Patellar tendinopathy treatment in Manchester
Settle the pain below your kneecap and build a tendon strong enough for jumping, running and heavy legs days.
Patellar tendinopathy physio in Manchester city centre
Reviewed by Nick Chatziviltsos, PgDip, HCPC-registered physiotherapist (PH114351), November 2026
At a glance
Who gets it: People who jump, sprint and change direction: basketball, volleyball, football, netball and HIIT classes. Most common between 15 and 30.
Main symptom: Sharp pain just below the kneecap when you jump, land, squat or take stairs. Often stiff first thing, then warms up.
Typical recovery: Usually 3 to 6 months of steady strength work. Long-standing cases can take longer.
Sessions: Most people need 6 to 8 over 3 to 4 months.
Avoid: Complete rest, or playing through sharp pain. Both tend to make the tendon weaker.
Get checked: A loud pop, then you can't straighten your knee or lift your leg: go to A&E the same day.
Patellar tendinopathy, often called jumper's knee, is pain in the tendon that joins your kneecap to your shin. It hurts when you load the knee, especially jumping, landing and squatting. It's common, it's frustrating, and it usually responds well to the right exercise.
The tendon doesn't like sudden changes. A new class, a new league or a few weeks off followed by a big return can all tip it over. Rest alone often helps the pain for a while. Then it comes straight back when you start jumping again.
What a good physio adds is a plan that loads the tendon in the right amount, in the right order. You need to know three things. Is it really the tendon? What overloaded it? And how do you build it back up so it copes with your sport?
🛠️ How we treat patellar tendinopathy
Every patellar tendinopathy plan at Athos Physio follows the same three steps. What changes is what we find at each one.
Step 1. Find the root cause
Pain below the kneecap isn't always the tendon. In your first 60-minute session we work out three things:
What's sore: the patellar tendon itself, the joint behind the kneecap, the fat pad under the tendon, or something inside the knee
What overloaded it: more jumping, a new sport, a jump in training volume, a change of surface or shoes, or a return after time off
What's keeping it going: weak quads and calves, stiff ankles, landing technique, poor sleep, or a habit of playing through sharp pain
We show you the tendon on a 3D anatomy model, so you can see where it attaches and why certain movements hurt.
Step 2. Treat what's driving it
Calm the pain. Soft tissue work and IASTM for tight quads and calves, plus joint mobilisation if your ankle or hip is stiff.
Adjust the load. We cut back the jumping, sprinting and deep squats that flare it. We don't stop everything.
Start loading straight away. Simple holds, such as a wall-sit or Spanish squat, often ease tendon pain enough to keep you active.
Fix the drivers. Ankle mobility, hip strength and landing mechanics, if they're part of the picture.
Step 3. Build it to last
This is the part that makes the biggest difference. Tendons get stronger with heavy, slow, progressive loading over months.
Heavy slow strength. Leg press, split squats and squats with a slow 3-second lowering and 3-second lift.
Rehab on the gym floor. Being inside F45 NQ means we can load you properly with real equipment, not just resistance bands.
Spring and speed. Hops, bounds and landings, brought back in once your tendon tolerates heavy load.
Back to your sport. Jumping, cutting and sprinting rebuilt step by step, with a weekly plan you can follow.
We finish when you're back doing what you want with confidence, not just when the pain has gone.
Want to know whether it's really your tendon and how long it'll take to fix? Your first 60-minute session finds out and starts treatment the same day. Book your assessment →
🔍 What is patellar tendinopathy?
Your patellar tendon runs from the bottom of your kneecap to the bump at the top of your shin. It works like a spring. It stores and releases energy every time you jump, land, run or squat.
When the load on the tendon rises faster than it can adapt, it becomes painful and less able to cope. The older name, tendonitis, suggests inflammation. Most long-standing cases are really a change in the tendon's structure, which is why we now say tendinopathy.
The pain is usually right at the bottom tip of the kneecap. You can often press on one sore spot and find it.
How irritable is your tendon?
Early or reactive: pain came on recently after a spike in jumping or training. The tendon is sore and may feel puffy; reduce the spike, keep loading with holds and slow strength. Often settles in weeks.
