Knee Tendonitis – Causes, Symptoms & Treatment

Is pain around your kneecap making walking, climbing stairs or enjoying your usual activities increasingly uncomfortable?

Perhaps you've noticed a sharp pain just below your kneecap when climbing stairs, getting up from a chair or going for your usual walk.

Or maybe your knee feels stiff when you first get moving, only to become increasingly uncomfortable after exercising or spending time on your feet.

Even everyday activities like gardening, squatting or getting into the car can become frustrating when your knee isn't moving as comfortably as it should.

If you've been diagnosed with knee tendonitis, you'll know just how much this discomfort can interfere with your normal routine.

The good news is that many cases improve with appropriate treatment and rehabilitation. Understanding which tendon is affected, what's causing the pain and how to manage the strain on your knee can help you take the right steps towards recovery.

In this article, we'll explain the common causes and symptoms of knee tendonitis, the treatment options available and how OSMO Patch may offer a drug-free option for managing suitable knee swelling and associated pain.

What Is Knee Tendonitis?

Your knee relies on several strong tendons to help you bend, straighten and support your body weight throughout the day.

Tendons are tough bands of tissue that connect muscles to bones. Around the front of your knee, two important tendons work together to help straighten your leg.

These are the patellar tendon and the quadriceps tendon.

When a tendon is subjected to repeated strain or more physical activity than it's able to tolerate, the tissue can become irritated and painful.

This is commonly referred to as knee tendonitis. However, there's an important distinction worth understanding.

Although the word tendonitis suggests inflammation, longer-standing tendon problems frequently involve changes within the tendon fibres rather than inflammation alone. Healthcare professionals often use the broader term knee tendinopathy to describe these conditions. 1

What Are the Different Types of Knee Tendonitis?

Two common forms of knee tendonitis affect the front of the knee.

Patellar Tendonitis – Pain Below the Kneecap

The patellar tendon connects your kneecap (patella) to the upper part of your shinbone (tibia). It works with the muscles at the front of your thigh to help straighten your knee.

When this tendon becomes irritated or develops a tendinopathy, pain is commonly felt just below the kneecap. This condition is often called patellar tendonitis or jumper's knee.

Although it's commonly associated with sports involving jumping and running, you don't have to be an athlete to develop the condition. Suddenly increasing your walking distance, returning to exercise after a break or repeatedly climbing stairs can also place additional demands on the tendon.

Quadriceps Tendonitis – Pain Above the Kneecap

The quadriceps tendon connects the large muscles at the front of your thigh to the upper part of your kneecap. It plays an important role in straightening the knee and controlling movements such as walking downstairs, squatting and standing up from a chair.

When this tendon becomes irritated, pain is generally felt just above the kneecap. Like patellar tendonitis, quadriceps tendonitis can develop through repetitive loading or excessive physical strain.

The location of the pain can provide a useful indication of which tendon is affected, although a proper examination may be needed to confirm the diagnosis. 2

What Are the Symptoms of Knee Tendonitis?

One of the frustrating things about knee tendonitis is that the pain may not be constant.

You might feel reasonably comfortable when resting, only to experience discomfort when climbing stairs, walking downhill or getting up from a chair.

Common symptoms include:

• Pain above or below the kneecap: Depending on whether the patellar or quadriceps tendon is affected.

• Tenderness to touch: The affected tendon may feel particularly sensitive when pressed.

• Pain when climbing stairs: Especially when going downstairs or placing additional weight through the knee.

• Stiffness after resting: Discomfort when first getting up in the morning or after sitting for an extended period.

• Pain during exercise: Running, jumping, squatting or walking longer distances may aggravate symptoms.

• Localised swelling or thickening: Some people notice mild swelling or tenderness around the affected tendon.

Another common feature is that the discomfort may initially improve as you warm up, only to return later during activity or afterwards.

This doesn't necessarily mean the tendon has recovered. It may simply be responding temporarily to movement.

What Causes Knee Tendonitis?

Knee tendonitis generally develops when the demands placed on a tendon exceed its ability to recover and adapt. 

This can happen gradually or after a sudden increase in physical activity. Several factors may contribute.

Repetitive Physical Activity

Running, jumping, squatting or repeatedly climbing stairs can place considerable strain on the tendons around your knee.

