks for putting in all the time to put this out to us.

    Before I start I want to know if wearing a brace, while properly rehabbing, would be at all beneficial. If so, when should I wear the brace?

    • Martin Koban says

      Hey Gavin,

      I’m happy to hear that my videos have brought you hope to get back to 100%. That’s great!

      You can wear the brace if you feel like it helps you in any way, but unless you need it to keep your knee stable (like after ligament tears, surgery, or meniscus tears) I don’t see any reason why it should be necessary.

  54. Gaetan Lion says

    Martin, I have bought and read your book “Beating Patellar Tendonitis.” from Amazon.com. I do find it somewhat overwhelming. There must be the equivalent of 30 different stretches. And, it would seem one would need over an hour a day at least to maintain one of your recommended therapies. Also, the name of the exercises are not so intuitive. One needs to refer back to where the exercise was shown tens of pages earlier.

    In order to synthesize your knowledge of the subject in a streamlined and more visual format, I have attempted to download your 20 page pdf file at this website twice. And, I have not succeeded. Now, when I try to do it by submitting my email address, I get an answer that “You are already subscribed.” But, the pdf file download still gets blocked at the 50% level. Can you facilitate my getting this 20 page pdf file?

    Thanks in advance.

    Gaetan Lion

  55. Austin says

    Hi Martin,
    About a year and a half ago, I injured my knee playing indoor soccer (lateral MCL injury). I was going to a physio for rehabilitation for months, and while the MCL was feeling stronger, I kept insisting that most of my pain was at the front of my knee. They ignored me and kept focusing on treating the MCL so I switched physio’s. I was blown away with there disregard towards what I was telling them. I tried another physio, and still focused on the MCL…. Eventually, a hard bump (bone spur like) began forming at the base of my knee cap and knots in patella tendon were easily felt. Have you ever heard of these bone spurs forming and are there ways to reduce their size? I think it is the cause my tendon knotting and pain as the tendon no longer has a smooth surface to ride along? You’re program looks promising and want to start soon, I’m just looking for ideas to fix the bone spur issue first.
    Thanks!

  56. George says

    Hi Martin,

    Thanks a lot for all the info and methods to cure PT. My doctor says that I should try Prolotherapy followed by minor strengthening and stretch exercices to cure my jumpers knee . I was wondering what your thoughts are about prolotherapy ? Do you know if it works ? Why didn’t you do it to cure your knee ?

    Thanks a lot !
    George

  57. Heike says

    Hi Martin,

    I’m not sure if I remember correctly, but in your book “Beating Patellar Tendinitis” you said not to do any other exercises then the ones you showed in your book. But it’s also very important to keep the cardiovascular system fit anyhow I think. Have you got any advices for us all which kind of movement is possible during rehab as long as it does not stress the tendon or at least not that much? How about “sitting or lying on the ground workouts” as alternative? Or gentle movements in water (not necessarily swimming)? And is it in your opinion useful to go to a yoga course while I use your exercises as well?

  58. Jacek says

    Hi Martin!
    I have problem with working on low ankle mobility. To improve ankle mobility i strech calf, rool calf, do dorsliflexion drill and samurai sit.
    If samurai sit is hard for me it means that ankle could cause me knee pain?
    And i want to do excersise where i move forward my knee to e.g wall(i hope you know what i mean- your recomended excersise on ankle- http://www.fix-knee-pain.com/jumpers-knee-treatment-triangle/- (HOW TO IMPROVE ANKLE MOBILITY)
    but me knee hurts and pain is becoming stronger when i do it?
    Should i lose it excersise and focus on others?

  59. Jacek says

    Hi Martin!
    I am afraid about one think. I actually stopped playing football for 2 months in my club. I do only sport that doesn’t hurt me knee and i do rehab. And i don’t know when to come back to sport. Now i feel better than 2 months ago.
    My small aim now is to do one leg ecscentric squat. If i am able to do them next step would be running a little then more and more running and then come back to football?
    I am 17 years old and i don;t know why God hurts me like that but i know its challenge that i have to deal with. And you said rehab should take 3 months. 3 months is time to improve all hidden causes if i had and to strenghten my pattelar tendon and be able to do 5×15 one leg squat?