Ongoing, still playing: pain at the start of training, eases as you warm up, worse the next morning; heavy slow strength plus managed sport. You may keep playing at a lower level.
Long-standing: months or years of pain that stops you jumping or playing properly; a longer, structured programme over 3 to 6 months or more, then a gradual return to jumping.
Working out where you are on this scale changes how hard we load you and how fast you progress.
⚠️ Patellar tendinopathy symptoms
Patellar tendinopathy usually comes on gradually over days or weeks, rather than from one injury. You might notice:
Pain at the bottom tip of your kneecap, in a spot you can point to with one finger
Pain when you jump, land, sprint, squat or go down stairs
Pain at the start of training that eases as you warm up, then aches afterwards
Stiffness or pain the next morning, especially after a jumping session
Pain when sitting for a long time with your knee bent, such as at the cinema or on a long drive
Tenderness when you press on the tendon, sometimes with mild thickening
Is it patellar tendinopathy, runner's knee or something else?
Pain behind or around the kneecap, worse on stairs and after sitting, is often patellofemoral pain. See our runner's knee page.
Pain on the inner or outer joint line, with locking or catching, may be a meniscus tear.
Pain on the outside of the knee in runners or cyclists may be IT band syndrome.
Pain and a bony bump just below the knee in a teenager is often Osgood-Schlatter disease.
Pain just above the kneecap is more likely quadriceps tendinopathy.
We test each of these at your first session rather than guessing from the symptoms alone.
🔍 What causes patellar tendinopathy?
The main cause is load. Your tendon is asked to do more jumping, landing or deep knee bending than it's built for right now. It's rarely one session. It's usually a few weeks of doing more than the tendon can adapt to.
Common triggers we see in Manchester
Five-a-side and Sunday league football on hard 3G pitches, especially at the start of a new season.
Basketball, volleyball and netball, where repeated jumping and landing load the tendon hard.
HIIT and functional fitness classes, with lots of box jumps, jump squats, skater jumps and lunges in one session.
A big return after time off, such as straight back into full training after Christmas or a holiday.
Adding hills, stairs or speed work to running too quickly.
Deep squatting days in the gym, stacked on top of sport in the same week.
Other factors that make it more likely include weak quads and calves, stiff ankles and stiff landings. A sudden rise in body weight can also add load.
Myths about patellar tendinopathy
"Rest will fix it." Rest usually eases the pain, but the tendon also gets weaker. The pain often returns as soon as you jump again.
"It's inflammation, so anti-inflammatories will cure it." Long-standing tendon pain isn't mainly an inflammation problem. Painkillers may help short term but don't rebuild the tendon.
"A strap will sort it." A patellar strap may ease pain during sport for some people. It doesn't replace strength work.
"Any pain means damage." Some discomfort during loading is normal and safe, as long as it settles within 24 hours.
🧪 How we assess patellar tendinopathy
Your first session lasts 60 minutes, so there's time to assess properly and start treatment the same day.
Your story (10 to 15 minutes). When it started, your sport and training week, any recent changes, and what makes it better or worse.
Safety screen. We check for swelling, locking, giving way and signs of infection or a rupture.
VISA-P questionnaire. A short score of how your tendon copes with daily life and sport. We repeat it to track progress.
Tendon tests. We press along the tendon to find the sore spot, then use the single-leg decline squat on a slant board to load it.
Movement and landing. We watch you squat, lunge, step down and hop, and see how you land and absorb force.
Strength and range. Quad, calf and hip strength, ankle mobility with the knee-to-wall test, and hip and thigh flexibility.
Your diagnosis and plan. In plain English: what's causing your pain, what to change this week, whether a scan would help, and how many sessions we expect.
We also check the joint behind the kneecap, the fat pad and the meniscus, so nothing gets missed. You'll leave with treatment started and the first two or three exercises of your custom rehab plan. If we think you need imaging or a specialist opinion, we'll tell you and write to your GP.
🛠️ Patellar tendinopathy treatment at Athos Physio
Every plan moves through four phases. How fast you move depends on how your tendon responds, not on the calendar.
