The act of straightening the leg during walking, running, jumping, or standing is accomplished through a coordinated anatomical mechanism involving the quadriceps muscles that attach to the patella (kneecap), which is connected to the tibia (shin bone) via the patellar tendon. Repetitive and forceful knee-extension movements can overload this tendon, leading to injury or inflammation known as patellar tendinopathy, commonly referred to as jumper’s knee. This raises an important question: can conservative treatments such as chiropractic care effectively manage this condition or is surgery required?

The classic presentation of patellar tendinopathy is pain at the front of the knee associated with physical activity, typically localized to the patellar tendon itself. The condition occurs more frequently in males, particularly those participating in high-intensity sports during adolescence and young adulthood. However, adults who engage in repetitive jumping or high-load activities are also at increased risk. Diagnosis is usually made through a detailed patient history and physical examination, though diagnostic ultrasound may be used to confirm the condition. Treatment is generally divided into three phases: pain reduction, strengthening and load progression, and functional training with return to sport.

The initial phase focuses on pain reduction and involves a temporary modification of activity. This may include limiting jumping activities, reducing training volume, avoiding hard surfaces, and allowing for increased recovery time between sessions. Complete immobilization is discouraged, as it can lead to muscle atrophy and weakness that may delay recovery. Ice and other anti-inflammatory strategies may be used between training sessions to help manage symptoms.

The second phase emphasizes progressive loading through isometric and isotonic exercises such as wall sits, leg presses, and squats to gradually increase tendon stiffness and load tolerance. Because kinetic-chain dysfunction often precedes patellar tendinopathy, care may also include manual therapies—such as those provided by chiropractors—and targeted exercises to address contributing factors including quadriceps weakness, hip abductor and external rotator weakness, limited ankle dorsiflexion, and poor landing mechanics.

Once pain during rehabilitation scores no higher than 3 on a 10-point scale (0 = no pain; 10 = worst pain imaginable), symptoms resolve within 24 hours of activity, and discomfort during normal daily tasks is minimal, patients can begin a gradual return to sport. Full recovery typically takes three to six months; however, if the condition becomes chronic before treatment begins, the rehabilitation process may take considerably longer.

Surgical intervention is generally reserved for cases in which symptoms fail to improve after approximately twelve weeks of well-supervised conservative management. The good news is that conservative care results in satisfactory outcomes for most individuals with patellar tendinopathy.