  60. Jeffrey Vincent says

    Hi Martin! I was diagnosed with patellar tendonitis over a year and a half ago and have had severe pain ever since.

    In 2014 I thru-hiked the Appalachian Trail from Georgia to Maine. It took me just under 6 months to hike 2,185 miles. A few days after I was done hiking, the pain in my knees came with a fury.

    My doctor had done steroid injections that temporarily relieved the pain. After the first failed attempt I didn’t want anymore of that stuff injected into my knees.

    Just over 3 months ago I found you. I’ve been doing the best I can with keeping up with my routine but I am still having a lot of pain in my knees.

    I’ve rested, but not over rested. I’m a hiking guide in the mountains of upstate New York, but when I hike I try not to push it or over due it. Some days hurt worse than others still.

    My doctor suggest I get lubrication injections in my knees next. What do you think about that? Also, do you feel the same way about KT tape as you do patellar straps?

    It’s been a long year and a half, and I NEED to get over this patellar tendonitis in orer to get on with my life.

    Thanks for all that you do and I’m looking forward to a response to my comment.

  61. Dorian says

    Martin,

    I have been suffering from Patella Tendonosis for 5 years. Have had 2 surgeries (including Patella Tendon Repair, very large bone spur removed behind patella tendon), 3 PRP shots, 2 sets of Synvisc shots, 500+ hours of PT, thousands of hours of PT exercises on my own. I have tried practically everything I could find or think of and I’m still in a lot of pain.

    The activity that causes my pain is Driving, commuting in stop and go traffic. Have you dealt with folks who get the injury from driving and not from exercises? Does that make a difference? I would think biomechanic issues play a much smaller role because of that.

    Any guidance is appreciated here.

    Dorian

  62. Nick says

    Hi Martin,

    Your article is an extremely interesting read. I am a UK trained physiotherapist with musculo-skeletal experience in an outpatients setting. I find the concept of ‘Jumpers knee’ interesting as I, as well as many of my patient’s have suffered from the injury. Currently I am still experiencing knee pain after 24 months and I just wanted to ask a few questions that I hope you don’t mind;

    Firstly – in one of your YouTube videos you talk about how research supports that tightness throughout the calf limiting dorsiflexion has a statistically significant impact on patella pain (I am really impressed with your breadth of research used and named in your article btw!). “Jumpers knee” typically refers to overload of the patella tendon. However thinking of this concept and the fact I play squash I cannot see the direct relevance to me. When playing squash I find my knee is most painful when lunging forward deep into the front corners – causing an overload on the patella tendon from the eccentric quads contraction. I understand the lack of dorsiflexion will cause the patella tendon to take more load but in this movement I will rarely translate my tibia forwards enough to significantly dorsiflex – I would like to know your thoughts on this and whether you believe calf tightness is still relevant to my situation.

    In regards to rehab in general – I have never fully practiced what I preach, and I have returned to sport often prematurely. I am currently spending daily sessions trying to loosen quads, glutes and hip flexors as well as strengthening generally through glutes and core. Specifically I am attempting decline squats and have made my own slant board – I was hoping you might be able to clarify the angle needed for the board. The only research I have found has talked about a 25-degree decline. Would you agree?

    Lastly, thinking about the biomechanics and movements involved with the game of squash – can you possibly recommend any further rehab you feel may be specific and helpful for my situation, given the sport rarely emits loading through ‘jumping’ but instead, lunging.

    Your thoughts would be greatly appreciated and I would like to say how much I enjoyed your article and how useful this will be in my daily clinical practice when working with aggressive or chronic forms of the injury.

    Regards,

    Nick

  63. Steven says

    Hi Martin,

    I am a few weeks into your recovery program. I notice slight discomfort in the single leg negative squats, but absolutely no more than pain level 3. However, i feel some more pain when pushing on the patellar with my fingers as I relax my quads. Is that normal? Should I ignore that pain and only focus on pain levels during the squats and 24 hours after the squats?