Settle (weeks 0 to 2). Ease pain and find a level of activity your tendon accepts. Holds such as wall-sits or Spanish squats, 5 sets of 30 to 45 seconds; soft tissue work and IASTM; cutting back jumping and deep squats.
Strengthen (weeks 2 to 8). Build quad, calf and hip strength with heavy, slow loading. Leg press, split squats and squats with a 3-second lowering and 3-second lift, 3 times a week, getting heavier over time.
Spring (weeks 8 to 12). Restore the tendon's ability to store and release energy. Decline squats, skipping, low hops, then bounds and box landings, added 2 to 3 times a week.
Return to sport (week 12 onwards). Get back to full jumping, sprinting and matches. Sport drills, sprints and cutting, a planned return to games, and a long-term strength routine.
Your home programme is usually 3 to 4 exercises, taking about 20 minutes, on 3 to 4 days a week. Heavy strength days need a day of recovery between them. Most people need 6 to 8 sessions over 3 to 4 months.
We use a simple pain rule. Pain during exercise up to about 3 out of 10 is fine, as long as it settles by the next morning. If it's worse the next day, we ease off a little.
We don't offer shockwave therapy. Some clinics use it for persistent cases that haven't improved after a good loading programme. If you reach that point, we'll talk you through it and refer you.
What actually works for patellar tendinopathy?
Progressive loading exercise is the main treatment for patellar tendinopathy. Two trials shape how we treat it.
In a 2009 trial by Kongsgaard and colleagues, 39 men did 12 weeks of heavy slow resistance training, decline squats or steroid injections. All three groups improved at 12 weeks. At 6 months, the heavy slow group kept its gains and 73% were satisfied. The steroid group's gains faded.
In a 2021 trial by Breda and colleagues, people with patellar tendinopathy did either progressive tendon loading or eccentric decline squats. After 24 weeks, the progressive loading group improved more on the VISA-P score: 28 points versus 18. More returned to sport (43% versus 27%), though that difference wasn't statistically certain.
Recommended: progressive strength training that gets heavier over time, including heavy slow resistance; staying active at a level your tendon accepts, rather than complete rest; a gradual return to jumping and sprinting, built in stages; working on calf, hip and landing control where these are part of the problem.
Less useful or not recommended: long periods of complete rest; steroid injections. They may help for a few weeks, but gains faded by 6 months in the Kongsgaard trial; relying on straps, massage or stretching alone without strength work.
Tendon rehab takes patience. Most of the change happens between weeks 6 and 12 and beyond, so sticking with the plan matters.
⏱️ How long does patellar tendinopathy take to heal?
Early or reactive, caught within a few weeks: feeling much better: 2 to 4 weeks; back to full training: 6 to 12 weeks.
Ongoing, still playing with pain: feeling much better: 6 to 12 weeks; back to full training: 3 to 4 months.
Long-standing, months or years of pain: feeling much better: 3 to 6 months; back to full training: 6 months or more.
"Back to full training" means your normal sport or gym sessions, including jumping, not just being pain-free walking around.
✅ Patellar tendinopathy in sport, the gym and at work
If you play sport
Don't stop completely. Keep training at a level where pain stays under about 3 out of 10 and settles by the next morning.
Cut back the highest-load work first: jumping, landing drills and sprints.
Space out your hardest sessions. Avoid jumping on back-to-back days.
Add volume back slowly, by about 10% a week if the tendon stays settled.
If you train in the gym or do HIIT classes
Swap box jumps, jump squats and skater jumps for slow strength work for now.
Keep squatting, but go to a depth that's comfortable and slow the lowering down.
Don't stack a heavy legs day straight after a jumping session.
Tell your coach. Most F45 workouts can be adapted station by station.
If you run
Reduce hills, stairs and speed work for now. Flat, easy running is often fine.
Keep runs short and frequent rather than long.
Bring back hills and intervals one at a time, once strength work feels easy.
If you sit or kneel a lot at work
Stretch your legs out under your desk rather than sitting with your knees tightly bent.
Get up and walk every 30 to 45 minutes.
Use a cushion or pad if kneeling is part of your job.
