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Jumper's Knee Protocol
Fixing anterior knee pain
Do NOT start this protocol if:
Loading an injured tissue without assessment can make things significantly worse. If any of these apply, see a physiotherapist or physician before starting.
- •Acute tendon tear or rupture — requires imaging and specialist assessment, not loading
- •Swelling, bruising, or sudden onset after a specific trauma — see a physician first
- •Pain above 5/10 during or after exercise — reduce load, do not push through
- •Pain that wakes you at night or is present at complete rest
When to see a physiotherapist
See a physiotherapist if you experience: pain that radiates down a limb, numbness or tingling, swelling that does not resolve within 72 hours of rest, or symptoms that worsen over 1–2 weeks of consistent protocol.
Overview
Evidence-based loading protocol for patellar tendinopathy (Jumper's Knee). Two phases: isometric holds to reduce pain and "wake up" cortical inhibition, then heavy slow resistance to remodel the tendon structure. Based on Rio et al. (2015) and Beyer et al. (2015).
Equipment Needed
- •Decline board (or weight plates stacked to create an incline)
- •Something to hold for stability (wall, post, squat rack)
- •Leg extension machine OR weighted backpack for heavy slow resistance phase
Phases
Analgesic Isometrics
Weeks 1–2Isometric holds reduce pain and cortical motor inhibition almost immediately. Do this phase daily, and always before any other activity that loads the tendon. If pain during holds exceeds 3/10, reduce the depth of the squat.
Goals
- →Reduce pain to below 3/10 during load
- →Restore cortical motor drive to the quadriceps
- →Build the daily adherence habit before adding heavy load
| Exercise | Sets | Reps | Hold | Frequency |
|---|---|---|---|---|
Spanish Squat Hold Loop a heavy band around a fixed post at knee height and around the backs of your knees. Sit back into a mid-squat with shins vertical. Hold. Depth controls intensity — shallower is easier, deeper is harder. | 5×1 | 1 | 45 seconds | 2–3× daily, at least 6 hours apart |
Heavy Slow Resistance
Weeks 3–12Remodel the tendon with heavy load at slow tempo: 3 seconds up, 3 seconds down. Start at 15RM and progress to 6RM over the 10 weeks. Some discomfort (up to 5/10) during load is acceptable as long as it settles within 24 hours.
Goals
- →Increase tendon stiffness and collagen alignment
- →Build lower-limb strength
- →Return to sport-specific loading at week 12
| Exercise | Sets | Reps | Hold | Frequency |
|---|---|---|---|---|
Single-Leg Decline Squat Stand on a 25-degree decline board on the affected leg. Hold a dumbbell or use a weighted backpack for added load. Slow controlled descent (3 seconds down), pause, 3 seconds back up. | 3×15-6 | 15RM → 6RM over 10 weeks | — | Every other day (3×/week) |
Leg Extension (Heavy Slow Resistance) Gym-based alternative. Single-leg leg extension, 3 seconds up, 1-second pause, 3 seconds down. Load progresses from 15RM to 6RM over the phase. | 3×15-6 | 15RM → 6RM over 10 weeks | — | Every other day (3×/week) |
Sources
- •Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy — Rio E, Kidgell D, Purdam C, et al. (2015)
- •Heavy Slow Resistance Versus Eccentric Training as Treatment for Achilles and Patellar Tendinopathy: A Randomized Controlled Trial — Beyer R, Kongsgaard M, Hougs Kjær B, et al. (2015)
- •Physical therapies for patellar tendinopathy: a systematic review — Mendonça LD, Leitão L, Ocarino JM, et al. (2019)
Last updated: 2026-04-10
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Medical Disclaimer
This is a research summary, not medical advice. Body Signals is an independent research digest — it summarises published research for informational purposes and is not a healthcare provider. Stop immediately if pain increases, radiates, or persists beyond the session. Seek a physiotherapist for acute injuries, swelling, numbness, tingling, or symptoms that worsen over 1–2 weeks of consistent protocol. Movement-based rehab should gradually reduce pain, not cause it. In an emergency, call 911.
Need hands-on guidance?
A physiotherapist can tailor this programme to your injury severity, mobility level, and recovery goals.
Find a physiotherapist near you