    Thanks once again,

    Steven

  64. Nawaf says

    Hello,

    i had patellar tendonitis 7 months ago for the first time. I rested it and then got it back again and it has been haunting me for the past 2 months.

    I got it while playing football and basketball. My question is, can i swim ?

    and what are other “OK” workouts or sports i can do ?

    Regards,

  65. Hosting says

    In jumper’s knee, the patellar tendon is damaged. Since this tendon is crucial to straightening the knee, damage to it causes the patella to lose any support or anchoring. This causes pain and weakness in the knee, and leads to difficulty in straightening the leg.

  66. Kris says

    Great book, I bought it after reading the fabulous reviews on amazon. I have been suffering with this condition for over two years now. I have a few quick questions. I read the book and don’t recall anything specific about MRIs in their effectiveness in diagnosing patellar tendonosis. I have had two MRIs done, the most recent one about a month ago and it showed only minor edema of the knee. I was wondering if you could comment on what exactly would show up on an MRI for a knee that has patellar tendonosis.

    My second question is whenever I am doing eccentric exercise is it ok to feel a little discomfort at max 3/10? I came across a peer review study that mentioned to do up to 90 reps a day for 6 weeks, this seems like a little much and I believe your book mentioned 48 hours in between for the collagen growth.

    My last question is whether you have heard any testimonials from anyone who has had pain primary over the tibial tubercle, that is where the majority of my pain stems from. Oddly enough there was alot of “signal” there from the MRI but I guess the radiologist did not believe it was enough to be degenerative.

    Thanks for reading hoping to hear back soon.

  67. Nikhil Khanduja says

    Hi Martin,

    This is Nikhil from India. I am an amateur athalete. I suspect that I am having stage 3 patellar tendonitis.Let me tell you my symptoms first.

    I am having pain in my left knee for more than an year. The pain is always in the front part of the knee below knee cap. It also increases a lot during the night and wanes off in the day. Also the pain recoccours sharlpy as soon as I start playing sports. I have got it checked with an orthopedic doctor who has done a Xray and a MRI. He suspected no such problem and gave me some supplements and suggested exercises to strengthen my quadriceps. Obviously those haven’t done much help.

    So for the last few weeks, I have been searching on the net, through which I stumbled upon your website. Can you kindly tell me if these symptoms are of patellar tendonitis. If yes kindly provide me with an exercise routine so that I can improve my patellar tendon. Also is it wise to start swimming and upper body gym workout or wait till the exercise routine is over and patellar tendon has completely healed.

    P.S.: I have also ordered your book. I hope the book arrives soon so I can get a better insight into this.

  68. Niall says

    Hi,

    I have just started working through this and I am already seeing a difference. I can now walk up and down stairs pain free which is great. My only issue is when I sit down for a long time (like the cinema or a flight) that’s when the pain gets quite bad. Would you have any recommendations for before or during a long period of sitting to prevent or help that pain.

    Thanks very much
    Niall

  69. Sean says

    Hey Martin,
    I am 19 but I have been dealing with knee pain since I was around 16. I’ve done plenty of physical therapy since being told I had patellar tendinitis. Regardless of that every time I finished PT and returned to basketball within a week I was back to pain so I wanted to know if there was any extra advice you could give me before and while I am doing this pain relief program. Also if you could give me some insight as too if the pain will come back after I’ve committed to it for the 3 months without any other exercise programs.

  70. Damian says

    Hi Martin,

    I have problem with PT for 2 years. I tried to do something with this (massages, kinesiotaping, solcoseryl, mobillity and stretch) but this was for nothing cause i did big mistake = no rest.. I bought your book and i do this exercises everyday for 3 weeks. I have problem with my PT because i still feel pain and feel stiffness on tendons when i wake up. Can u tell me is it normal feeling in treatment patellar tenonitis?? I think it’s normal because the ligament grows? Second question is why in this training program we start at foam rolling, we shouldnt do this after training to remove the load on muscles? I also study as Strenght and Condition Trainer so that’s why i ask. I hope u will read this and answer me on question. Thank you for your book and this site, u doing great job!