Self-help
Do a wall-sit hold for 30 to 45 seconds, 5 times, when the tendon feels sore. Many people find it eases the pain for a few hours.
Ice for up to 20 minutes after sport can ease soreness, but it won't fix the tendon.
Keep a simple training diary of what you did and how the tendon felt the next morning.
Sleep well. Tendons recover between sessions, not during them.
Related conditions
Runner's knee: pain around or behind the kneecap, worse on stairs and after sitting
Meniscus tear: pain on the joint line with catching, locking or swelling
IT band syndrome: sharp pain on the outside of the knee when running or cycling
Knee osteoarthritis: stiff, achy knees that are worse in the morning or after rest
❓ Patellar tendinopathy FAQs
🚨 Physio, GP or A&E?
Most patellar tendinopathy is safe to manage with a physio. A few signs need a doctor or urgent care first. The NHS advises calling 111 if your knee is very painful, badly swollen, locks or gives way.
Book a physio (no GP referral needed): pain below the kneecap that's linked to jumping, running or squatting; pain that hasn't improved after a few weeks of easing off (book a physio; we'll check whether it's the tendon or something else).
Call your GP urgently or 111: a hot, red, swollen knee, or you feel feverish or unwell (call your GP or NHS 111 the same day); your knee is badly swollen, locks, gives way, or you can't put weight on it (call NHS 111 or go to an urgent treatment centre).
Call 999 or go to A&E: a sudden pop below the kneecap, then you can't straighten your knee or lift your leg (go to A&E now; this can be a tendon rupture).
Tendon ruptures are rare, but they need surgical care quickly. If you're ever unsure, ring us on 07475 433300 and we'll tell you honestly whether you should see us or someone else first.
Not sure whether you need a physio, a scan or a GP? Book a free 15-minute call and we'll tell you honestly. Book a free call →
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Yes. Progressive strength training is the main treatment, and most people improve with a structured plan over 3 to 6 months.
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Yes. Jumper's knee is the common name. Patellar tendonitis is an older name for the same problem.
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Usually not completely. Most people can keep playing at a lower level while pain stays mild and settles by the next morning.
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Short-term easing off helps, but complete rest weakens the tendon. Pain often returns when you start jumping again.
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Usually yes. Slow, heavy squats and leg presses are part of the treatment. We'll adjust depth and load to suit your tendon.
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They help some people with pain during sport. They don't rebuild the tendon, so use them alongside strength work, not instead of it.
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Not usually. We can diagnose most cases from your history and tests. A scan can help if the pain isn't typical or isn't improving.
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It may ease pain for a few weeks. In one trial, the benefits faded by 6 months, while heavy strength training kept working.
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Most people improve over 3 to 6 months of steady loading. Long-standing cases can take longer.
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Most people need 6 to 8 over 3 to 4 months. We'll give you an estimate at your first appointment.
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Your first 60-minute assessment and treatment is £95. Follow-up sessions are £55 for 30 minutes, £95 for 60 minutes or £135 for 90 minutes. See our price list for all fees.
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Yes. Book a free 15-minute consultation and we'll tell you honestly whether physio is the right next step.
📍 Book patellar tendinopathy physio in Manchester city centre
Athos Physio is inside F45 NQ, 77 Piccadilly, Manchester M1 2BU, a two-minute walk from Piccadilly station and Piccadilly Gardens. We're open 7am to 8pm, Monday to Friday, so you can come in before or after work.
Your first appointment is a 60-minute assessment and treatment (£95). Follow-ups are £55 for 30 minutes, £95 for 60 minutes or £135 for 90 minutes. We work with Bupa, WPA, Vitality and Aviva, and you can see all our fees on the price list.
Can't get into town? We also offer home physio visits and online physiotherapy. Not sure physio is right for you? Book a free 15-minute call and we'll talk it through.
Call or WhatsApp 07475 433300, or book online.
Other services: Physiotherapy and active rehab · Sports massage · Pregnancy and postnatal physio · Home visits · Online physio
Written by Nick Chatziviltsos, physiotherapist and founder of Athos Physio, BSc (Hons) Physiotherapy, HCPC registered. Last reviewed: November 2026.
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