I remember the first time I got patellar tendonitis. I was 23 years old, playing a lot of soccer, going back in forth from America’s MLS to Denmark & Singapore & then back to MLS and the [then called] A-League. I remember after a game we traveled 2 hours in a minivan from Cincinnati to Louisville for a pre-season scrimmage. My knee was really flaring up with pain, but when I would prop it up or even straighten it would feel instant relief. This was my first experience with patellar tendonitis. Note: This post contains some affiliate links for your convenience. Click here to read my full disclosure policy.
What is patellar tendonitis?
Patellar tendonitis is when the tendon becomes inflamed and irritated; this usually comes from lots of jumping like in basketball or volleyball, or lots of stop and go change of direction like soccer & tennis. It’s a tendon that connects from the kneecap (the patella) and goes down to the shinbone (tibia). This also connects to the quadriceps tendon & quad muscle.
Is this a serious injury?
This can be serious if you tear the patellar tendon but in my life of playing soccer as a youth, college and pro as well as 8+ years training youth & adults, I have never seen anyone tear it. There are a fair share of players who get the patellar tendonitis. For a soccer player it is important because this allows your leg to straighten & bend as well as give you the kicking motion.
Patellar tendonosis (different than tendonitis) is more of a chronic condition that is more of a gradual thing that causes microscopic tears. Again this is something that I have not seen much in my playing career or coaching. The patellar tendonitis is the injury that most athletes will see.
How can I relieve the pain?
With patellar tendonitis you want to stretch out your quad because it helps relieve the pain and pull in your knee. When the quad is tight it pulls on the knee which causes discomfort & irritation, so sitting in a vehicle with your knee bent can cause pain/irritation in the knee.
I went from being drafted by FC Dallas in Major League Soccer and also playing Pro in Singapore Super League (1st Div) and Danish 2nd Div to the Cincinnati Riverhawks 2nd Tier in U.S. because I wanted to start & get more money instead of sit the bench in the MLS for less money. The bad thing I learned was the transportation at some of the 2nd Tier Clubs was not like the MLS (haha). 
During the start of one season at Cincinnati the club didn’t even have a bus to travel to the short travel games. So instead, they rented mini vans to travel 2-3 hours for game which is a tight fit. I guess it’s not so bad; I mean the NFL & NBA teams in the east coast have their own bus to travel a few hours from New York to Philadelphia. But a nice bus lets you have leg room while a van with 6-8 players does not. The point of my story is we all have to travel tight at times, but make sure when you are traveling long distances to stretch the knees, hips & back out every so often and change sitting positions.
Traveling tips & tricks for Patellar Tendonitis
The sitting position is so bad for our knees, hips & back, especially when we have an injury! A lot of you reading this are Players, Parents or Coaches who travel for tournaments from Dallas to Houston, Midland to Fort Worth, New York to New Jersey or any U.S. Metroplex which is an easy 1+ hour drive. Make sure you travel comfortable, extend your legs every 45 minutes or so, especially with injuries!
If you have a hurt knee, make sure you keep it active and moving by straightening it, bending it and try to even prop it up for a few minutes just to let the blood move. While stopping to get gas or snacks continue to walk or stretch.
Cool Travel Tricks are rolling or pumping your ankles and doing knee bends just to keep the blood flowing and muscles from getting tight or sore. I once had a PT in Denver (shout out: Christian G!) tell me that you don’t want to sit in any position for long periods of time. Change your position when your body starts to talk to you (hurt).
What are the causes?
Jumping & Planting are going to be 2 of the main ways an athlete can develop Patellar Tendonitis. For this reason basketball & soccer players who play high level, which could be youth select players up to pros. Jumping for basketball players is something you have to do often so the extra pressure and weight of not only jumping up but landing on the hard court. I think jumping hurts worse than landing personally… In this situation you have 3 things that lead to basketball players getting this injury:
- Jumping
- Landing
- Hard Court Surface for basketball players or any sport on hard court.
Soccer players don’t jump that often (or on a hard surface) so that’s not the issue.
- PLANTING is the issue for soccer players, as they kick the ball with their right foot they are planting with their left foot, which is the foot that gets the injury more than the strong foot. EX: In Soccer, a Right footed player would call it their “Strong Foot” and their Left foot their “Weak Foot”. And yes, for a Lefty they would call their left the strong and right their weak.
- Another cause for soccer players, or any athlete, is going to be LACK OF STRETCHING before and after training and games. You need to warm up & cool down! The quad pulls on the patellar when the quad is tight so stretching the quad is going to help relieve that extra tension.
- KEEP YOUR HAMSTRINGS STRONG because, if they get weak, it will make the quad do extra work and tighten up which could pull on the patellar, causing pain.
- Lots of RUNNING & playing can cause different forms of small injuries so take care of yourself early but doing the simple things, like warming up and stretching, can make a huge difference.