Sudden Increases in Exercise

Perhaps you've recently started walking longer distances, returned to the gym or taken up a new activity.

Increasing the intensity or duration of exercise too quickly can overload a tendon that isn't accustomed to the additional demands.

Muscle Weakness

Weakness in the quadriceps, hip or surrounding leg muscles can affect how forces are distributed through the knee.

Insufficient Recovery

Repeatedly placing high loads on a tendon without allowing adequate recovery can contribute to ongoing irritation.

Age-Related Tendon Changes

As we get older, tendons may become less tolerant of sudden changes in physical activity, particularly following periods of reduced exercise.

Often, several factors are involved rather than one particular injury.

Knee Tendonitis vs Knee Bursitis – What's the Difference?

Knee tendonitis and knee bursitis can sometimes cause pain in similar areas, particularly around the front of the kneecap. However, they affect different tissues.

Knee tendonitis: This involves irritation or changes within the tendons that connect the muscles to the bones. Tendonitis more commonly causes pain associated with loading the affected tendon, such as climbing stairs, squatting or running.

Knee bursitis: This involves inflammation of one of the small fluid-filled sacs that cushion the tissues around the joint. Bursitis may produce a more noticeable, localised swelling, particularly when the bursa is close to the skin.

If you wish to learn more aboout knee bursitis please visit the following pages:

>> Knee Bursitis Information

>> Knee Bursitis Treatment

An accurate diagnosis is important before deciding on treatment.

How Is Knee Tendonitis Diagnosed?

If you're experiencing persistent pain above or below your kneecap, it's worth having the condition properly assessed. A healthcare professional will generally begin by discussing your symptoms, medical history and any activities that aggravate the discomfort. 

They may examine the knee to identify the location of tenderness, assess your range of movement and check the strength of the surrounding muscles.

In many cases, a clinical examination provides sufficient information to make an initial diagnosis. However, additional investigations may sometimes be recommended.

Ultrasound: An ultrasound can help assess the structure of the affected tendon and identify thickening or other changes.

MRI Scan: An MRI may be considered when the diagnosis remains uncertain or another soft-tissue injury is suspected.

X-rays: Although X-rays don't directly show tendon inflammation, they may help rule out fractures or other bone-related conditions.

What Are the Treatment Options for Knee Tendonitis?

If you've been struggling with ongoing knee pain, your first priority is understandably to find some relief. However, unlike some conditions involving fluid accumulation, persistent tendonitis isn't always primarily an inflammation problem.

Treatment generally focuses on reducing excessive strain while gradually restoring the tendon's ability to tolerate normal activity.

1. Rest and Activity Modification

Temporarily reducing activities that aggravate your knee is often an important first step. You may need to limit running, jumping, deep squatting or repeatedly climbing stairs while your symptoms are particularly troublesome.

However, complete rest for extended periods generally isn't recommended. Tendons need appropriate loading to maintain strength and recover. The aim is to reduce activities that overload the tendon while continuing with movements that remain reasonably comfortable.

2. Heat and Cold Therapy

Cold therapy may help manage discomfort after physical activity or during a painful flare-up. Applying a cold pack wrapped in a towel for approximately 10–20 minutes may provide temporary relief.

For longer-standing stiffness or muscle tension around the knee, gentle heat may sometimes help improve comfort. However, heat should be avoided over an unusually hot, red or significantly swollen knee, particularly when infection is possible.

3. Physiotherapy and Rehabilitation

Physiotherapy is one of the most important treatments for persistent knee tendinopathy.

During a painful flare-up, strenuous exercises that place excessive strain on the affected tendon may need to be temporarily reduced or modified. However, appropriately selected strengthening exercises can often begin before all discomfort has disappeared.

A gradual rehabilitation program may help:

• Restore comfortable knee movement.
• Improve quadriceps and surrounding muscle strength.
• Increase the tendon's tolerance to everyday loading.
• Address weakness that has developed through reduced activity.
• Support a gradual return to exercise and recreational activities.

Exercise programs are generally progressed over time rather than relying on rest alone. The appropriate exercises and intensity depend on which tendon is affected and the severity of your symptoms. 3

4. Knee Supports and Other Medical Treatments

Some people find that a patellar tendon strap or suitable knee support helps reduce discomfort during certain activities.

Pain-relieving medication may also be recommended, although it doesn't necessarily address the underlying tendon problem.