    Best wishes,
    Damian.

  71. Dusan says

    Hello.

    I started your routine of healing my pattelar tendonitis. I have one question though. Is it helpfull if I tape my pattela (knee) with kineziology tape, or would it just be uselless?
    Also bough the book on amazon, great stuff, thank you.

    Best regards

  72. Sal says

    Martin,
    I have been hardcore active my whole life. I played Basketball, Soccer, Football and track growing up. I spent every waking moment of free time, as a kid, on a basketball court or running distance in the desert. Never had any knee problems or pain what so ever. After high school I joined the U.S. Army as a Paratrooper. This is an extremely physically demanding job. Carrying heavy weight on my back for months on end and jumping out of airplanes. When paratroopers hit the ground they hit hard. Still, I never had any knee pain what so ever. After the Army I went back to college to double major in engineering degrees. I was sitting for 8 to 13 hours a day to study. I had never done this much sitting before. I would usually jump back into exercising when the semester ended. Well, in 2014 when I tried to jump back into running I got patellar tendonitis. I didn’t know what the hell it was. After a few days of running on it I realized it wasn’t going away. I stumbled onto your book online somehow and bought it. I have been studying it religiously and and practicing everything to an insane degree. I am 110% sure I am doing the exercises right. I have looked up other info and read countless other books this type of thing and yours is the most clear cut program specifically for patellar tendonitis. I have identified a lot of muscle imbalances in my legs. They were horribly imbalanced.

    My problem is I cant get past phase 1. When I get to about 4×15 of the eccentric squats it hurts 24 hours later and it is re-injured. I usually add 5 reps every other day and I have to start over . I also have no idea how many 1 leg squats I should start doing to transition. I was thinking maybe start at 3 and add 1 every other day. I just started doing amosov squats (30 reps) and that caused a re-injury. One thing that has helped a lot was ditching the stick for the eccentric squats. I bought a pull up wrack with ropes to completely lift myself up out of the squat position. I thought I would now have this thing beat and be able to cruise through the program. Well, here I am stuck again… I feel extremely demoralized and I feel like I have played with this thing long enough to where it should have worked. I know this program can work b/c I feel the results. If you have any ideas hit me up.

    Thanks for righting this book. It has changed my life and I will be doing those exercises until the day I die.

    -Sal

  73. Scedrick says

    Hey Mark,
    My name is Scedrick and I play basketball for my school team and I’m the best player and I’m afraid to take to much time off for rest my doctor told me to rest for 2 weeks and then they are going to give me an MRI and physical therapy what should I do?!??!

  74. David says

    Hi Martin,

    Thanks for all your research and advice- it looks promising!

    I’ve had patellar tendinitis for 8-9 years. I’ve sporadically gone to physical therapy, but nothing has really helped. I assumed I was past the point of healing. I didn’t want to stop being active, so I just managed the pain and kept playing.

    What do you think? Can I repair my tendons using your program at this point? If so, how long would you recommend setting aside for rehab?

  75. Dan Nash says

    Hi Martin, I am a professional high altitude climber and have been suffering from patellar tendonitis for about 4 months. I quit my regular exercise program which consisted of cycling, plyometric exercises, hill running and carrying a weighted backpack up hills. I tried rehab and even tried palette replacement therapy and nothing has really helped. I am going to start trying your program from the beginning, but must admit am very frustrated. I have been an athlete my entire life and have already missed to big climbing trips to Tibet and Peru. Very frustrating….any advise would be appreciated at this point.

    Dan

  76. Tunde benson says

    I am a 38yrs old man suffering from chronic Patella Tendonitis and i have been for a few years now. I am still very actively playing football (soccer) through excruciating pain, but i do this because it is the only exercise i get through out the week, as running on proves to painful on a daily bases.

    I would love to fully recover with your help, so please HELP ME!!!!!

    Regards,
    Tunde Benson

  77. John Wood says

    Martin,

    I was looking at buying your book, but I want to see if there’s anything that would not be applicable or would change in my case. I developed my knee pain not from chronic use, but from an acute injury from squatting. I had never had knee pain before, but it was extremely painful after that. Is it possible to have jumper’s knee from an injury rather than from overuse and degeneration, or was I looking at a partial tear most likely?