Most injuries lead up from the same root causes, which are lack of warming up, stretching, cool down stretches, & overuse – which usually means not taking care of your body between sessions. I hear so many players tell me their coaches don’t have them warm up & stretch. When I hear players say they do proper warm ups and cool downs I’m shocked.
Educate & protect yourself!
Parents: make sure you educate your kids on warming up, stretching & cool downs. Doing a little core work at home will also help keep most body parts strong and protected.
Coaches: set yourself apart from the rest and make sure your players are getting proper warm ups, stretching, training sessions. Don’t do ball striking at the beginning of training because the body is not ready for that right away. Athletes need to warm up and also they need to do the right amount of ball striking (not too much).
Players: you have to do these things on your own if your coach doesn’t. Get to practice a little early and jog around the field one time or back and forth using a 15 yard area.
Try to avoid these things
If you have patellar tendonitis, try to avoid jumping over high hurdles or even low ones, especially before a good warm up. If your coach has this set up, maybe you tell them about your injury and that it causes pain. Hopefully they are cool about it and let you skip that part. If not you should get to practice early and get a good warm up on your own. No reason to irritate it more and slow down recovery.
If you have ever wondered how basketball players play every day on hard court is because they warm up better than most other athletes. I remember in college our head trainer of all the sports told our soccer team that the basketball team did a better job than all the other sports at warming up. I was surprised because I thought our soccer team did such a great job compared to when I was in high school.
It’s amazing how much you learn going from high school to college to pro. The preparation and treatment methods keep getting better! This is why I share the knowledge I have; I want you to know this for yourself, your kids, your players. Make sure you avoid hitting hard shots on goal or to a mate before you warm up! This is so bad for your knees, hip flexors, groin & back! Warm up and stretch before you play.
How do you know if you have patellar tendonitis?
There are 3 main ways you know. These 3 things will cause pain on top of the kneecap (the patella).
- Walking down stairs
- Walking down hills
- Jumping
How can you treat this injury?
Treatment is simple and easy so make sure you do these things. This injury could last months but if you keep stretched out, keep your quads and hamstring strong, as well as your core, you will be able to get healthy again.
Also while playing, you can get a patellar strap which goes under your knee and all the way around your knee. You can use pre-wrap by wrapping it around your knee and then rolling it up or down so that it makes the shape of a circular band. Here is one I made for a client at training one day & a picture of pre-wrap tape:
- Warm up by jogging or even using a heat pad before you warm up. You could put the heat pad on your knee while you are traveling in the car to practice or games. In college and pro, players will put heat pads on for 10 mins or so. Especially in the Winter when the weather is cold you want to be extra cautious.
- Stretch the Quad good before and after you play but warm up first! This helps prevent the quad from pulling on the knee which causes some of the pain besides the inflammation.
- Use the Patellar band to help relieve the pull and pain. See the picture of what lots of players even pros use. It’s pre-wrap that trainers use before putting on tape but instead of using tape afterward, all you do is wrap it around your knee 5 or 6 times and then roll it down or up so that it makes a circular band which can be placed just under your knee cap. If it’s too tight you can pull on it to loosen it.
- ICE using a ice bag or a ice cup massage. The ice cup is good because all you need it 5 mins to rub the whole top of the knee cap. Get some paper cups, fill with water all the way to the top, put in freezer and once frozen you can peel the top of the paper cup. Rub on your knee for 5 minutes but make sure you have a towel to place underneath because it will drip like crazy!
If using an ice bag be careful on icing the outside of your knee for more than 5-10 minutes. Depending on the age of the player especially, because you can freeze the common peroneal nerve, which can make your lower leg go numb and hurt. This is the only part of the body I have ever been told to be careful with when icing. You can feel the different type of pain when this happens or comes close to happening so again be careful. For Kids (ages 12 & under) you have to be extra careful when icing because their bodies are so much smaller and easier to get cold or hot. For teens or adults most trainers and athletes ice for 20 minutes but, like I said – depending on the area of the injury and how old the athlete is – maybe you only do 10 minutes (usually until numb). - Ice Bath for 7 – 10 minutes is great for every injury, especially the hip, because the hip is so hard to ice with a bag, + that part of the body is warmer by nature. I remember while on a trial with Miami FC, FIFA World Cup Winner Zinho would take 7 minutes in the ice bath, while my whole life everyone else would do 10-20 minutes. In my opinion you want to do 7-10 minutes, not 15-20. If you are a youth player especially you don’t need more than 10 minutes.
- I highly recommended Hot & Cold Tubs {for more on this, check out my post on Injury Prevention and scroll to the bottom}. If you have a hot (bath)tub at home you have to now buy a 4 foot trash can bin and fill it with ice water. Put the Ice Bin right up next to the Hot Tub but please make sure it is secure so that it doesn’t slip or fall over, causing a different injury!