Corticosteroid injections are generally not recommended directly around the patellar tendon because of concerns about tendon weakening and rupture.

Surgery is rarely required and is generally reserved for selected cases that haven't responded to appropriate conservative management.

Drug-Free, Non-Invasive Knee Swelling Relief with OSMO Patch

If you're looking for a drug-free, non-invasive option to help manage swelling and associated pain around your knee, OSMO Patch offers a convenient home treatment designed to work while you sleep.

Simply apply the patch over the appropriate affected area before going to bed, following the supplied application instructions.

OSMO Patch is designed to help reduce swelling and associated discomfort without the use of drugs, steroids or invasive procedures.

It may be considered alongside appropriate rest and activity modification.

Discover how OSMO Patch may help you manage suitable knee swelling and associated pain — so you can get back to enjoying your everyday activities.

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How Long Does Knee Tendonitis Take to Heal?

Recovery times vary depending on which tendon is affected, how long symptoms have been present and how well the tendon responds to appropriate rehabilitation.

Mild cases may improve over several weeks after reducing aggravating activities.

However, longer-standing tendon problems can take several months to improve, particularly when the tendon has been subjected to repeated strain over an extended period.

One important point is that feeling less pain doesn't necessarily mean the tendon has fully recovered.

Returning too quickly to strenuous activities may aggravate symptoms and prolong recovery.

A gradual strengthening program, combined with appropriate activity modification, can help rebuild the tendon's tolerance to physical demands.

 

Frequently Asked Questions About Knee Tendonitis

Why Does My Knee Hurt Just Below the Kneecap When I Walk or Climb Stairs?

Pain directly below the kneecap may be associated with patellar tendonitis, also known as patellar tendinopathy.

The patellar tendon is placed under additional load during activities such as climbing stairs, squatting and walking downhill.

However, other knee conditions can cause similar pain, so persistent symptoms should be properly assessed.

Can I Keep Walking if I Have Knee Tendonitis?

In many cases, gentle walking is fine if it doesn't significantly aggravate your symptoms.

However, longer distances, hills or repeated stair climbing may increase discomfort.

Temporarily reducing your walking distance and gradually increasing activity as your symptoms improve may help.

Why Does My Knee Feel Better Once I Start Moving, Then Hurt Afterwards?

This can happen with tendon problems.

The initial stiffness or discomfort may ease as the tendon warms up, even though it hasn't fully recovered.

If the activity places more strain on the tendon than it's able to tolerate, pain may return afterwards or become worse the following morning.

Is Knee Tendonitis the Same as Jumper's Knee?

Jumper's knee is a common name for patellar tendinopathy, which affects the tendon immediately below the kneecap.

However, knee tendonitis can also involve the quadriceps tendon above the kneecap.

You don't have to participate in jumping sports to develop either condition.

Should I Completely Rest My Knee Until the Tendonitis Goes Away?

Not usually.

Temporarily reducing painful or strenuous activities may be helpful, but prolonged complete rest can contribute to muscle weakness and reduced tendon capacity.

Appropriately graded strengthening exercises are an important part of rehabilitation for many persistent tendon problems.

Why Isn't My Knee Tendonitis Getting Better?

Persistent symptoms may occur when the tendon continues to be overloaded or when rehabilitation hasn't sufficiently restored its strength and ability to tolerate activity.

Sometimes the original diagnosis may also need to be reconsidered.

If your knee pain isn't improving, particularly after several weeks of appropriate management, arrange an assessment with a qualified healthcare professional.

 

When Should You Seek Medical Attention?

If knee pain persists, worsens or significantly interferes with walking, sleeping or everyday activities, consult a qualified healthcare professional.

Seek urgent medical assessment if you experience sudden severe pain following an injury, hear or feel a pop, cannot straighten your knee or are unable to bear weight.

A hot, red or rapidly swollen knee, particularly with fever, also requires prompt assessment.

Medical References

[1] Healthdirect Australia: Tendinopathy – Symptoms, Causes and Treatment. Read the Healthdirect medical resource

[2] Mayo Clinic Orthopedics & Sports Medicine: Patellar Tendinitis/Quadriceps Tendinitis. Read the Mayo Clinic medical guidance

[3] NHS Musculoskeletal Matters: Knee Pain – Patella Tendinopathy. Read the NHS rehabilitation guidance