    Either way, I trained on it on and off for the last year and a half. I went to physical therapy but had to come back for the end of the season, and now I’m about back where I started; in a lot of pain. It got to the point where it was almost pain free before coming back. Would this indicate that it was tendonitis and not a partial tear, and I could do this program as prescribed?

  78. Bob says

    Hi Martin,

    I have had PT for just over 4 weeks. At least that is when I started to feel pain after recently starting walking exercises each morning working up to 6 miles per day.

    Slant board squatting at home really helps but here is my problem. I travel every week on business. Walking through airports, through hotels and to meetings inevitably aggravates the PT.

    Can you please recommend “hotel room” exercises I can do while traveling? Bringing a slant board on travel just won’t work. I have been tempted to use the hotels health clubs and ease into an elliptical routine but fear that will just aggravate the PT.

  79. Emmanuel says

    Hi Martin, I’m a semi-pro soccer player, and I’ve just come across your articles and videos. I’d like to start your program to help my injured tendon but I don’t see how many reps , sets or times a week I should work for. Please in don’t want to worsen my injuries by doing too much Thanks.

  80. Jimmy says

    Hei Martin, first let me introduce myself.

    My name is jimmy, i’ve had my jumpers knee since years ago from playing basketball, i keep playing through the pain untill a couple days ago, the pain is already so unbearae even for me to going up and down on a stair.

    I’ve been reading a lot on the internet about jumpers knee, even have an MRI on my left knee, after i consult to local doctor in my town, he just said that i have to live with this injury for the rest of my life. I got very devastated after hearing that i might not be able to play basketball anymore.

    But thankfully, i found your article, and i got excited because it means i can recover from this injury!

    I’ve been enrolling to local gym to strengthen muscle around my knee, and i have a question for you..

    Does leg press and leg extending machine good for my patella?

    Or i should stop the exercise and just practicing 1 leg eccentric squad on slant board?

  81. christine says

    Hi Martin !
    I had my ACL reconstructed using my patellar tendon last year Sept 2015, and broke my patella Oct 2015. Since healing of the patella fracture I’ve developed tendonitis. MRI confirms ‘severe proximal patellar tendonitis’. I’m very worried this has become a permanent problem. Do you know of similar situations where people have recovered from this ?

  82. christine says

    Hi Martin !
    I had my ACL reconstructed using my patellar tendon last year Sept 2015, and broke my patella Oct 2015. Since healing of the patella fracture I’ve developed tendonitis. MRI confirms ‘severe proximal patellar tendonitis’. I’m very worried this has become a permanent problem. Do you know of similar situations where people have recovered from this ?

    thanks
    Christine

  83. Andrew says

    Hi Martin and I have bought your book and it makes good reading but the link that relates to the negative affect of “Leg Extensions” cannot be accessed and I am hoping you can shed some light on why Leg Extensions and or Eccentric Leg Extension are so bad for me? Many thanks

    Andrew

    • Martin Koban says

      Hi Andrew,

      Leg extensions place stress on the ACL, because the exercise isolates the quads, so there’s no contraction of the hamstrings. That’s the biggest issue, but based on the experience of experts that used the exercise extensively to rehab patellar tendonitis, only 10% of people get pain from leg extensions (source: physioedge podcast with Dr. Peter Malliaras). Based on the anecdotal evidence I have through friends and family, I thought the number would be higher though. Start with low weights and work your way up. If you want to play it safe, do isometrics at a 60 degree knee angle.

      – Martin

  84. Jonathan says

    Hello Martin,

    I originally came to your website with patellar tendonitis and have basically healed my knees however I have a similar chronic ankle pain from the medial ankle ligaments on my right ankle. I was wondering if you knew any exercise I could do that would use the same philosophy as your knee pain program and the eccentric squat. I have had the ankle pain for about 3 years now, any help would be much appreciated.

    Thank you,
    Jonathan