This is inflammation of the tendon joining the knee cap to the shin bone. It is an overuse injury of the knee, and is commonly seen in jumping and landing sports where repeated micro trauma to the tendon accumulates faster than it can be repaired. Factors that can bring this on include an increase in training, change in footwear, change in playing surfaces, inadequate rest, and poor flexibility.
You will feel pain just below the kneecap, worse with activity such as jumping, landing bounding or running. Initially the pain may only be after exercise, but as the condition progresses it can impact on participation, and start to become a problem with day to day activities, especially going up and down stairs. At the beginning you may find the pain improves with warm-up only to recur when you cool down after sport.
If you think you have this injury it is well worth getting it checked out by Mr Willis-Owen. It is best to treat this early before it gets too bad. Rest, ice, compression and elevation can be useful for flare ups. You should avoid any aggravating activities with may prolong the problem. It will generally not get better on its own unless diagnosed early and treated appropriately.
Treatment involves first confirming the diagnosis and establishing the underlying cause. Physiotherapy (eccentric strengthening) and anti-inflammatories are required. Usually a carefully directed graduated physiotherapy program is all that is needed but recovery can be slow for severe injuries. Shockwave therapy is particularly effective for this condition, and injections sometimes have a role. Very rarely surgery is needed in cases where no other treatment works.
Mr Willis-Owen has suffered from this himself when training hard for marathons. He managed to resolve his tendonitis using eccentric strengthening and went on to get a pretty good marathon time.